School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK.
School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK.
J Clin Psychol Med Settings. 2024 Sep;31(3):571-584. doi: 10.1007/s10880-023-09989-7. Epub 2024 Jan 5.
We investigated whether attachment insecurity (anxiety and avoidance) moderated the association between satisfaction with social support and pain disability. We also tested whether the relationship between insecure attachment and pain disability was serially mediated by pain catastrophising and psychological inflexibility. A large-scale cross-sectional correlational design was employed. Data were collected using an online survey. Correlation, serial mediation and moderated regression analyses were used. Data from 894 people with self-reported chronic pain were analysed. Based on correlations, age, depression, and pain intensity were included as covariates. No direct effect of satisfaction with social support on pain disability was observed in the moderation. Attachment anxiety was positively associated with pain disability (b = 1.20, t = 2.03, p < .05), but attachment avoidance was not (b = -0.08, t = -0.13, p = .90). The association between attachment anxiety and pain disability was partially mediated by pain catastrophising and psychological inflexibility (c = 1.21, t = 4.37, p < .001; a1db2 = 0.33, t = 5.15, p < .001). The relationship between attachment avoidance and pain disability was fully mediated by pain catastrophising and psychological inflexibility (c = 0.15, t = 0.54, p = .59; a1db2 = 0.13, t = 2.24, p < .05). This study provided initial evidence that pain catastrophising and psychological inflexibility mediate the association between insecure attachment and pain disability. Follow-up research using a longitudinal design is recommended.
我们研究了依恋不安全感（焦虑和回避）是否调节了社会支持满意度与疼痛残疾之间的关系。我们还测试了不安全依恋与疼痛残疾之间的关系是否通过疼痛灾难化和心理不灵活性的连续中介作用。采用了大规模的横断面相关性设计。数据通过在线调查收集。使用相关性、连续中介和调节回归分析进行分析。对 894 名自我报告患有慢性疼痛的人进行了数据分析。根据相关性，将年龄、抑郁和疼痛强度作为协变量进行分析。在调节中，社会支持满意度对疼痛残疾没有直接影响。依恋焦虑与疼痛残疾呈正相关（b=1.20，t=2.03，p<.05），但依恋回避与疼痛残疾无显著相关（b=-0.08，t=-0.13，p=0.90）。依恋焦虑与疼痛残疾的关系部分通过疼痛灾难化和心理不灵活性的中介作用（c=1.21，t=4.37，p<.001；a1db2=0.33，t=5.15，p<.001）。依恋回避与疼痛残疾的关系完全通过疼痛灾难化和心理不灵活性的中介作用（c=0.15，t=0.54，p=0.59；a1db2=0.13，t=2.24，p<.05）。这项研究提供了初步证据，表明疼痛灾难化和心理不灵活性中介了不安全依恋与疼痛残疾之间的关系。建议采用纵向设计进行后续研究。
