BACKGROUND:Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, is particularly prevalent in stress-related disorders, such as depression, anxiety, adjustment disorders, and somatic symptom disorders. This is especially evident in inpatients treated for psychosomatic conditions arising from chronic somatic distress, emotional dysregulation, and personality vulnerabilities. Although alexithymia, narcissistic traits, and work-related stress have each been associated with burnout, their combined effects remain understudied. OBJECTIVES:This study examined the associations between burnout and personality traits (narcissism, alexithymia, overcommitment) and work-related stress (effort-reward imbalance, ERI) in inpatients treated for stress-related disorders, and tested whether alexithymia moderates the relationship between narcissistic vulnerability and burnout severity. METHODS:A retrospective observational study was conducted using routinely collected psychometric data from adult inpatients treated for stress-related disorders at the clinic OBERWAID in Switzerland (April 2018-November 2024; N = 1239). Burnout was assessed using the Maslach Burnout Inventory. Multiple linear regressions, adjusted for age, sex, and psychological distress, tested main and interaction effects. RESULTS:Burnout was significantly predicted by alexithymia (b = 0.241, p < .001), ERI quotient (b = 0.431, p < .001), overcommitment (b = 0.063, p < .001), psychological distress (b = 0.025, p = .004), and age (b = -0.014, p < .001). Narcissistic vulnerability showed a trend toward significance (b = 0.124, p = .062). The alexithymia × narcissism interaction was significant (b = -0.207, p = .016), and the interaction model explained more variance (R2 = 0.318) than the main model (R2 = 0.302). CONCLUSIONS:Burnout in inpatients treated for stress-related disorders reflects the joint impact of personality vulnerabilities and occupational stress. Alexithymia attenuates (buffers) the effect of narcissistic vulnerability on burnout at higher levels of alexithymia, highlighting the need for tailored interventions targeting emotional awareness and stress regulation.
Objective Many cancer patients report severe psychological distress, which is also reflected in higher prevalence rates for suicidal ideation (compared to the general population). Yet, the underlying cognitive-emotional mechanisms preceding suicidal ideation have not been sufficiently examined. Building on the Integrated Motivational-Volitional Model of Suicidal Behavior, we investigated the association between entrapment and suicidal ideation as well as the potential moderating effect of resilient coping. Explorative analyses of potential gender differences extended the analyses. Methods In total, 618 individuals with cancer (231 women) from various settings completed questionnaires assessing sociodemographic, cancer-related, and psychological characteristics such as entrapment, resilient coping, and suicidal ideation. Stepwise logistic regression analyses were conducted to examine the association and interplay of the entrapment and resilient coping with suicidal ideation. Results Suicidal ideation was reported by 11.74% (women 40%, men: 60%). Entrapment was associated with suicidal ideation across genders (r = 0.32, p < .001). Resilient coping was neither directly associated with suicidal ideation nor moderated the link between entrapment and suicidal ideation. No gender patterns were found in the current sample. Conclusion Experiencing entrapment is closely linked to suicidal ideation among individuals with cancer and should be taken into account in screening and intervention efforts; independently of one's gender. Resilient coping and gender might not determine proximal associations with suicidal ideation but rather shape earlier processes, such as the emergence of existential distress closely linked to the illness itself (e.g., defeat, entrapment).
Stigma and perceived discrimination are understudied psychosocial components in hereditary angioedema due to C1-inhibitor deficiency (HAE-C1INH). This cross-sectional pilot study assessed stigma and perceived discrimination in 20 HAE-C1INH patients, comparing those with (HAE A+) and without (HAE A-) attacks. Stigma scores above the normative mean were observed in 65% of patients. The HAE A+ group reported significantly higher stigma than HAE A- (p = .04, r = 0.46), while perceived discrimination did not differ between groups. Stigma was significantly associated with worse quality of life (QoL), poorer disease control, and higher attack frequency; perceived discrimination showed no significant associations with clinical outcomes. However, these results should be interpreted in light of the study's primary limitations, including the cross-sectional design, the small sample size, the absence of formal linguistic validation of the instruments used, and the multiple comparisons performed without alpha correction, all of which preclude causal inference and limit the generalisability of the results.These findings suggest that stigma in HAE-C1INH patients is closely tied to disease activity, while perceived discrimination, though comparable across groups, follows distinct attribution patterns, pointing to shame and fear of social judgment as priority targets for psychosocial intervention.
