Carlatan, City of San Fernando La Union

COLLEGE OF PHYSICAL AND RESPIRATORY THERAPY

APPROVAL SHEET

This Thesis hereto entitled:

PERCEPTION OF PAIN BASED ON DIFFERENT PERSONALITY TYPES OF THE

STUDENTS OF LORMA COLLEGES S.Y. 2016-2017 prepared and submitted by 5th year Bachelor of
Science in Physical Therapy in partial fulfillment of the requirements for the degree of Bachelor of
Science in Physical Therapy has been examined and is recommended for acceptance and approval for
ORAL EXAMINATION.

Ms. Sheena Tayaban

Adviser

Approved by the Committee on Oral Examination with a grade of PASSED on ______________

____________________
Chair

Member

Accepted in partial fulfillment of the requirement for the degree of Bachelor of Science in Physical
Therapy

Noted by:

Bernardo B. Tayaban Jr, PTRP, MDA

Research Instructor
Dean, College of Physical and Respiratory Therapy
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 CHAPTER 1

INTRODUCTION

Situation Analysis

From the tiniest of pin prick to an actual gunshot wound, from a simple direct to the point

pinch to its most bizarre kind of phantom sensation, or its other forms of loss grief, heartache or

adversity, call it what you like but it is pain. Pain is something that we feel all the time, pain is

essential component of living – of life itself that some even say that pain is what makes us human

in that it shapes us the same way other things, such as experience, shape us. According to

novelist John Green pain demands to be felt, meaning pain is not pain when it is in no way

affecting the person. It is amazing of how something so physical and basic and primitive can

affect how people react and behave. That is why pain in the research world is a very much

studied concept, maybe because pain is something that all of us experience but for as much as

possible wants to avoid.

Pain is a critical component of patient care. In the Physical Therapy world, pain is one of

the most common symptoms that may lead someone to seek the help of a physical therapist or

other health care professional. Since pain is mainly measured using subjective reports of intensity

and symptom behavior, it is often misinterpreted despite its popularity of being considered the

fifth vital sign. (Nair &Peate, 2009) The International Association for the Study of Pain (IASP)

introduced the most widely used definition of pain. The IASP defined pain as an “unpleasant

sensory and emotional experience associated with actual or potential tissue damage, or

described in terms of such damage’’ (IASP, 2017).

As cited by Jensen et. al (2011), pain that is classified on the basis of its presumed

underlying pathophysiology is broadly classified into two main types-nociceptive or neuropathic

pain. Nociceptive pain is the most common type of pain seen in the acute clinical setting and it is

the primary focus of this study. Neuropathic pain is defined as “pain caused by injury or disease

of the somatosensory nervous system”

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 Another classification of pain is either acute or chronic. The research will basically focus

on acute pain. And it was once defined simply in terms of duration. But it is now viewed as a

“complex, unpleasant experience with emotional and cognitive, as well as sensory, features that

occur in response to tissue trauma” (D’Arcy, 2017).

McCaffery as cited by Aschennbrenner and Venable (2009) defined pain as “whatever

the experiencing person says it is, existing whenever s/he says it does”. This definition

emphasizes that pain is a subjective experience with no objective measures, pain is subjective. It

mainly depends on how the patient reports the pain to the medical practitioner. There is no

objective measure in pain aside from pain scale and analog experimental study or any study

related to pain perception or personality types.

In the authors’ scales, and even though there is such, that is still based on the perception

of the patient - on how he/she perceives the pain. It also stresses that the patient, not clinician, is

the authority on the pain and that his or her self-report is the most reliable indicator of pain. The

patient's perception of his pain is the only way for clinicians to assess their pain as well as on how

to manage it.

Perception is a sequence of process that work together to determine our experience of

and reaction of stimuli in the environment (Goldstein, 2014) Moreover perception as cited by

Klenoff (2014), is the integration of sensory impressions into information that is psychologically

meaningful, it is the interpretation and recognition of the objects and events that we sense. These

events might as well be events that may inflict pain in an individual so therefore this will again

support the claim that pain really is subjective. So therefore, there is more to it than the pain

stimuli but rather also on how an individual perceive his/her pain. The perception of pain is a

complex phenomenon that is influenced by the emotional state and past experiences of the

individual (Snell, 2010).

The IASP (2017) defines pain threshold as the minimum intensity of a stimulus that is

perceived as painful or simply the point beyond which a stimulus causes pain. Conversely pain

tolerance is maximum intensity of a pain-producing stimulus that a subject is willing to accept as

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perceived in a given situation. With these definitions of pain threshold and pain tolerance, the

researchers came up with the collective term Perception of Pain describing the said two.

It is often debated on whether this pain threshold is dictated by common factors or just

simply differs in each individual, for example is the sex or gender differences. According to

popular myth as stated from more than 10 people of Agoo, pain threshold of women is higher as

compared to their counterparts. They reasoned this out that since their body is program to stand

higher intensities of pain such as childbirth, they ought to have higher pain threshold. This claim

however was disproved their hypothesis in the study conducted by Paller et. al. (2009) and stated

that that women experience greater clinical pain, suffer greater pain-related distress, and show

heightened sensitivity to experimentally induced pain compared with men. The factors

underpinning sex differences in the experience of pain are multifactorial and complex; for

example, psychosocial factors such as pain-related catastrophizing may explain sex-based

differences in reporting certain types of pain, as women tend to use catastrophizing to a greater

degree. This claim supported by the results from the study of Bartley and Fillingim, (2013). They

stated that "previous qualitative and quantitative reviews have generally concluded that women

display greater sensitivity to multiple pain modalities compared with men, and that women show

greater temporal summation of pain while men display greater conditioned pain modulation". The

study showed experimentally induced pain have produced a very consistent pattern of results,

with women exhibiting greater pain sensitivity, enhanced pain facilitation and reduced pain

inhibition compared with men, though the magnitude of these sex differences varies across

studies.

