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Relationships Between Adult Attachment Dimensions and Patient-Physician Relationship Quality

Published online by Cambridge University Press:  03 October 2018

Lachlan A. McWilliams Open the ORCID record for Lachlan A. McWilliams [Opens in a new window]
Lachlan A. McWilliams*
Affiliation:
Department of Psychology, University of Saskatchewan, Saskatoon, Canada
*
Address for correspondence: Lachlan McWilliams, Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada. Email: [email protected]
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Abstract

Positive associations between attachment insecurity and indicators of poorer patient-physician relationship quality have been found in samples of patients consulting with physicians for a variety of specific medical conditions or needs. The current study was the first to investigate associations between adult attachment characteristics and relationship quality with family physicians. University students (N = 239) completed measures assessing attachment and their relationships with their family physician. Attachment avoidance was associated with poor affective relationship quality and with greater communication difficulties. Attachment anxiety was associated with greater communication difficulties, but was unrelated to affective relationship quality. Those with insecure attachment, particularly those with high levels of avoidance, have poorer relationships with their family physicians than those with more secure attachment.

Keywords

attachmentpatient-physician relationshipshealthcare
Type
Research Article
Information
Journal of Relationships Research , Volume 9 , 2018 , e15
Copyright
Copyright © The Author(s) 2018 

