This study examined associations between adult attachment dimensions, perceived health status and worrying (coping strategy with chronic pain), and explored whether worrying mediated observed relationships between attachment dimensions and health outcomes within a sample of 128 Portuguese female fibromyalgia patients. Physical health status was inversely correlated with dependence and worrying; mental health status was positively correlated with trust, and inversely related to attachment-related ambivalence, dependence and worrying. Finally, worrying mediated relationships between dependence and both physical and mental health status; moreover, worrying partially mediated the relationship between ambivalence and mental health status. Implications of the findings are discussed.
Ainsworth, M., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the Strange Situation. Hillsdale, NJ: Erlbaum.
2.
Baron, R., & Kenny, D. ( 1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations . Journal of Personality and Social Psychology, 51, 1173-1182.
3.
Bartholomew, K., & Horowitz, L. ( 1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226-244.
4.
Bastos, M. ( 2006). A solidão e os processos de vinculação nos jovens e a sua inter-relação com a utilização da Internet. Unpublished doctoral dissertation, Faculty of Psychology and Educational Sciences, University of Porto, Portugal.
5.
Blotman, F., & Branco, J. ( 2007). Fibromyalgia: Daily aches and pain. Toulouse: Éditions Privat.
6.
Bowlby, J. ( 1969/1982). Attachment and loss. Vol. 1: Attachment . New York: Basic Books.
7.
Bowlby, J. ( 1988). A secure base: Parent-child attachments and healthy human development. New York: Basic Books .
8.
Branco, J., Saraiva, F., Caubère, J., André, E., Roué-Le Lay, K., & Taieb, C. ( 2008a). Prevalência da fibromialgia em Portugal: Resultados finais. Poster presented at XIV Congresso Português de Reumatologia, Vilamoura, Portugal, April.
9.
Branco, J., Saraiva, F., Cerinic, M., Bannwarth, B., Failde, I., Abello, J. et al. (2008b). Prevalência da fibromialgia na Europa . Poster presented at XIV Congresso Português de Reumatologia, Vilamoura, Portugal, April.
10.
Cavalcante, A., Sauer, J., Chalot, S., Assumpção, A., Lage, L., Matsutani, L. et al. (2006). A prevalência de fibromialgia: Uma revisão de literatura. Revista Brasileira de Reumatologia, 46, 40-48.
11.
Centre for Health Studies and Research-University of Coimbra. (1997). Portuguese second version of Medical Outcomes Study 36-Item Short Form Health (SF-36V.2). Coimbra, Portugal: Centre for Health Studies and Research, University of Coimbra.
12.
Ciechanowski, P., Sullivan, M., Jensen, M., Romano, J., & Summers, H. ( 2003). The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain. Pain, 104, 627-637.
13.
Ciechanowski, P., Walker, E., Katon, W., & Russo, J. ( 2002). Attachment theory: A model for health care utilization and somatization. Psychosomatic Medicine, 64, 660-667.
14.
Da Costa, D., Dobkin, P., Fitzcharles, M., Fortin, P., Beaulieu, A., Zummer, M. et al. (2000). Determinants of health status in fibromyalgia: A comparative study with systemic lupus erythematosus. Journal of Rheumatology, 27, 365-372.
15.
Edwards, R., Bingham, C., III, Bathon, J., & Haythornthwaite, J. (2006). Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis & Rheumatism (Arthritis Care & Research), 55, 325-332.
16.
Ferreira, P. ( 2000a). Criação da versão portuguesa do MOS SF-36. Parte I: Adaptação cultural e linguística . Acta Médica Portuguesa, 13, 55-66.
17.
Ferreira, P. ( 2000b). Criação da versão portuguesa do MOS SF-36. Parte II: Testes de validação. Acta Médica Portuguesa, 13, 119-127.
18.
Ferreira, P., & Santana, P. ( 2003). Percepção do estado de saúde e de qualidade de vida da população activa: Contributo para a definição das normas portuguesas. Revista Portuguesa de Saúde Pública, 21, 15-30.
19.
Field, A. ( 2005). Discovering statistics using SPSS, 2nd edn. London: SAGE.
20.
Frazier, P., Tix, A., & Barron, K. ( 2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51, 115-134.
21.
Fuendeling, J. ( 1998). Affect regulation as a stylistic process within adult attachment. Journal of Social and Personal Relationships, 15, 291-322.
22.
Giesecke, T., Williams, D., Harris, R., Cupps, T., Tian, X., Tian, T. et al. (2003). Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors. Arthritis & Rheumatism, 48, 2916-2922.
23.
Hallberg, L., & Carlsson, S. ( 1998). Psychosocial vulnerability and maintaining forces related to fibromyalgia: In-depth interviews with twenty-two female patients. Scandinavian Journal of Caring Sciences, 12, 85-103.
24.
Hassett, A., Cone, J., Patella, S., & Sigal, L. ( 2000). The role of catastrophizing in the pain and depression of women with fibromyalgia syndrome. Arthritis & Rheumatism , 43, 2493-2500.
25.
Hazan, C., & Shaver, P. ( 1987). Romantic love conceptualized as an attachment process . Journal of Personality and Social Psychology, 52, 511-524.
26.
Kemp, M., & Neimeyer, G. ( 1999). Interpersonal attachment: Experiencing, expressing, and coping with stress. Journal of Counseling Psychology, 46, 388-394.
27.
Kraaimaat, F., & Evers, A. ( 2003). Pain-coping strategies in chronic pain patients: Psychometric characteristics of the Pain-Coping Inventory (PCI). International Journal of Behavioral Medicine, 10, 343-363.
