Cloninger's personality model in fibromyalgia syndrome: A systematic review and meta-analyses

Document Type : Review Article

Authors

1 Department of Psychology, University of Isfahan, Isfahan, Iran.

2 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Introduction: Fibromyalgia Syndrome (FMS) is a widespread chronic musculoskeletal pain disorder. Although many treatments are available for fibromyalgia, management remains a challenge. Recent evidence suggests that personality traits may influence fibromyalgia.
 
Materials and Methods: According to PRISMA guidelines, this systematic review and meta-analysis explored harm avoidance and self-directedness in fibromyalgia patients using Cloninger's personality model. The meta-analysis included 14 studies evaluating harm avoidance and 11 studies evaluating self-directedness in patients with fibromyalgia compared with healthy individuals. Reported data from primary studies were pooled in a random-effects model using the Hedges' g approach.
 
Results: Fibromyalgia patients demonstrated high harm avoidance (Hedges' g= 1.31; 95% CI: 0.97 to 1.65) and low self-directedness (Hedges' g= -0.71; 95% CI: -1.00 to -0.42) comparing to healthy individuals. Additionally, the results showed that high harm avoidance was significantly related to an increased risk of FMS, although high self-directedness played a protective role against it.
 
Conclusion: The results demonstrated that high harm avoidance and low self-directedness are distinct personality traits in patients with fibromyalgia. Early identification and evaluation of a profile of high harm avoidance and low self-directedness may help conceptualize the underlying complex mechanisms of fibromyalgia. Additionally, it could identify patients who are more prone to entering a vicious cycle of disability and pain. Further research is required to understand the role of personality characteristics better.

