Evaluation of Attachment Style and Social Support in Patients With Severe Migraine. Applications in Doctor-Patient Relationships and Treatment Adherence
Open Access
- 12 July 2021
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Neurology
- Vol. 12, 706639
- https://doi.org/10.3389/fneur.2021.706639
Abstract
Objectives: The aim of this observational study was to describe social support and patterns of attachment among patients with migraine. We hypothesized that in comparison to the general population, insecure attachment is overrepresented in migraine patients, and that these patients have less social support. We also aimed to study the specific relationship between attachment and social support. We hypothesized that patients with an insecure attachment style have less social support than patients with a secure attachment style. Methods: A total of 101 consecutive patients (88.1% women) aged between 25 and 60 (average age = 41.4) were recruited at the Specialized Center for the Consultation of Primary Headaches at the Regional University Hospital Center of Besançon (France). Migraine impact and disability were evaluated using the Headache Impact Test (HIT-6) questionnaire and Migraine Disability Assessment (MIDAS) questionnaire. Patients also completed several self-administered psychological questionnaires in their validated French versions: the Medical Outcome Survey 36-Item Short-Form Health Survey, the Cungi Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Relationship Scales Questionnaire and the Sarason's Social Support Questionnaire. Results: The distribution of attachment profiles was different from that of the general population, with an overrepresentation of insecure attachment styles (p = 0.018). Our study showed that migraine patients had less social support than the general population, both in terms of the number of people providing support (p = 0.002) and the level of satisfaction concerning this social support (p = 0.000). We also found that neither the number of available persons score nor the satisfaction score were statistically different between the four attachment categories (p = 0.49). Patient's attachment style and social support influence the patient-doctor relationship, the therapeutic alliance and health behaviors such as treatment adherence. Conclusions: Based on the data we obtained, we developed applications in patient care for people with particular attachment styles and low social support. A treatment plan adapted to the patient's attachment profile should be created to develop “precision medicine” using a personalized approach to the doctor-patient relationship. We would also recommend encouraging patients to participate in support groups, in order to strengthen their attachment systems and gain social support. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03577548, identifier NCT03577548.This publication has 34 references indexed in Scilit:
- Does attachment insecurity affect the outcomes of a multidisciplinary pain management program? The association between attachment insecurity, pain, disability, distress, and the use of opioidsSocial Science & Medicine (1982), 2012
- Validation of the Headache Impact Test (HIT-6™) across episodic and chronic migraineCephalalgia, 2010
- The GRIM2005 Study of Migraine Consultation in France. III: Psychological Features of Subjects With MigraineCephalalgia, 2009
- Attachment Relationships as Determinants of Physical HealthThe Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 2008
- The GRIM2005 Study of Migraine Consultation in France I. Determinants of Consultation for Migraine Headache in FranceCephalalgia, 2007
- Recognition and Therapeutic Management of Migraine in 2004, in France: Results of FRAMIG 3, a French Nationwide Population‐Based SurveyHeadache: The Journal of Head and Face Pain, 2006
- Anxiety and depression associated with migraine: Influence on migraine subjects' disability and quality of life, and acute migraine managementPain, 2005
- Attachment styles and headacheThe Journal of Headache and Pain, 2005
- The Relationship Between Perceived Stress, Social Support and Chronic HeadachesHeadache: The Journal of Head and Face Pain, 1993
- Early Mother‐Infant ReciprocityPublished by Wiley ,1975