Purpose Childhood sexual maltreatment is a well-documented risk factor for adverse perinatal physical and mental health outcomes, which are worse in women of color compared to white women. Yet, the pathways through which early sexual trauma influences childbirth experiences and the role of ethnicity/race in these associations are insufficiently understood. This study examined the relationship between childhood sexual maltreatment and negative childbirth experiences, with a focus on the potential mediating roles of late-pregnancy posttraumatic stress symptoms (PTSS) and fear of childbirth. Ethnic/racial group differences were also evaluated. Methods Women (N = 433) were drawn from the Michigan Prenatal Stress Study, a large longitudinal, prospective study of the influence of prenatal stressors on mother and infant outcomes. Participants reported on childhood sexual maltreatment, PTSS, fear of giving birth (third trimester), negative childbirth experiences, and ethnic/racial identity. Results Childhood sexual maltreatment was significantly associated with more negative childbirth experiences, and late-pregnancy PTSS mediated this association. Although this PTSS-mediated pathway did not significantly differ by race/ethnicity, it was only significant among women of color. Conclusions Findings highlight the importance of addressing trauma-related stress during pregnancy to improve perinatal outcomes for all women with a history of childhood sexual maltreatment. Targeted interventions aimed at reducing PTSS in pregnancy may mitigate the impact of childhood sexual trauma on childbirth experiences and promote maternal and infant well-being.
BACKGROUND:A reciprocal association of atrial fibrillation (AF) and depression has been proposed, but depression is often underdiagnosed in cardiology. We assessed the prevalence of suspected depression in a consecutive cohort of patients with AF examined its association with disease-related quality of life (QoL) and handgrip strength. METHODS:In this single-center cross-sectional study of a prospectively recruited consecutive cohort of patients with documented AF, 100 patients completed the AF Effect On Quality-Of-Life Questionnaire (AFEQT) questionnaire. The Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) was used to scale suspected depression severity. Handgrip strength was measured using a hydraulic handgrip dynamometer. A multivariable linear regression analysis for reduced handgrip was performed and associations between AFEQT, PHQ-9 and MADRS were assessed via Spearman correlation analysis. RESULTS:Depressive symptoms were found in 53% of patients on at least one screening tool, and 30% met criteria in both PHQ-9 and MADRS. Most cases (79.3%) represented new suspected diagnoses. Patients with suspected depression had lower AFEQT scores (49.1 points [38.5-65.7]) compared to those without (71.3 points [59.3-88.0], p < 0.001). The AFEQT overall score moderately correlated with PHQ-9 (r = -0.534, p < 0.001) and MADRS (r = -0.410, p < 0.001). Handgrip strength did not differ between groups but was independently associated with older age (B = -0.47, p < 0.001), female sex (B = -12.5, p < 0.001), and higher MADRS scores (B = -0.40, p = 0.012), R = 0.773. Among patients with suspected depression, 28% indicated willingness to use a mental health app, with higher acceptance in those <70 years. CONCLUSION:Previously unrecognized depressive symptoms are highly prevalent and often newly detected in patients with AF, with a significant negative association with disease-specific QoL. Routine screening with validated tools should be integrated into cardiology practice to enable timely diagnosis and comprehensive psycho-cardiological management.
BACKGROUND:Type 2 diabetes mellitus (T2DM) has been associated with executive-function vulnerability, yet the role of psychological resilience in neuropsychological and psychosocial functioning remains unclear. This study examined whether resilience was associated with executive-function performance, clinical indicators, and psychosocial adaptation in adults with T2DM and healthy controls. METHODS:This cross-sectional study included 206 adults (102 with T2DM and 104 healthy controls) after excluding individuals with low global cognitive screening scores. Resilience was assessed using the Connor-Davidson Resilience Scale and classified as low or moderate-to-high. Participants completed executive-function tests and questionnaires assessing diabetes self-management, depressive symptoms, quality of life, and perceived family support. General linear models controlled for age and education, with Holm-Bonferroni correction applied within related outcome sets; sensitivity analyses additionally adjusted for depressive symptoms and body mass index. RESULTS:Participants with T2DM showed poorer Digit Span and WCST performance after correction, indicating vulnerabilities in attention span, working memory, cognitive flexibility, and concept formation. A significant disease status × resilience interaction was found for Tower of London (planning) performance; simple main-effects analysis indicated a significant resilience effect within the T2DM group but not among controls, and this interaction remained significant after adjustment for depressive symptoms and body mass index. Resilience was broadly associated with better psychosocial outcomes, and lower resilience in T2DM was also associated with higher mean HbA1c and systolic blood pressure. DISCUSSION:T2DM was associated with executive-function vulnerability, whereas resilience was selectively related to planning performance and more broadly associated with psychosocial adaptation.
