Attachment and adjustment in individuals with a history of functional abdominal pain
Laird, Kelsey Thompson
Objective. This study tested the Attachment-Diathesis Model of Chronic Pain (Meredith, Ownsworth, & Strong; 2008) in a group of adolescents and young adults with a history of pediatric functional abdominal pain (FAP). We hypothesized that attachment anxiety would be a diathesis for poor adjustment, and that pain self-efficacy, pain threat, and passive coping would mediate this effect. Methods. Participants (N = 274) were recruited from a database of consecutive new patients evaluated for abdominal pain at a pediatric gastroenterology clinic. Participants’ mean age at the follow-up assessment was 21 years. Structural equation modeling was used to test the fit of our conceptual model to the data. Results. Model fit was good (CFI=.982, TLI=.961, RMSEA=.053). Attachment anxiety significantly predicted both poorer mental and poorer physical health. Pain self-efficacy, pain threat, and passive coping mediated the effect of anxious attachment on physical health. By contrast, there was no significant mediation of the effect of attachment anxiety on mental health. Conclusions. Among individuals with a history of pediatric functional abdominal pain, those with anxious attachment may be at risk for poor physical and mental health. Pain beliefs and coping mediate the relation between anxious attachment and health outcomes and may serve as effective targets for intervention in chronic pain.