Adult attachment and parental bonding: associations with fibromyalgia and alexithymia

Fibromyalgia (FM) is a chronic pain syndrome, associated with different psychological conditions such as alexithymia. Insecure attachment styles and inadequate parental care appear to play an important role in the onset and maintenance of both alexithymia and chronic pain. Therefore, the aim of the present study was to examine the associations between attachment styles, parental bonding, and alexithymia among patients with FM compared with healthy controls (HCs). One hundred women with FM and 107 healthy women were recruited for the present study and filled in the following questionnaires: (1) Toronto Alexithymia Scale (TAS-20), to evaluate alexithymia; (2) Parental Bonding Instrument (PBI) and (4) Attachment Style Questionnaire (ASQ), to assess parental care and adult attachment styles, respectively. A first logistic regression model was tested to examine whether parental bonding, adult attachment styles, and alexithymia predicted group membership (FM vs. HC). Results showed that “difficulty identifying feelings” (OR= 0.77; 95% CI= 0.71;0.84;) and “difficulty describing feelings” (OR=1.17; 95% CI= 1.04;1.33) subscales of the TAS-20 were statistically significant predictors of group membership (i.e., the likelihood of having FM). The final model explained 56% of the variance and correctly classified 80% of the cases. A second logistic regression was run in order to examine the effects of parental bonding and attachment styles on the likelihood of having alexithymia (both in patients with FM and HCs). Results showed that “discomfort with closeness” (OR= 1.06; 95% CI= 1.01;1.12) and “relationships as secondary” (OR= 1.09; 95% CI= 1.02;1.17) subscales of the ASQ were statistically significant predictors of the likelihood of having alexithymia. The final model explained 30% of the variance and correctly classified 81% of the cases. Taken together, the present findings highlight both the relevance of alexithymic traits to the definition of FM and the centrality of an insecure attachment style to the manifestation of alexithymia.