The relationship between adult attachment style and fibromyalgia as mediated by social cognition

This study aimed to determine whether there are significant relationships between fibromyalgia syndrome (FMS), social cognition, and adult insecure attachments. It was also hypothesised that social cognition would mediate the relationship between insecure attachment style and FMS.

A quantitative, cross-sectional design was employed to compare experiences of 105 individuals with FMS and 172 healthy controls (HC). A correlation and a mediation analysis were used to explore relationships between insecure attachment, social cognition, and FMS symptoms. Data were obtained via self-report measures filled in either in paper form or via on-line questionnaire.

The relationships between anxious and avoidant attachment styles and FMS were confirmed. The significance of the relationship between social cognition and FMS varied depending on the measure used. When ability to recognise emotions in others was tested (Reading the mind in the eyes test) there were no significant differences between FMS and HC. However, the mentalization measure- Reflective Function Questionnaire, which additionally tests the ability to recognise one’s own feelings, showed a significant relationship with FMS. The relationship of FMS with both insecure attachment styles as well as with mentalization were strongly mediated by psychological distress. Social cognition was not shown to mediate the relationship between insecure attachment and FMS.

Although causality cannot be inferred, psychological distress was strongly related to FMS and significantly influenced the way FMS is related to insecure attachment and poor social cognition. Implications for clinical practice and future research are discussed.