Trauma, attachment, and disability within the model of a complex adaptive system of chronic low back pain

This study examined the model of chronic low back pain-related disability from a developmental perspective to uncover factors that may contribute to the development and maintenance of chronic low back pain. This model was conceptualized as part of a complex adaptive system of chronic pain. The literature review integrated recent findings connecting social pain to chronic pain through neuroscience. The study employed a quantitative cross-sectional research design with four independent variables (i.e., adult attachment style, trauma history over the lifespan, current PTSD symptoms, and depression symptoms) and one dependent variable (i.e., chronic low back pain-related disability) and investigated how the independent variables are related to the level of chronic low back pain-related disability. Results indicated that attachment anxiety, PTSD, and depression were individually significant predictors of disability. Significant mediated pathways were found from attachment anxiety to chronic low back-pain disability through depression and attachment avoidance to disability through depression. The findings suggest that the development of chronic low back pain has a direct relationship with psychosocial developmental risk factors and that underlying social pain may be an important vehicle in developing chronic pain.