Riediger Christian, Ferl Mark, Lohmann Christoph H, Schönrogge Maria
Orthopädische Universitätsklinik Magdeburg, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.
Orthopadie (Heidelb). 2025 Sep 9. doi: 10.1007/s00132-025-04718-4.
The Type D personality ("distressed personality") is characterized by a combination of negative affectivity and social inhibition. While this personality style was originally researched in the context of cardiovascular disease, recent studies also show a significant association with chronic pain disorders, especially back pain.
This narrative review examines the current state of knowledge on the relationship between type D personality and back pain. The aim is to analyze possible psychological, behavioral, and biological mechanisms and to derive clinical implications for orthopedic pain therapy.
A selective literature search was conducted in the PubMed, PsycINFO and Google Scholar databases. Original studies, systematic reviews and meta-analyses from the last 20 years focusing on psychosomatic aspects of chronic back pain were included.
Several studies show that individuals with Type D characteristics have an increased risk of developing and chronicizing back pain. Possible mediating mechanisms include maladaptive stress processing, somatisation, reduced social support and changes in neuroendocrine and inflammatory processes.
Type D personality is a relevant psychosocial risk factor in the development and persistence of chronic back pain. Early detection may contribute to improving multidisciplinary therapeutic approaches.
D型人格（“痛苦型人格”）的特征是消极情感和社交抑制并存。虽然这种人格类型最初是在心血管疾病的背景下进行研究的，但最近的研究也表明它与慢性疼痛疾病，尤其是背痛之间存在显著关联。
本叙述性综述探讨了D型人格与背痛之间关系的现有知识状况。目的是分析可能的心理、行为和生物学机制，并得出骨科疼痛治疗的临床意义。
在PubMed、PsycINFO和谷歌学术数据库中进行了选择性文献检索。纳入了过去20年中关注慢性背痛心身方面的原始研究、系统评价和荟萃分析。
多项研究表明，具有D型特征的个体患背痛并使其慢性化的风险增加。可能的中介机制包括适应不良的压力处理、躯体化、社会支持减少以及神经内分泌和炎症过程的变化。
D型人格是慢性背痛发生和持续存在的一个相关社会心理风险因素。早期发现可能有助于改进多学科治疗方法。