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References

Aiken, L., & West, S.G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
Bachinger, S.M., Kolk, A.M., Smets, E.M.A. (2009). Patients’ trust in their physician-psychometric properties of the Dutch version of the ‘Wake Forest Physician Trust Scale’. Patient Education and Counseling, 76, 126–131.Google Scholar
Bartholomew, K., & Horowitz, L.M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226–244.Google Scholar
Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. London: Penguin Books.Google Scholar
Bowlby, J. (1975). Attachment and loss: Vol. 2. Separation: Anxiety and anger. London: Penguin Books.Google Scholar
Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. London: Penguin Books.Google Scholar
Brennan, K.A., Clark, C.L., & Shaver, P.R. (1998). Self-report measurement of adult attachment: An integrative overview. In Simpson, J.A. & Rholes, W.S. (Eds.), Attachment theory and close relationships (pp. 46–76). New York: The Guilford Press.Google Scholar
Ciechanowski, P.S., Katon, W.J., Russo, J.E., & Walker, E.A. (2001). The patient-provider relationship: Attachment theory and adherence to treatment in diabetes. American Journal of Psychiatry, 158, 29–35.Google Scholar
Ciechanowski, P., Russo, J., Katon, W., Simon, G., Ludman, E., Von Korff, M., … Lin, E. (2006). Where is the patient? The association of psychosocial factors and missed primary care appointments in patients with diabetes. General Hospital Psychiatry, 28, 9–17.Google Scholar
Ciechanowski, P., Russo, J., Katon, W., Von Korff, M., Ludman, E., Lin, E., … Bush, T. (2004). Influence of patient attachment style on self-care and outcomes in diabetes. Psychosomatic Medicine, 66, 720–728.Google Scholar
Ciechanowski, P.S., Sullivan, M., Jensen, M., Romano, J., & Summer, H. (2003). The relationship between attachment style to depression, catastrophizing and health care utilization in patients with chronic pain. Pain, 104, 627–637.Google Scholar
Ciechanowski, P.S., Walker, A.E., Katon, W.J., & Russo, J.E. (2002). Attachment theory: A model for health care utilization and somatization. Psychosomatic Medicine, 64, 660–667.Google Scholar
Clark, L., Beesley, H., Holcombe, C., & Salmon, P. (2011). The influence of childhood abuse and adult attachment style on clinical relationships in breast cancer. General Hospital Psychiatry, 33, 579–586.Google Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.Google Scholar
Feeney, J.A., & Ryan, S.M. (1994). Attachment style and affect regulation: Relationships with health behavior and family experiences of illness in a student sample. Health Psychology, 13, 334–345.Google Scholar
Fraley, R.C., Waller, N.G., & Brennan, K.A. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350–365.Google Scholar
Fuertes, J.N., Anand, P., Haggerty, G., Kestenbaum, M., & Rosenblum, G.C. (2015). The physician-patient working alliance and patient psychological attachment, adherence, outcome expectations, and satisfaction in a sample of rheumatology patients. Behavioral Medicine, 41, 60–68.Google Scholar
Fuertes, J.N., Mislowack, A., Bennett, J., Paul, L., Gilbert, T.C., Fontan, G., & Boylan, L.S. (2007). The physician-patient working alliance. Patient Education and Counseling, 66, 29–36.Google Scholar
Galassi, J.P., Schanberg, R., Ware, W.B. (1992). The patient reactions assessment: A brief measure of the quality of the patient-provider medical relationship. Psychological Assessment, 4, 346–351.Google Scholar
Gallo, L.C., & Matthews, K.A. (2006). Adolescents’ attachment orientation influences ambulatory blood pressure responses to everyday social interactions. Psychosomatic Medicine, 68, 253–261.Google Scholar
George, C., Kaplan, N., & Main, M. (1996) Attachment Interview for Adults protocol (3rd ed.). Unpublished manuscript, University of California at Berkeley.Google Scholar
Green, B.L., Kaltman, S.I., Chung, J.Y., Holt, M.P., Jackson, S., Dozier, M. (2012). Attachment and health care relationships in low-income women with trauma histories: A qualitative study. Journal of Trauma & Dissociation, 13, 190–208.Google Scholar
Griffin, D.W., & Bartholomew, K. (1994). The metaphysics of measurement: The case of adult attachment. In Bartholomew, K. & Perlman, D. (Eds.), Attachment processes in adulthood: Vol. 5. Attachment processes in adulthood (pp. 17–52). London: Jessica Kingsley.Google Scholar
Hahn, S.R., Kroenke, K., Spitzer, R.L., Brody, D., Williams, J.B., Linzer, M., & deGruv, F.V. (3rd), (1996). The difficult patient: Prevalence, psychopathology, and functional impairment. Journal of General Internal Medicine, 11, 1–8.Google Scholar
Hahn, S.R., Thompson, K.S., Wills, T.A., Stern, V., & Budner, N.S. (1994). The difficult doctor-patient relationship: Somatization, personality and psychopathology. Journal of Clinical Epidemiology, 47, 647–657.Google Scholar
Harrington, J., Noble, L., & Newman, S. (2004) Improving patients' communication with doctors: a systematic review of intervention studies. Patient Education and Counseling, 54, 7–16.Google Scholar
Hazan, C., & Shaver, P.R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511–524.Google Scholar
Hinnen, C., Pool, G., Holwerda, N., Sprangers, M., Sanderman, R., & Hagedoorn, M. (2014). Lower levels of trust in one's physician is associated with more distress over time in more anxiously attached individuals with cancer. General Hospital Psychiatry, 36, 382–387.Google Scholar
Holwerda, N., Sanderman, R., Pool, G., Hinnen, C., Langendijk, J.A., Bemelman, W.A., Hagedoorn, M., & Sprangers, M.A.G. (2013). Do patients trust their physician? The role of attachment style in the patient-physician relationship within one year after a cancer diagnosis. Acta Oncologica, 52, 110–117.Google Scholar
Hunter, J.J., & Maunder, R.G. (2001). Using attachment theory to understand illness behavior. General Hospital Psychiatry, 23, 177–182.Google Scholar
Hunter, J.J., & Maunder, R.G. (Eds.). (2016). Improving patient treatment with attachment theory: A guide for primary care practitioners and specialists. Cham: Springer International Publishing.Google Scholar
Kolb, L.C. (1982). Attachment behavior and pain complaints. Psychosomatics, 23, 413–425.Google Scholar
Lo, C., Walsh, A., Mikulincer, M., Gagliese, L., Zimmerman, C., & Rodin, G. (2009). Measuring attachment security in patients with advanced cancer: Psychometric properties of a modified and brief experiences in close relationships scale. Psychooncology, 18, 490–499.Google Scholar
Mallinckrodt, B., Gantt, D.L., & Coble, H.M. (1995). Attachment pattern in the psychotherapy relationship: development of the Client Attachment to Therapist Scale. Journal of Counseling Psychology, 42, 307–317.Google Scholar
Maunder, R.G., & Hunter, J.J. (2001). Attachment and psychosomatic medicine: Developmental contributions to stress and disease. Psychosomatic Medicine, 63, 556–567.Google Scholar
Maunder, R.G., & Hunter, J.J. (2009). Assessing patterns of adult attachment in medical patients. General Hospital Psychiatry, 31, 123–130.Google Scholar
Maunder, R.G., & Hunter, J.J. (2016). Can patients’ be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient-provider relationships. BMJ Open, 6, e011068.Google Scholar
Maunder, R.G., Panzer, A., Viljoen, M., Owen, J., Human, S., & Hunter, J.J. (2006). Physicians’ difficulty with emergency department patients is related to patients’ attachment style. Social Science & Medicine, 63, 552–562.Google Scholar
McWilliams, L.A., & Asmundson, G.J.G. (2007). The relationship of adult attachment dimensions to pain-related fear, hypervigilance, and catastrophizing. Pain, 127, 27–34.Google Scholar
McWilliams, L.A., Cox, B.J., & Enns, M.W. (2000). Impact of adult attachment styles on pain and disability associated with arthritis in a nationally representative sample. The Clinical Journal of Pain, 16, 360–364.Google Scholar
Mikail, S.F., Henderson, P.R., & Tasca, G.A. (1994). An interpersonally based model of chronic pain: An application of attachment theory. Clinical Psychology Review, 14, 1–6.Google Scholar
Mikulincer, M., & Shaver, P.R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guildford Press.Google Scholar
Ognibene, T.C., & Collins, N.L. (1998). Adult attachment styles, perceived social support and coping strategies. Journal of Social and Personal Relationships, 15, 323–345.Google Scholar
Pegman, S., Beesley, H., Holcombe, C., Mendick, N., & Salmon, P. (2011). Patients’ sense of relationship with breast cancer surgeons: The relative importance of surgeon and patient variability and the influence of patients’ attachment style. Patient Education and Counseling, 83, 125–128.Google Scholar
Stone-Romero, E.F., & Anderson, L.E. (1994). Relative power of moderated multiple regression and the comparison of subgroup correlation coefficients for detecting moderating effects. Journal of Applied Psychology, 79, 354–359.Google Scholar
Tracey, T.J., & Kokotovic, A.M. (1989). Factor structure of the working alliance inventory. Psychological Assessment, 1, 207–210.Google Scholar
Wei, M., Russell, D.W., Mallinckrodt, B., & Vogel, D.L. (2007). The experiences in Close Relationship Scale (ECR)-Short Form: Reliability, validity, and factor structure. Journal of Personality Assessment, 88, 187–204.Google Scholar