Meredith Pamela J, Strong Jenny, Feeney Judith A
Division of Occupational Therapy, The University of Queensland, St Lucia Queensland, Brisbane, Queensland, 4072 Australia.
Pain. 2006 Jan;120(1-2):44-52. doi: 10.1016/j.pain.2005.10.008. Epub 2005 Dec 13.
Although insecure attachment has been associated with a range of variables linked with problematic adjustment to chronic pain, the causal direction of these relationships remains unclear. Adult attachment style is, theoretically, developmentally antecedent to cognitions, emotions and behaviours (and might therefore be expected to contribute to maladjustment). It can also be argued, however, that the experience of chronic pain increases attachment insecurity. This project examined this issue by determining associations between adult attachment characteristics, collected prior to an acute (coldpressor) pain experience, and a range of emotional, cognitive, pain tolerance, intensity and threshold variables collected during and after the coldpressor task. A convenience sample of 58 participants with no history of chronic pain was recruited. Results demonstrated that attachment anxiety was associated with lower pain thresholds; more stress, depression, and catastrophizing; diminished perceptions of control over pain; and diminished ability to decrease pain. Conversely, secure attachment was linked with lower levels of depression and catastrophizing, and more control over pain. Of particular interest were findings that attachment style moderated the effects of pain intensity on the tendency to catastrophize, such that insecurely attached individuals were more likely to catastrophize when reporting high pain intensity. This is the first study to link attachment with perceptions of pain in a pain-free sample. These findings cast anxious attachment as a vulnerability factor for chronic pain following acute episodes of pain, while secure attachment may provide more resilience.
尽管不安全依恋与一系列与慢性疼痛适应不良相关的变量有关，但这些关系的因果方向仍不明确。从理论上讲，成人依恋风格在发展上先于认知、情感和行为（因此可能导致适应不良）。然而，也可以认为，慢性疼痛的经历会增加依恋不安全感。本项目通过确定在急性（冷压痛）疼痛体验之前收集的成人依恋特征与在冷压痛任务期间及之后收集的一系列情绪、认知、疼痛耐受性、强度和阈值变量之间的关联，对这一问题进行了研究。招募了58名无慢性疼痛史的便利样本参与者。结果表明，依恋焦虑与较低的疼痛阈值、更多的压力、抑郁和灾难化思维、对疼痛控制感的降低以及减轻疼痛的能力降低有关。相反，安全依恋与较低水平的抑郁和灾难化思维以及对疼痛的更多控制有关。特别有趣的是，依恋风格调节了疼痛强度对灾难化倾向的影响，即不安全依恋的个体在报告高疼痛强度时更有可能出现灾难化思维。这是第一项在无疼痛样本中将依恋与疼痛感知联系起来的研究。这些发现表明，焦虑依恋是急性疼痛发作后慢性疼痛的一个脆弱因素，而安全依恋可能提供更大的恢复力。