Objective Premenstrual distress is a common and burdensome experience among women. Yet, its psychological risk factors remain insufficiently understood. The present daily diary study addresses this issue by examining whether uncontrollability beliefs about the premenstrual period and emotion regulation dispositions are associated with variations in women's distress across the menstrual cycle. Method Ninety-four French women first completed a questionnaire assessing uncontrollability beliefs about the premenstrual period. They subsequently reported their daily distress, use of reappraisal and rumination to regulate negative emotions, and menstrual status each evening over a 31-day period. Results Findings obtained with multilevel modeling revealed a general increase in distress during the premenstrual period. This increase was stronger among women endorsing greater uncontrollability beliefs about the premenstrual period. By contrast, emotion regulation dispositions were associated with overall distress levels rather than with specifically premenstrual variations in distress. Women reporting lower use of reappraisal and higher use of rumination experienced elevated distress throughout the menstrual cycle. Conclusion The findings suggest that distinguishing cognitive factors specifically associated with the increase in distress during the premenstrual period from those associated with elevated distress more generally across the menstrual cycle may represent an important step toward a more precise understanding of premenstrual distress.
OBJECTIVE:This study aimed (i) to examine symptom burden, health care use, perceived treatment effectiveness and experiences of trivialization among women with chronic pelvic pain (CPP), and (ii) to identify predictors of the number of physician visits and sick days. DESIGN AND SETTING:Cross-sectional online survey among 1204 women aged ≥18 years reporting CPP for ≥6 months. METHOD:Data were collected via a self-administered questionnaire assessing CPP-related symptoms, illnesses, comorbidities, consulted specialists, perceived symptom trivialization by physicians, perceived treatment effectiveness and CPP-related sick days. Poisson regression and negative binomial regression were performed to identify predictors of the number of consulted specialists and of the number of sick days, respectively. RESULTS:Among the study population, 70.60% (n = 850) reported endometriosis, 63.63% (n = 766) reported to have consulted more than five physicians, and 79.90% (n = 962) reported trivialization experiences. Trivialization and perceived improvement through both pharmaceutical and non-pharmaceutical treatments were associated with a higher number of specialist consultations (incident rate ratios [IRRs] = 1.21, 1.26, ps < 0.001). Among women reporting sick days, trivialization (IRR = 1.20, p < 0.041) and perceived improvement through both treatments (IRR = 1.69, p < 0.001) were related to a higher number of sick days among those with at least one sick day. CONCLUSION:Experiences of trivialization and greater perceived treatment improvement were associated with a higher number of CPP-related sick days and specialist consultations, emphasizing the need to take CPP seriously from the first consultation.
BACKGROUND:Prior research suggests that the personality traits negative affectivity (NA) and social inhibition (SI) are synergistically related to an increased risk of adverse events in patients with cardiovascular disease (CVD). Both traits-as measured by the DS14 questionnaire-are multidimensional, each comprising three facets. It remains unclear whether all facets of NA and SI contribute equally to the risk of major adverse cardiac events (MACE), or whether certain facets play a greater role. Here, we answer this question using individual patient data from four prospective studies. METHODS:The combined dataset included 1750 patients with CVD, measuring age, sex, NA and SI facets, and the occurrence of MACE during follow-up. Multilevel logistic regression models estimated synergistic interactions between NA and SI facet pairs on MACE. FINDINGS:After controlling for age and sex, the NA facet anxious apprehension synergistically interacted with the SI facets reticence (OR = 1.18 [1.05, 1.32]) and lack of social poise (OR = 1.17 [1.04, 1.32]). Higher scores on the NA facets dysphoria (OR = 1.33, [1.16, 1.52]) and irritability (OR = 1.25 [1.09, 1.42]) were associated with increased odds of MACE, independent of SI facets. No evidence was found that SI facets were independently related to MACE. CONCLUSIONS:Specific combinations of NA and SI facets synergistically increased the risk of MACE in patients with CVD. The synergy primarily reflects a personality profile combining excessive worrying with having difficulty in making contact with others and keeping others at a distance. Dysphoric and irritable patients showed elevated MACE risk regardless of their social inhibition.
