Table 1: Selected Studies that Relate to Aspects of Personality in Patients with Fibromyalgia

Author Date Population Personality Scale Construct Investigated Comment
MMPI: Minnesota Multiphasic Personality Inventory
Payne T, Leavitt F, Garron D et al. [30] 1982 FM 30
RA 30
OA 30
MMPI Personality differences and levels of psychopathology Concluded that FM individuals psychological state is not directly due to pain or their disability; that their psychological status is variable and contributes significantly to the symptoms that they experience.
Wolfe F, Cathey MA, Kleinheksel SM et al. [65] 1984 FM 46
RA 32
RA no FM 43
MMPI Psychological factors that contribute to psychopathology Just over 25% of FM patients had “normal profile” compared to over 50% of controls; FM patients report significant psychopathic, psychasthenia and paranoia scales along with significant anxiety and depression scales
Ahles T, Yunus M, Gaulier B, Riley S, Masi A [35] 1986 FM 45
RA 30
NC 32
MMPI Psychological factors that contribute to psychopathology Low psychopathology found in FM, even though similar patterns were obtained when recalculating groups based on new contemporary norms. Raises suggestions that using previous norms may reflect findings based on living with a chronic condition, directly or indirectly, rather than actual psychopathology.
Yunus MB, Ahles TA, Aldag JC, Masi A [13] 1991 FM 103 MMPI Psychological factors that contribute to psychopathology MMPI divided group into 3 categories, symptoms don’t confound outcomes of the MMPI, with exception of pain severity that was influenced by psychological factors.
Herken H, Gursoy S, Yetkin OE, Virit O, Esgi K [5] 2001 FM 48
NC 48
MMPI Personality characteristics and depression levels Patients reported high levels of anxiety and poor ability to cope with stress, leading to somatizing.
Ardic F, Toraman F [4] 2002 FM 45
CP 40
RA 20
NC 20
MMPI/2 Psychological dimensions Neurotic symptoms identified in pain conditions unlike control; psychological disturbance alters with pain duration.
Gerson A, Fox D [32] 2003 FM 19
CP 19
All litigating
MMPI 2 Personality variables in FM reviewed to the level of psychiatric disorder Psychopathology not uniquely different between groups, outcomes potentially influenced by litigation, FM had greater somatic pre-occupation, more likely to have past psychiatric treatment.
Rains JC, Penzien DB [66] 2003 CP 21 (FM 18)
Psychiatric 15
Medical 18
MMPI Psychological relationships explored CP group reported higher on hypochondriasis and hysteria and slightly lower on depression scales than the psychiatric group. CP exhibited pain profile suggesting that psychological distress relates to somatic complaints.
Blasco Claros L, Mallo Cano M, Mencia Presa M, et al. [67] 2006 FM 75
NC 55
MMPI/2 Differing profiles based on personality disorders/personality psychopathology Two different psychopathological patterns, identified from Bradley’s classification from the MMPI-2 in FM, provide a new measure that discriminates the severity of FM symptoms.
Johnson A, L, Storzbach D, Binder LM, et al. [68] 2010 FM 49
Non epileptic seizure 49
Epileptic seizure 49
NC 49
All Gulf war veterans
MMPI 2 Personality differences were studied between those with a somatic disorder compared to individuals with a physical illness. The FM individuals reported higher hypochondriasis and hysteria scales than the epileptic and NC. The non epileptic seizure and FM similar in the hysteria scale (both said to be “medically unexplained” conditions)
CMPS Cesarec Marke Personality Schedule
Johannsson V [69] 1993 FM 110 (computer)
FM 45
CMPS Needs and Motives that underlie the psychopathology of FM No difference between the paper and pen versus computer version of the CMPS. The findings suggest FM patients show increased need for order, perfectionism, and a lower sense of self-esteem.
