Personality, Defence Mechanisms and Psychological Distress in Women with Fibromyalgia

Several studies show that many personality traits are associated with fibromyalgia (FM), a chronic pain syndrome, worsening both the quality of life and psychological distress of patients. Despite the high comorbidity of psychopathological disorders in this syndrome and their association with immature defence styles, few studies have examined the defence mechanisms used by FM patients. The main aim of our study was to investigate the personality traits and defence mechanisms in a sample of FM patients and compare them to a pain-free healthy control group (HC). In addition, we investigated the effect of personality traits and defence mechanisms on psychological distress (anxiety and depressive symptoms) in FM patients. In order to reach these goals, 54 women with FM and 54 chronic-pain free women were asked to fill in the following measures: (1) Temperament and Character Inventory–Revised; (2) Toronto Alexithymia scale; (3) Defense Style Questionnaire and (4) Hospital Anxiety and Depression Scale. The results indicated that FM patients display higher alexithymia (p < 0.001, d =0.776), higher harm avoidance p <0 .001, d =1.707), lower self-directedness (p < 0.003, d =1.211), lower persistence (p < 0.001, d =0.840), higher use of maladaptive defence style (p < 0.001, d =0.891) and higher levels of anxiety/depressive symptoms (p < 0.001, d =0.978), compared to HC. Moreover, we found that alexithymia (β = 0.426, p =0.004), harm avoidance (β = 0.299, p =0.014) and maladaptive defence style (β = 0.393, p =0.015) are significant predictors of psychological distress in FM patients. The final model explained 48% of the variance [F(1, 47) =9.222, p =.004]. The present study is the first to explore the contribution of both defence mechanisms and personality characteristics on psychological distress among female FM patients. Our findings have important clinical implications and may help diagnose and treat FM patients better.