BACKGROUND:Loneliness can have profound health consequences for cancer patients, yet age-related patterns of loneliness remain inconsistent and mainly cross-sectional. We describe loneliness in young (<40 years), middle-aged (40-65 years), and older (≥65 years) patients over time during early cancer survivorship, identify biopsychosocial risk factors for loneliness, and examine its impact on health outcomes across age groups. METHODS:This multicenter prospective longitudinal study included cancer patients within two months of diagnosis and at 6-, 12-, and 18-month follow-ups. Loneliness was measured using the UCLA loneliness scale. Generalized-linear-mixed-models examined changes over time. Mixed-effects regression models identified risk factors for loneliness and examined the predictive value of loneliness on physical and mental health outcomes over time. RESULTS:In total, 994 patients (53% men, 60.5 years) were included in this analysis. Older patients reported lowest and most stable loneliness over time (15-20%), whereas middle-aged (19-31%) and young (25-38%) patients reported higher loneliness values, particularly shortly after diagnosis. Risk factors for being lonely included lower social support, absence of a partner, lower socioeconomic status, advanced disease, and greater comorbidity burden (all p < 0.05). Higher loneliness at diagnosis predicted mental disorders and psychosocial care needs at follow-ups, in addition to distinct age-specific relationships of reduced physical and mental QoL for middle-aged, and non-adherence for older patients (all p < 0.05). CONCLUSION:Loneliness is common during early cancer survivorship, particularly among young and middle-aged patients shortly after cancer diagnosis. Age-related mechanisms, vulnerabilities and consequences of loneliness may inform clinical communication, e.g. about non-adherence or recommendation of tailored psychosocial support. TRIAL REGISTRATION:This study was registered in the International Clinical Trials Registry (NCT04620564, https://clinicaltrials.gov/).
Psychosocial assessment of living related-kidney donors is important, yet limited prospective data exist on donor-perceived family functioning after transplantation. Identifying donors at high risk for deterioration in family functioning prior to transplantation is crucial for management. This study aimed to identify preoperative psychosocial predictors of post-donation family dysfunction to facilitate early targeted intervention, and to identify clinical predictors of functional change. A total of 106 Japanese LRKT donors were included in the analysis. Family functioning was assessed using the Family Assessment Device (FAD) before and 1 year after LRKT. Based on the General Functioning subscale, participants were classified into maintenance family function or deterioration groups. Binomial logistic regression was used to identify factors independently associated with deterioration in family functioning. Although most donors maintained stable family functioning, 17.2% (n = 15/87) of donors with good preoperative functioning experienced significant deterioration 1 year after LRKT. Multivariable analysis identified two independent predictors of deterioration: higher pre-LRKT FAD Affective Involvement scores (odds ratio [OR], 9.28; 95% confidence interval [CI], 1.60-53.88; p = .013) and a perception that life satisfaction after LRKT was worse than anticipated (OR, 2.25; 95% CI, 1.10-4.59; p = .026).These findings underscore the critical need for healthcare professionals to evaluate family dynamics before LRKT. Notably, inappropriate emotional connections (higher Affective Involvement) and unmet expectations regarding life after donation are potent predictors of donor-perceived family dysfunction. Therefore, comprehensive care that addresses potential changes in family roles and the realities of postoperative life is essential for identifying and supporting high-risk LRKT donors.
PURPOSE:Allogeneic hematopoietic stem cell transplantation (allo-HSCT) relies heavily on donations from unrelated donors (UDs). This study aimed to examine longitudinal changes in symptoms among UDs and identify associated predictors from the initiation of mobilization through the first post-donation year. METHODS:UDs registered with the China Marrow Donor Program who were scheduled to donate hematopoietic stem cells at a public hospital in China were enrolled. A total of 139 UDs completed the Allo-HSCT Donor Symptom Assessment Scale at nine time points. Repeated-measures analysis of variance and linear mixed-effects models were used to analyze changes in symptoms over time and associated predictors. RESULTS:The total symptom score and all seven symptom dimensions changed significantly over time. Overall symptom burden followed an inverted U-shaped temporal pattern (F = 151.934, P < 0.001), peaking on day 4 of mobilization and declining to near-baseline levels by two weeks post-donation. The pain-related symptom dimension showed the greatest fluctuation (F = 210.642, P < 0.001), followed by the morbid sensation and body temperature symptom dimensions (F = 66.929, P < 0.001; F = 17.671, P < 0.001, respectively). The peripheral sensory symptom dimension showed a distinct pattern, peaking on the day of apheresis. Individual symptoms within dimensions demonstrated considerable heterogeneity. Higher symptom burden was associated with older age and higher BMI. Protective factors included being male, engaging in regular physical activity, and having blood type A (vs. type O). CONCLUSION:This study provides the first detailed longitudinal characterization of symptom changes in UDs, revealing distinct phase-specific patterns. Regular physical activity may represent a potentially modifiable protective factor for reducing symptom burden.
