Type D Personality, and Stigma in Myofascial Pain Syndrome

NCT07292155 | Completed

• 1 other identifier: 2025-GOKAEK-2513_2025.07.02505
• Study Type: observational
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Cervical myofascial pain syndrome is a chronic musculoskeletal condition characterized by the presence of sensitive trigger points and taut muscle bands, resulting in localized or referred pain, muscle stiffness, and limited range of motion. The disorder frequently leads to functional limitations and a reduction in quality of life. Although the physical features of cervical myofascial pain syndrome have been well documented, its psychological and social dimensions have not been adequately explored. Personality traits and social factors may influence pain perception, coping mechanisms, and treatment adherence. Type D personality, also known as distressed personality, is defined by the coexistence of negative emotions and social inhibition and has been associated with worse outcomes in various chronic diseases. Stigma represents another psychosocial factor that may contribute to disability and emotional distress in chronic pain conditions. This case-control study aims to investigate the prevalence of Type D personality traits and anticipated stigma among patients with cervical myofascial pain syndrome compared with healthy individuals. The study further explores the relationships between personality type, stigma, and clinical and psychological parameters, including anxiety, depression, disability, and health-related quality of life. Findings are expected to support a more comprehensive, biopsychosocial understanding of cervical myofascial pain syndrome and emphasize the importance of psychological screening and social support in clinical management.

Conditions

Cervical Myofascial Pain Syndrome; Chronic Neck Pain; Type D Personality; Psychological Distress; Stigma; Anxiety and Depression; Quality of Life

Keywords

Myofascial Pain Syndrome; Cervical Pain; Chronic Pain; Type D Personality; Distressed Personality; Negative Affectivity; Social Inhibition; Psychological Factors; Stigma; Anticipated Stigma; Chronic Illness Stigma; Anxiety; Depression; Neck Disability; Health-Related Quality of Life; Pain Psychology; Psychosocial Factors; Biopsychosocial Approach

Outcome Measures

Primary Outcomes (2)

• Type D Personality Scale

  The Type D Personality Scale is a 14-item self-report instrument assessing two stable personality traits: negative affectivity and social inhibition. Each item is rated on a five-point scale ranging from 0 (false) to 4 (true). Subscale scores range from 0 to 28. Individuals scoring 10 or higher on both subscales are classified as having Type D personality. A validated Turkish version of the scale is available

  At baseline

• Chronic Illness Anticipated Stigma Scale

  The Chronic Illness Anticipated Stigma Scale is a 12-item questionnaire measuring anticipated stigma across three domains: family and friends, work environment, and healthcare providers. Each item is rated on a five-point Likert scale ranging from 1 (very unlikely) to 5 (very likely). Subscale scores range from 4 to 20, and total scores range from 12 to 60, with higher scores indicating greater perceived stigma. A validated Turkish version of the scale is available.

  At baseline

Secondary Outcomes (4)

• Headache Impact Test

  At baseline

• Neck Disability Index

  At baseline

• Hospital Anxiety and Depression Scale

  At baseline

• Short Form 36 Health Survey

  At baseline

Study Arms (2)

Cervical Myofascial Pain Syndrome Group

This group includes adults between 18 and 65 years of age who were clinically diagnosed with cervical myofascial pain syndrome for at least six months. Participants were evaluated at the Departments of Neurology and Physical Medicine and Rehabilitation at Bozok University. Each participant completed a detailed clinical and psychosocial assessment using standardized questionnaires, including the Headache Impact Test, the Neck Disability Index, the Hospital Anxiety and Depression Scale, the Type D Personality Scale, the Chronic Illness Anticipated Stigma Scale, and the Short Form 36 Health Survey. These assessments were used to evaluate pain severity, neck-related disability, emotional status, personality traits, perceived stigma, and quality of life.

Healthy Control Group

This group includes healthy volunteers who were matched to the patient group by age, sex, and education level. Individuals in this group did not have any musculoskeletal, rheumatologic, neurological, or psychiatric disorders. They completed the same assessment battery as the patient group, including the Headache Impact Test, the Neck Disability Index, the Hospital Anxiety and Depression Scale, the Type D Personality Scale, the Chronic Illness Anticipated Stigma Scale, and the Short Form 36 Health Survey, in order to allow direct comparison of psychological and functional characteristics between groups.

