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#personality and #ChronicPain

I have thought often about personality changes and chronic pain. I have written about it before in How Chronic Pain Affects Personality. The fact is pain is a significant, constant stressor on us that has to impact certain factors of our personality. Immediately I believe we are impacted just in how we cope in how we hide the pain... in the facade we adapt to mask the pain. This facade of wellbeing often becomes a part of who we are. However, over times there are other changes that can happen. I have becomes more isolated for example, since pain certainly when I was working made it difficult to just have the energy and capacity to engage in any extra activities beyond work. That led to a rather hermit lifestyle.

A study looked into some brain changes that could account for some of the personality changes we see in chronic pain conditions.

"interested in finding out whether more subtle changes to the brain, known to occur in people with chronic pain, could also lead to shifts in personality.
Their study, published recently in PLOS ONE, studied 22 people with chronic nerve pain on one side of their face.
"These people report a severe burning pain in their face. They say it's like lightning or a knife through their cheek," says Gustin, adding such pain can occur if nerves are injured during dental surgery.
Using five different brain imaging methods the researchers compared the brains of the chronic pain patients with those of healthy controls.
They also assessed the personality of participants using a 240-item questionnaire.
Gustin and colleagues found that people with chronic pain were more passive and less novelty seeking than the controls.
"Chronic pain patients are less likely to want to go out and explore the world," says Gustin.
Imaging found chronic pain patients had greater activity in parts of the brain involved in emotions, cognition and behaviour
In particular, they had more neuronal growth in the prefrontal cortex, which is a part of the brain linked to emotions, cognition and behaviour -- including seeking out new experiences.
The degree of nerve growth was correlated with the degree of personality change, says Gustin.
She says previous research in animals also showed similar changes associated with chronic pain, says Gustin.
Gustin and colleagues argue that these brain changes occur after the onset of chronic pain and lead to a reduction in novelty seeking.
Importantly, all the changes seen in the brain were on the opposite side to that of the face pain.
Given that the right side of the brain controls the left side of the body and vice versa, this supports the idea that the pain was directly linked with the brain changes.

Focus on pain

Gustin thinks greater nerve growth occurs in the prefrontal cortex because people are focusing more on their pain.
"I think this is because these people are thinking and worrying more," she says.
She says this worrying in turn could prove to be "vicious cycle" by exacerbating the brain linkages that lead to decreased novelty-seeking.
Gustin says other diseases could also lead to subtle personality changes like this.
The findings challenge a long-standing view that people don't change their personality after the age of 18, she adds.
In future research she would like to see if it is possible to reverse brain and personality changes due to chronic pain by altering brain rhythms.
Gustin says a major outstanding question is why some people develop chronic pain in the first place and others, with the same injuries, don't"

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