Attachment predicts daily catastrophizing and social coping in women with pain

Objective: To examine how anxious and avoidant adult attachment styles moderate within-day associations between pain intensity, pain catastrophizing, and social coping. Method: Two-hundred and ten women with osteoarthritis and/or fibromyalgia from the community completed an initial questionnaire assessing attachment dimensions and a 30 day electronic diary. Outcomes were measured with daily ratings of pain intensity, catastrophizing, and social coping. Results: Attachment anxiety showed a context-specific relation with catastrophizing: days of increased pain predicted greater increases in pain catastrophizing for women who were anxious compared to nonanxious women. Attachment avoidance scores were related to higher mean levels of pain intensity and pain catastrophizing, and lower mean levels of social coping, across the diary period. In addition, compared to nonavoidant women, avoidant women showed smaller increases in use of social coping strategies on days of high catastrophizing. Conclusions: Dimensions of adult attachment, anxiety and avoidance, predict different aspects of daily pain and pain coping in women with chronic pain. Findings suggest that a social development perspective can inform our understanding of adjustment to chronic pain and the creation and use of more effective prevention and treatment strategies.