Journal of Behavioral Medicine

, Volume 38, Issue 3, pp 518–526 | Cite as

Attachment insecurity predicts responses to an interdisciplinary chronic pain rehabilitation program

  • John KowalEmail author
  • Lachlan A. McWilliams
  • Katherine Péloquin
  • Keith G. Wilson
  • Peter R. Henderson
  • Dean A. Fergusson


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.


Chronic pain Adult attachment Interdisciplinary Treatment outcomes Pain management Psychosocial 



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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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • John Kowal
    • 1
    • 2
    • 3
    Email author
  • Lachlan A. McWilliams
    • 4
  • Katherine Péloquin
    • 5
  • Keith G. Wilson
    • 1
    • 2
    • 3
  • Peter R. Henderson
    • 1
    • 2
  • Dean A. Fergusson
    • 3
  1. 1.PsychologyThe Ottawa Hospital Rehabilitation CentreOttawaCanada
  2. 2.School of PsychologyUniversity of OttawaOttawaCanada
  3. 3.The Ottawa Hospital Research InstituteOttawaCanada
  4. 4.Department of PsychologyUniversity of SaskatchewanSaskatoonCanada
  5. 5.Département de PsychologieUniversité de MontréalMontréalCanada

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