Does attachment anxiety increase vulnerability to headache?

Abstract Background Attachment-related anxiety and avoidance are potentially important aspects of pain experience and management, but have not been investigated in episodic headache sufferers or in relation to experimentally-evoked headache. Objective To determine whether adult insecure attachment styles were associated with sensitivity to pain or headache before, during or after stressful mental arithmetic in an episodic migraine or tension-type headache (T-TH) sample. Methods Thirty-eight participants with episodic migraine, 28 with episodic T-TH and 20 headache-free participants intermittently received a mild electric shock to the forehead before, during and after stressful mental arithmetic. Results A preoccupied attachment style and attachment anxiety, but not attachment avoidance, were associated with forehead pain and the intensity of headache before and after, but not during stressful mental arithmetic. These relationships were independent of Five Factor Model personality traits. Neither attachment anxiety nor avoidance was associated with episodic migraine or T-TH. Conclusions Anxiously attached individuals may express greater pain or show a stronger attentional bias toward painful sensations than securely attached individuals. However, distraction during psychological stress may override this attentional bias.