Keywords

References

  1. Han CL, Sheng YC, Wang SY, Chen YH, Kang JH. Serum proteome profiles revealed dysregulated proteins and mechanisms associated with fibromyalgia syndrome in women. Sci Rep 2020; 10(1): 1-11.
  2. Gyorfi M, Rupp A, Abd-Elsayed A. Fibromyalgia pathophysiology. Biomedicines 2022; 10(12): 3070.
  3. Bair MJ, Krebs EE. Fibromyalgia. Ann Intern Med 2020; 172(5): ITC33.
  4. Häuser W, Sarzi-Puttini P, Mary-Ann F. Fibromyalgia syndrome: Under-, over-and misdiagnosis. Clin Exp Rheumatol 2019; 37(116): 90-97.
  5. Grayston R, Czanner G, Elhadd K, Goebel A, Frank B, Üçeyler N, et al. A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia: Implications for a new paradigm in fibromyalgia etiopathogenesis. Semin Arthritis Rheum 2019; 48(5): 933-40.
  6. Bucourt E, Martaillé V, Mulleman D, Goupille P, Joncker-Vannier I, Huttenberger B, et al. Comparison of the Big Five personality traits in fibromyalgia and other rheumatic diseases. Joint Bone Spine 2017; 84(2): 203-7.
  7. Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: An update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol 2020; 16(11): 645-60.
  8. Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, et al. AAPT Diagnostic Criteria for Fibromyalgia. J Pain 2019; 20(6): 611-28.
  9. Koca TT, Tugan CB, Koçyiğit BF, Nacitarhan V. Fibromyalgia awareness in women aged between 18 and 75 years: A current view to fibromyalgia. Journal of public health 2019; 27(6): 491-7.
  10. Di Tella M, Ghiggia A, Tesio V, Romeo A, Colonna F, Fusaro E, et al. Pain experience in fibromyalgia syndrome: The role of alexithymia and psychological distress. J Affect Disord 2017; 208: 87-93.
  11. Schaefer C, Mann R, Masters ET, Cappelleri JC, Daniel SR, Zlateva G, et al. The comparative burden of chronic widespread pain and fibromyalgia in the United States. Pain Pract 2016; 16(5): 565-79.
  12. Wolfe F, Brähler E, Hinz A, Häuser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: Results from a survey of the general population. Arthritis Care Res 2013; 65(5): 777-85.
  13. Mascarenhas RO, Souza MB, Oliveira MX, Lacerda AC, Mendonça VA, Henschke N, et al. Association of therapies with reduced pain and improved quality of life in patients with fibromyalgia: A systematic review and meta-analysis. JAMA Intern Med 2021; 181(1): 104-12.
  14. Hackshaw K. Assessing our approach to diagnosing Fibromyalgia. Expert Rev Mol Diagn 2020; 20(12):
    1171-81.
  15. Freitas RP de A, Andrade SC de, Spyrides MHC, Micussi MTABC, Sousa MBC de. Impacts of social support on symptoms in Brazilian women with fibromyalgia. Rev Bras Reumatol 2017; 57(3): 197-203.
  16. D’Onghia M, Ciaffi J, Ruscitti P, Cipriani P, Giacomelli R, Ablin JN, et al. The economic burden of fibromyalgia: A systematic literature review. Semin Arthritis Rheum 2022; 56: 152060.
  17. Maugars Y, Berthelot JM, Le Goff B, Darrieutort-Laffite C. Fibromyalgia and associated disorders: From pain to chronic suffering, from subjective hypersensitivity to hypersensitivity syndrome. Front Med 2021; 8: 666914.
  18. Vojnović L, Popović D, Vidić J, Panić DS, Aleksandrić T, Knežević A. Generalized pain hypersensitivity in fibromyalgia patients. Acta medica Median 2023; 62(2): 15-22.
  19. Bell T, Trost Z, Buelow MT, Clay O, Younger J, Moore D, et al. Meta-analysis of cognitive performance in fibromyalgia. J Clin Exp Neuropsychol 2018; 40(7): 698-714.
  20. Mathkhor A, Ibraheem N. Prevalence and impact of obesity on fibromyalgia syndrome and its allied symptoms. J Fam Med Prim Care 2023; 12(1): 123.
  21. Creed F. A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Pain 2020; 161(6): 1169-76.
  22. Leombruni P, Zizzi F, Miniotti M, Colonna F, Castelli L, Fusaro E, et al. Harm avoidance and self-directedness characterize fibromyalgic patients and the symptom severity. Front Psychol 2016; 7: 579.
  23. Billones R, Lukkahatai N, Saligan L. What works in mindfulness interventions for medically unexplained symptoms? A systematic review. Asian Pac Isl Nurs J 2020; 5(1): 21-34.
  24. Ramírez-Maestre C, Martínez AEL, Zarazaga RE. Personality characteristics as differential variables of the pain experience. J Behav Med 2004; 27(2): 147-65.
  25. Montoro CI, Reyes del Paso GA. Personality and fibromyalgia: Relationships with clinical, emotional, and functional variables. Pers Individ Dif 2015; 85: 236-44.
