Attachment styles in children affected by migraine without aura

Abstract

BackgroundIn recent years, great attention has been given to the presence of psychological problems and psychiatric comorbidity that are also present in children affected by primary headaches. The relationship between pain and attachment has been identified, and it may be that pain perception may change in relation with specific attachment styles. The aim of the present study was to assess the prevalent attachment style and verify its putative relationship and correlation with the main characteristics of migraine attacks, in school-aged children affected by migraine without aura (MoA).Materials and methodsThe study population consisted of 219 children (103 males, 116 females) aged between 6 and 11 years (mean 8.96 ± 2.14 years), consecutively referred for MoA compared with 381 healthy controls (174 males, 207 females; mean age 9.01 ± 1.75 years) randomly selected from schools. All the children were classified according to the attachment typologies of the Italian modified version of the Separation Anxiety Test; monthly headache frequency and mean headache duration were assessed from daily headache diaries kept by all the children. Headache intensity was assessed on a visual analog scale. The chi-square test and t-test, where appropriate, were applied, and the Spearman rank correlation test was applied to explore the relationship between the types of attachment style and clinical aspects of MoA.ResultsThe MoA group showed a significantly higher prevalence of type A (avoidant) attachment (P<0.001) and a significantly lower prevalence of type B (secure) attachment (P<0.001) compared with the control group. Moreover, the Spearman rank correlation analysis showed a significant relationship between MoA characteristics and the attachment style of MoA children.ConclusionThe main findings of the present study were the higher prevalence among MoA children of the avoidant attachment style (type A) and the significantly lower prevalence of the secure style attachment (type B) compared with the normal controls, suggesting that the study of psychiatric comorbidity in pediatric headache may be enriched by this new aspect of analysis.

Defense mechanism is predicted by attachment and mediates the maladaptive influence of insecure attachment on adolescent mental health

“…Given our findings that attachment has a significant effect on defenses, as well as the growing body of literature suggesting both attachment and defenses have a significant impact on physical health (Davies et al 2009;Esposito et al 2013;, it is important to consider the medical implications of these factors when assessing a pediatric patient.…”

“…Migraine headaches (Esposito et al 2013), chronic pain (Davies et al 2009), chronic illness, and disease , have all been attributed to insecure attachment styles.…”

Attachment and Chronic Pain in Children and Adolescents

“…Indeed, a large portion of the literature investigating attachment styles and pain has drawn conclusions based on patients with headaches or migraines (e.g., [15,30,31,32]) and functional abdominal pain (e.g., [33,34]). However, if acute physical threats are likely to activate attachment-based behaviors [16], it seems conceivable that attachment behavior patterns may contribute to an acute pain problem which has resulted from an injury or surgery transitioning into a chronic pain problem.…”

“…Insecure attachment has been found to be significantly more common in children with migraine compared to controls [31]. More specifically, the avoidant attachment style was found to have positive associations with migraine characteristics, including frequency, intensity and duration of attacks [31].…”

“…Insecure attachment has been found to be significantly more common in children with migraine compared to controls [31]. More specifically, the avoidant attachment style was found to have positive associations with migraine characteristics, including frequency, intensity and duration of attacks [31]. The authors highlighted the involvement of neurotransmitter patterns involved in the manifestation of attachment-related behavioral tendencies that also share links with the presence of migraine.…”