Impact of adult attachment styles on pain and disability associated with arthritis in a nationally representative sample

Objective: The objective of this study was to evaluate Mikail et al.'s hypothesis that adult attachment styles are associated with important pain-related variables such as pain and disability levels. Design: A cross-sectional design was used to examine the relation between measures of adult attachment styles and both pain and disability. Setting: The data used were obtained from the National Comorbidity Survey, a large and nationally representative sample of community-dwelling individuals aged 15 to 54 years. In the present study, individuals (n = 381) in the National Comorbidity Survey with arthritis or related conditions were included. Outcome Measures: Ratings regarding three adult attachment styles (secure, anxious, and avoidant) were obtained by administering Hazan and Shaver's attachment self-report in an interview format. Pain and disability were assessed in a similar manner using four-point rating scales. Results: Ratings of insecure attachment were positively and significantly correlated with both pain and disability. A multiple regression analysis revealed that pain severity and the rating of anxious attachment could account for 20.3% of the variance in disability. Conclusions: The attachment theory holds promise for understanding reactions to pain conditions, and Mikail et al.'s model warrants further investigation.