  26. Da Silva JAP, Jacobs JWG, Branco JC, Canaipa R, Gaspar MF, Griep EN, et al. Can health care providers recognise a fibromyalgia personality? Clin Exp Rheumatol 2017; 35(105): 43-49.
  27. Kadimpati S, Zale EL, Hooten MW, Ditre JW, Warner DO. Associations between neuroticism and depression in relation to catastrophizing and pain-related anxiety in chronic pain patients. PLoS One 2015; 10(4): e0126351.
  28. Seto A, Han X, Price LL, Harvey WF, Bannuru RR, Wang C. The role of personality in patients with fibromyalgia. Clin Rheumatol 2019; 38(1): 149-57.
  29. Kern A, Kramm C, Witt CM, Barth J. The influence of personality traits on the placebo/nocebo response: A systematic review. J Psychosom Res 2020; 128: 109866.
  30. Hajek A, Bock JO, König HH. The role of personality in health care use: Results of a population-based longitudinal study in Germany. PLoS One 2017; 12(7): e0181716.
  31. Ko KM, Moon SJ, Koh JH, Pae CU, Min JK. Contribution of personality traits, psychological factors, and health-related quality of life to medication adherence in patients with rheumatoid arthritis. Yonsei Med J 2020; 61(5): 406-15.
  32. Wranker LS, Rennemark M, Elmståhl S, Berglund J. The influence of personality traits on perception of pain in older adults – Findings from the Swedish National Study on Aging and Care – Blekinge study. Scand J Pain 2015; 7(1): 3-8.
  33. Santos D de M, Lage LV, Jabur EK, Kaziyama HHS, Iosifescu DV, de Lucia MCS, et al. The association of major depressive episode and personality traits in patients with fibromyalgia. Clinics 2011; 66(6): 973-8.
  34. Di Tella M, Castelli L. Alexithymia and fibromyalgia: Clinical evidence. Front Psychol 2013; 4: 909.
  35. van Middendorp H, Kool MB, van Beugen S, Denollet J, Lumley MA, Geenen R. Prevalence and relevance of type D personality in fibromyalgia. Gen Hosp Psychiatry 2016; 39: 66-72.
  36. Galvez-Sánchez CM, Duschek S, Del Paso GAR. Psychological impact of fibromyalgia: Current perspectives. Psychol Res Behav Manag 2019; 12: 117-27.
  37. Torres X, Bailles E, Valdes M, Gutierrez F, Peri JM, Arias A, et al. Personality does not distinguish people with fibromyalgia but identifies subgroups of patients. Gen Hosp Psychiatry 2013; 35(6): 640-48.
  38. Malin K, Littlejohn G. Personality and fibromyalgia syndrome. Open Rheumatol J 2012; 6(1): 273.
  39. Johannsson V. Does a fibromyalgia personality exist? J Musculoskelet Pain 1993; 1(3-4): 245-52.
  40. Conrad R, Wegener I, Geiser F, Kleiman A. Temperament, character, and personality disorders in chronic pain topical collection on psychiatric management of pain. Curr Pain Headache Rep 2013; 17(3): 1-9.
  41. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993; 50(12): 975-90.
  42. Conrad R, Schilling G, Bausch C, Nadstawek J, Wartenberg HC, Wegener I, et al. Temperament and character personality profiles and personality disorders in chronic pain patients. Pain 2007; 133(1-3): 197-209.
  43. Farmer RF, Goldberg LR. A psychometric evaluation of the revised Temperament and Character Inventory (TCI-R) and the TCI-140. Psychol Assess 2008; 20(3): 281-91.
  44. Naylor B, Boag S, Gustin SM. New evidence for a pain personality? A critical review of the last 120 years of pain and personality. Scand J Pain 2017; 17: 58-67.
  45. Lundberg G, Anderberg UM, Gerdle B. Personality features in female fibromyalgia syndrome. J Musculoskelet Pain 2009; 17(2): 117-30.
  46. Vesal M, Asgari K, Roohafza H, Adibi P. [Personality traits and fibromyalgia syndrome]. Journal of Babol University of Medical Sciences 2022; 24(1): 510-25. (Persian)
  47. Gustin SM, Burke LA, Peck CC, Murray GM, Henderson LA. Pain and personality: Do individuals with different forms of chronic pain exhibit a mutual personality? Pain Pract 2016; 16(4): 486-94.
  48. Romeo A, Benfante A, Geminiani GC, Castelli L. Personality, defense mechanisms and psychological distress in women with fibromyalgia. Behav Sci (Basel) 2022; 12(1): 10-21.
  49. Garcia-Fontanals A, Portell M, García-Blanco S, Poca-Dias V, García-Fructuoso F, López-Ruiz M, et al. Vulnerability to psychopathology and dimensions of personality in patients with fibromyalgia. Clin J Pain 2017; 33(11): 991-7.
  50. Balbaloglu O, Tanik N, Alpayci M, Ak H, Karaahmet E, Inan LE. Paresthesia frequency in fibromyalgia and its effects on personality traits. Int J Rheum Dis 2018; 21(7): 1343-9.
