A fearful adult attachment style is associated with double the presence of chronic pain compared to secure attachment: A national survey of a South African population

IF 2.5 2区心理学 Q1 PSYCHOLOGY, CLINICAL

British Journal of Health Psychology Pub Date : 2025-09-23 DOI:10.1111/bjhp.70024

Gabriella Elisabeth Stamp, Stella Iacovides, Antonia Louise Wadley

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引用次数: 0

Abstract

Objectives

Preliminary epidemiological evidence suggests that within chronic pain cohorts, insecure attachment styles (comprising dismissing, preoccupied and fearful styles) are more prevalent. Our aim was to determine, in a general population, the association between adult attachment style and the presence and burden of chronic pain.

Methods

A nationwide online survey in South Africa determined adult attachment style (using the Experience in Close Relationships—Relationship Structures Questionnaire), the presence of chronic pain and typically associated psychological factors. In participants reporting chronic pain, the association with attachment style and pain burden (pain sites, severity and interference, using the Brief Pain Inventory [BPI]) was further explored. Results of the 2371 participants were analysed using multivariable generalized linear models.

Results

In our young (median age 23 years; IQR 20–28), well-educated and primarily female (74%) cohort with a predominantly middle-to-high socioeconomic status, we found a higher than typically reported prevalence of chronic pain (27%). Compared to the secure attachment style, all insecure attachment styles were associated with increased chronic pain presence (secure: 23%; dismissing: 31%, odds ratio [95% CI] = 1.38 [1.02–1.85], p = .037; preoccupied: 42%, odds ratio [95% CI] = 2.26 [1.62–3.13], p < .001; fearful: 49%, odds ratio [95% CI] = 2.95 [2.03–4.29], p < .001). All three insecure attachment styles were associated with worse pain interference, and a Fearful attachment style was associated with increased pain severity and .78 times more pain sites (95% CIs: not spanning 0, ps < .05).

Conclusions

Adult attachment style was associated with chronic pain presence and pain burden. The presence of chronic pain was more than double in the fearfully insecure compared to securely attached individuals.

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一项针对南非人口的全国性调查显示，与安全型依恋相比，恐惧型成人依恋类型与双倍的慢性疼痛相关。

目的：初步的流行病学证据表明，在慢性疼痛人群中，不安全的依恋类型（包括忽视型、专注型和恐惧型）更为普遍。我们的目的是在一般人群中确定成人依恋类型与慢性疼痛的存在和负担之间的关系。方法：在南非进行了一项全国性的在线调查，确定了成人依恋类型（使用亲密关系体验-关系结构问卷）、慢性疼痛的存在以及典型的相关心理因素。在报告慢性疼痛的参与者中，我们进一步探讨了依恋类型和疼痛负担（疼痛部位、严重程度和干扰，使用简短疼痛量表[BPI]）之间的关系。采用多变量广义线性模型对2371名参与者的结果进行分析。结果：在我们的年轻（中位年龄23岁；IQR 20-28岁），受过良好教育，主要是女性（74%），主要是中高社会经济地位的队列中，我们发现慢性疼痛的患病率高于通常报道的患病率（27%）。与安全依恋类型相比，所有不安全依恋类型均与慢性疼痛存在增加相关(安全依恋类型：23%；拒绝依恋类型：31%，比值比[95% CI] = 1.38 [1.02-1.85], p = 0.037；专注依恋类型：42%，比值比[95% CI] = 2.26 [1.62-3.13]， p结论：成人依恋类型与慢性疼痛存在和疼痛负担相关。与安全型依恋个体相比，恐惧型不安全个体中慢性疼痛的存在是安全型依恋个体的两倍多。

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来源期刊

British Journal of Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

14.10

自引率

1.30%

发文量

期刊介绍： The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.