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Findings shed light on the potential significance of recognizing and managing type D personality traits in the context of fibromyalgia care.
A high prevalence of type D personality traits was observed in patients with fibromyalgia, which coincided with a negative impact on clinical measures, according to a study published in Medical Science Monitor.1
The term “type D personality” stems from the initials of “distrustful” and “distressed.” Patients with this personality type frequently experience negative emotional responses, predisposes them to chronic distress, and are prone to depression, anxiety, irritability, and dysphoria. These patients often display increased levels of worry and self-blame, have an elevated fear of rejection, and exhibit a generally pessimistic outlook on life.2
“Moreover, individuals with type D personality traits are more susceptible to physical and mental health conditions,” wrote a team of investigators from Istanbul Medipol University, Istanbul, Turkey. “Research suggests that type D personality can elevate the risk of heart attacks and is more prevalent among individuals with heart disease, indicating a link between these personality traits and heart conditions. Furthermore, patients with ankylosing spondylitis and type D personality tend to experience more severe clinical symptoms.”
Investigators recruited 50 adult patients with clinically diagnosed fibromyalgia and 50 matched healthy controls to assess the effects of type D personality on quality of life, anxiety, depression, pain, and sleep quality. Both baseline and post-treatment assessments involved a visual analog scale for pain, Beck Depression Inventory, Beck Anxiety Inventory, Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index, and the SF-36 Short Form Questionnaire. A sociodemographic questionnaire collected information on age, sex, occupation, educational background, marital status, alcohol and smoking status, and history of chronic illnesses. The effects of this personality type on clinical measurements were evaluated using the subgroup of participants with the D-Type Personality Scale (DS-14).
Patients in the fibromyalgia cohort had an average disease duration of 40.2 months, a visual analog scale pain score of 7, and a FIQ score of 69.6.
Most patients (n = 30, 60%) with fibromyalgia had type D personality traits compared with only 12 patients (24%) in the control group (P <.001). Patients with fibromyalgia and type D personality reported significantly higher Beck Anxiety Inventory (P = .023) and Beck Depression Inventory (P = .036) scores when compared with those without type D personality. Further, the SF-36 domains of vitality (P = .002) and mental health (P >.001) were significantly lower in this patient population.
No statistically significant differences in sleep quality regarding depression, sleep, and quality of life were observed among participants, regardless of type D personality status (P = .086). Among controls, regardless of type D personality traits, no significant differences in depression, quality of life, and sleep were reported.
Investigators identified the small sample size and single-center setting as limitations of the study which may affect generalizability. Additionally, the cross-sectional design made it difficult to analyze causal relationships. The reliability of results may have been impacted due to memory errors and variability. Lastly, participant behavior may have been affected by observer effects and non-response issues, which may have led to a potential misrepresentation of the outcomes.
“Recognizing type D personality traits in patients with fibromyalgia and managing them through psychotherapeutic interventions can lead to the development of adaptive coping strategies,” investigators concluded. “In light of the results obtained, expanding the sample size and conducting new studies can provide a clearer understanding of the relationship between fibromyalgia and type D personality.”