The relationship of adult attachment to emotion, catastrophizing, control, threshold and tolerance, in experimentally-induced pain

Although insecure attachment has been associated with a range of variables linked with problematic adjustment to chronic pain, the causal direction of these relationships remains unclear. Adult attachment style is, theoretically, developmentally antecedent to cognitions, emotions and behaviours (and might therefore be expected to contribute to maladjustment). It can also be argued, however, that the experience of chronic pain increases attachment insecurity. This project examined this issue by determining associations between adult attachment characteristics, collected prior to an acute (coldpressor) pain experience, and a range of emotional, cognitive, pain tolerance, intensity and threshold variables collected during and after the coldpressor task. A convenience sample of 58 participants with no history of chronic pain was recruited. Results demonstrated that attachment anxiety was associated with lower pain thresholds; more stress, depression, and catastrophizing; diminished perceptions of control over pain; and diminished ability to decrease pain. Conversely, secure attachment was linked with lower levels of depression and catastrophizing, and more control over pain. Of particular interest were findings that attachment style moderated the effects of pain intensity on the tendency to catastrophize, such that insecurely attached individuals were more likely to catastrophize when reporting high pain intensity. This is the first study to link attachment with perceptions of pain in a pain-free sample. These findings cast anxious attachment as a vulnerability factor for chronic pain following acute episodes of pain, while secure attachment may provide more resilience. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Adult attachment, anxiety, and pain self-efficacy as predictors of pain intensity and disability

Pain self-efficacy and anxiety have each been shown to contribute substantially to pain intensity and pain-related disability. Although adult attachment theory has been related separately to chronic pain, anxiety, and self-efficacy, it has not before been investigated with either pain self-efficacy or anxiety in the context of chronic pain. This study investigated the interrelations between these aspects of the chronic pain experience and their relative contributions towards pain intensity and disability. A clinical sample of 152 chronic pain patients participated in this study, completing self-report measures of attachment, self-efficacy, pain intensity, and disability, prior to attending a multidisciplinary pain clinic. Results revealed that fearful and preoccupied (anxious) attachment categories were associated with low pain self-efficacy, while high scores on the attachment dimension of comfort with closeness were linked with high pain self-efficacy, particularly for males. Insecure attachment (whether defined in terms of categories or dimensions) was related to higher levels of anxiety. Pain self-efficacy proved a stronger predictor of pain intensity than did anxiety and was a stronger predictor of disability than pain intensity or anxiety. In addition, comfort with closeness moderated the associations between pain self-efficacy and disability, pain self-efficacy and pain intensity, and anxiety and disability. Together, these findings support the value of adopting an attachment theoretical approach in the context of chronic pain. Treatment considerations and future research directions are considered. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Attachment Theory Shaping Adult Development: Impact on Mentoring Experiences

Mentoring is increasingly used for career and psychosocial development. Very few studies that have investigated the role of individual differences in mentoring relationships have addressed the attachment styles of mentors and protégés. The purpose of this study is to find the connections between attachment styles, adult development, and mentoring experiences.

The relationship of adult attachment dimensions to depression and agoraphobia

We examined the unique relations between the five dimensions of the Attachment Style Questionnaire (ASQ; Feeney, Noller, & Hanrahan, 1994) and depression and agoraphobic behavior (i.e., avoidance of situations where high anxiety is experienced). In addition, we examined mediation models in an attempt to clarify the link between adult attachment and these two dimensions of psychopathology. In testing these models, we administered the ASQ, General Self-Efficacy Scale, Agoraphobic Catastrophic Cognitions Questionnaire, Beck Depression Inventory, and the Mobility Inventory for Agoraphobia (a measure of the degree to which situations are avoided that are typically anxiety provoking for people with agoraphobia) to 122 participants (44 with agoraphobia, 25 with a current major depressive disorder, and 53 with no current psychopathology). The results showed that the insecure attachment dimensions of need for approval, preoccupation with relationships, and relationships as secondary were uniquely associated with depression and that general self-efficacy partly mediated the relationship between need for approval and depression. In contrast, only preoccupation with relationships was uniquely associated with agoraphobic behavior, and catastrophic cognitions about bodily sensations partly mediated this association.

Adult attachment representations predict cortisol and oxytocin responses to stress.

