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February 28, 2026Journal of Clinical MedicineOpen Access

Prevalence of Type-D Personality and Its Association with Pain, Disability, and Psychological Distress in a University Spine Outpatient Clinic: A Cross-Sectional Study

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Key result

Type-D personality linked to ~1.2-point higher pain intensity and greater disability in spine outpatients.

  • β = 1.18 increase in VAS pain intensity, 95% CI 0.92–1.44; β = 6.42 increase in ODI, 95% CI 4.21–8.63
  • P<0.001
  • n=300

Why the study?

Type-D personality is associated with adverse outcomes in chronic pain and cardiovascular populations, but evidence in spine outpatient settings remains limited.

Is Type-D personality associated with greater pain, disability, and psychological distress in patients presenting to a spine outpatient clinic?

Population

300 consecutive patients (18–85 years) presenting to a university spine outpatient clinic

Comparison

Type-D vs non-Type-D personality

Design

Exploratory cross-sectional study

Authors

CRChristian RiedigerUniversity Hospital MagdeburgMFMark FerlUniversity Hospital MagdeburgCLChristoph H. LohmannUniversity Hospital Magdeburg

Discussion

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Implication

Type-D screening may identify spine outpatients needing integrated care; extends prior evidence but leaves open whether modification improves outcomes.

Key Points

  • The study aims to assess the prevalence of Type-D personality and its association with pain, disability, and psychological distress in spine outpatient patients.
  • Exploratory cross-sectional design involving 300 patients aged 18-85.
  • Patients assessed using the Type-D Scale-14, Hospital Anxiety and Depression Scale, Visual Analog Scale for pain, and Oswestry Disability Index.
  • Demographic and clinical characteristics were recorded for all participants.
  • Comparative analyses performed between Type-D and non-Type-D patients.
  • Prevalence of Type-D personality was 32.3%.
  • Type-D patients reported significantly higher pain intensity (VAS: 5.23 vs. 3.88) and disability (ODI: 38.6 vs. 31.3).
  • Anxiety and depression scores were also higher in Type-D patients (HADS-A: 10.0 vs. 6.5, HADS-D: 8.4 vs. 6.4).
  • Correlation analyses indicated moderate to strong links between Type-D traits and psychological distress.

Study Design

Type

Cross-Sectional (n=300)

Multicenter

No

Structured PICO

Is Type-D personality associated with greater pain, disability, and psychological distress in patients presenting to a spine outpatient clinic?

P
Population
300 consecutive patients (18–85 years) presenting to a university spine outpatient clinic
I
Intervention
Type-D personality (defined as negative affectivity ≥10 and social inhibition ≥10 on DS14)
C
Comparator
Non-Type-D personality
O
Outcome
Prevalence of Type-D personality and its association with pain intensity (VAS), functional disability (ODI), and psychological distress (HADS)patient reported

Main Result

Effect estimate: β = 1.18 increase in VAS pain intensity, 95% CI 0.92–1.44; β = 6.42 increase in ODI, 95% CI 4.21–8.63 (95% CI 0.92–1.44 for pain; 4.21–8.63 for disability)

Absolute Event Rate: 5.23% vs 3.88%

p-value: p=<0.001

Type-D personality is highly prevalent (32.3%) in spine outpatients and is strongly associated with increased pain, functional disability, and psychological distress.

Limitations

  • Single-center tertiary care setting may limit generalizability
  • Use of self-reported measures without objective clinical or imaging parameters
  • No comparison to general population norms for Type-D prevalence
  • No a priori sample size calculation, only post hoc sensitivity analysis
  • No formal correction for multiple comparisons, risk of Type I error inflation
  • Possible conceptual overlap between Type-D personality and anxiety/depression scales

Cite This Study

Riediger et al. (2026) conducted a cross-sectional in Adult patients (18-85 years) presenting to a university spine outpatient clinic with cervical, thoracic, or lumbar spine-related pain (n=300). Type-D personality (high negative affectivity ≥10 and social inhibition ≥10) vs. Non-Type-D personality was evaluated on Pain intensity (Visual Analog Scale, 0-10) and functional disability (Oswestry Disability Index, 0-100) (β = 1.18 increase in VAS pain intensity, 95% CI 0.92–1.44; β = 6.42 increase in ODI, 95% CI 4.21–8.63, 95% CI 0.92–1.44 for pain; 4.21–8.63 for disability, p=<0.001). Type-D personality was present in 32.3% of spine outpatients and was associated with a 1.18 point higher pain intensity (VAS) and a 6.42 point greater disability (ODI) compared to non-Type-D patients, both p < 0.001.

synapsesocial.com/papers/69a287010a974eb0d3c025b4https://doi.org/10.3390/jcm15051753
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