Assessment of personality in psychosomatic medicine: current concepts

The notion that personality variables can affect vulnerability to specific diseases has been widely promoted in psychosomatic medicine. Over the time, some personality patterns have been extensively studied. Among them, alexithymia, type A, and type D personality are the most relevant. However, also temperament and character has increasingly been object of studies. Alexithymia is currently recognized as a risk factor for medical, psychiatric, or behavioral problems; type A personality is recognized to increase the risk for coronary artery disease, and type D personality has been related to adverse cardiac events and cardiovascular outcomes. The growing interest and clinical role of the personality constructs in psychosomatic medicine has been favored by the revolutionary understanding that personality factors are not causes of medical disease but their moderators/mediators, and by the decline of the psychometric distinction between state and trait. Indeed, it is nowadays recognized that psychological constructs traditionally conceived as trait dimensions may surprisingly display sensitivity to change in specific clinical situations. Assessing personality, thus, has become worth pursuing since it may give unique information about individuals with medical conditions and contribute to completely understand medical patients and their global health as well as formulating optimal decision-making and treatment planning. In this framework, the present chapter has the aim to provide insight into personality dimensions in psychosomatic medicine and describe the main instruments to assess it.