There are many factors contributing to individual variations in the response to stressful experiences. The present study evaluated the patterns of stress responses according to attachment representations in 28 adults from a community sample, plus 46 subjects expected to be particularly sensitive to stress, having been exposed during childhood and/or adolescence to traumatizing events such as abuse or potentially lethal illnesses. Subjects were given the Adult Attachment Interview, which provides attachment classifications, and the Trier Social Stress Test (TSST), involving an experimental psychosocial challenge. Subjective responses to the TSST, as well as saliva samples (assayed for cortisol) and blood plasma samples (assayed for ACTH and oxytocin) were collected before, during and after the stress procedure. The stress responses presented specific patterns according to attachment classifications. Subjects with an autonomous attachment classification reported relatively low subjective stress, they presented a moderate response of the hypothalamic-pituitary-adrenal (HPA) axis (ACTH and cortisol), and a high level of oxytocin. Subjects with a dismissing classification reported a moderate subjective stress, they presented an elevated response of the HPA axis, and moderate levels of oxytocin. Subjects with a preoccupied classification presented moderate levels of subjective stress, and of HPA response, and a relatively low level of oxytocin. Finally, subjects with an unresolved classification reported elevated subjective stress; they presented a suppressed HPA response, and moderate levels of oxytocin. These data support the notion that attachment representations may affect stress responses, and suggest a specific role of oxytocin in both the attachment system and the stress system.

Adult attachment orientation and implicit behavioral mimicry

We investigated whether adult attachment orientation predicted the extent to which individuals engaged in implicit behavioral mimicry of a confederate presented by video. Results demonstrated that following an attachment threat prime: (1) those low in attachment anxiety and high in attachment avoidance showed less mimicry of face-rubbing gestures than individuals low in both attachment avoidance and attachment anxiety; (2) those high in attachment anxiety and low in attachment avoidance showed less mimicry of face-rubbing gestures than individuals low in both attachment avoidance and attachment anxiety. Importantly, attachment orientation did not predict baseline levels of face-rubbing gesturing; demonstrating that attachment orientation had an effect on mimicry rather than overall behavior expression. Attachment anxiety was positively related to attraction to the confederate such that those higher in attachment anxiety rated the confederate as more attractive. The findings are discussed with reference to both the mimicry and attachment literatures.

Emotional Content in Autobiographical Memory through an Attachment Theory Framework

The current study investigates the relationship between individual differences in attachment style and the recall of autobiographical memories. According to attachment theory, affect regulation strategies employed by individuals high in attachment anxiety and high in attachment avoidance are likely to influence how information about the past is recalled. This study examines how attachment anxiety and attachment avoidance relate to the presence of negative emotions in autobiographical memories of upsetting events with important relationship figures (i.e., mother, father, or roommate). Participants included 248 undergraduate students ranging from ages 18-22 that attend a public university in the northeast. As hypothesized, individuals with an avoidant attachment expressed less sadness in their responses to the written narrative task, especially when prompted for memories involving their primary caregiver. Contrary to the hypothesis, anxiously attached individuals did not display higher levels of worry/fear emotions in their responses to the written narrative. Attachment anxiety was related to some differences in emotional content; however, this varied by relationship partner. The results provide evidence linking attachment style to emotion selection and retrieval in autobiographical memories of ‘upsetting’ events. Implications for close relationships and therapy are discussed.

The Clinical Utility of the Adult Attachment Projective Picture System: A Clinician's Perspective

The Adult Attachment Projective Picture System (AAP) is the first performance- based measure of adult attachment to be developed. The purpose of the measure is to provide a clinical understanding of an adult client's attachment status and associated coping mechanisms. The AAP is a relatively new measure that has yet to be examined from a utility perspective. In the current study, seven psychologists completed a structured survey in order to identify their perspectives of the AAP and its utility as a clinical instrument. A phenomenological qualitative analysis of the data was conducted to derive themes about the AAP and its clinical utility. Analyses aimed to answer the following: What clinical considerations do clinician's focus on when deciding to use this measure? What are common factors among clinician's who do use the measure as well as those who do not? What aspects of the measure are user-friendly and what aspects are difficult? General themes that emerged include (a) the clinical information provided by the AAP is viewed by those who use it as unique and beneficial; (b) time commitment and cost for the clinician are common considerations when clinician's are deciding whether or not to use the AAP or when pursuing training; (c) the AAP provides an increased understanding of one's relational capacities and defenses; and (d) the coding system and transcription process are difficult aspects of the AAP and influence how and/or when it is used. In addition to these themes, multiple respondents discussed potential changes for the AAP that would increase their future use of the instrument. Finally, the implications of these results are discussed.

Adult Attachment Style on the MMPI-2: Does an Elevated Scale 4 Predict Dismissing Attachment?

This study examines some aspects of Caldwell's (200 I) hypotheses about the adaptations associated with elevations on the clinical scales of the Minnesota Multiphasic Personality Assessment-2 (MMPI-2). The argument is made that the adaptation to early rejection and neglect, which he attributes to Scale 4, parallels the adaptation represented by a dismissing attachment. Archival data of 72 individuals who completed assessment batteries that included both the MMPI-2 and that Adult Attachment Projective (AAP) were analyzed to determine if there was a relationship between elevations on Scale 4 and classification as dismissing attachment. No significant relationship was found for the primary hypothesis; however, some small effects were noted in related exploratory analyses. Possible reasons for the lack of a significant result are discussed a well as directions for future research.