Ciechanowski Paul, Sullivan Mark, Jensen Mark, Romano Joan, Summers Heidi
Department of Psychiatry and Behavioral Sciences, Box 356560, University of Washington School of Medicine, Seattle, WA 98195-6560, USA Department of Rehabilitation Medicine, Box 356490, University of Washington School of Medicine, Seattle, WA 98195-6490, USA Multidisciplinary Pain Center, University of Washington Medical Center-Roosevelt, 4245 Roosevelt Way Northeast, Seattle, WA 98105-6920, USA School of Medicine, University of Washington, Seattle, WA 98195, USA.
Pain. 2003 Aug;104(3):627-637. doi: 10.1016/S0304-3959(03)00120-9.
Attachment theory and research suggest that patterns of interpersonal relationships may be important determinants of illness behavior, care seeking, and treatment response in individuals with chronic health problems, including chronic pain. Attachment styles have been shown to be associated with psychological adjustment in the context of chronic illness, but little research has been conducted so far examining these relationships in patients with chronic pain. We assessed 111 patients with chronic pain participating in a multidisciplinary pain treatment program to determine if attachment style is associated with pain, depression, catastrophizing and physical disability at pre-treatment and 12-month follow-up, and with change in health care utilization pre-treatment to follow-up. At both pre-treatment and follow-up, fearful attachment style was associated with significantly greater depression and catastrophizing, and secure attachment was associated with significantly lower levels of depression. Preoccupied attachment style was associated with greater than weekly pain-related visits at 12 months follow-up, even after controlling for depression, catastrophizing and pre-treatment pain-related health care utilization. The findings suggest that attachment style may be a useful construct for examining factors affecting adjustment and treatment response of patients with chronic pain.
依恋理论与研究表明，人际关系模式可能是患有慢性健康问题（包括慢性疼痛）的个体中疾病行为、就医行为及治疗反应的重要决定因素。依恋风格已被证明与慢性病背景下的心理调适有关，但迄今为止，针对慢性疼痛患者中这些关系的研究甚少。我们评估了111名参与多学科疼痛治疗项目的慢性疼痛患者，以确定依恋风格在治疗前及12个月随访时是否与疼痛、抑郁、灾难化思维和身体残疾相关，以及在治疗前到随访期间医疗保健利用情况的变化。在治疗前和随访时，恐惧型依恋风格均与显著更高的抑郁和灾难化思维相关，而安全型依恋与显著更低的抑郁水平相关。即使在控制了抑郁、灾难化思维和治疗前与疼痛相关的医疗保健利用情况后，在12个月随访时，痴迷型依恋风格仍与每周多于一次的疼痛相关就诊有关。研究结果表明，依恋风格可能是一个有用的概念，可用于研究影响慢性疼痛患者调适和治疗反应的因素。
