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Vulnerability to Psychopathology and Dimensions of Personality in Patients With Fibromyalgia

Garcia-Fontanals, Alba PhD*; Portell, Mariona PhD; García-Blanco, Susanna PhD; Poca-Dias, Violant MD; García-Fructuoso, Ferran PhD, MD; López-Ruiz, Marina MSc§; Gutiérrez-Rosado, Teresa PhD*; Gomà-i-Freixanet, Montserrat PhD*; Deus, Joan PhD*,§

doi: 10.1097/AJP.0000000000000506
Original Articles

Objective: 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.

Materials and Methods: 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.

Results: 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.

Conclusions: 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.

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

This work was supported in part by the Spanish Ministry of Science and Innovation (Grant I+D PSI2014-53524-P) (Spain); the Department of Clinical and Health Psychology at the Autonomous University of Barcelona (Grant PIF 1927), (Barcelona, Spain) and the Agency of University and Research Funding Management of the Catalan Government (Research Group SGR 2014/1673) (Barcelona, Spain). The authors declare no conflict of interest.

Reprints: Alba Garcia-Fontanals, PhD, Department of Clinical and Health Psychology, Autonomous University of Barcelona, Campus de la UAB, Bellaterra (Cerdanyola del Vallès), Barcelona 08193, Spain (e-mail:

Received July 25, 2016

Received in revised form November 11, 2016

Accepted April 8, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.