Back to Journals » Journal of Pain Research » Volume 13

Big Five Personality Traits and Disabling Chronic Low Back Pain: Association with Fear-Avoidance, Anxious and Depressive Moods

Authors Ibrahim ME, Weber K, Courvoisier DS, Genevay S

Received 6 November 2019

Accepted for publication 24 March 2020

Published 14 April 2020 Volume 2020:13 Pages 745—754


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael A Überall

Maha Emad Ibrahim,1,2 Kerstin Weber,3 Delphine S Courvoisier,1,4,5 Stéphane Genevay1

1Division of Rheumatology, University Hospitals of Geneva, Geneva, Switzerland; 2Department of Physical Medicine, Rheumatology and Rehabilitation, Suez Canal University, Ismailia, Egypt; 3Medical Direction, University Hospitals of Geneva, Geneva, Switzerland; 4Quality of Care Service, Geneva University Hospitals, Geneva, Switzerland; 5Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland

Correspondence: Maha Emad Ibrahim
Department of Physical Medicine, Rheumatology and Rehabilitation, Suez Canal University, Ring Road, Ismailia 41511, Egypt
Tel +20 1005607210

Purpose: Physical dysfunction in chronic low back pain patients is influenced by psychological variables rather than by pain severity. Assessing personality traits may help clinicians address the complexity of patients’ experiences and design treatments that target these vulnerabilities. This study aimed to identify the distinguishing personality traits of a cohort of patients with disabling chronic low back pain and to determine associations between those traits and fear-avoidance beliefs, depressive, and anxious moods.
Patients and Methods: This cross-sectional study included 102 chronic low back pain patients (57% male), who failed standard management and were referred to a multidisciplinary rehabilitation program. All patients completed the five domains of the NEO Personality Inventory (NEO PI)–Revised (Neuroticism, Extraversion, Openness to experience, Agreeableness and Conscientiousness), the Tampa Scale for Kinesiophobia (TSK), and the Hospital Anxiety and Depression Scale (HADS). One-sample t-test was used to compare sample personality means with average population norms. Association between the five personality domains with TSK and HADS was assessed using Pearson’s correlation, adjusted for patient demographics and pain-related variables. Linear regression was used to estimate associations adjusted for covariates.
Results: Both men and women had significantly lower scores in the Openness to experience domain and significantly higher scores in the Conscientiousness domain than the general population norms. After adjusting for covariates, Neuroticism was associated with higher fear-avoidance, depression and anxiety scores. Conversely, Extraversion and Openness to experience negatively correlated with depression scores. Extraversion also inversely correlated with fear-avoidance. Conscientiousness negatively correlated with depression and anxiety after adjustment.
Conclusion: Patients with disabling chronic low back pain show personality characteristics that deviate significantly from the normal population norms but do not reach maladaptive forms of personality disorders. Clinicians would benefit from assessing patients’ personality traits to address protective and risk factors for psychological distress, particularly in difficult-to-treat, highly disabled low back pain patients.

Keywords: NEO PI, anxiety, depression, kinesiophobia, chronic low back pain, personality

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]