Introversion, Extraversion, and Worsening of Chronic Pain Impact during Social Isolation: A Mediation Analysis

Abstract

COVID-19 social distancing mandates increased social isolation, resulting in changes in pain severity and interference among individuals with chronic pain. Differences in personality (e.g., introversion/extraversion) may modulate responses to social isolation. We examined the influence of introversion on reported social distancing-related increases in pain interference and assessed for mediators of this relationship. Individuals with chronic pain (n = 150) completed validated questionnaires 4-8 weeks after implementation of social distancing mandates. Introversion/extraversion was measured using a subscale of the Myers-Briggs Type Indicator and changes in pain and psychosocial variables were calculated by comparing participants' recalled and current scores. Association between introversion/extraversion and other variables were assessed using linear regression. A parallel mediation was used to examine mediators of the association between introversion and change in pain interference. Higher introversion was associated with a decrease in pain interference after social distancing (Rho = − .194, p = .017). Parallel mediation analysis revealed that the relationship between introversion/extraversion and change in pain interference was mediated by changes in sleep disturbance and depression, such that higher introversion was associated with less isolation-induced sleep disruption and depression, and thereby less worsening of pain interference. These findings suggest that personality factors such as introversion/extraversion should be considered when personalizing treatment of chronic pain.

Psychiatric disorders, personality traits, and childhood traumatic events predicting incidence and persistence of chronic pain: results from the CoLaus|PsyCoLaus study

“…20,30 Aside from MD or psychiatric symptoms, few cross-sectional studies have also explored the links between the personality dimensions neuroticism and extraversion and pain. 15,20,43 One earlier study found both neuroticism and extraversion to be associated with pain characteristics, 43 whereas another study suggested that neuroticism is associated with the way pain is experienced. 20 Moreover, a very recent study conducted during the COVID-19 pandemic revealed that higher extraversion was associated with an increase in pain interference after social distancing.…”

“…20 Moreover, a very recent study conducted during the COVID-19 pandemic revealed that higher extraversion was associated with an increase in pain interference after social distancing. 15 Several retrospective studies also found early-life traumatic events (ETEs) to be associated with pain-related medical conditions in adulthood. 19,36,38,44 However, the cross-sectional design of these studies impeded researchers to characterize the nature of these associations.…”

Effect of Personality and Pain Catastrophizing on Postoperative Analgesia Following Cesarean Section: A Prospective Cohort Study

“…Therefore, introversion and extraversion personality factors should be considered in the individualized management of pain. 34 Neuroticism is an important factor in pain control. 35 Elgaeva et al 36 showed that neurotic personality traits may influence pain through a positive feedback loop.…”

Kristin Schreiber, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award

“…25 This longitudinal study of the impact of COVID-induced isolation allowed insights into a rarely studied aspect of the biopsychosocial model: how social forces influence pain, and how they impact a patient's psychology and their processing of pain. [25][26][27][28] Her work is changing the way we think about personalizing perioperative care in an era of multiple enhanced recovery after surgery protocols that often dictate a one-size fits all approach. 29 Dr. Schreiber has a tremendous record of local, national, and international academic service, ranging from local institutional review board expert review and leadership in research infrastructure, to involvement in the Early-Stage Anesthesia Scholars program as part of International Anesthesia Research Society and serving as an Editor of Anesthesiology.…”

“…25 This longitudinal study of the impact of COVID-induced isolation allowed insights into a rarely studied aspect of the biopsychosocial model: how social forces influence pain, and how they impact a patient’s psychology and their processing of pain. 25–28 Her work is changing the way we think about personalizing perioperative care in an era of multiple enhanced recovery after surgery protocols that often dictate a one-size fits all approach. 29…”