Studies were also conducted to know whether the “nurture”, as in “Nature vs. Nurture” of

an individual, plays as factor in pain threshold. Yi et.al. (2015) put on an experiment wherein a

total of 48 male patients aged 18 to 38 years who had undergone elective laparoscopic

appendectomy under general anesthesia then divided into religious backgrounds (two levels:

without religion background, with religion background). All subjects received the same

anesthesia, surgical procedure, and postoperative analgesia with Parecoxib Sodium. The patient

was subjected to temperature pain threshold and electrical pain threshold were detection 1h

5
before and after analgesia. The results however were that, there was no interaction between the

religious backgrounds in terms of temperature pain threshold and electrical pain. In the factor o f

Socio Economic Status however, there are contradicting studies. One study involving 15,474

respondents and SES, based on education, income and profession, concluded that even at the

same intensity of pain and the same number of painful body sites, people in the lowest as

compared to the highest socio-economic class were twice to three times more likely to feel

disabled through pain therefore lower pain thresholds (Dorner et. al., 2015). Persad et. al. (2017)

however concluded that SES was a weak predictor of pain threshold because no significant

differences were seen between those with higher SES and lower SES.

On the side of pain tolerance, one factor that may affect this tolerance is ethnic group.

One conducted study by Williams et. al. (2012) which concluded that there are potentially

important ethnic/ racial group differences in experimental pain perception. It has translational

merit for culturally competent clinical care and for addressing and reducing pain treatment

disparities among ethnically/ racially diverse groups.

As cited by Sharma (2013), Eysenck defined personality as a more or less stable and

enduring organization of a person’s character, temperament, intellect and physique, which

determine [the] unique adjustment to the environment. The phrase “adjustment to the

environment” can be made again as a connection that personality may be a factor in the

perception of pain.

These differences in pain threshold and pain perception basing on an individual’s

personality type is also very apparent in physical therapy practice. In an example of sprained

ankle, some patients may report sharp excruciating pain with a pain scale of 10/10 upon injury,

while some may report 7/10 pain scale upon injury even though both patients are experiencing

the same injury, say both a grade 2 ankle sprain. Again in the clinical setting, many also often

observe that agitated patients when asked to rate their pain from 1-10, 10 being the most painful,

often report higher pain scales as compared to the more timid or shy patients who tend to report

less. These differences in the reports of pain even in same incidents and mechanisms of injury

6
led the researchers into thinking that maybe the patient personality may affect their perception of

pain in the first place

A report in 2011 by the Institute of Medicine indicated that there is a systemic lack of

understanding of pain among researchers and health care providers and this lack of

understanding continues to have a major impact on relief for patients with pain. This report is

based on the United States of America, a country with far better health care system than the

Philippines who’s still adapting to newer technologies and ways in providing healthcare.

Therefore, it is understood that a better understanding of pain must take place.

In the Physical Therapy practice, a considerable number of topics are placed in the

curriculum of bachelors of physical therapy on pain management. These pain management

methods range from modalities (therapeutic ultrasound, hot moist pack) to exercises (peripheral

joint mobilization etc.). Pain management is a big deal to physical therapy because this is often

the reason why patients visit the physical therapy rehab. According to a study by Liu and Fletcher

(2006) One-third (33%) of the referrals sent to physical therapy included no medical diagnosis,

with the most common reason for the referral listed as “pain.” Therefore, pain assessment and

management must not be confined in just asking if it still hurts. The researchers’ objective in

conducting this research is to add knowledge in pain management although may not directly but

at least add knowledge and ultimately raise the quality of health service.

The purpose of the study focused on explaining the relationship of perception of pain of

individuals with different personality types among Bachelor of Physical Therapy Lorma Colleges

students. This study will significantly contribute not only in physical therapy profession but also to

the students, repondents, patients as well as the future researchers. For the respondent, they will

have awareness of the personality types and their tendencies in perceiving pain. For the

Students, especially the students of taking up Bachelor in Physical Therapy, this will serve as a

guide in dealing and handling patients with different personality types during pain management

and knowing their tendencies and response to treatment of pain to be applied in their clinical

duties as interns. For the Physical Therapist in practice, they will have an idea by the results of

the study in dealing and handling patients with different personality types during pain

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management and knowing their tendencies and response to treatment of pain for the more

effective patient care. The patients will be aware of the tendencies of oneself in response to the

treatment given to them in the case of pain management. And lastly for the future researchers,

the findings of the study will serve as a reference material and a guide for future researches who

wish to conduct the same contention that pain assessment studies must be continuously studied

as the society and the environment drastically evolving throughout time. This will provide the

physical therapist a clear knowledge that can potentially help to improve the management as well

as in dealing with patients.

The researchers were also encouraged to do the research because of their personal

observations and experience in assessing and managing pain. Observations were made during

the clinical exposures as part of the curriculum of Cinical Education subject as well as in

assessing the patients they have met inside and outside the clinic. Although the researchers

presently have minimal exposure to the clinic, they believe that the observation that has already

been made, needs to be studied deeply to find out if there is really significant relationship

between different personality type and perception of pain.

Theoretical Framework of the Study

This study is anchored on the following theories:

The Gate Control Theory explains that in the brain acts a gate to increase or decrease

the flow of nerve impulses from the peripheral fibers to the Central Nervous System. An “open”

gate allows the flow of nerve impulses, and the brain can perceive pain. A “closed” gate does not

allow flow of nerve impulses, decreasing the perception of pain. It mentioned that pain, thoughts,

beliefs and emotions may affect how much pain we feel from a given physical sensation. The

fundamental basis for this theory is the belief that physiological as well as physical factors guide

the brain’s interpretation of painful sensation and the subsequent response. (Srivastava, 2010)

This theory clinically recognized the importance of the mind and brain in pain perception.

