title: Attachment insecurity predicts responses to an interdisciplinary chronic pain rehabilitation program.
abstract: The aim of this study was to examine the hypothesis that attachment insecurity is associated with poorer responses to interdisciplinary treatment for chronic pain. Patients (n = 235) admitted to a 4-week interdisciplinary rehabilitation program were recruited. At pre-treatment, participants completed a battery of questionnaires assessing adult attachment styles and dimensions, as well as pain intensity, disability, self-efficacy, pain catastrophizing, and depressive symptoms. The latter measures were completed again at post-treatment. Nearly two-thirds of participants (65.5 %) reported having an insecure attachment style. Attachment insecurity was unrelated to pre- and post-treatment reports of pain intensity and pain-related disability, but was significantly associated with most other clinical variables at both time points. Regression analyses controlling for pre-treatment functioning indicated that attachment insecurity was associated with less improvement in pain catastrophizing, pain self-efficacy, and depressive symptoms. Further research is warranted to investigate the processes by which attachment characteristics influence patients' responses to chronic pain rehabilitation.
authors.affiliation: Psychology, The Ottawa Hospital Rehabilitation Centre, 505 Smyth Road, Ottawa, ON, K1H 8M2, Canada, jkowal@ottawahospital.on.ca.
authors.forename: John
authors.initials: J
authors.lastname: Kowal
authors.forename: Lachlan A
authors.initials: LA
authors.lastname: McWilliams
authors.forename: Katherine
authors.initials: K
authors.lastname: Péloquin
authors.forename: Keith G
authors.initials: KG
authors.lastname: Wilson
authors.forename: Peter R
authors.initials: PR
authors.lastname: Henderson
authors.forename: Dean A
authors.initials: DA
authors.lastname: Fergusson
mesh_terms: D000328:Adult; D000368:Aged; D058443:Catastrophization; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D003299:Cooperative Behavior; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology; D019962:Reactive Attachment Disorder / Q000150:complications / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult