Adult attachment variables predict depression before and after treatment for chronic pain.
ABSTRACT The complex relationship between chronic pain and depression has long been of clinical and empirical interest. Although attachment theory has been described as a "theory of affect regulation", and has been lauded as a developmental framework for chronic pain, surprisingly little research specifically considers the links between adult attachment variables and pain-related depression. A sample of 99 participants with chronic pain of non-cancer origin was evaluated before and after pain rehabilitation. Results demonstrated that two attachment dimensions (comfort with closeness and relationship anxiety) were related to pre- and post-treatment depression. Of particular interest was the finding that comfort with closeness was the unique predictor of lower levels of post-treatment depression, usurping pain intensity and pre-treatment depression. These results are discussed in terms of clinical implications, and suggest that adult attachment theory may prove a valuable perspective in pain treatment programs.
- SourceAvailable from: Pamela J Meredith10/2014;
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ABSTRACT: Introduction: Labour is considered to be one of the most painful and significant experiences in a woman’s life. The aim of this study was to examine whether women’s attachment style is a predictor of the pain experienced throughout labour and post-delivery. Material and Methods: Thirty-two pregnant women were assessed during the third trimester of pregnancy and during labour. Adult attachment was assessed with the Adult Attachment Scale – Revised. The perceived intensity of labour pain was measured using a visual analogue scale for pain in the early stage of labour, throughout labour and post-delivery. Results: Women with an insecure attachment style reported more pain at 3 cm of cervical dilatation (p < 0.05), before the administration of analgesia (p < 0.01) and post-delivery (p < 0.05) than those securely attached. In multivariate models, attachment style was a significant predictor of labour pain at 3 cm of cervical dilatation and before the first administration of analgesia but not of the perceived pain post-delivery. Discussion: These findings confirm that labour pain is influenced by relevant psychological factors and suggest that a woman’s attachment style may be a risk factor for greater pain during labour. Conclusion: Future studies in the context of obstetric pain may consider the attachment style as an indicator of individual differences in the pain response during labour. This may have important implications in anaesthesiology and to promote a relevant shift in institutional practices and therapeutic procedures.Acta medica portuguesa 11/2014; 27(6):692-699. · 0.28 Impact Factor
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ABSTRACT: This study evaluated the clinical efficacy of a time limited psychodynamic therapy for a group of young adult patients in terms of outcome and process. The results register a favourable outcome concerning not only the gravity of patients' initial symp-toms but also the structural personality changes and attachment style. In an exploratory perspective this study investigated the connection between the outcome of the tre-atment and therapeutic alliance measured by CALPAS-G in three different time intervals of therapy. A correlational analysis highlighted a strong connection between the Patient Commitment scale assessed at the beginning and the final outcome of the therapy. Work-ing Strategy Consensus and Group Understanding and Involvement assessed in the middle of the therapy course, show significant correlations with the final outcome of therapy. In the last ten years more data on the efficacy and economical use of group psychotherapies has contri-buted to promoting their diffusion in public services and in clinical practice. However, literature has show-ed some critical issues among a limited number of re-search studies in clinical outpatient contexts (Bur-lingame, Fuhriman, & Mosier, 2003). There are few studies on analytic and psychodynamic long-term therapies (Tschuschke, Anbeh, & Kiencke, 2007) whereas there are many studies concerning cognitive behavioral therapies (Burlingame, MacKenzie, & Strauss, 2004). In regard to the Italian scene, research into groups has mainly developed in the theoretical-clinical field rather than in the empirical one (Gullo & Lo Verso, 2008). Moreover, if we consider the thera-peutic process and its connection with the outcome we find other issues. To this end Lorentzen (2006) sta-tes that empirical research on long term psychodyna-mic therapy has analyzed outcome and process varia-bles separately. Even though the theoretical‒clinical literature un-derlines the contribution of group therapeutic factors (Yalom & Leszcz, 2009) to the effects of therapy, which include group cohesion and therapeutic al-liance, there are some difficulties in an empirical envi-ronment starting with the operationalization of the constructs. In the process‒outcome research of group therapies many studies consider group cohesion as the variable which mediates the presence of other factors with a direct impact on outcome (01/2014; 17(1):9-20.