Thus, enabled the researcher to discover the physiological factors play a role in the perception of

pain. Although the theory accounts for phenomena that are primarily mental in nature - that is, pain

8
itself as well as some of the psychological factors influencing it - its scientific beauty is that it provides a

physiological basis for the complex phenomenon of pain.

The Central Biasing Pain Theory explains the concept of “learned behavior”. It is built on the

pain gate control theory and addresses brain influences on incoming and outgoing messages.

Cognitive effects can alter sensory discrimination, the location of the pain source, the intensity of the

pain and the nature of the pain (Ching et. al., 2009). The central biasing pain theory has a motivational-

affective influence. An internal drive or external stimulation can have a strong influence on thought

processes and therefore, affect the perception of pain. The ascending message of pain passes through

the reticular formation, the thalamus and may enter the limbic system when then links the motivational

and emotional responses to the pain message (Gilman & Newman, 2009). This explains the different

emotional responses to pain, i.e. fear, range, crying, panic, denial, and anxiety, and control to pain.

Hence, pain tolerance, which is the maximum degree of pain intensity a person is willing to experience,

should take in consideration the cortex of an individual’s brain, the limbic system, reticular formation,

and the thalamus. These brain structures interpret the intensity of pain, send autonomic responses,

regulate pain threshold and modify the emotional responses to pain. This suggest that pain responses.

Appears to be more physiological than psychological in origin (Watson, 2009). Moreover, culture,

ethnicity, socioeconomic status, personality type will all influence pain tolerance (Ching, 2009)

The study was also guided by the concept, Psychological Factors on Pain by Hardy,

Wolff, and Goodell. The theory suggested the two components of pain: perception of pain and the

reaction to pain. The perception of pain is a process that has special structural, functional, and

perceptual properties and is accompanied by means of simple and primitive neural receptive and

conductive mechanisms. The reactions to pain, conversely, is a complex proc ess relating the

cognitive functions to pain experience, culture, and a range of psychological factors that influence

the reaction pain stimuli (Hardy, et al, 2010).

In other words, this theory is linking the stimulus intensity and perception of pain. The

concept of total pain encompasses the multidimensional factors that contribute to the patient’s

experience of pain. It may include all the following: Intellectual Pain, Emotional Pain,

Interpersonal Pain, Financial Pain, Spiritual Pain, and Physical Pain (McCaffey & Bebbe, 2010).

9
 Pain is a completely individualized experience. We often use different terms to describe

it, but it is hard to know if you feel pain the same way as your friends or family feel pain. Some

people talk about having a high or low tolerance to pain, but becaus e pain is such a subjective

experience, science has not developed accurate ways to measure pain tolerance.

As cited by Sharma (2013), Eysenck stated that personality is a “more or less stable and

enduring organization of a person’s character, temperament, intellect and physique, which

determine [the] unique adjustment to the environment”. Eysenck, based on own studies,

determined that the structure of personality is divided into three independent dimensions. The

traits are formed hierarchically and contain primary factors which stem from groups of correlated

habits and behavior. The main dimensions, referred to as super traits in this theory, are:

psychoticism (P), extraversion (E) and neuroticism (N), which are polar.

The Enneagram typology is a useful tool for researchers, providing an integrative

framework for models of explicit and implicit personality. (Sutton, 2012) The Enneagram is mainly

a diagnostic tool of one's emotional outlook on life. It will not cure one's problems, but may he lp

point out their underlying fixations. It is also useful as a guide to how other people see the world

differently.

The Enneagram is being used in a variety of health care settings as a powerful method

for improving the working relationships between disparate leaders and stakeholders with different

viewpoints and needs – between patients and physicians, between hospital administrators and

physicians, between health care professionals working together across the continuum of care or

on a given case, and between health care delivery systems and insurance companies. The

Enneagram also helps health care providers understand the best course of treatment from an

emotional and cognitive perspective. Studying the Enneagram can lead to a better understanding

of self, and a better understanding of others (Bland, 2010). And finally, the Enneagram is being

used to help coach patients as they become more responsible making health care decisions,

managing their own care, and utilizing the health care remedies that are suggested to

them. (Hufano, 2009)

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 Each of the nine Enneagram types has a distinct adaptive pattern based upon and

supporting a specific core belief, yet no type is deemed more or less healthy than any other type.

Here are brief descriptions of the nine basic types: (Daniels, 2016)

Type One: The Reformer believes you must be good and right to assure a satisfying life

in a world that demands good behavior and punishes bad behavior. Consequently, Reformers are

conscientious, responsible, improvement-oriented, and self-controlled, but can be critical,

resentful, and self-judging.

Type Two: The Helper believes you must give fully to others to assure a satisfying life in

a give-to-get world. Consequently, Helpers are caring, helpful, supportive, and relationship-

oriented, but can be prideful, overly intrusive, and demanding.

Type Three: The Achiever believes you must accomplish and succeed to assure a

satisfying life in a world that rewards doing, rather than being. Consequently, Achievers are

industrious, fast-paced, goal-focused, and efficiency-oriented, but can be inattentive to feelings,

impatient, and image-driven.

Type Four: The Individualist believes you must obtain the longed-for complete and highly

idealized relationship or situation to assure a satisfying life in a world that otherwise would

abandon you. Consequently, Individualists are idealistic, deeply feeling, empathetic, authentic to

self, but can be dramatic, moody, and sometimes self-absorbed.

