What is the role of personality traits in the etiology of fibromyalgia?

Updated: Apr 23, 2020
  • Author: Chad S Boomershine, MD, PhD, CPI, CPT; Chief Editor: Herbert S Diamond, MD  more...
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Personality traits have the largest effect on the cognitive processes by which people attach meanings and implications to their pain. [35] For example, neuroticism, which is associated with hypochondriasis, irritability, and emotional disturbance, has no influence on the discrimination of thermal pain but exerts powerful influences in the delayed reflective stage of pain (ie, at the level of emotions related to suffering, including depression, anxiety, and, especially, frustration).

Several personality styles among patients with fibromyalgia are encountered in clinical practice. [73, 74] Most common is a perfectionism-compulsiveness personality, characterized by a rigid belief system in the need to be perfect, high underlying anxiety, and an unawareness of feelings and emotions. Another common personality style is the self-sacrificing type, characterized by a tendency to put everyone else’s needs before one’s own.

Less common is the "wounded warrior" type. These patients, who may be totally helpless and disabled physically and psychologically, carry a great burden of adverse psychosocial experiences and psychiatric comorbidity.

These 3 personality styles are difficult to treat and often require counseling or psychiatric intervention. The "resilient" patient who lacks maladaptive schemas and psychiatric comorbidity has a much better prognosis.

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