Attachment Style Differences in the Affective Experience of Chronic Pain in Osteoarthritis

Objective: To examine the role of adult attachment style in the daily affective experiences of older adults with physician-confirmed knee osteoarthritis (OA). Methods: As part of a larger study of racial/ethnic differences in everyday quality of life with OA, 292 persons over the age of 50 completed a baseline interview including the Revised Adult Attachment Scale (RAAS; Collins, 1996). Dimensional RAAS attachment scores were coded into the secure, preoccupied, fearful, and dismissing groups (Bartholomew & Horowitz, 1991). Positive affect (PA), negative affect (NA), and pain were assessed using an experience sampling methodology consisting of 4 daily phone calls over 7 days. These analyses used ANCOVAs to examine 28-call means and SDs for PA, NA, and pain. Results: After controlling for demographics, results indicated significant group differences in average PA, NA, and pain. Pairwise comparisons indicated that participants endorsing a stable attachment style reported significantly more PA and less NA than those with a fearful attachment style. Group differences for pain were marginal and less clear cut. Significant differences also emerged for variability of NA and pain. Individuals with a secure attachment style were significantly less variable in NA than those in the fearful and preoccupied groups. For pain variability, the preoccupied group showed more variability than those with secure or dismissive styles. Implications: Results contribute to a growing understanding of how individual attachment style may underlie the day-to-day affective experience of chronic pain. (Supported by R01-AG041655, D. Smith and P. Parmelee, PIs.)