Associations Between Type D Personality, Psychological Symptoms, Pain Severity, and Migraine-Related Outcomes in Women with Migraine

Background/Objectives: Migraine is common in women and is associated with significant disability and reduced quality of life. Type D personality, characterized by negative affectivity and social inhibition, has been linked to poorer outcomes in chronic illnesses; however, its association with migraine-related impact and functioning in women has not been fully clarified. This study examined the associations of Type D personality with headache impact and overall functioning in women with migraine, with an exploratory focus on the indirect statistical associations involving psychological symptoms, pain severity, and age. Methods: In this cross-sectional study, 204 women with migraine were assessed. Type D personality was measured using the DS14, headache impact using the HIT-6, and functioning using the FAST. Anxiety and depression were measured with the HADS, and pain severity with a visual analog scale. Analyses included group comparisons, correlations, exploratory mediation analyses, and moderation analyses. Results: Type D personality was present in 41.2% of participants. Women with Type D personality had more chronic migraine, physical comorbidities, lower education and employment, and greater functional impairment. Type D personality was correlated with headache impact, functional impairment, anxiety, and depression. Anxiety and pain severity showed significant indirect statistical associations in the relationship between Type D personality and headache impact, while depression showed a significant indirect statistical association in the relationship between Type D personality and functioning. Age moderated the association between Type D personality and headache impact, with a stronger association observed in older women. Conclusions: In women with migraine, Type D personality was associated with greater functional impairment, whereas its association with headache impact was attenuated after adjustment for relevant clinical and psychological factors. Psychological symptoms and pain severity showed significant indirect statistical associations with migraine-related outcomes; however, causal inferences cannot be drawn due to the cross-sectional design. These findings highlight the potential clinical relevance of assessing personality traits and psychological symptoms in women with migraine.