BACKGROUND AND AIMS:Fatigue is one of the most common and burdensome extraintestinal manifestations of inflammatory bowel disease (IBD) with a multifactorial aetiology that may extend beyond inflammatory activity. This study aimed to clarify the relative contribution of biological, psychological and central sensitization-related factors to fatigue in outpatients with IBD. METHODS:A cross-sectional study was conducted in a sample of 106 adult consecutive outpatients with IBD. Participants completed questionnaires assessing fatigue, central sensitization, depressive and anxiety symptoms. Laboratory data including fecal calprotectin (FC), C-reactive protein (CRP), and hemoglobin (Hb) levels were retrieved from medical records. A hierarchical regression analysis assessed the contribution of biological markers (Block 1) and psychological and central sensitization-related symptoms (Block 2) to fatigue severity. RESULTS:Clinically significant fatigue was present in 42.5% of patients. Biological markers explained a small, non-significant proportion of variance in fatigue severity. In the full model, central sensitization-related symptoms (β = 0.54, p < .001) were the strongest independent correlates of fatigue, followed by depressive symptoms (β = 0.30, p = .006) and FC (β = 0.26, p = .001). Anxiety, CRP, and hemoglobin were not independently associated with fatigue. The full model explained 55.5% of the variance in fatigue severity. In a sensitivity analysis removing fatigue-related items from the psychological scales, central sensitization-related symptoms and FC remained independently associated with fatigue, whereas depressive symptoms did not. DISCUSSION:Although intestinal inflammation contributed independently, fatigue was more closely related to central sensitization-related symptoms than to depressive symptoms, inflammatory or hematological markers. These findings support a multidimensional assessment of fatigue, extending beyond inflammation-focused care toward an integrated, multidisciplinary approach.
BACKGROUND:Stress may exacerbate neuroinflammation and symptom burden in people with multiple sclerosis (pwMS). Engaging in stress-reducing activities (SRAs), such as meditation and mind-body practices, may reduce inflammation thereby improve health outcomes. The objective of the study was to assess determinants of SRAs use and prospective associations with health outcomes. METHODS:Data from 952 pwMS were analysed over a 5-year follow-up. Meditation and other SRAs were queried as a part of a survey of demographic, clinical, and lifestyle factors and categorised as: meditation; other SRAs; meditation + SRAs; or none. Baseline determinants of SRAs engagement at 5-year were examined using multivariable models. Prospective associations between baseline SRAs use and 5-year disability, fatigue, depression, and quality of life (QoL), were estimated using log-binomial and linear regression, adjusted for relevant covariates. RESULTS:University education, both lower than average and higher than average socioeconomic status, high quality diet, regular physical activity, vitamin D exposure, non-smoking, and clustering of ≥3 healthy behaviours predicted higher engagement with SRAs. Employment and obesity predicted lower use. Meditation practice alone was associated with a reduced 5-year risk of depression (aRR = 0.49, 95% CI: 0.24-0.97), and when combined with SRAs were associated with higher emotional QoL (aβ = 3.22, 95% CI: 0.21-6.23). CONCLUSION:Engagement in meditation and other SRAs is socially patterned and prospectively associated with improved mental health outcomes in pwMS. Addressing barriers to engagement may support more equitable integration of stress-management strategies within MS care.