28.
Lopez, F. (in press). Adult attachment security: The relational scaffolding of positive psychology. In C. R. Synder & S. J. Lopez (Eds.), Handbook of positive psychology (2nd edn). New York: Oxford University Press.
29.
Lopez, F., & Brennan, K. ( 2000). Dynamic processes underlying adult attachment organization: Toward an attachment theoretical perspective on the healthy and effective self. Journal of Counseling Psychology, 47, 283-300.
30.
Matos, P., Barbosa, S., & Costa, M. ( 2001). Avaliação da vinculação amorosa em adolescentes e jovens adultos: Construção de um instrumento e estudos de validação. RIDEP, 11, 93-109.
31.
Matos, P., & Costa, M. (2001). Romantic Attachment Questionnaire. Unpublished manuscript, Faculty of Psychology and Educational Sciences, University of Porto, Portugal.
32.
McWilliams, L., & Asmundson, G. ( 2007). The relationship of adult attachment dimensions to pain-related fear, hypervigilance, and catastrophizing. Pain, 127, 27-34.
33.
Meredith, P., Ownsworth, T., & Strong, J. ( 2008). A review of the evidence linking adult attachment theory and chronic pain: Presenting a conceptual model. Clinical Psychology Review, 28, 407-429.
34.
Meredith, P., Strong, J., & Feeney, J. ( 2006a). The relationship of adult attachment to emotion, catastrophizing, control, threshold and tolerance, in experimentally-induced pain. Pain, 120, 44-52.
35.
Meredith, P., Strong, J., & Feeney, J. ( 2006b). Adult attachment, anxiety, and pain self-efficacy as predictors of pain intensity and disability. Pain, 123, 146-154.
36.
Meredith, P., Strong, J., & Feeney, J. ( 2007). Adult attachment variables predict depression before and after treatment for chronic pain. European Journal of Pain, 11, 164-170.
37.
Mikail, S., Henderson, P., & Tasca, G. ( 1994). An interpersonally based model of chronic pain: An application of attachment theory. Clinical Psychology Review, 14, 1-16.
38.
Mikulincer, M., & Shaver, P. ( 2005). Mental representations of attachment security: Theoretical foundation of a positive social psychology. In M. Baldwin (Ed.), Interpersonal cognition (pp. 233-266). New York: Guilford Press.
39.
Mikulincer, M., Shaver, P., & Pereg, D. ( 2003). Attachment theory and affect regulation: The dynamics, development, and cognitive consequences of attachment-related strategies. Motivation and Emotion, 27, 77-102.
40.
Myers, L., & Vetere, A. ( 2002). Adult romantic attachment styles and health-related measures . Psychology, Health & Medicine, 7, 175-180.
41.
Neumann, L., Berzak, A., & Buskila, D. ( 2000). Measuring health status in Israeli patients with fibromyalgia syndrome and widespread pain and healthy individuals: Utility of the Short Form 36-Item Health Survey (SF-36). Seminars in Arthritis and Rheumatism, 29, 400-408.
42.
Oliveira, P. ( 2008). Variáveis psicossociais e fibromialgia. Unpublished doctoral dissertation, Faculty of Psychology and Educational Sciences, University of Porto, Portugal.
43.
Oliveira, P., & Costa, M. ( 2005). Portuguese version of Pain Coping Inventory. Unpublished manuscript, Faculty of Psychology and Educational Sciences, University of Porto, Portugal.
44.
Pallant, J. ( 2001). SPPS: Survival manual. Buckingham : Open University Press.
45.
Schlenk, E., Erlen, J., Dunbar-Jacob, J., McDowell, J., Engberg, S., Sereika, S. et al. (1998). Health-related quality of life in chronic disorders: A comparison across studies using the MOS SF-36. Quality of Life Research, 7, 57-65.
46.
Simpson, J., & Rholes, W. ( 1994). Stress and secure base relationships in adulthood. Advances in Personal Relationships, 5, 181-204.
47.
Sullivan, M., Thorn, B., Haythornthwaite, J., Keefe, F., Martin, M., Bradley, L. et al. (2001). Theoretical perspectives on the relation between catastrophizing and pain. Clinical Journal of Pain, 17, 52-64.
48.
Taylor, R., Mann, A., White, N., & Goldberg, D. ( 2000). Attachment style in patients with unexplained physical complaints. Psychological Medicine, 30, 931-941.
49.
Tüzün, E., Albayrak, G., Eker, L., Sözay, S., & Daskapan, A. ( 2004). A comparison study of quality of life in women with fibromyalgia and myofascial pain syndrome. Disability and Rehabilitation , 26, 198-202.
50.
Ware, J. ( 2000). SF-36 Health Survey update. SPINE, 25, 3130-3139.
51.
Watson, D., & Pennebaker, J. (1989). Health complaints, stress and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234-254.
52.
Wearden, A., Cook, L., & Vaughan-Jones, J. (2003). Adult attachment, alexithymia, symptom reporting and health-related coping. Journal of Psychosomatic Research, 55, 341-347.
53.
Wearden, A., Perryman, K., & Ward, V. ( 2006). Adult attachment, reassurance seeking and hypochondrical concerns in college students. Journal of Health Psychology , 11, 877-886.
54.
Wolfe, F., Smythe, H., Yunus, M., Bennett, R., Bombardier, C., Goldenberg, D. et al. (1990). The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: Report of the multicenter criteria committee. Arthritis and Rheumatism, 33, 160-172.