Type Five: The Investigator believes you must protect yourself from intrusion to insure a

satisfying life in a world that demands too much and gives too little. Consequently, Investigators

are self-sufficiency-seeking, non-demanding, analytic/thoughtful, and unobtrusive, but can be

withholding, detached, and overly private.

Type Six: The Loyalist believes you must gain certainty and security to assure a

satisfying life in a hazardous and unpredictable world you can’t trust. Consequently, Loyalists

themselves are trustworthy, inquisitive, good friends, and questioning, but can be overly doubtful,

accusatory and fearful.

Type Seven: The Enthusiast believes you must keep things positive and open to assure a

satisfying life and escape from a world that causes pain and imposes limitation. Consequently,

11
Enthusiasts are optimistic, upbeat, pleasure and possibility seeking, and adventurous, but can be

pain-avoidant, uncommitted, and self-serving.

Type Eight: The Challenger believes you must be strong and powerful to assure a

satisfying life in a tough and unjust world in which the powerful will take advantage of you.

Consequently, Challengers are justice-seeking, direct, strong, and action-oriented, but can be

overly impactful, excessive, and impulsive.

Type Nine: The Pacemaker believes you must blend in with others and “go along to get

along” to assure a satisfying life in a world that makes you unimportant or requires you to blend

in. Consequently, Pacemakers are harmony-seeking, comfortable, and steady, but can be self-

forgetting, conflict-avoidant, and stubborn.

In addition to focusing on the nine types of core belief patterns, the Enneagram system

works with all three centers of intelligence---head, heart, and body---and the three basic aversive

emotions associated with these centers of intelligence---fear, distress, and anger. We all have

some of each type in us, but it’s important to determine a client’s core type because, as the

following case illustrates, it gives us leverage with which to support the work of personal

transformation. (Daniels, 2016)

Personality traits, alongside the specific situation, define how frequently an individual

experiences a transient state, such as anxiety or negative mood. Due to the relationship these

transient states have on pain sensitivity it is of upmost importance to understand how personality

interacts with pain. As personality may change due to a life changing event such as the diagnosis

and trauma of a medical condition it is troublesome to identify a causal relationship between

these two factors. Due to this complication the bulk of research cannot identify personality prior to

the onset of a pain condition but can simply state comorbidity of extreme personality traits and

pain. (Cameron, 2011)

These theories support the idea of the researchers to conduct this study. The given

theories- Gate Control Theory, Central Biasing Pain Theory, Psychological Factors on Pain ,

Enneagram Typology are not yet proven but it gives us the provisional explanation for the facts

12
needed to this is study. As of this moment, there are limited resources or literatures regarding

pain, pain perception, and personality types.

The above mentioned theories and concepts helped the researcher in the

conceptualization of the study. The conceptual framework is illustrated in the paradigm. The

independent variable- dependent variable model has been adopted.

Figure 1 shows the interplay of the variables. The independent variable Pain Perception

which includes the Pain Threshold and the Pain Tolerance, as well as the Personality Type.

Whereas Dependent Variable includes the relationship of the Pain Perception and Personality

Type.

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 INDEPENDENT VARIABLE DEPENDENT VARIABLE

1. Pain Perception
a. Pain Threshold
b. Pain Tolerance

2. Personality Types
a. Type One: Reformer
b. Type Two: Helper
c. Type Three: Relationship of pain perception and
Achiever personality type
d. Type Four:
Individualist
e. Type Five:
Investigator
f. Type Six: Loyalist
g. Type Seven:
Enthusiast
h. Type Eight:
Challenger
i. Type Nine:
Pacemaker

Figure1. The Research Paradigm

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Statement of the Problem

This study aims to determine the perception of pain of the students of Bachelor of Science in

Physical Therapy of Lorma Colleges with different personality types.

Specifically, it aimed to answer the following questions:

1. What is the personality type of students of Bachelor of Science in Physical Therapy of Lorma

Colleges based on Enneagram Personality Test?

2. What is the level of perception of pain students of Bachelor of Science in Physical Therapy of

Lorma Colleges in terms of pain threshold and pain tolerance?

3. Is there any significant relationship between pain perception and personality type?

Hypotheses

The hypothesis will be raised in the study and will be tested

Ho: There is no significant relationship in the perception of pain of individuals based on their

personality types as demonstrated by the students of Bachelor of Science in Physical Therapy of

Lorma Colleges.

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 CHAPTER 2

METHODOLOGY

This chapter presents the methodology of the study. It includes research design, source of data

and analysis of data.

Research Design

This study will use the descriptive method of the survey type of research which describe and

interpret data about the study.

According to Mansen and Horn (2008), the descriptive method of study is an effective way to

obtain information used in devising hypotheses and proposing associations. This method is adopted to

gather relatively limited data from a relatively large number of cases. The variables that will be measured

are not directly observable and based from indirect measures. A questionnaire will be used to enable the

researchers to identify the personality type of each of the respondents based on their answers and the

interpretations correspondingly.

Descriptive research is designed to provide a picture of a situation as it naturally happens. It may

be used to justify current practice and make judgment and also to develop theories. For the purpose of

this study, descriptive research was used to obtain a picture of the perception of pain of students of

Bachelor of Physical Therapy in Lorma Colleges and its connection to their personality types.

Source of Data

This study will be conducted in Lorma Colleges Physical Therapy Department located at

Carlatan, City of San Fernando, La Union within a month duration. The sample size is based on the total

number of 3rd year and 4th year students of Bachelor of Science in Physical Therapy which is 62. The

respondents must meet the following criteria: (1) freedom from acute and chronic pain of any type prior to

the procedure; (2) no use of any medications.

Unfortunately, due to reasons such as conflicting schedules, not meeting the aforementioned

criteria or simply being uncooperative, seven respondents were not able to attend to the study. The study

therefore only had 55 respondents able to complete all stages of the study.