KSP Karolinska Scales of Personality
Ekselius L, Bengtsson A, Von Knorring L [16] 1998 FM 73
NC 200
RA 33
KSP Measure of personality traits that may underlie development of medical conditions. Limited results, found that only the psychasthenia scale correlated with duration of FM illness. This personality trait was inferred to potentially increase the likelihood of developing central sensitization.
TCI Temperament and character inventory
Anderberg UM, ForsgrenT, Ekselius l, Marteindottir I, Hallman J [27] 1999 FM 38
NC 38
TCI Personality traits identified through understanding of the psychobiological components Increased “harm avoidance” found in FM suggesting a greater chance of producing more pessimistic thinking, increased anxiety regarding their world and increased levels of fatigue.
State Trait
Amir M., Neuman L, Bor O, Shir Y, Rubinow A, Buskila
D [6]
2000 FMS 51
RA 51
LBP 50
NC 50
State trait Anger
Coping inventory
Personality traits reported as different patterns of coping and anger. Suggests there is no unique personality style-no significant difference between groups and investigation of traits need to take into account the context that evokes the response.
HAB Habituele Actiebereidheid Handleiding-self report questionnaire of action-proneness
Van Houdenhove B, Neerinckx E, Onghena P, Lysens R, Vertommen H [64] 2001 FM 68
CF 124
HAB Personality features Action proneness (a personality feature) may underlie the development, maintenance and exacerbation of FM and chronic fatigue syndrome.
NEO The NEO Five-Factor Inventory
Kersh BC, Bradley LA, Alarcon GS, et al. [58] 2001 FM 79
NC 37
NEO 5-Factor Stable personality traits
Psychosocial variables
Extraversion, neuroticism, openness significantly different.
Limited influence of personality variable.
DMTm Defense Mechanism Technique (modified)
Trygg T, Lundberg G, Rosenlund E, Timpka T Gerdle B [33] 2002 FM 33
NC (neck pain) 31
Clinical characteristics of psychopathology underlying personality
Consists of reconstruction of past and current understandings of current life situation; interpretation of past and current together that form personality.
MMPI aligns with a person’s conscious thought where as the DMTm aligns with awareness of motivation.
No psychopathology identified in either scale.
Aim was to compare personality between groups. Both scales identified cognitive capacities deemed important in FM
The MMPI results suggest that FM aligns with a more neurotic structure that directly influences cognitive ability and thus infers issues that relate to disability.
EPQ Eysenck Personality Questionnaire (revised)
Malt EA, Olafsson S, Lund A, Ursin H [63] 2002 FM 42
NC 48
EPQ Neuroticism used to measure the tendency to over react Neuroticism found to be a predictor of pain, said to influence the autonomic nervous system producing a tendency to over react to triggers.
KSP Karolinska Scales of Personality
Kendall SA, Elert J, Ekselius L, Gerdle B [20] 2002 FM 36 KSP Personality traits identified to operationalize constructs that underlying psychopathology Anxiety underlay muscle tension, compared to a past reference group.
Panek PE, Skowronski JJ, Wagner EE [70] 2002 FM 29
OA 31
Headaches 30
Projective hand test Personality profiles consisting of traits of seeking attention, goal seeking, fear, abandonment and environmental interactions Different personality profiles for different pain conditions were identified.
Eysenck Personality Inventory
Ramirez-Maestre C, Lopez Martinez A E, Zarazaga, R E [71] 2004 FM 14
OA 22
Arthrosis 21 Cancer 13 Lumbago 9
OP 8
Neuralgia 4
Hernia 3
Trauma 2
Eysenck personality Inventory Neuroticism and extraversion explored Individual pain experiences were not explored, overall neuroticism positively correlated to passive coping, extraversion partially correlated positively to active coping techniques.