  51. Santos DM, Lage LV, Jabur EK, Kaziyama HHS, Iosifescu DV, De Lucia MCS, et al. The influence of depression on personality traits in patients with fibromyalgia: A case-control study. Clin Exp Rheumatol 2017; 35: 13-19.
  52. Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021; 372: n160.
  53. Gillespie NA, Cloninger CR, Heath AC, Martin NG. The genetic and environmental relationship between Cloninger’s dimensions of temperament and character. Pers Individ Dif 2003; 35(8): 1931-46.
  54. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016; 46(3): 319-29.
  55. Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F, Botella J. Assessing heterogeneity in meta-analysis: Q statistic or I 2 Index? Psychol Methods 2006; 11(2): 193-206.
  56. Soeken KL, Sripusanapan A. Assessing publication bias in meta-analysis. Nurs Res 2003; 52(1): 57-60.
  57. Mazza M, Mazza O, Pomponi M, Di Nicola M, Padua L, Vicini M, et al. What is the effect of selective serotonin reuptake inhibitors on temperament and character in patients with fibromyalgia? Compr Psychiatry 2009; 50(3): 240-4.
  58. Ablin JN, Zohar AH, Zaraya-Blum R, Buskila D. Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients. Peer J 2016; 4: e2421.
  59. Conrad R, Wegener I, Geiser F, Kleiman A. Temperament, character, and personality Disorders in Chronic Pain. Curr Pain Headache Rep 2013; 17(3): 318.
  60. Conrad R, Schilling G, Bausch C, Nadstawek J, Wartenberg HC, Wegener I, et al. Temperament and character personality profiles and personality disorders in chronic pain patients. Pain 2007; 133(1): 197-209.
  61. Pelissolo A, Mallet L, Baleyte J-M, Michel G, Cloninger CR, Allilaire J-F, et al. The Temperament and Character Inventory-Revised (TCI-R): Psychometric characteristics of the French version. Acta Psychiatr Scand 2005; 112(2): 126-33.
  62. Hansenne M, Delhez M, Cloninger CR. Psychometric properties of the Temperament and Character Inventory–Revised (TCI–R) in a Belgian sample. J Pers Assess 2005; 85(1): 40-49.
  63. Atiye M, Miettunen J, Raevuori-Helkamaa A. A meta-analysis of temperament in eating disorders. Eur Eat Disord Rev 2015; 23(2): 89-99.
  64. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 2010; 62(5): 600-10.
  65. Galvez-Sánchez CM, Montoro CI, Duschek S, Reyes del Paso GA. Depression and trait-anxiety mediate the influence of clinical pain on health-related quality of life in fibromyalgia. J Affect Disord 2020; 265: 486-95.
  66. Wolfe F, Häuser W. Fibromyalgia diagnosis and diagnostic criteria. Ann Med 2011; 43(7): 495-502.
  67. Ferguson CJ, Brannick MT. Publication bias in psychological science: Prevalence, methods for identifying and controlling, and implications for the use of meta-analyses. Psychol Methods 2012; 17(1): 120-28.
  68. oz C, Velioglu S, Ozmenoglu M, Sayar K, Alioglu Z, Yalman B, et al. Temperament and character profiles of patients with tension-type headache and migraine. Psychiatry Clin Neurosci 2004; 58(5): 536-43.
  69. Mongini F, Fassino S, Rota E, Deregibus A, Levi M, Monticone D, et al. The temperament and character inventory in women with migraine. J Headache Pain 2005; 6(4): 247-9.
  70. Abbate-Daga G, Fassino S, Lo Giudice R, Rainero I, Gramaglia C, Marech L, et al. Anger, depression and personality dimensions in patients with migraine without aura. Psychother Psychosom 2007; 76(2): 122-8.
  71. Malmgren-Olsson EB, Bergdahl J. Temperament and character personality dimensions in patients with nonspecific musculoskeletal disorders. Clin J Pain 2006; 22(7): 625-31.
  72. Garramone F, Baiano C, Russo A, D’Iorio A, Tedeschi G, Trojano L, et al. Personality profile and depression in migraine: A meta-analysis. Neurol Sci 2020; 41(3): 543-54.
  73. Santangelo G, Garramone F, Baiano C, D’Iorio A, Piscopo F, Raimo S, et al. Personality and Parkinson’s disease: A meta-analysis. Park Relat Disord 2018; 49: 67-74.
  74. Galli F, Lodi G, Sardella A, Vegni E. Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis. Cephalalgia 2017; 37(3): 265-77.
  75. Rezaei F, Hemmati A, Rahmani K, Komasi S. A systematic review of personality temperament models related to somatoform disorder with main focus on meta-analysis of Cloninger’s theory components. Indian J Psychiatry 2020; 62(5): 462-9.
  76. Láng A. Harm avoidance BT - Encyclopedia of personality and individual differences. In: Zeigler-Hill V, Shackelford TK. (editors). Cham: Springer International Publishing; 2020: 1886-8.
