The tridimensional personality theory and pain: harm avoidance and reward dependence traits correlate with pain perception in healthy volunteers

Abstract

The aim of the present study was to examine the possible role of personality traits in determining the variability of pain perception among individuals. More specifically, it was intended to test whether or not the three personality dimensions suggested by Cloninger in 1987 - mainly harm avoidance (HA), but also reward dependence (RD), and novelty seeking (NS), can predict interpersonal differences in responsiveness to experimental pain. Seventy healthy volunteers participated in the study. Their personality traits were evaluated through Cloninger's tridimensional personality questionnaire (TPQ). Pain threshold (latency to pain onset), pain magnitude (VAS), and pain tolerance (time to withdrawal) were measured by using the cold pressor test. Bonferroni-adjusted correlations were found between HA and the pain parameters as follows: a negative correlation between HA and threshold (rho=-0.297, P(adj)=0.039); no significant correlation between HA and tolerance (rho=-0.219, P(adj)=0.207); and a trend for a positive correlation between HA and VAS (rho=0.266, P(adj)=0.081). Possible correlations between pain perception and the various possible combinations of high and low scoring for each of the three traits were also investigated. Correlations were found only for the combinations of high/low HA and high/low RD. The low HA/low RD combination demonstrated the lowest responsiveness to pain (VAS 65.2+/-21.4; tolerance 107.6+/-71.8 s), whereas the high HA/low RD combination was correlated with the highest responsiveness (VAS 83.3+/-10.8; tolerance 30.8+/-28.4 s). The results indicate that HA personality trait correlates best with pain responsiveness. As such, a high HA are likely to predict a heightened pain response. RD may modify this pattern. The possible relevant behavioral and neuro-chemical mechanisms are discussed.

Personality in patients with migraine evaluated with the "Temperament and Character Inventory"

“…On the other hand the higher scores of HA in patients with acquired pain, such as radiculopathies, neuropathies and osteoarthritis, raise the possibility of developing this personality profile in acquired conditions also, and not only genetically related, as some authors have suggested [46]. In keeping with our results, Pud et al [47] showed a correlation between high scores of HA with pain threshold (latency to pain onset), pain magnitude (VAS), and pain tolerance (time to withdrawal) using the cold pressor test in healthy patients. The involvement of serotonin in chronic pain [48][49][50][51] is consistent with the proposed physiopathological mechanisms of HA in the central nervous system [23].…”

Sub-Grouping Healthy Subjects’ Sensitivity to Pain and Its Relationship to Personality Traits: Results of a Cluster Analysis

“…During the last decade, several studies have applied Cloninger's theory to the area of pain perception in healthy subjects as well as to various clinical pain conditions. We have previously demonstrated that a high HA level was the major trait determining heightened cold pain perception in healthy volunteers [6]. Even more so, in that previous study we also found that individuals with a high score of HA in combination with a low score of RD appear to be the most sensitive to pain, whereas those with a low score of HA and a low score of RD appear to be the least sensitive to pain.…”

“…Moreover, there was an attempt to determine if the subjects in these subgroups differed in their Cloninger's three dimensions of personality scores [18] (i.e., outcome measure). Given the complexity of the pain experience and the associations found with personality traits in previous research [6] we deemed it worthwhile to further explore this issue in an attempt to strengthen earlier findings.…”

“…According to the biopsychosocial approach, the experience of pain consists of complex and dynamic interactions between the biological, socio-cultural, and psychological domains [1]. Each of these domains consists of several factors that can contribute to the entire experience of pain, including gender [2], ethnicity [3], age [4], tendency for catastrophizing and anxiety [5], personality traits [6] and genetic factors [7]- [9].…”

Personality, coping and atypical facial pain. Case reports

“…Besides, reward dependence, novelty seeking, and harm avoidance have been associated with the anxiety trait of patients with chronic pain. Moreover, cooperativity and self-transcendence are directly or indirectly associated with coping [7][8][9][10][11][12] . The Temperament and Character Inventory (TCI) is an international instrument to evaluate personality, validated to the Portuguese Language 13 .…”