The role of personality traits in pain perception and disability.

Abstract

According to the biopsychosocial model of chronic pain and disability, the experience of pain is the result of a dynamic interaction between physiological, psychological, and social factors. Fear-avoidance beliefs have been identified as being among the most prominent psychological factors influencing the development and persistence of chronic pain. This article reviews the evidence that personality traits contribute to the process of pain chronification by making people more vulnerable to respond to physical threat in an anxious and avoidant manner. We will consider three potential vulnerability factors: negative affectivity, anxiety sensitivity, and injury/illness sensitivity. For all three factors evidence has been found that they may indeed contribute to maladaptive ways of dealing with pain. Recently researchers have also begun to consider the role of resilience factors that may protect people against maladaptive cognitive and behavioral reactions to acute and chronic pain. We will review the evidence for three of these potential resilience factors: optimism, hope, and (generalized) self-efficacy. It is concluded that there is at least some evidence pointing towards a role of these three factors in chronic pain and disability, but the evidence for trait characteristics acting as resilience factors in chronic pain is less compelling than that for traits acting as vulnerability factors.