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This study investigates the role of Type D personality in central sensitization, kinesiophobia, and psychological distress among fibromyalgia patients.

March 5, 2026Open Access

Psychosocial correlates of central sensitization and kinesiophobia: the role of Type D personality in fibromyalgia — a cross-sectional study

HMHatice Betigul MeralIstanbul Medipol University TATehran ALİYEVA ZOZeynep Meral ObholzerOxford Health NHS Foundation Trust

Key Points

This study investigates the role of Type D personality in central sensitization, kinesiophobia, and psychological distress among fibromyalgia patients.
Analyzed data from 120 women, including 60 with fibromyalgia and 60 healthy controls.
Employed various assessments including the Type D Scale-14 and Central Sensitization Inventory.
Conducted multiple linear regression analyses to determine predictors of clinical scores.
Type D personality was observed in 61.7% of fibromyalgia patients vs. 30% of controls (p < 0.001).
Patients with Type D had significantly higher central sensitization (CSI scores) and kinesiophobia (TSK scores) compared to non-Type D patients (both p < 0.001).
Strong positive correlations were found between Type D personality traits and clinical parameters in fibromyalgia patients, indicating more severe symptoms.

Abstract

Fibromyalgia (FM) is a multifactorial syndrome involving central sensitization and psychosocial factors such as fear of movement and emotional distress. Type D personality (TDP) may exacerbate these factors, but its role in FM remains unclear. This study aimed to investigate the associations between TDP and central sensitization, kinesiophobia, disease severity, and psychological distress in patients with FM. A total of 120 women (60 with FM, 60 healthy controls) aged 18–60 years were included in this cross-sectional study. Participants were assessed using the Type D Scale-14 (DS-14), Central Sensitization Inventory (CSI), Tampa Scale for Kinesiophobia (TSK), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Visual Analog Scale (VAS), and Short Form-36 (SF-36). Multiple linear regression analyses with backward elimination based on the Akaike Information Criterion were conducted to identify independent predictors of CSI and FIQ scores. TDP was present in 61.7% of patients and 30% of controls (p < 0.001). Patients with TDP had significantly higher CSI scores (61 ± 9 vs. 34 ± 10, p < 0.001), TSK scores (42 ± 4 vs. 29 ± 6, p < 0.001), and FIQ scores (68.7 ± 11.1 vs. 45.9 ± 9.7, p < 0.001) compared to non-Type D patients. Pain intensity (VAS: 8 ± 1 vs. 6 ± 2, p = 0.004) and pain duration (104 ± 92 vs. 59 ± 53 months, p = 0.046) were significantly higher in patients with TDP. Furthermore, strong positive correlations were found between DS-14 subscale scores and clinical parameters in FM patients, including CSI (r = 0.84), TSK (r = 0.75), and FIQ (r = 0.76) (all p < 0.001). Among the DS-14 subscales, negative affectivity independently predicted both central sensitization symptoms (CSI; β = 0.27, p = 0.018) and disease severity (FIQ; β = 0.49, p = 0.004) in multivariable analyses. TDP is highly prevalent among patients with FM, and patients with Type D traits demonstrated higher central sensitization, greater fear of movement, more severe clinical symptoms, and lower quality of life compared to those without these traits. These findings underscore the importance of incorporating personality traits into routine clinical assessment and support the adoption of more individualized, psychologically informed treatment approaches.

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