Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review

Abstract

Introduction:Fibromyalgia (FM) is the second most common rheumatic disease with many effects on patient's quality of life. It has been described as a chronic condition characterized by widespread musculo-skeletal pain, sleep disorders and prominent fatigue. Regarding the role of personality factors in fibromyalgia, researchers have focused both on personality traits and psychopathological aspects showing inconsistent results. In particular, several studies have examined the role of alexithymia in FM patients, a trait of personality characterized by difficulty in identification, recognition and description of emotions and feelings, while others have focused on a specific type of personality, such as type D personality (distressed personality). Other studies investigated personality in FM patients referring to Cloninger’s model, a psychobiological model of personality that includes both temperamental and character dimensions of personality. Analyzing scientific literature on this subject seems well suited to provide a critical review of the latest studies and their results.Methods:The method used for this review satisfies the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). We identified PsycInfo and PubMed as databases for our research.Results:Personality is studied under many aspects and a reference model is not always present. Many studies underline high levels of alexithymia and type D personality in FM patients but when depression is controlled, these results do not differ from those of healthy controls.Conclusion:Studies that use a comprehensive model of personality present a different theoretical approach and use alternatively the Big-Five model, Eysenck’s and Cloninger’s models. The use of a comprehensive model of personality and the control of psychopathological disorders, such as anxiety and depression, seem to be very relevant for a better understanding of a specific personality profile associated with fibromyalgia.

Psychotherapy for Physical Pain in Patients with Fibromyalgia: A Systematic Review

“…Studies report high levels of alexithymia (difficulty in recognizing and describing one's own emotions and feelings) and type D/distressed personality (elevated propensity to psychological distress due to a constant tendency to experience negative emotions across different life circumstances, called negative affectivity, and the restricted expression of emotions and behaviors in social interaction, called social inhibition) in patients with FS. Nevertheless, when depression is controlled, the results do not seem to differ from those of healthy controls [14]. Regarding psychopathology, the proportion of personality disorders appears far greater in patients with FS than in the general population, mainly obsessive-compulsive, avoidant, histrionic, and borderline personality disorders [15].…”

Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

“…Prior research examining personality traits suggests patients with functional neurological disorders (including motor symptoms, non-epileptic attacks, fibromyalgia and chronic fatigue) may exhibit lower levels of extraversion [ 16 ], higher neuroticism [ 17 , 18 , 19 , 20 ], higher somatisation, [ 21 ] and score highly on items targeting symptom over-reporting [ 22 , 23 ]. Many patients with functional disorders do not have personality difficulties [ 24 ] and study results vary depending on the recruitment source, personality model used, and comparator groups [ 25 ]. People with functional disorders affecting other organ systems (such as irritable bowel syndrome and fibromyalgia) display a similar profile of cognitive difficulties to one another [ 13 ], including difficulties in executive function and selective attention.…”

Alexithymia and Psychological Distress in Patients With Fibromyalgia and Rheumatic Disease

“…The most common comorbidities are mood disorders, with a prevalence of 29–34.8% and anxiety disorders, with a prevalence of 22.3–32.2%; indeed, a careful screening of depressive and anxiety symptoms and their proper management is a primary target in FMS (Epstein et al, 1999; Thieme et al, 2004; Uguz et al, 2010; Piccinni et al, 2011; Consoli et al, 2012; Veltri et al, 2012; Davis et al, 2014; Kudlow et al, 2015). Several studies also highlight the presence of variables associated with psychological vulnerability such as low self-esteem, neuroticism, dependency, passivity, victimization, catastrophization, irritability and maladaptive response to loss (Hassett et al, 2000; Bradley, 2005; Conversano et al, 2010, 2018a,b; Carmassi et al, 2014; Bucourt et al, 2017). Fibromyalgia may indeed negatively affect daily life and mood, consequently inducing feelings of hopelessness, sadness, anger, anxiety or stress.…”