Abstract
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.
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Data for this project is stored on PsychArchives repository: https://doi.org/10.4668/psycharchives.7064.
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Acknowledgements
Thank you to all of our participants, and to the following charities who advertised the study: Back Care, The Brain Charity, Burning Nights Complex Regional Pain Syndrome (CRPS), Endometriosis UK, Fibromyalgia Action UK, FibroSupport Wales, Herpes Viruses Association & Shingles Support Society, Lipodemia UK, Migraine Trust, Northamptonshire Chronic Pain Support, Paget’s Association, Pain UK, Pelvic Pain Support Network, Polio Survivors Network, Royal Osteoporosis Society, Trigeminal Neuralgia Association UK, and Vulval Pain Society.
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This study was completed in part-fulfilment of a Doctorate in Clinical Psychology degree. A budget of £250 was available through Newcastle University School of Psychology to support participant recruitment.
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All authors contributed to the study conception, design and methodology. Claire Borthwick was responsible for data collection. Data analysis was performed by Claire Borthwick and Lucy Robinson. The original draft was written by Claire Borthwick, with supervision, reviewing, and editing from Lucy Robinson and Chris Penlington. All authors read and approved the final manuscript.
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Borthwick, C., Penlington, C. & Robinson, L. Associations Between Adult Attachment, Pain Catastrophizing, Psychological Inflexibility and Disability in Adults with Chronic Pain. J Clin Psychol Med Settings (2024). https://doi.org/10.1007/s10880-023-09989-7
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DOI: https://doi.org/10.1007/s10880-023-09989-7