{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:00:45Z","timestamp":1792522845807,"version":"4.5.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012320","name":"Otto-von-Guericke University Magdeburg","doi-asserted-by":"publisher","award":["DE 811 640 443"],"award-info":[{"award-number":["DE 811 640 443"]}],"id":[{"id":"10.13039\/501100012320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: Type-D personality, characterized by negative affectivity (NA) and social inhibition (SI), has been associated with adverse outcomes in chronic pain and cardiovascular populations. Evidence in spine outpatient settings remains limited. We aimed to assess the prevalence of Type-D personality and its association with pain, disability, and psychological distress in patients presenting to a university spine outpatient clinic. Methods: This exploratory cross-sectional study included 300 consecutive patients (18\u201385 years) presenting to a university spine outpatient clinic between 2023 and 2025. Patients completed the Type-D Scale-14 (DS14; Type-D defined as NA \u226510 and SI \u226510), the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale for pain (VAS, 0\u201310), and the Oswestry Disability Index (ODI, 0\u2013100). Demographic and clinical characteristics were recorded. Comparisons between Type-D and non-Type-D patients were performed. Results: The prevalence of Type-D personality was 32.3% (95% CI: 27.0\u201337.6%). Compared with non-Type-D patients, Type-D patients reported higher pain intensity (VAS: 5.23 vs. 3.88), disability (ODI: 38.6 vs. 31.3), anxiety (HADS-A: 10.0 vs. 6.5), and depression (HADS-D: 8.4 vs. 6.4); all p &lt; 0.01. Between-group differences were clinically relevant, with large effect sizes for pain intensity (VAS; Cohen\u2019s d \u2248 1.10) and moderate-to-large effect sizes for functional disability (ODI; Cohen\u2019s d \u2248 0.75). Correlation analyses showed moderate to strong associations between Type-D personality traits (negative affectivity and social inhibition) and psychological distress. In stratified analyses, longer pain duration was descriptively associated with greater disability, particularly among patients with Type-D personality. Conclusions: Type-D personality is common in spine outpatient populations and is associated with greater pain, disability, and psychological distress. These findings underscore the relevance of psychosocial factors in spine outpatient care and highlight the need for further longitudinal research to clarify prognostic implications and potential targets for intervention.<\/jats:p>","DOI":"10.3390\/jcm15051753","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T09:31:32Z","timestamp":1772098292000},"page":"1753","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence of Type-D Personality and Its Association with Pain, Disability, and Psychological Distress in a University Spine Outpatient Clinic: A Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2336-6684","authenticated-orcid":false,"given":"Christian","family":"Riediger","sequence":"first","affiliation":[{"name":"Orthopaedic University Clinic Magdeburg, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Ferl","sequence":"additional","affiliation":[{"name":"Orthopaedic University Clinic Magdeburg, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2962-2183","authenticated-orcid":false,"given":"Christoph H.","family":"Lohmann","sequence":"additional","affiliation":[{"name":"Orthopaedic University Clinic Magdeburg, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Sch\u00f6nrogge","sequence":"additional","affiliation":[{"name":"Orthopaedic University Clinic Magdeburg, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3404-0735","authenticated-orcid":false,"given":"Agnieszka","family":"Halm-Pozniak","sequence":"additional","affiliation":[{"name":"Orthopaedic University Clinic Magdeburg, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.4102\/sajp.v78i1.1783","article-title":"Biopsychosocial factors associated with chronic low back pain-related activity limitations in Burundi","volume":"78","author":"Nduwimana","year":"2022","journal-title":"S. 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