Five-factor personality traits and functional somatic disorder: A systematic review and meta-analysis 2025 Lamm et al

Andy

Andy

Retired committee member
Highlights
  • First review on functional somatic disorder and five-factor personality traits.
  • Functional Somatic Disorder higher on neuroticism than healthy & somatic controls.
  • Functional Somatic Disorder lower on agreeableness than healthy controls.
  • Functional Somatic Disorder lower on extraversion than healthy controls.
  • No difference in trait score observed for openness and conscientiousness.

Abstract

Introduction
Functional Somatic Disorders (FSD) is an umbrella term for various conditions characterized by persistent and troublesome physical symptoms, that are not better explained by other psychiatric or somatic conditions. Personality traits may play a crucial role in FSD, but the link is not fully understood. This study presents a systematic review and meta-analysis examines the relationship between the Five-Factor Model (FFM) of personality traits and FSD.

Methods
The review was based on the PRISMA statement, and drew data from systematic searches in PsycInfo, PubMed, and Embase. To be eligible for inclusion, studies had to include eligible FSD groups and control groups and to assess FFM traits. Data were analyzed using random effects models. Sub-group and sensitivity analyses as well as meta-regression were used to explore the heterogeneity and robustness of findings.

Results
In total 6841 records were screened and 52 included. FSD cases scored higher on neuroticism (k = 46, Hedge's g = 0.72, [95 % CI, 0.61: 0.83]) and lower on extraversion (k = 31, g = −0.41, [−0.55:-0.28]) and agreeableness (k = 15, g = −0.22, [−0.36:-0.09]) than healthy/unspecified controls. FSD cases scored higher on neuroticism (k = 9, g = 0.26 [0.08:0.44]) and agreeableness (k = 4, g = 0.43 [0.28:0.59]) than somatic controls, but did not differ on extraversion (k = 6, g = −0.17 [−0.45:0.11]). No significant differences were found for conscientiousness and openness. For psychiatric controls, meta-analysis was only possible for neuroticism (k = 3,= −0.61, [−1.98:0.77]). Findings displayed significant heterogeneity but no publication bias.

Conclusions
This review reveals significant associations between FFM traits and FSD, providing insight into the etiology, classification, and management of FSD.

Open access, https://www.sciencedirect.com/science/article/pii/S0272735824001508
 
"Functional Somatic Disorder (FSD) is a recently proposed classification for conditions characterized by persistent and impairing physical symptoms that are not better explained by other psychiatric or somatic diagnoses (Burton et al., 2020). FSD was introduced to address the overlap between diagnostic categories within the field (Budtz-Lilly et al., 2015; Burton et al., 2020). For instance, although Fibromyalgia, Chronic Fatigue Syndrome, and Irritable Bowel Syndrome are widely used and distinct constructs, their symptom presentations overlap significantly (Fink, Toft, Hansen, Ørnbøl, & Olesen, 2007; Petersen et al., 2020; Schröder & Fink, 2011; Wessely, Nimnuan, & Sharpe, 1999; Witthöft, Hiller, Loch, & Jasper, 2013). The FSD classification aims to simplify the classification of these and other similar conditions (e.g. Somatization Disorder (SzD) and Somatic Symptom Disorder) in order to facilitate improved communication, clinical management, and research within the field, which has historically been fragmented by the use of a variety of different operationalizations."
 
Oh how delightful, so we are neurotic, disagreeable, introverts now.

Oh, but hang on, we're only more disagreeable than healthy controls, we're more agreeable than somatic controls. So that's all right then.

This sort of 'research' disgusts me.
 
Trish said:
This sort of 'research' disgusts me.
Click to expand...
The only way this “research” is valuable is seeing how systemic denial of illness, mistreatment by the medical system, and having a disabling chronic illness might affect someone’s personality.

Like yeah sure. I did go from a smiling extrovert to a frowning introvert, but the causality this paper suggests is all wrong.

This research is the equivalent of looking at personality traits in someone dying from cancer and claiming the personality differences is causing the cancer. As opposed to you know, the tumour.
 
It’s hard to not see this personality “research” as similar ableist pseudoscience to what the differences based of race (leading to false claims of white genes being “better”) was during the eugenics movement. A poorely conducted excuse for research that gets funding and attention because it helps people rationalise their prejudices.

I hope one day it will be looked back upon as such.
 
I agree with what you say, @Yann04. It's very important that cause and effect are not confused.

However, there is another problem that papers like this never seem to mention. The questionnaires are designed on the assumption that answers relate to the person's personality or character, not to their illness.

For example, questions about anxiety often include physical signs which may have nothing to do with anxiety such as tachycardia. And depression questionnaires often include behavioural questions such as difficulty getting up in the morning or leaving the house, which may be physical difficulties of a physical illness and nothing to do with depression.

I suspect the same applies to the questionnaires in this study. So they may not be measuring what they say the measure at all, giving lots of false positive results for introversion, agreeableness etc.
 
re: arbitrary assigning of causation

They know what they are doing. One of the most consistent features of psychosomatic studies is the lack of discussion about and accounting for the serious problems and dangers with assigning causation without adequate testing, which they rarely, if ever, do. Causation is just asserted or assumed.
 
Well, as everyone knows, you can select for a paladin class and that will allow you to have a score of at least 14 on constitution, unless you choose orc or one of the "evil" races, then you will be limited to 12, so that when you roll a dice on a poison hit you won't have more than a 30% chance of not being poisoned and suffering from at least a 50% temporary penalty on hit points, which may leave you more vulnerable to a backstabbing one-hit kill attack or slowly ticking to death in 5 rounds, depending on your 12-roll. So if your main concern is any form of sickness attack, definitely choose a "noble" race personality trait and stack up on those health bonuses!

(Details completely made-up since I haven't played DnD in decades but the point remains that this nonsense here is just as ridiculous as applying DnD character attributes in real life, or Meyers-Briggs, or astrological signs)

You certainly have to appreciate how excessively obvious your assumptions and biases have to be to even think this is anything but junk nonsense. Medicine has truly perfected the absolute peak of pseudoscience, there will never be any pseudoscience more absurd and widely applied as this.
 
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