Overlap of cognitive concepts in chronic widespread pain: An exploratory study

<p>Abstract</p> <p>Background</p> <p>A wide variety of cognitive concepts have been shown to play an important role in chronic widespread pain (CWP). Although these concepts are generally considered to be distinct entities, some might in fact be highly overlapping. The objectives of this study were to (i) to establish inter-relationships between self-efficacy, cognitive coping styles, fear-avoidance cognitions and illness beliefs in patients with CWP and (ii) to explore the possibility of a reduction of these cognitions into a more limited number of domains.</p> <p>Methods</p> <p>Baseline measurement data of a prospective cohort study of 138 patients with CWP were used. Factor analysis was used to study the associations between 16 different cognitive concepts.</p> <p>Results</p> <p>Factor analysis resulted in three factors: 1) negative emotional cognitions, 2) active cognitive coping, and 3) control beliefs and expectations of chronicity.</p> <p>Conclusion</p> <p>Negative emotional cognitions, active cognitive coping, control beliefs and expectations of chronicity seem to constitute principal domains of cognitive processes in CWP. These findings contribute to the understanding of overlap and uniqueness of cognitive concepts in chronic widespread pain.</p

A review of the evidence regarding associations between attachment theory and experimentally induced pain

Theoretical and empirical evidence suggests that adult attachment and pain-related variables are predictably and consistently linked, and that understanding these links may guide pain intervention and prevention efforts. In general, insecure attachment has been portrayed as a risk factor, and secure attachment as a protective factor, for people with chronic pain conditions. In an effort to better understand the relationships among attachment and pain variables, these links have been investigated in pain-free samples using induced-pain techniques. The present paper reviews the available research linking adult attachment and laboratory-induced pain. While the diverse nature of the studies precludes definitive conclusions, together these papers offer support for associations between insecure attachment and a more negative pain experience. The evidence presented in this review highlights areas for further empirical attention, as well as providing some guidance for clinicians who may wish to employ preventive approaches and other interventions informed by attachment theory

Attachment theory and pain

From his first conceptualisation of attachment theory, Bowlby recognised the relationship between attachment and pain, and described pain as one of the triggers of the attachment system. Over the last 10 years, attachment theory has been investigated in relation to acute and experimental pain, various painful conditions, and outcomes from pain treatment programs. It has been considered in relation to pain experienced by adults, adolescents, and children. Insecure attachment has also been conceptualised as a risk factor for the development of chronic pain in the face of acute pain experiences. Attachment theory provides a useful lens through which to view the assessment and treatment of pain, informs research, and opens the field to exciting new possibilities. In this chapter, the literature on the associations between pain and attachment will be reviewed in order to understand how an attachment framework informs our understanding, and management, of pain. Special emphasis will be given to the Attachment-Diathesis Model of Chronic Pain