Adult attachment variables predict depression before and after treatment for chronic pain

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.