Associations between maladaptive personality traits and physical health: Results of a cohort study with a large representative sample.

OBJECTIVE

While links between chronic somatic diseases and mental health are well documented, associations with maladaptive personality traits as defined by DSM-5 or ICD-11 have not been systematically examined. This study investigates whether maladaptive traits are associated with common chronic somatic diseases and whether these patterns are highly specific or generalize across traits, reflecting general severity of personality disorder (PD).

METHODS

Data from a large, representative German cohort (N = 4737; mean age = 54.13 years; 50.2% female; GESIS Panel, 2017-2019) were analyzed. Associations between maladaptive traits and self-reported physician-diagnosed diseases (e.g., rheumatic spectrum diseases, diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular conditions) were assessed using multiple logistic regressions, controlling for sex, age, smoking status, physical activity, alcohol consumption, and body mass index (BMI).

RESULTS

General severity of PD showed strongest associations across most investigated conditions (ORs 1.25-1.84). Specific trait-disease links were also observed such as negative affectivity with hypertension (OR = 1.20, 95% CI: 1.09-1.32), and detachment with stroke (OR = 1.84, 95% CI: 1.38-2.44). Further, maladaptive personality traits correlated with higher BMI and adverse health behaviors such as smoking, frequent doctor visits and sick days.

CONCLUSIONS

General severity of PD appears to index broad somatic vulnerability or burden, while specific maladaptive personality traits may show condition-specific links. These findings underscore the clinical relevance of integrating psychological assessments into somatic care. Future research should explore underlying biological mechanisms and examine moderators and mediators linking personality dysfunction with somatic disease.