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of adult outpatients aged 18-65 years who were diagnosed with cervical myofascial pain syndrome and healthy volunteers matched by age, sex, and education level. All participants were recruited from the Departments of Neurology and Physical Medicine and Rehabilitation at Bozok University Faculty of Medicine. Written informed consent was obtained from each participant after verbal and written explanations of the study procedures.

You may qualify if:

• Adults aged 18 to 65 years.
• Patients diagnosed with cervical myofascial pain syndrome according to Travell and Simons criteria:
• localized pain at rest,
• referred pain or altered sensation in the typical referral zone of a trigger point,
• a palpable taut band containing a hypersensitive tender spot, and
• restricted range of motion of the affected muscle.
• Duration of symptoms for at least six months.
• Outpatients followed in the Department of Physical Medicine and Rehabilitation.
• Voluntary participation and provision of written informed consent.
• Healthy control participants matched by age, sex, and education, without musculoskeletal or systemic diseases.

You may not qualify if:

• History of cervical disc herniation, radiculopathy, or myelopathy.
• Presence of systemic or rheumatologic diseases.
• Current psychiatric or neurological disorders such as schizophrenia, bipolar disorder, dementia, epilepsy, autism, or intellectual disability.
• Use of psychotropic medication or ongoing psychiatric treatment.
• History of major surgery or trauma involving the cervical region.
• Pregnancy or lactation.
• Inability to complete questionnaires due to cognitive or language barriers.
• Refusal or withdrawal of informed consent.

Sponsors & Collaborators

• Gulseren Demir Karakilic: lead
• Bozok University: collaborator

Study Sites (1)

Yozgat Bozok University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Yozgat, Yozgat, 66100, Turkey (Türkiye)

Location

Related Publications (6)

• Kocyigit, H., Turkish validity and reliability of short-form 36. Drug Treat, 1999. 12: p. 102-106.

  BACKGROUND

• Tünerir, E., Kronik hastalıklarda beklenen stigma ölçeğinin Türkçe geçerlilik ve güvenilirlik çalışması (Tıpta uzmanlık tezi). Sağlık Bilimleri Üniversitesi, İstanbul, 2019.

  BACKGROUND

• Öncü, E. and S.K. Vayısoğlu, D Tipi Kişilik Ölçeğinin Türk toplumunda geçerlilik ve güvenirlilik çalışması. Ankara Medical Journal, 2018. 18(4): p. 646-656.

  BACKGROUND

• Aydemir, O., Hastane anksiyete ve depresyon olcegi Turkce formunun gecerlilik ve guvenilirligi. Turk Psikiyatri Derg., 1997. 8: p. 187-280.

  BACKGROUND

• Telci EA, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2009 Jul 15;34(16):1732-5. doi: 10.1097/BRS.0b013e3181ac9055.

  PMID: 19770615 BACKGROUND

• Dikmen PY, Bozdag M, Gunes M, Kosak S, Tasdelen B, Uluduz D, Ozge A. Reliability and Validity of Turkish Version of Headache Impact Test (HIT-6) in Patients with Migraine. Noro Psikiyatr Ars. 2020 Apr 24;58(4):300-307. doi: 10.29399/npa.24956. eCollection 2021.

  PMID: 34924791 BACKGROUND

MeSH Terms

Conditions

Social Stigma; Anxiety Disorders; Depression; Myofascial Pain Syndromes; Neck Pain; Chronic Pain

Condition Hierarchy (Ancestors)

Social Behavior; Behavior; Mental Disorders; Behavioral Symptoms; Muscular Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor, Principal Investigator

Study Record Dates

• First Submitted: December 5, 2025
• First Posted: December 18, 2025
• Study Start: July 3, 2025
• Primary Completion: October 6, 2025
• Study Completion: October 6, 2025
• Last Updated: December 29, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: The IPD and related materials will be available beginning 6 months after publication of the article and will remain accessible for 3 years following publication.
• Access Criteria: Researchers who submit a reasonable request describing a methodologically sound proposal for data use may obtain access to de-identified data. Requests should be directed to the corresponding author at the email address listed in the publication. Data will be shared electronically via secure file transfer after approval of the request.

Locations

TU (1)