A set of personality traits were found to be associated with the likelihood of persistent pain and opioid medication use, according to study results published in the Journal of Psychosomatic Research.

It is estimated that two-thirds of individuals who misuse opioids are prescribed those medications for pain management. Pain is determined by psychological and social factors, in addition to biological ones. Personality factors that include ways in which a person thinks, behaves and feels have been associated with the pain experience.

The aim of the current study was to examine the association between personality traits and persistent pain and opioid use over a 10-year period.

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The study included 8491 participants (mean age, 65.93 years; 61% women) from the Health and Retirement Study who were asked to report on their personality and experience of pain using the 26-item Midlife Development Inventory that assesses: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Of 8491 participants, 3440 (40%) were experiencing persistent pain, and 1166 (14%) reported using opioids within the previous 3 months.

Participants who reported persistent or infrequent pain vs no pain had higher scores in neuroticism and lower scores in extraversion, and conscientiousness. Openness scores were higher in participants reporting experiencing persistent pain vs no pain.

Neuroticism was found to be associated with a greater risk for persistent pain (odds ratio [OR], 1.44; 95% CI, 1.38-1.51; P <.001) and opioid use (OR, 1.21; 95% CI, 1.14-1.29). Extraversion was associated with a reduced risk for persistent pain (OR, 0.83; 95% CI, 0.80-0.87; P <.001) and opioid use (OR, 0.92; 95% CI, 0.86-0.97; P = .005).   

Conscientiousness was associated with a lower risk for persistent pain (OR, 0.83; 95% CI, 0.79-0.87; P <.001) and opioids use (OR, 0.91; 95% CI, 0.86-0.97; P =.003).

Study limitations include the lack of data on the specific cause and course of pain, the use of self-reported assessments of opioid prescription medication use, and the lack of information on opioid use before the 2016 assessment.

“[S]table psychological functioning may be one factor that makes an individual more vulnerable to persistent pain and may be useful in developing targeted prevention and treatments programs to manage pain,” concluded the study researchers.


Sutin AR, Stephan Y, Luchetti M, Terracciano A. The prospective association between personality traits and persistent pain and opioid medication use. J Psychosom Res. 2019;123:109721.