Cloninger’s personality model in fibromyalgia syndrome: A systematic review and meta-analyses

Introduction: Fibromyalgia Syndrome (FMS) is a widespread chronic musculoskeletal pain disorder. Although many treatments are available for fibromyalgia, management remains a challenge. Recent evidence suggests that personality traits may influence fibromyalgia.   Materials and Methods: According to PRISMA guidelines, this systematic review and meta-analysis explored harm avoidance and self-directedness in fibromyalgia patients using Cloninger’s personality model. The meta-analysis included 14 studies evaluating harm avoidance and 11 studies evaluating self-directedness in patients with fibromyalgia compared with healthy individuals. Reported data from primary studies were pooled in a random-effects model using the Hedges’ g approach.   Results: Fibromyalgia patients demonstrated high harm avoidance (Hedges’ g= 1.31; 95% CI: 0.97 to 1.65) and low self-directedness (Hedges’ g= -0.71; 95% CI: -1.00 to -0.42) comparing to healthy individuals. Additionally, the results showed that high harm avoidance was significantly related to an increased risk of FMS, although high self-directedness played a protective role against it.   Conclusion: The results demonstrated that high harm avoidance and low self-directedness are distinct personality traits in patients with fibromyalgia. Early identification and evaluation of a profile of high harm avoidance and low self-directedness may help conceptualize the underlying complex mechanisms of fibromyalgia. Additionally, it could identify patients who are more prone to entering a vicious cycle of disability and pain. Further research is required to understand the role of personality characteristics better.