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Data Gathering Tool

Personality Type Evaluation

The Riso-Hudson Enneagram Type indicator (RHETI, Version 2.5) will be utilized in this study.

But for the purpose of shorter exam time and lesser questions to be answered as it may affect the output

by the respondents, the Riso-Hudson Enneagram Type Indicator Sampler (RHETI Sampler) will be used

in this study. This questionnaire part of the full, independently scientifically validated 144-question Riso-

Hudson Enneagram Type Indicator (RHETI, Version 2.5) personality inventory . It has 36-item, self-

report questionnaire. It consists of questions relating to the experiences of an individual’s life. This RHETI

Sampler, like its original form of Riso-Hudson Enneagram Type indicator, is also advertised by the

leading authority of Enneagram Type – the Enneagram Institute. According to Kim and Pries (2017), the

Enneagram as represented by The Enneagram Institute is a more efficacious measure of personality

traits than any other personality typing test Interestingly, the Enneagram measures nine personality

types, which correspond with the nine enneagram types. The viability of the Enneagram as a personality

measurement system has been validated in a number of studies (Bland, 2010). As cited by Talbott

(2012), Enneagram Institute press release about one study of the validity of the Enneagram system,

Professor David Bartram is quoted affirming, “The nine personality types of the Enneagram are real and

objective, and…stand on a par psychometrically with the Myers-Briggs system, the Big Five, and other

well-known, accepted psychological systems”. The nine types identified by the RHETI are: 1 = Reformer;

2 = Helper; 3 = Achiever; 4 = Individualist; 5 = Investigator; 6 = Loyalist; 7 = Enthusiast; 8 = Challenger; 9

= Peacemaker (Matise, 2007).

Cold Pressor Test

The cold pressor test (CPT) is an empirically validated test commonly used in research on stress,

pain and cardiovascular reactivity. (Streff et. al., 2009). As cited by Mitchell (2013), the cold pressor test is

a widely used experimental technique for human pain or stress induction, involving immersion of the hand

or forearm in cold water. As a method of experimental pain induction, the cold pressor test is thought to

mimic the effects of chronic conditions effectively. A survey of previous studies using the cold pressor,

17
however, revealed a lack of standardization and control of water temperature, questioning comparability

and reliability.

In this study, we will utilize a modified Cold Pressor Test apparatus. The ice water will be put in a

cooler to preserve the coolness of the temperature with 8 inches depth (measured using a ruler). The

temperature will be measured throughout the procedure using a thermometer with 5°C with a maximum

temperature variance of ±0.5 ºC. In an effort in preserving the uniformity of the procedure, the containers

that will be utilized is of the same dimensions, the temperature of the icy water is to be monitored and

maintained at 5oC with a maximum temperature variance of ±0.5 ºC and the hand will be immersed at the

same level of 3 inches superior to the ulnar styloid process. This tool will be used to measure the pain

threshold by recording the time they first felt pain upon immersion. Also in this tool the pain tolerance of

the subjects is determined by the duration on how long they can tolerate the pain in their hand.

Visual Analog Scale

The modified pain Visual Analog Scale (VAS) that will be used in this study is a continuous scale.

Instructions, time period for reporting, and verbal descriptor anchors have varied widely in the literature

depending on intended use of the scale. (Hawker et. al., 2011) The scale will include the name of the

sample and two (2) VAS for pain threshold and pain tolerance accordingly.

In spite of the best efforts to minimize all limitations that might creep in the course of the research,

there were certain aspects of the experiments that might limit the research such as the instruments or

tools that will be used for eliciting painful stimulus to the subjects cannot be measured to the greatest

accuracy. Due to lack of resources, the instruments or tools which will be used in the experiment will not

be in their prime state throughout the study. Also, the environment where the research is conducted will

be adjusted to the best we can in order to promote uniformity, but some aspects such as room

temperature and humidity may not be controlled.

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Data Gathering Procedure

The researchers will ask the respondents to answer the tests provided by the site 9types.com.

They will firstly accomplish the questionnaires to identify their personality types by clicking the circle on

the left of each statement as an answer to a corresponding question. The interpretation of the result will

also be done by the site itself.

After interpreting the data from the questionnaires, the personality types of the respondents are

identified and group accordingly. After which they will proceed to the Cold Pressor Test.

The respondents will immerse their non-dominant hand in the CPT bath in still position with

fingers wide apart for as long as they could. A cut-off time of 180 seconds will be set for safety reasons.

This initial immersion is considered training or familiarization, and the results will not be used for statistical

analysis. Ten minutes later, a second CPT immersion will be conducted in the same manner.

Respondents will be instructed to indicate the exact point in time when the cold sensation began

to hurt, and they first felt pain. This will be considered as pain threshold. The latency to intolerability

(spontaneous hand removal) will be considered as pain tolerance. Tolerance for subject that did not

withdraw their hand for the entire 180 seconds will be recorded as 180 seconds. Immediately afte r

withdrawing their hand, subjects will be asked to mark on a modified 100 mm VAS ruler the maximal pain

and minimum pain intensity they experienced during the cold stimulus for additional data. The data

gathered will be tallied and tabulated. These data became the bases of analysis and interpretation.

Analysis of Data

In identifying the personality type based on the site’s questionnaire, the same site will interpret

the results. Every question has a corresponding personality type (see appendix C). The scores on each

type will be summed up and the highest score will determine the personality type of the respondents.

However, if there is an equal highest total, the respondent will choose between the highest total score.

To identify the pain threshold and pain tolerance of the respondents, the researchers will use the

exact point in time where the subjects first felt pain (pain threshold) and the exact time when respondents

19
withdraw their hand from the water (pain tolerance). The researchers will then get the mean of the

respondents’ pain scales on pain threshold and pain tolerance.