TPQ Tridimensional Personality Questionnaire
Buskila D, Cohen H, Neumann L, Ebstein RP [50] 2004 FM 81
NC 458
TPQ Personality domains [Harm Avoidance/Novelty seeking] linked to genetics of three main neurotransmitters. FM mechanisms (neurotransmitters) associated with personality traits
Glazer Y, Buskila D,
Cohen H, Ebstein R P Neumann L [72]
2010 FM 129
Undiagnosed relatives with FM 27
NC 30
TPQ Genetic links to personality (temperament) traits, exploration of three neurotransmitters associated with activation (novelty seeking), inhibition (fear avoidance) and maintenance (reward) Findings suggest that there are similarities within first generation families of FM individuals, suggesting a hereditary component.
The Big Five Personality Inventory
Zautra A, Johnson L, Davis M [73] 2005 FM 86
OA 38
The Big Five The degree of neuroticism displayed by the sample population The FM group displayed higher neurotic traits than the OA group; development of chronic pain linked to lack of resilience, stated as a lack of positive emotional resources rather than increased negative affect. Neuroticism is challenged as basis for emotional difficulties.
Malin K, Littlejohn G O [74] 2011 FM 27
NC 29
The Big Five Associations between personality traits, psychological variables and clinical features explored. Neuroticism trait in females with FM under age 39 significantly linked to clinical features, psychological co-morbidities and stress
NEO-PI The NEO Personality Inventory/Revised
Raselli C, Broderick J [61] 2007 FM 44
OA 27
RA 5
AS 5
NEO-PI Neuroticism levels Neuroticism was found only to influence rating the change in pain, not accuracy, recall or memory.
SAS Sociotropy and Autonomy Scale
Nordahl H, Stiles T [28] 2007 FM 44
MDD 43
NC 41
SAS Personality Style based on cognitive traits Personality style was related to depressive mood but not to FM. FM individuals had a higher sociotropic personality style that differed significantly from NC. FM without past MDD reported style similar to NC.
TCI-R Temperament and character inventory
Lundberg G, Anderberg U, Gerdle B [43] 2009 FM 191
NC 652
TCI-R Differences in temperament and character Independent personality patterns were established between FM and NC triggered by the (in) ability to cope with stress. Character and temperament in FM high in harm avoidance, persistence and low in self-directedness.
Verdejo-Garcia A, Lopez-Torrecillas F, Clandre E, Delgado-Rodriguez A, Bechara, A [75] 2009 FM 36
NC 36
TCI-R Personality measures and relationship to cognitive functioning Suggest a mild correlation between personality traits (persistence and reward dependence) and cognitive performance.
Mazza M, Mazza O, Pomponi M, Nicola M Padua L, Vicini M, et al. [76] 2009 FM 60
NC 80
TCI-R Temperament and Character profiles Results indicated a potential altered sensory input influencing central sensitization through the SSRI response and the personality profiles used. Has the potential to identify FM individuals who would benefit from treatment.
Riva R, Mork PJ, Westgaard RH, Ro M, Lundberg U [77] 2010 FM 29
NC 29
EPQ (r )
To measure stable personality traits, three subscales used inability to relax, worrying and feeling anxious and autonomous disturbance and links to being over or under responsive. FM had increased psychological characteristics that included higher levels of neuroticism, and more subjective physiological complaints, both somatic and psychological, in comparison to NC

Key to abbreviations: CFChronic fatigue CMPSCesarec Marke Personality ScheduleCPChronic painDMTmDefense Mechanism Technique (modified)EPQ (r)Eysenck Personality Questionnaire (revised)FMFibromyalgiaHABHabituele Actiebereidheid Handleiding-self report questionnaire of action-pronenessKSPKarolinska Scales of PersonalityLBPLow back pain MMDDMajor depressive disorderMMPIMinnesota Multiphasic Personality InventoryNCNormal controlsNEO-FFIThe NEO Five-Factor InventoryNEO PI/RThe NEO Personality Inventory/RevisedOAOsteoarthritisRARheumatoid arthritisSASSociotropy and Autonomy ScaleTCITemperament and character inventoryTPQTridimensional Personality Questionnaire