Academic journal article The Journal of Rehabilitation

Attachment Anxiety, Stranger Support, and Attentional Bias for Relational Negativity in Response to Pain among Women

Academic journal article The Journal of Rehabilitation

Attachment Anxiety, Stranger Support, and Attentional Bias for Relational Negativity in Response to Pain among Women

Article excerpt

Chronic pain has been defined as pain lasting six months or more after injury (Taylor, 2012), and is associated with a variety of ailments from depression to physical dysfunction (Jensen & Turk, 2014). Conte and Banerjee (1993) have suggested that treatment of chronic pain has evolved from a medical issue to one primarily psychosocial in nature, requiring interdisciplinary approaches addressing psychosocial goals. Recent literature has also emphasized attention to individual factors affecting chronic pain, as Jensen and Turk have suggested ideal treatment would involve matching persons with chronic pain (PWCP) to interventions based on "relevant predictive characteristics" (Jensen & Turk, 2014, p. 114).

Into this milieu, attachment and empathy have emerged as two such factors which may influence pain response (e.g., Hurtcr, Paloyelis, Williams & Fotopoulou, 2014; Sambo, Howard, Kopel-man, Williams & Fotopoulou, 2010). Insofar as longstanding biases in information processing are thought to result in negative mood states when combined with a stressor like chronic pain (Pinkus & Williams, 1999 as cited in Meredith et al., 2008), it is possible that the effects of empathy and attachment on pain coping are influenced by attentional factors. Indeed, Coan's (2008) neuroscientific approach to attachment, argues that attachment figures are relied upon to support many safety- and health-enhancing behaviors including vigilance for threat and negative affect regulation. In the current study, we focus particularly on the pain response of women, as literature suggests they are more likely influenced by empathy or support for pain than men (Chambers, Craig & Bennett, 2002; Jackson, Iezzi, Chen, Ebnet & Eglitis, 2005). Accordingly, we sought to extend research on pain adjustment by addressing how empathic support for pain, in the context of participants' attachment, influences the allocation of neurobiological attentional resources for threatening social stimuli among women.

Attachment

Bowlby (1977) explained attachment in terms of one's behavior in securing and retaining relationships with close others. He described the importance of early attachment behavior, noting that children use an attachment figure, such as a parent or caregiver, as a "secure base" from which to explore the world. These relationships inform the child's understanding of how worthy of care he or she is and how worthy their caregiver is of trust. These relationship patterns become internal working models for the child and eventually develop into a trait-like characteristic influencing approach to relationships into adulthood and throughout the lifespan.

Speaking to the influence of evolutionary stresses on attachment, Bowlby (1973) described how attachment behavior emerges from one's need to self-regulate in a threatening environment. He noted that one is in more danger when alone, and so human beings are motivated to affiliate with others to distribute risk. Likewise, the presence of others confers physical survival benefits, such that social relationships may help one to procure food and other resources. Social affiliation in Bowlby's view, then, serves to support the individual both emotionally and physiologically.

Many means have been developed to quantify attachment, though one of the more commonly used is that of Brennan, Clark and Shaver (1998), whose dimensional approach informed the basis of their popular attachment measure, the Experiences in Close Relationships (ECR). These authors defined attachment in terms of anxiety and avoidance, referring to one's tendency to fear abandonment or to have trouble connecting with others respectively. Anxiety has also been described as "hyperactivating" and related to a worry that one's attachment figure will not be available when needed, while avoidance is "deactivating" and indicative of distrust in the attachment figure and a desire to be emotionally distant and autonomous from the partner (Mikulincer, Dolev & Shaver, 2004). …

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