In an effort to determine if there is a significant relationship in the perception of pain of the

respondents and their different personality types Chi-square will be used as a statistical tool.

A chi-square statistic is one way to show a relationship between two categorical variables. The

chi-squared statistic is a single number that tells you how much difference exists between your observed

counts and the counts you would expect if there were no relationship at all in the population. (Andale,

2017).

Based on this, it will be determined if we will accept or reject the null hypothesis.

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 CHAPTER 3

RESULTS AND DISCUSSION

This chapter contains the results and discussion of the findings of the study.

Level of Perception of Pain of Students of Bachelor Of Science in Physical Therapy of Lorma

Colleges in Terms of Pain Threshold and Pain Tolerance

This section discusses the level of perception of pain as percieved by the students of Bachelor of

Science in Physical Therapy of Lorma Colleges in terms of pain threshold and pain tolerance.

Table 1. Personality Type of Students of Bachelor of Science in Physical Therapy of Lorma

Colleges Based on Enneagram Personality Test

SUBJECT PERSONALITY TYPE

Subject 1 Type 7

Subject 2 Type 4

Subject 3 Type 7

Subject 4 Type 6

Subject 5 Type 4

Subject 6 Type 2

Subject 7 Type 6

Subject 8 Type 7

Subject 9 Type 2

Subject 10 Type 2

Subject 11 Type 2

Subject 12 Type 2

Subject 13 Type 7

Subject 14 Type 2

21
Continuation of Table 1…

Subject 15 Type 1

Subject 16 Type 7

Subject 17 Type 2

Subject 18 Type 8

Subject 19 Type 2

Subject 20 Type 2

Subject 21 Type 9

Subject 22 Type 9

Subject 23 Type 2

Subject 24 Type 2

Subject 25 Type 3

Subject 26 Type 2

Subject 27 Type 2

Subject 28 Type 2

Subject 29 Type 7

Subject 30 Type 2

Subject 31 Type 5

Subject 32 Type 7

Subject 33 Type 8

Subject 34 Type 8

Subject 35 Type 3

Subject 36 Type 7

Subject 37 Type 2

Subject 38 Type 3

Subject 39 Type 9

Subject 40 Type 6

22
 Continuation of Table 1…

Subject 41 Type 2

Subject 42 Type 5

Subject 43 Type 7

Subject 44 Type 2

Subject 45 Type 2

Subject 46 Type 9

Subject 47 Type 9

Subject 48 Type 7

Subject 49 Type 5

Subject 50 Type 8

Subject 51 Type 8

Subject 52 Type 5

Subject 53 Type 2

Subject 54 Type 9

Subject 55 Type 5

Table 1 shows the personality types of each subject. The respondents were grouped according to

the Enneagram Personality Type Test. Data shows that most number of respondents are type 2- twenty

in number. This type of personality which is also called ‘the helper’ according to Enneagram Personality

Test is characterized as caring, interpersonal type. Twos are empathetic, sincere, and warm -hearted.

They are friendly, generous, and self-sacrificing, but can also be sentimental flattering, and people-

pleasing. They are well-meaning and driven to be close to others, but can slip into doing things for others

in order to be needed. They typically have problems with possessiveness and with acknowledging their

own needs. They are unselfish and altruistic, they have unconditional love for others.

Followed by ten type 7 respondents. They are also called ‘the enthusiasts’. They are busy,

productive type. Sevens are extroverted, optimistic, versatile, and spontaneous- Playful, high-spirited, and

23
practical, they can also misapply their many talents, becoming over-extended, scattered, and

undisciplined. They constantly seek new and exciting experiences, but can become distracted and

exhausted by staying on the go. They typically have problems with impatience and impulsiveness. They

focus their talents on worthwhile goals, becoming appreciative, joyous, and satisfied.

Six respondents are type 9. Also called ‘the peacemaker’. The easy-going, self-effacing

type. Nines are accepting, trusting, and stable. They are usually creative, optimistic, and supportive, but

can also be too willing to go along with others to keep the peace. They want everything to go smoothly

and be without conflict, but they can also tend to be complacent, simplifying problems and minimizing

anything upsetting. They typically have problems with inertia and stubbornness. They are indomitable and

all-embracing, they are able to bring people together and heal conflicts.

Five respondents are type 5. They are also called ‘the investigator’. They are perceptive, cerebral

type. Fives are alert, insightful, and curious. They are able to concentrate and focus on developing

complex ideas and skills. Independent, innovative, and inventive, they can also become preoccupied with

their thoughts and imaginary constructs. They become detached, yet high-strung and intense. They

typically have problems with eccentricity, nihilism, and isolation. They are visionary pioneers, often ahead

of their time, and able to see the world in an entirely new way.

Also, five respondents are type 8-‘the challenger’. The powerful, aggressive type. Eights are self-

confident, strong, and assertive. Protective, resourceful, straight-talking, and decisive, but can also be

ego-centric and domineering. Eights feel they must control their environment, especially people,

sometimes becoming confrontational and intimidating. Eights typically have problems with their tempers

and with allowing themselves to be vulnerable. They are self-mastering, they use their strength to

improve others’ lives, becoming heroic, magnanimous, and inspiring.

Three respondents on each type 3 and type 6- ‘the achiever’ and ‘the loyalist’ type respectively.

The achiever are the adaptable, success-oriented type. Threes are self-assured, attractive, and charming.