PURPOSE:No prior systematic review has specifically evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) in improving both psychological and physical outcomes among cancer populations. This study aims to assess MBCT's effects on cancer patients' mental and physical health. METHOD:Following PRISMA guidelines and with PROSPERO registration (CRD42023453581), we systematically searched PubMed, Cochrane CENTRAL, Embase, and Web of Science for randomized controlled trials (RCTs) were searched up to June 2026. Eligible trials enrolled adults (≥ 18 years) with any cancer type/stage, compared MBCT delivered per standard manual against non-MBCT controls, and reported at least one validated measure of distress, depression, or anxiety; secondary outcomes included fatigue, quality of life, and mindfulness skills. Two reviewers independently selected studies, extracted data, and assessed risk of bias using the Cochrane tool; random-effects meta-analyses were performed in Stata 16. RESULTS:11 RCTs comprising 1122 participants (mean age 54.8 years; 91% female) were included. MBCT produced large, significant reductions in psychological distress (SMD = -0.81, 95% CI-1.27 to-0.40), depression (SMD = -0.95, 95% CI -1.40 to-0.49), and anxiety (SMD = -0.86, 95% CI -1.22 to-0.51). It also markedly decreased fatigue (SMD = -0.83, 95% CI-1.10 to-0.56), improved quality of life (SMD = 0.56, 95% CI 0.22-0.88), and enhanced mindfulness skills (SMD = 0.76, 95% CI 0.59-0.92). CONCLUSIONS:This meta-analysis is the first to exclusively synthesize RCT evidence of standardized MBCT in cancer care, demonstrating significant dual benefits for emotional and physical well-being while providing strong support for integrating MBCT into comprehensive oncology rehabilitation.
INTRODUCTION:Prevalence estimates for anxiety after acute myocardial infarction (AMI) range from 12% (formal diagnoses) to 38% (self-reported symptoms). Many patients perceive an AMI as a life-threatening event. Acute chest pain, pain in other areas, and several vegetative symptoms can occur. The aim was to investigate the association between the symptoms during AMI and anxiety symptoms afterwards. METHODS:Data from 994 AMI survivors enrolled in the Myocardial Infarction Registry Augsburg, assessing 12 acute symptoms and anxiety symptoms at a mean follow-up of 12.4 months using the Generalized Anxiety Disorder-7 questionnaire (GAD-7) were analyzed. Chest pain, pain in other areas (left or right arm, between shoulder blades, upper abdomen, jaw), dyspnea, vertigo, sweating, nausea, syncope, and fear of death were assessed. Multivariable linear regression models were calculated to analyze the association between symptoms at the acute event and anxiety symptoms at follow-up. RESULTS:Ninety-five (9.6%) participants reported clinically relevant symptoms of anxiety (GAD-7 ≥ 10). Having ≥5 symptoms (compared to 0-2 symptoms) during AMI was positively associated with anxiety symptoms (β = 0.96, p-value =0.004) after the event. Having three or more non-typical pain symptoms (β = 2.18, p-value <0.001) and having three or more vegetative symptoms (β = 1.18, p-value = 0.006) was positively associated with anxiety symptoms (reference: no non-typical pain or vegetative symptoms). CONCLUSION:A greater number of symptoms occurring during AMI, particularly non-typical pain and vegetative symptoms, is associated with elevated anxiety symptoms post-AMI. These findings need confirmation but highlight the importance of monitoring mental health in patients presenting with diverse symptom profiles after AMI.
OBJECTIVE:To examine the association between personality domains and concurrent and incident pain to identify psychological risk and protective factors. METHOD:Participants were middle-aged and older adults (N > 40,000; Age-range: 23-104, Mean Age = 65.52) from seven cohort studies from the US, England, and Japan. In each sample, personality, demographic factors, disease burden, depressive symptoms, and pain were assessed at baseline. Pain was assessed again 5 to 15 years later. RESULTS:Random-effects meta-analyses indicated that neuroticism was associated with higher likelihood of concurrent (Odds Ratio [OR] = 1.33, 95%CI: 1.26-1.40, p < .001) and incident (OR = 1.16, 95%CI: 1.11-1.21, p < .001) pain. In contrast, higher extraversion and conscientiousness were related to a lower likelihood of concurrent (extraversion OR = 0.86, 95% CI = 0.81-0.93, p < .001; conscientiousness OR = 0.85, 95% CI = 0.83-0.87, p < .001) and incident (extraversion OR = 0.93, 95% CI = 0.90-0.97, p < .001; conscientiousness OR = 0.93, 95% CI = 0.90-0.97, p < .001) pain. Openness and agreeableness were unrelated to both concurrent and incident pain. Disease burden and depressive symptoms partially accounted for the association between personality and pain. Age and sex did not systematically moderate these associations. CONCLUSION:The present study found replicable associations between personality and concurrent and incident pain. Neuroticism may be a risk factor of pain, whereas extraversion and conscientiousness may be protective factors, suggesting that personality assessment could inform personalized pain interventions.
