Trait Sensitivity, Anxiety, and Personality Are Predictive of Central Sensitization Symptoms in Patients with Chronic Low Back Pain

• Published in: Pain practice 2019-11, Vol.19 (8), p.800-810
• Main Authors: Clark, Jacqui R., Nijs, Jo, Yeowell, Gillian, Holmes, Paul, Goodwin, Peter C.
• Format: Article
• Language: English
• Subjects: Adult; Anxiety - diagnosis; Anxiety - epidemiology; Anxiety - psychology; Central Nervous System Sensitization - physiology; central sensitization; Chronic Pain - diagnosis; Chronic Pain - epidemiology; Chronic Pain - psychology; Cross-Sectional Studies; cross‐sectional observational study; Female; Humans; Ireland - epidemiology; Low Back Pain - diagnosis; Low Back Pain - epidemiology; Low Back Pain - psychology; Male; Middle Aged; nonspecific chronic low back pain; Personality - physiology; Personality Disorders - diagnosis; Personality Disorders - epidemiology; Personality Disorders - psychology; personality type; predicting central sensitization symptom scores; Predictive Value of Tests; sensory profiles; trait anxiety; trait characteristics
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.12809

Background Sensitivity‐related trait characteristics involving physical and emotional sensitivities and high trait anxiety personality types have been observed in individuals with nonspecific chronic low back pain (NSCLBP). High trait sensitivity to sensory stimulation combined with interpretation biases based on personality type may contribute to the development of central sensitization (CS) symptoms. To date, there is limited research that has considered both sensitivity levels and personality type in NSCLBP with CS. The purpose of this study was to investigate (1) relationships between trait sensory profiles, trait anxiety, and CS symptoms, and (2) the predictive capacity of sensory profiles, trait anxiety, and personality types on CS symptoms in people with NSCLBP. Methods This was a cross‐sectional observational study using 4 self‐report measures on adults (N = 165, mean age = 45 ± 12 [standard deviation] years) from physiotherapy clinics in England, Ireland, and New Zealand. Inclusion: NSCLBP > 6 months, age 18 to 64 years, predominant CS pain presentation, no other pathology. Parametric and nonparametric correlation statistics and regression analyses were used. Results Positive correlations were found between central sensitization inventory (CSI) scores and sensory hypersensitivity profiles and trait anxiety. CSI score increases could be predicted by sensory‐sensitive, low‐registration profiles; trait anxiety scores; and extreme defensive high anxious personality type. Conclusions Trait sensory hyper‐ and/or hyposensitivity and high trait anxiety–related personality type characteristics predict the extent of CS symptoms in people with NSCLBP. Further investigation is required to establish causality between these characteristics and CS symptoms.