24
Ambitious, competent, and energetic, they can also be status-conscious and highly driven for

advancement. They are diplomatic and poised, but can also be overly concerned with their image and

what others think of them. They typically have problems with workaholism and competitiveness. They are

self-accepting, authentic, everything they seem to be—role models who inspire others. Whereas, ‘the

loyalist’ are the committed, security-oriented type. Sixes are reliable, hard-working, responsible, and

trustworthy. Excellent "troubleshooters," they foresee problems and foster cooperation, but can also

become defensive, evasive, and anxious—running on stress while complaining about it. They can be

cautious and indecisive, but also reactive, defiant and rebellious. They typically have problems with self -

doubt and suspicion. They are internally stable and self-reliant, courageously championing themselves

and others.

There are two type 4 respondents which is also called ‘the Individualist’. The introspective,

romantic type. Fours are self-aware, sensitive, and reserved. They are emotionally honest, creative, and

personal, but can also be moody and self-conscious. Withholding themselves from others due to feeling

vulnerable and defective, they can also feel disdainful and exempt from ordinary ways of living. They

typically have problems with melancholy, self-indulgence, and self-pity. They are inspired and highly

creative, they are able to renew themselves and transform their experiences

Lastly, one respondent classified as type 1 which is also called ‘the reformer’. The principled,

idealistic type. Ones are conscientious and ethical, with a strong sense of right and wrong. They are

teachers, crusaders, and advocates for change: always striving to improve things, but afraid of making a

mistake. Well-organized, orderly, and fastidious, they try to maintain high standards, but can slip into

being critical and perfectionistic. They typically have problems with resentment and impatience. They are

wise, discerning, realistic, and noble. Can be morally heroic.

25
 Table 2. Level of Perception of Pain of Students of Bachelor of Science in Physical Therapy of

Lorma Colleges in Terms of Pain Threshold and Pain Tolerance

MEAN SCORES

PAIN THRESHOLD PAIN TOLERANCE

TIME (s) 12.76 29.86

PAIN SCALE PS 4.5/10 PS 9.01/10

Table 2 shows the level of pain threshold of the subjects based on the time they first felt

the pain and pain scale using visual analog scale during the cold pressor test. The table reveals that with

a mean of 10.79 seconds, the subjects first felt the pain during the cold pressor test and with a mean pain

scale of 4.03/10.

Researchers have paid attention to the psychological aspects of pain as a real and new concept Formatted: Font color: Auto

besides its physical aspect. According to Yadollahi 2013, psychologists believe that the psychological

mode can lead to a positive or negative situation in confrontation with pains and physical illnesses. It

can accelerate or delay the effect of a physical illness and can also be effective in treatment of illnesses.

Furthermore, psychological and social factors including personality factors, attitudes, beliefs, patients’

expectations from themselves and their problems, their ability in coping with an illness, and the

healthcare system can indirectly influence the patients’ expression of pain, inability, and response to

pain. These occur through a decrease in physical activity and muscular flexibility.

Table 2 also shows the level of pain tolerance of the subjects based on the time they tolerated the

pain and pain scale using visual analog scale during the cold pressor test. Data shows that the subjects’

tolerance is within 26.28 seconds using the cold pressor test and with a mean pain scale of 8.96/10.

26
 According to Pathophysiology of Pain Perception by Filligim and Lautenbacher, 2012, an addition Formatted: Font color: Auto

to this exclusively neurophysiological explanation wherein it stressed the role of psychological or the

behavioral and cognitive factors in explaining how pain sensitivity. According to Fillingim (2012) they have

suggested that generalization of behavior or personality patterns previously established by operant

learning may explain decreased pain tolerance and increased pain report.

Chapman 2012 theorized that there are some personality pattern with long lasting pain would

become more reactive to stimulus which previously has not been perceived as being painful.

Table 3. Relationship between Personality Type and Perception of Pain

Perception of Pain Variables Computed Value Critical Value Remarks

Pain Threshold 33.93 15.51 Not Significant

Pain Tolerance 11.06 15.51 Significant

In this study, the respondents have different level of pain threshold that made the result

insignificant.

Pain tolerance on the other hand, yielded a computed value of 11.06 and a critical value

of 15.51 which is high. This means that pain tolerance of the respondents have significant relationship

between personality type. It also means that every personality type has different response to pain.

Marskey and Spear (2013) stated that “pain threshold is more dependent on physiological factors and Formatted: Font color: Auto

pain tolerance on psychological factors.”

Buxton and Perrin (2011), The submersion of a subject's nondominant hand in cold

water does not elicit as high an anticipatory effect as does an electrical shock, a spiked pressor gage, or

radiant heat that can blister the skin. This was of concern in getting a pure reading on pain threshold

and pain tolerance.

27
 CHAPTER 4

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

SUMMARY/ CONCLUSION

Limitation and Further Research

In the present study conducted on a population of students, we established differences in how Formatted: Font color: Auto

pain is perceived by people with different personality traits. However, there was no significant results

noted due to the discussed discrepancies with the results of other studies, further analysis of this

phenomenon is required. As stated by a certain contexts Laughter et. al (2007), pain perception does not

depends on the personality traits, but it correlates with certain illnesses. Therefore, it is essential to

continue this line of research to find out which coping strategies are best related to the highest and lowest

levels of pain. This will also help us to identify the strategies that would lead to better adaptation levels in

individuals. We suggest that this pilot study be redone taking into consideration the above results.

Relevance of Pain

The original aims of this investigation were to identify a collection of personality traits that are Formatted: Font color: Auto

related to pain sensitivity in order to define a pain prone personality. The failings of these two self-

report measures led to an inadequate assessment of participants, rendering the investigations results

troublesome to validly interpret. With refinements of these two measures a valid pain prone personality

can be established alongside a potentially stronger observed effect of anomalous perception on pain.

As functional pain patients experience greater pain during perceptually anomalous experiences Formatted: Left

(McCabe, Cohen & Blake, 2007) it is important to identify whether this is due to an anomalously

perceptive personality and if so how can medicine reduce these traits in an effort to relieve pain.

