Corrigendum to "Does insecure attachment affect treatment outcome in young persons with post-concussion symptoms? A secondary analysis of the GAIN trial". J Psychosom Res. 2023 Jan;164:111100

Abstract

Background: Insecure attachment may negatively affect symptom reporting and disability in physical illness, but research on its influence on treatment outcome is scarce. We explored if insecure attachment: 1) impacted overall treatment outcome, and 2) moderated the effect of an early interdisciplinary intervention in young persons with long-lasting postconcussion symptoms (PCS).

Methods: This is a secondary analysis of the 'Get going After concussIoN' (GAIN) trial. Participants aged 15-30 years were randomised to either GAIN or enhanced usual care (EUC). Attachment insecurity (anxiety and avoidance) was measured at baseline with the Experiences in Close Relationships-Relationship Structure Questionnaire, and treatment outcome measured by PCS was recorded by the Rivermead Post-Concussion Symptoms Questionnaire. The impact of insecure attachment was explored using both a dimensional and a categorical approach. Multiple linear regression analysis was applied.

Results: Ninety-one out of 112 trial participants were included. Neither attachment anxiety nor attachment avoidance independently affected the treatment outcome. However, in a categorical approach, fearful patients (i.e., combined high anxiety and high avoidance) had a less favourable outcome (β = 9.98, 95 % CI: 4.05; 15.92, p = 0.001) than nonfearful patients. Insecure attachment did not moderate the superior effect of GAIN on PCS compared with EUC.

Conclusion: This study provided weak support for an association between insecure attachment and the outcome of an early intervention against long-lasting PCS in young persons after a concussion. However, patients with fearful attachment may represent a more vulnerable subgroup. Further research is needed to explore if attachment-informed intervention may enhance treatment prospects.