  77. Chen CY, Lin SH, Li P, Huang WL, Lin YH. The role of the harm avoidance personality in depression and anxiety during the medical internship. Med (United States) 2015; 94(2): e389.
  78. Garcia D, Cloninger KM, Lester N, Cloninger CR. Self-directedness BT- Encyclopedia of personality and individual differences. In: Zeigler-Hill V, Shackelford TK. (editors). New York: Springer International Publishing; 2020: 4705-8.
  79. Meulders A. From fear of movement-related pain and avoidance to chronic pain disability: a state-of-the-art review. Curr Opin Behav Sci 2019; 26: 130-6.
  80. Vlaeyen JWS. Learning to predict and control harmful events: Chronic pain and conditioning. Pain 2015; 156(4): S86-93.
  81. Vlaeyen JWS, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain 2012; 153(6): 1144-7.
  82. Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. J Behav Med 2007; 30(1): 77-94.
  83. Pud D, Eisenberg E, Sprecher E, Rogowski Z, Yarnitsky D. The tridimensional personality theory and pain: Harm avoidance and reward dependence traits correlate with pain perception in healthy volunteers. Eur J Pain 2004; 8(1): 31-8.
  84. Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain 2000; 85(3): 317-32.
  85. Licht CL, Mortensen EL, Hjordt LV, Stenbæk DS, Arentzen TE, Nørremølle A, et al. Serotonin transporter gene (SLC6A4) variation and sensory processing sensitivity—Comparison with other anxiety-related temperamental dimensions. Mol Genet Genomic Med 2020; 8(8): e1352.
  86. Nahman-Averbuch H, Yarnitsky D, Sprecher E, Granovsky Y, Granot M. Relationship between personality traits and endogenous analgesia: The role of harm avoidance. Pain Pract 2016; 16(1): 38-45.
  87. Paredes S, Cantillo S, Candido KD, Knezevic NN. An association of serotonin with pain disorders and its modulation by estrogens. Int J Mol Sci 2019; 20(22): 5729.
  88. Cassisi G, Sarzi-Puttini P, Casale R, Cazzola M, Boccassini L, Atzeni F, et al. [Pain in fibromyalgia and related conditions]. Reumatismo 2014; 66(1): 72-86. (Italian)
  89. Wang L, Tobe J, Au E, Tran C, Jomy J, Oparin Y, et al. Selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: Systematic review and meta-analysis of randomised controlled trials. Br J Anaesth 2022; 128(1): 118-34.
  90. Nir RR, Yarnitsky D. Conditioned pain modulation. Curr Opin Support Palliat Care 2015; 9(2): 131-7.
  91. Facchin F, Barbara G, Saita E, Erzegovesi S, Martoni RM, Vercellini P. Personality in women with endometriosis: Temperament and character dimensions and pelvic pain. Hum Reprod 2016; 31(7): 1515-21.
  92. Garcia-Fontanals A, García-Blanco S, Portell M, Pujol J, Poca-Dias V, García-Fructuoso F, et al. Cloninger’s psychobiological model of personality and psychological distress in fibromyalgia. Int J Rheum Dis 2016; 19(9): 852-63.
  93. Galvez-Sánchez CM, Del Paso GAR. Diagnostic criteria for fibromyalgia: Critical review and future perspectives. J Clin Med 2020; 9(4): 1219.
  94. Hadlandsmyth K, Dailey DL, Rakel BA, Zimmerman MB, Vance CGT, Merriwether EN, et al. Somatic symptom presentations in women with fibromyalgia are differentially associated with elevated depression and anxiety. J Health Psychol 2020; 25(6): 819-29.
  95. Tominaga Y, Aomori T, Hayakawa T, Kijima N, Morisky DE, Takahashi K, et al. Possible associations of personality traits representing harm avoidance and self-directedness with medication adherence in Japanese patients with type 2 diabetes. J Pharm Heal Care Sci 2018; 4(1): 1-7.
  96. Zaninotto L, Solmi M, Toffanin T, Veronese N, Cloninger CR, Correll CU. A meta-analysis of temperament and character dimensions in patients with mood disorders: Comparison to healthy controls and unaffected siblings. J Affect Disord 2016; 194: 84-97.
  97. Su MH, Chen HC, Lu ML, Feng J, Chen IM, Wu CS, et al. Risk profiles of personality traits for suicidality among mood disorder patients and community controls. Acta Psychiatr Scand 2018; 137(1): 30-8.
  98. Hadlandsmyth K, Dailey DL, Rakel BA, Zimmerman MB, Vance CGT, Merriwether EN, et al. Somatic symptom presentations in women with fibromyalgia are differentially associated with elevated depression and anxiety. J Health Psychol 2020; 25(6): 819-29.
  99. Homann D, Stefanello JMF, Góes SM, Breda CA, Paiva E dos S, Leite N. Stress perception and depressive symptoms: Functionality and impact on the quality of life of women with fibromyalgia. Rev Bras Reumatol 2012; 52(3): 319-30.
