Garcia-Fontanals Alba, Portell Mariona, García-Blanco Susanna, Poca-Dias Violant, García-Fructuoso Ferran, López-Ruiz Marina, Gutiérrez-Rosado Teresa, Gomà-I-Freixanet Montserrat, Deus Joan
Departments of *Clinical and Health Psychology †Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona §Magnetic Resonance Imaging (MRI) MRI Research Unit, CRC Mar, Hospital Mar ‡Rheumatology Department, Hospital CIMA Sanitas, Barcelona, Spain.
Clin J Pain. 2017 Nov;33(11):991-997. doi: 10.1097/AJP.0000000000000506.
Fibromyalgia (FM) patients may present psychopathology and some characteristic personality traits that may affect their adaptation to the disease. The aim of this paper was to study the relationship between personality dimensions according to the psychobiological model of Cloninger and the presence of psychopathology.
The study sample consisted of 42 patients with FM and 38 pain-free controls. The assessment instruments administered were the Temperament and Character Inventory-Revised and the Millon Clinical Multiaxial Inventory.
A higher proportion of clinical psychopathologic syndromes (CPS) was observed in the FM group than in the control group, the most prevalent being anxiety disorder and dysthymia. Patients with FM (with CPS or without CPS) presented higher Harm Avoidance than the control group, and the presence of a CPS also increased Harm Avoidance scores. FM patients with CPS had low Self-directedness (SD) compared with both the control group and with their FM peers without CPS. Purposefulness and Anticipatory worry-Pessimism explained 38% of the variance of dysthymia, and anticipatory worry-Pessimism explained 18% of the variance of anxiety disorders.
Patients with FM have a high probability of anxious-depressive-type psychopathologic alterations. Their vulnerability to these conditions may be determined by personality traits. The SD character dimension may have implications for therapy, as low SD is associated with the presence of psychopathology and with a low capacity to cope with the disease.
纤维肌痛(FM)患者可能存在精神病理学问题以及一些可能影响其对疾病适应能力的特征性人格特质。本文旨在研究基于克隆宁格心理生物学模型的人格维度与精神病理学存在之间的关系。
研究样本包括42例FM患者和38例无疼痛的对照者。所使用的评估工具为修订版气质与性格量表和米隆临床多轴量表。
FM组中观察到的临床精神病理综合征(CPS)比例高于对照组,最常见的是焦虑症和心境恶劣。FM患者(有或无CPS)的回避伤害得分高于对照组,且CPS的存在也增加了回避伤害得分。与对照组以及无CPS的FM同伴相比,患有CPS的FM患者的自我导向性(SD)较低。目的性和预期担忧 - 悲观情绪解释了心境恶劣38%的变异,预期担忧 - 悲观情绪解释了焦虑症18%的变异。
FM患者有较高概率出现焦虑 - 抑郁型精神病理改变。他们对这些状况的易感性可能由人格特质决定。SD人格维度可能对治疗有影响,因为低SD与精神病理学的存在以及应对疾病的能力较低有关。