Personality Traits and Perceived Food Allergy: A Pilot Exploratory Study

Background: A substantial discrepancy exists between the prevalence of perceived food allergy and that of food allergy confirmed by objective diagnostic methods. The misperceptions of food-related symptoms in the absence of a confirmed food allergy may be related to maladaptive personality traits, such as neuroticism, which may shape symptom perception, illness experience, and the therapeutic alliance. From an integrative medicine perspective, maladaptive personality traits may be associated with the reporting and interpretation of food-related symptoms. Objective: This pilot exploratory study examined associations between personality traits and perceived food allergy. Methods: Twenty-one adults reporting food allergy symptoms underwent allergological assessment and standardized psychological evaluation. Participants were classified as having confirmed (n = 10) or excluded (n = 11) immune-mediated food allergy. Maladaptive personality traits were assessed using the Personality Inventory for DSM-5 Brief Form (PID-5-BF), and quality of life was measured using the WHOQOL-BREF. Between-group comparisons were performed using Mann-Whitney U tests. Results: Patients without confirmed food allergy demonstrated significantly higher Antagonism scores compared with those with confirmed allergy (p = 0.003; g = 1.03). No significant differences emerged in other personality domains, although moderate-to-large effect sizes were observed for Negative Affectivity, Disinhibition, and Psychoticism. These findings should be interpreted with caution given the small sample size and the exploratory nature of the study and should be considered preliminary and hypothesis-generating. Conclusions: Patients with confirmed food allergy may be primarily burdened by environmental limitations associated with disease management, whereas individuals without confirmed allergy may exhibit higher levels of maladaptive personality traits, particularly antagonism. Integrating psychological assessment into allergy care may support patient-centered, evidence-based integrative approaches in conditions marked by diagnostic uncertainty.