  100. Naylor B, Hesam-Shariati N, McAuley JH, Boag S, Newton-John T, Rae CD, et al. Corrigendum: Reduced glutamate in the medial prefrontal cortex is associated with emotional and cognitive dysregulation in people with chronic pain. Front Neurol 2022; 13: 460034.
  101. Palagini L, Domschke K, Benedetti F, Foster RG, Wulff K, Riemann D. Developmental pathways towards mood disorders in adult life: Is there a role for sleep disturbances? J Affect Disord 2019; 243: 121-32.
  102. Conversano C, Marchi L, Ciacchini R, Carmassi C, Contena B, Bazzichi LM, et al. Personality traits in Fibromyalgia (FM): Does FM personality exists? A systematic review. Clin Pract Epidemiol Ment Heal 2018; 14: 223-32.
  103. Fresán A, Robles-García R, López-Avila A, Cloninger CR. Personality differences according to age and sex in a Mexican sample using the Temperament and Character Inventory-Revised. Compr Psychiatry 2011; 52(6): 774-9.
  104. Brändström S, Richter J, Przybeck T. Distributions by age and sex of the dimensions of temperament and character inventory in a cross-cultural perspective among Sweden, Germany, and the USA. Psychol Rep 2001; 89(3): 747-58.
  105. Miettunen J, Veijola J, Lauronen E, Kantojärvi L, Joukamaa M. Sex differences in Cloninger’s temperament dimensions- a meta-analysis. Compr Psychiatry 2007; 48(2): 161-9.
  106. Huang WL, Chen TT, Chen IM, Chang LR, Lin YH, Liao SC, et al. Harm avoidance and persistence are associated with somatoform disorder psychopathology: A study in Taiwan. J Affect Disord 2016; 196: 83-86.
  107. Claes SJ, Campen E Van, Van Den Eede F, Moorkens G, Schotte C, Schacht R, et al. Use of the Temperament and Character Inventory (TCI) for assessment of personality in chronic fatigue syndrome. Psychosomatics 2009; 50(2): 147-54.
  108. Ballering AV, Bonvanie IJ, Olde Hartman TC, Monden R, Rosmalen JGM. Gender and sex independently associate with common somatic symptoms and lifetime prevalence of chronic disease. Soc Sci Med 2020; 253: 112968.
  109. Kapfhammer HP. Somatic symptoms in depression. Dialogues Clin Neurosci 2006; 8(2): 227-39.
  110. olfe F, Walitt B, Perrot S, Rasker JJ, Häuser W. Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. PLoS One 2018; 13(9): e0203755.
  111. Conversano C, Ciacchini R, Orrù G, Bazzichi L, Gemignani A, Miniati M. Gender differences on psychological factors in fibromyalgia: A systematic review on the male experience. Clin Exp Rheumatol 2021; 39(3): S174-85.
  112. Anderberg UM, Forsgren T, Ekselius L, Marteinsdottir I, Hallman J. Personality traits on the basis of the Temperament and Character Inventory in female fibromyalgia syndrome patients. Nord J Psychiatry 1999; 53(5): 353-9.
  113. Kim TS, Pae CU, Jeong JT, Kim SD, Chung KI, Lee C. Temperament and character dimensions in patients with atopic dermatitis. J Dermatol 2006; 33(1): 10-15.
  114. Verdejo-Garcia A, Lopez-Torrecillas F, Calandre EP, Delgado-Rodriguez A, Bechara A. Executive Function and decision-making in women with fibromyalgia. Arch Clin Neuropsychol 2009; 24(1): 113-22.
  115. Lundberg G, Anderberg UM, Gerdle B. Personality features in female fibromyalgia syndrome. J Musculoskelet Pain 2009; 17(2): 117-30.
  116. Glazer Y, Buskila D, Cohen H, Ebstein RP, Neumann L. Differences in the personality profile of fibromyalgia patients and their relatives with and without fibromyalgia. Clin Exp Rheumatol 2010; 28(6 Suppl 63): S27-32.
  117. Altunören Ö, Orhan FÖ, Nacitarhan V, Özer A, Karaaslan MF, Altunören O. [Evaluation of depression, temperament and character profiles in female patients with fibromyalgia syndrome]. Noro Psikiyatr Ars 2011; 48(1): 31-38. (Turkish)
  118. Gencay-Can A, Can SS. Temperament and character profile of patients with fibromyalgia. Rheumatol Int 2012; 32(12): 3957-61.
  119. Garcia-Fontanals A, García-Blanco S, Portell M, Pujol J, Poca-Dias V, García-Fructuoso F, et al. Cloninger’s psychobiological model of personality and psychological distress in fibromyalgia. Int J Rheum Dis 2016; 19(9): 852-63.
  120. Dogru A, Balkarli A, Tepeli E, Aydin E, Cobankara V. Association of synaptosomal-associated protein 25 (SNAP-25) gene polymorphism with temperament and character traits in women with fibromyalgia syndrome. Rev Psiquiatr Clin 2018; 45(4): 88-93.
Journal of Fundamentals of Mental Health
Volume 25, Issue 4
July and August 2023
Pages 215-230

Files

Share

How to cite

Statistics