Exploring the role of interpersonal and psychodynamic factors in chronic pain: Implications for treatment response

  • Abigail Methley

Student thesis: Doctor of Clinical Psychology


Paper one presents a systematic review of the current literature on associations between adult attachment and outcomes in chronic pain. Findings demonstrated consistent relationships between attachment and psychological outcomes (depression and pain catastrophizing), with inconsistent relationships between attachment and pain duration, pain intensity and self-reported disability. The strengths and limitations of the included studies are presented with recommendations for future research. This review has been prepared for submission to Clinical Psychology Review. Paper two presents the adaptation of a measure of thwarted belongingness and perceived burdensomeness for a chronic pain population and the validation of this adapted measure with a clinical sample of people with chronic pain. The adapted questionnaire performed well in multiple tests of reliability and validity, demonstrating clinical and research implications for screening for distress in chronic pain. This empirical paper has been prepared for submission to the European Journal of Pain. Paper three presents a large empirical study establishing the importance of interpersonal and psychodynamic variables (including perceived burdensomeness, social disconnectedness, emotion regulation, and eudaimonic wellbeing) as correlates of pain variables in a clinical sample of people with chronic pain. These findings are placed within the context of broader literature on interpersonal factors in chronic pain. This empirical paper has been prepared for submission to Pain. Paper four presents a critical appraisal of the preceding papers, discussing methodological considerations, recommendations for future research and clinical implications of findings.
Date of Award31 Dec 2017
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorAlison Wearden (Supervisor) & Richard Brown (Supervisor)


  • Chronic pain
  • Attachment
  • Psychodynamic

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