Dyadic interventions and attachment style in patient and caregiver populations coping with chronic pain
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Date
30/11/2020Author
Berlouis, Katherine May
Metadata
Abstract
Background: Chronic Pain is increasingly conceptualised as a phenomenon dictated by social context
and close relationships, with some interventions electing to include a significant other in the treatment
process. Moreover, research regarding attachment style and chronic pain is limited, particularly in
regards to how the attachment style of significant others influences the patient’s pain experience.
Aims: This thesis had two aims; to systematically review the literature investigating dyadic
interventions in chronic pain populations (Chapter 1), and to use Conditional Process Analysis and
Hierarchical Regression to explore how attachment style influences established aspects of pain
experience (Chapter 2).
Method: Controlled studies exploring the efficacy of dyadic psychosocial interventions targeting
distress were reviewed systematically. The empirical study employed Conditional Process Analysis
and Hierarchical Regression to investigate the predictive capacity of both patients and partner
attachment in predicting Depression, Self-Efficacy, Pain Disability and Psychological Flexibility.
Results: Findings of the systematic review indicate that dyadic interventions are effective in reducing
distress, but due to the limited quality of evidence, it is not yet possible to determine whether they are
superior to patient-only interventions. The results of the empirical study suggest that attachment
avoidance in patients has unique predictive capacity in depression and self-efficacy outcomes. Partner
attachment avoidance was found to influence levels of the patient’s psychological flexibility.
Findings from the empirical study suggest that avoidant attachment may amplify the relationship
between pain intensity, pain catastrophizing and psychological distress; assessing the attachment style
of patients may help to tailor psychological intervention to patient need. Avoidant partners may
influence patient levels of psychological flexibility, and therefore interpersonal attachment could be a
future consideration in Acceptance and Commitment Therapy Trials.