The Moderating Role Of Attachment Between Childhood Trauma And Somatic Pain Symptoms In Patients With Depressive Disorders

Objectives:This study explored the relationship between childhood trauma,attachment and depression level and somatic pain in patients with depressive disorders,further analyzed whether attachment plays a moderating role between childhood trauma and somatic pain through moderating effect test.Methods:A total of 192 adult patients with depression participated in this study;the level of depression was assessed by a psychiatric professional.Childhood trauma,pain symptoms,and attachment dimensions were tested by various questionnaires.The role of anxious attachment in the relationship between childhood trauma and pain symptoms was examined using the PROCESS Model 1 after controlling for the level of depression,age,and gender.Results:1.57.30%of the 192 patients in the sample of this study reported pain symptoms.Patients in the pain group had significantly higher HRSD-17 scores than the pain-free group(20.55±6.32 vs.17.31 ±6.32,P<0.001),and bivariate correlations showed a positive correlation between pain scores and HRSD-17 scores(r=0.25,P<0.01).2.Approximately 58.90%of the patients in the sample of this study experienced at least one type of childhood trauma;68.20%of the patients in the pain group experienced at least one type of childhood trauma,with a significantly higher frequency than the pain-free group(x2=9.25,P<0.001);the total childhood trauma score was significantly higher in the pain group than in the pain-free group(46.77±14.01 vs.40.17±12.55,P<0.001).Bivariate correlations showed that the total CTQ-SF score(r=0.25,P<0.01)were significantly associated with the level of pain ratings in depressed patients.3.The scores on the anxiety attachment dimension were significantly higher in the pain group than pain-free group(Z=-2.62,P<0.01);the scores on the close attachment dimension were significantly lower than pain-free group(Z=-3.73,P<0.01);and the scores on the dependency attachment dimension were significantly lower than pain-free group(t=2.45,P<0.01).4.Taking childhood trauma as the independent variable,pain ratings as the dependent variable,and anxiety attachment dimension as the moderating variable,the coefficient of the interaction term was significant(b=-0.004,t=-2.37,P<0.01);after controlling for depression level,age,and gender,the coefficient of the interaction term remained significant(b=-0.004,t=-2.55,P<0.05).Childhood trauma had a significant positive effect on pain ratings(b=0.03,t=2.55,P<0.01),while anxiety attachment attenuated the relationship between childhood trauma and somatic pain ratings.Conclusions:1.It is common for patients with depressive disorders to have somatic pain symptoms,and such pain symptoms were correlated with childhood traumatic experiences and depression levels.2.Childhood trauma showed a positive relationship with somatic pain ratings in depressed patients,which was attenuated by anxiety attachment as a moderating variable.3.For those depressed patients with severe childhood trauma experiences,a certain degree of anxiety attachment may alleviate pain levels.