THU0585 Over Half of Patients with Fibromyalgia have a Type D Personality
Authors: H. Van Middendorp, M. B. Kool, S. van Beugen, A. W. Evers, J. K. Denollet, M. A. Lumley, R. Geenen
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Type D personality combines 2 stable traits: negative affectivity and social inhibition. It has been linked to poor health status and disease course and outcome in cardiovascular and other chronic conditions [1]. Patients with fibromyalgia experience high negative affect associated with symptoms such as pain and fatigue [2] and may be socially inhibited, e.g., due to earlier victimization or lack of understanding for their medically unexplained symptoms [3]. Therefore, we hypothesized that Type D personality would be prevalent in fibromyalgia and potentially relevant for functioning. <h3>Objectives</h3> The aim of the current study was to examine the prevalence and correlates of Type D personality in fibromyalgia. <h3>Methods</h3> As part of an online cross-sectional questionnaire study, 559 English-speaking patients with fibromyalgia (94% women, 21 to 77 (M=47, SD=11) years), filled out measures of Type D personality (DS14), illness invalidation from the social environment (3*I), physical and mental health (RAND SF-36), and pain, loneliness, and quality of life (visual analogue scales). <h3>Results</h3> The internal consistency of the Type D questionnaire was high (α&gt;.90). Using the standard cut-score, Type D personality was present in 56% of patients, which exceeds the prevalence estimates in the general (13-24%), cardiovascular (27-31%), and diverse chronic pain (43%) populations [1,4]. Compared to the general population, negative affectivity was high (Cohen's d=1.28) and social inhibition was above average (Cohen's d=0.35). Having Type D personality was associated with worse mental health (d=1.02), more loneliness (d=0.72), more role limitations due to emotional functioning (d=0.54), lower quality of life (d=0.52), less vitality (d=0.36), poorer social functioning (d=0.27), and a higher perceived lack of understanding (d=0.23) and more discounting (d=0.20) from the social environment. Regarding physical health, only associations between type D personality and a worse general health were found (d=0.48). <h3>Conclusions</h3> Type D personality is highly prevalent in fibromyalgia and a potential risk factor for emotional and social adjustment in fibromyalgia. In contrast to the evidence in cardiovascular diseases, Type D is not associated with poorer physical health. <h3>References</h3> Mols F, Denollet J. Type D personality among noncardiovascular patient populations: A systematic review. Gen Hosp Psychiatry 2010;32:66-72. Van Middendorp H, Lumley MA, Jacobs JW, et al. Emotions and emotional approach and avoidance strategies in fibromyalgia. J Psychosom Res 2008;64:159-67. Kool MB, Van Middendorp H, Lumley MA et al. Lack of understanding in fibromyalgia and rheumatoid arthritis: The Illness Invalidation Inventory (3*I). Ann Rheum Dis 2010;69:1990-5. Barnett MD, Ledoux T, Garcini LM et al. Type D personality and chronic pain: Construct and concurrent validity of the DS14. J Clin Psychol Med Settings 2009;16:194-9. <h3>Acknowledgements</h3> This study was funded by the Dutch Arthritis Association. <h3>Disclosure of Interest</h3> None Declared