The Role of Personality in Patients with Fibromyalgia

Andrew Seto¹, Teresa Wu¹, Lori Lyn Price^2,3,4,5, Xingyi Han⁶, William F. Harvey¹ and Chenchen Wang⁷, ¹Tufts Medical Center, Boston, MA, ²Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, ³Clinical Care Research, Tufts Medical Center, Boston, MA, ⁴Biostatistics Research Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, ⁵Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, ⁶Public Health and Community Medicine, Tufts University, Boston, MA, ⁷Rheumatology, Tufts Medical Center, Boston, MA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: fibromyalgia, pain and psychosocial factors

Session Information

Date: Sunday, November 5, 2017

Title: ARHP Psychosocial Impact on Rheumatic Disease

Session Type: ARHP Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose:

Previous studies investigating the potential associations between personality and clinical symptoms in fibromyalgia (FM) patients have found mixed results. The purpose of this study was to clarify whether personality dimensions are associated with clinical symptoms, mindfulness, self-efficacy, social support, and outcome expectations among adult patients with FM.

Methods:

We performed a secondary analysis using baseline data from a randomized controlled comparative effectiveness trial between Tai Chi and aerobic exercise for FM. Personality was assessed using the NEO-Five Factor Inventory, a validated measure of 5 basic personality factors: agreeableness, conscientiousness, extraversion, neuroticism, and openness. Fibromyalgia syndrome was evaluated using the validated revised Fibromyalgia Impact Questionnaire (FIQR). Other measures included symptom severity, anxiety, depression, stress, health-related quality of life, social support, self-efficacy, mindfulness, and outcome expectations for exercise. Multivariable linear regression was performed to assess the associations between personality dimensions and measures of health and FM impact, while controlling for age, gender, body mass index (BMI), and living situation.

Results:

The sample consisted of 92 participants, with 95% female, mean age 52 years (SD 12), BMI 30 kg/m²(6), 52% white, 94% had a high school degree, and mean duration of body pain 14 years (11). After adjusting for covariates using multivariable linear regression, neuroticism was significantly associated with FIQR and symptom severity (Table 1). Higher neuroticism was also associated with higher levels of anxiety, depression, and stress, and worse mental component quality of life, lower self-efficacy, mindfulness, and social support. Higher conscientiousness and extraversion were associated with better mental component quality of life and mindfulness, and lower symptom severity, anxiety, depression, and stress. Higher conscientiousness was associated with better self-efficacy and outcome expectations. Higher extraversion was associated with better social support. More openness was associated with better outcome expectations, mindfulness, and lower levels of depression. Agreeableness was not significantly associated with any outcome. None of the 5 personality dimensions were associated with physical component of quality of life.

Conclusion:

Personality was significantly correlated with FM impact, a variety of health outcomes, and strongly associated with self-efficacy and mindfulness. Higher neuroticism was associated with worse psychosocial factors, suggesting this subset of patients may benefit from individualized treatment that takes personality into consideration. Results further elucidate characteristics of FM patients and highlight the importance of personality in the management of FM.

Table 1. Associations Between Personality and Fibromyalgia Impact, Psychosocial Factors, and Health Outcomes
Dependent Variable	Personality Dimension Beta (p-value)*
Dependent Variable	Agreeableness	Conscientiousness	Extraversion	Openness	Neuroticism
FIQR†	-0.04 (0.91)	-0.44 (0.12)	-0.61 (0.05)	-0.35 (0.25)	0.81 (0.002)
Symptom Severity†	0.04 (0.27)	-0.07 (0.02)	-0.07 (0.03)	0.003 (0.94)	0.08 (0.008)
HADS-Anxiety†	-0.09 (0.19)	-0.17 (0.002)	-0.14 (0.03)	-0.01 (0.84)	0.32 (<0.0001)
HADS-Depression†	-0.03 (0.75)	-0.20 (0.0012)	-0.36 (<0.0001)	-0.13 (0.047)	0.32 (<0.0001)
Perceived Stress †	-0.18 (0.22)	-0.49 (<0.0001)	-0.38 (0.004)	-0.02 (0.90)	0.68 (<0.0001)
SF-36 Mental Component Score	0.42 (0.06)	0.77 (<0.0001)	0.80 (<0.0001)	0.29 (0.12)	-1.05 (<0.0001)
SF-36 Physical Component Score	-0.28 (0.07)	-0.17 (0.17)	-0.11 (0.45)	-0.026 (0.84)	0.18 (0.14)
Medical Outcomes Study Social Support Survey	0.03 (0.11)	0.03 (0.10)	0.04 (0.02)	0.03 (0.13)	-0.049 (0.001)
Chronic Pain Self-Efficacy	-0.046 (0.26)	0.08 (0.009)	0.07 (0.06)	0.014 (0.69)	-0.07 (0.02)
Outcome Expectations for Exercise	0.02 (0.12)	0.03 (0.03)	0.01 (0.43)	0.03 (0.01)	-0.008 (0.51)
Five Facet Mindfulness Questionnaire -Total	0.64 (0.10)	1.39 (<0.0001)	1.35 (<0.0001)	0.87 (0.007)	-1.52 (<0.0001)
Note: FIQR = Revised Fibromyalgia Impact Questionnaire; HADS = Hospital Anxiety and Depression Scale; SF-36 = Short Form-36, a measure of quality of life Bolded p-values indicate statistical significance (p-value < 0.05) *All models were adjusted for age, gender, BMI, and living situation †Higher scores indicate worse health

Disclosure: A. Seto, None; T. Wu, None; L. L. Price, None; X. Han, None; W. F. Harvey, None; C. Wang, None.

To cite this abstract in AMA style:

Seto A, Wu T, Price LL, Han X, Harvey WF, Wang C. The Role of Personality in Patients with Fibromyalgia [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/the-role-of-personality-in-patients-with-fibromyalgia/. Accessed .

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