Evidence of a relationship between adult attachment variables and appraisals of chronic pain

Objective: Although threat and challenge appraisals of pain have been linked to both the acute and laboratory-induced pain experience, these appraisals have not yet been explored in relation to chronic pain. In addition, although attachment theory has been separately linked to the chronic pain experience and to responses to perceived threat, it has not been explored in the context of threat and challenge appraisals of chronic pain. The present paper addresses these two main goals. Methods: A sample of 141 participants reporting noncancer pain longer than two months in duration completed a battery of assessments before commencing treatment in one of two multidisciplinary rehabilitation programs. Results: Analysis of the pain appraisal inventory produced two factors (threat and challenge), replicating earlier findings. Reliability coefficients for the two extracted scales were 0.87 and 0.86, respectively. Links between the two pain appraisal scales and adult attachment variables proved to be significant. In particular, comfort with closeness was strongly related to challenge appraisal, while anxiety over relationships was strongly associated with threat appraisal. As expected, both appraisals and attachment variables were also related to catastrophizing and emotional distress. Conclusions: Results support use of the pain appraisal inventory as an evaluation tool for those with chronic pain. Findings further suggest a substantial association between adult attachment and pain appraisal, supporting the need for more in-depth analysis and consideration of implications for treatment. © 2005 Pulsus Group Inc. All rights reserved.