title: Impact of adult attachment styles on pain and disability associated with arthritis in a nationally representative sample.
abstract: OBJECTIVE
  The objective of this study was to evaluate Mikail et al.'s hypothesis that adult attachment styles are associated with important pain-related variables such as pain and disability levels.
  
  
  METHODS
  A cross-sectional design was used to examine the relation between measures of adult attachment styles and both pain and disability.
  
  
  METHODS
  The data used were obtained from the National Comorbidity Survey, a large and nationally representative sample of community-dwelling individuals aged 15 to 54 years. In the present study, individuals (n = 381) in the National Comorbidity Survey with arthritis or related conditions were included.
  
  
  METHODS
  Ratings regarding three adult attachment styles (secure, anxious, and avoidant) were obtained by administering Hazan and Shaver's attachment self-report in an interview format. Pain and disability were assessed in a similar manner using four-point rating scales.
  
  
  RESULTS
  Ratings of insecure attachment were positively and significantly correlated with both pain and disability. A multiple regression analysis revealed that pain severity and the rating of anxious attachment could account for 20.3% of the variance in disability.
  
  
  CONCLUSIONS
  The attachment theory holds promise for understanding reactions to pain conditions, and Mikail et al.'s model warrants further investigation.
authors.affiliation: Department of Psychology, University of Manitoba, Winnipeg, Canada.
authors.forename: L A
authors.initials: LA
authors.lastname: McWilliams
authors.forename: B J
authors.initials: BJ
authors.lastname: Cox
authors.forename: M W
authors.initials: MW
authors.lastname: Enns
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001168:Arthritis / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D006801:Humans; D008875:Middle Aged; D009769:Object Attachment; D010146:Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D011237:Predictive Value of Tests; D011581:Psychological Tests; D012044:Regression Analysis