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Attachment insecurity predicts responses to an interdisciplinary chronic pain rehabilitation program

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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.

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Acknowledgments

This research was supported by the Canadian Institutes of Health Research (MOP: 93645) and the Centre for Rehabilitation Research and Development of The Ottawa Hospital Rehabilitation Centre.

Conflict of interest

John Kowal, Lachlan A. McWilliams, Katherine Péloquin, Keith G. Wilson, Peter R. Henderson, and Dean A. Fergusson all declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants included in the study.

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Authors and Affiliations

  1. Psychology, The Ottawa Hospital Rehabilitation Centre, 505 Smyth Road, Ottawa, ON, K1H 8M2, Canada

    John Kowal, Keith G. Wilson & Peter R. Henderson

  2. School of Psychology, University of Ottawa, Ottawa, ON, Canada

    John Kowal, Keith G. Wilson & Peter R. Henderson

  3. The Ottawa Hospital Research Institute, Ottawa, ON, Canada

    John Kowal, Keith G. Wilson & Dean A. Fergusson

  4. Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada

    Lachlan A. McWilliams

  5. Département de Psychologie, Université de Montréal, Montréal, QC, Canada

    Katherine Péloquin

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  1. John Kowal
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  2. Lachlan A. McWilliams
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  3. Katherine Péloquin
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  4. Keith G. Wilson
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  5. Peter R. Henderson
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  6. Dean A. Fergusson
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Correspondence to John Kowal.

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Kowal, J., McWilliams, L.A., Péloquin, K. et al. Attachment insecurity predicts responses to an interdisciplinary chronic pain rehabilitation program. J Behav Med 38, 518–526 (2015). https://doi.org/10.1007/s10865-015-9623-8

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  • DOI: https://doi.org/10.1007/s10865-015-9623-8

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