Pain and Personality

28
 These findings introduce the possibility of an anomalously perceptive personality. If this trait is Formatted: Font color: Auto

independent of those defined by trait theorists it requires incorporation into their models. Incorporating

these findings into existing popular models is important, as devising original, invalidated models is

troublesome to apply to prior personality research. The introduction of this personality trait (or

collection of traits) and the results of the initial investigation also highlight personality’s interaction with

physiological processes. Fundamentally personality defines our overt, observable behaviours, but in this

case clearly alters pain sensitivity and potentially the frequency of anomalous experiences. Greater

investigation is required to identify how personality affects physiological and perceptual activity.

RECOMMENDATIONS

Recommendation for Research

The following recommendations are offered for related research in the field of Physical Therapy.

1. Given the changing nature of physical therapy practice, a series of longitudinal studies, based on

this model, would document trends and thereby increase the potential that decisions regarding

pain management would be relatively current and less exposed to personal bias.

2. While this research considers the pain perception based on personality types from a group of

students as subjects, it may be advantageous to conduct research which considers also the

distribution of the subjects in the context of other aspects of demographic profiles such as sex,

age, race etc.

Recommendation for Practitioners

The following recommendations are offered for practitioners in the field of Physical Therapy based on the

results acquired in the study:

1. It is recommended that Physical Therapy practitioners, use the information gathered on the

study as a basis for evaluating and treating patients.

29
Recommendation for Improving this Study

The following recommendations are offered as possible ways to improve this study.

1. Respondents partaking must be more committed to the study and be willing to fully participate in

all activities required during the course of the study

2. In spite of the best efforts to minimize all limitations that might creep in the course of the

research, there were certain aspects of the experiments that might have limited the research such

as:

a. The instruments or tools that were used for eliciting painful stimulus to the subjects

cannot be measured to the greatest accuracy.

b. Due to lack of resources, the instruments or tools which were used in the experiment

were not in their prime state throughout the study

c. The environment where the research was conducted was not controlled and uniformity

was only achieved to some extent, some aspects such as room temperature and

humidity and ambiance was not.

3. Wider scope of respondents, in terms of demographic profiles, as well as equal number on each

personality types may be subjected to same study to further validate the results of this research.

30
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 Macintyre P. and S. Schug (2015). Acute Pain Management: A Practical Guide. 4th edition. U.S.:

CRC Press

Mansen, E. and L. Horn (2008), Research Successful Approaches. 3rd edition. United States of

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Thompson, S. (2012). Sampling. 3rd edition. New Jersey: A. John Willey & Sons, Inc

C. ONLINE JOURNALS

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Daniels D. (2016). The Five “A’s” of Transformation: The Enneagram as a clinical tool.

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Dorner et. al. (2015). The impact of socio-economic status on pain and the perception of

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Hawker G. et. al. (2011). Measures of Adult pain: Visual Analog Scale of Pain (VAS Pain),

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Pain Grade Scale(CPGS), Short Form-36 Bodily Parts Scale (SF-36 BPS) and Measure of

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Jensen et. al. (2010). The Relationship of Changes in Pain Quality to Pain Interference and

Sleep Quality. Vol. 11. Issue 8. Retrieved from: http://dx.doi.org/10.1016/j.jpain.2009.11.009

Liu H. And Fletcher J. (2006). Analysis of physicians' referrals: is further diagnosis needed?

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Sharma P. (2013). A Correlational Of Personality Types And Performance Of The Teacher

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pain.pdf

35
 APPENDIX A

COVER LETTER

Carlatan, City of San Fernando La Union

COLLEGE OF PHYSICAL AND RESPIRATORY THERAPY

April 28, 2017

_______________
_______________

_______________

Dear Respondents,

We, the undersigned researcher of 4th year Bachelor of Science in Physical Therapy enrolled in
EDUC5: Intro to Research and Research Proposal are presently conducting a study entitled
“PERCEPTION OF PAIN BASED ON DIFFERENT PERSONALITY TYPES OF THE
STUDENTS OF LORMA COLLEGES S.Y. 2016-2017”.

At this juncture, may I ask you to share your precious time by answering the questionnaire on
http://9types.com/rheti/index.php completely and honestly. After answering the questionnaire, kindly
screen capture the results then send it to https://web.facebook.com/messages/t/mgswenzy.cruz. Rest
assured that your responses will be treated with utmost confidentiality.

Your cooperation in this study will be very much needed and appreciated. Thank you very much.

Respectfully yours,

Cruz, Wenzy Razzie P. Estacio, Patricia Ashley B.

Medriano, Lorraine R. Reyes, Dante Jr. M.

Picazo, Judy Fe J. Valite, Dale

36
Noted by:

Bernardo B. Tayaban Jr, PTRP, MDA

Research Instructor
Dean, College of Physical and Respiratory Therapy

37
 APPENDIX B

QUESTIONNAIRE

Enneagram Personality Test

Directions

The Enneagram Personality Test consists of 37 paired statements. It is a questionnaire which

requires you to choose the statement in each pair that best describes you as you have been throughout
most of your life.

Mark a circle to the left of the statement you have selected.

Some pairs of statements compare subtle differences between the personality types, and
choosing one over the other requires you to think carefully about which response has been more true of
you. In some of the pairs, both statements may almost be equally true. If you reflect carefully, however,
you will find that one of the statements has been more true of you than the other. Choose this statement
in each pair. You may want to skip particularly "difficult" pairs and return to them after you have finished
the entire test. Or, you may wish to review your choices for the whole test after you have finished. Feel
free to change an original response if, after further reflection, you feel that another response is more
appropriate. While it is useful to wrestle with "difficult" pairs of statements, there may be 2-5 pairs that
simply do not apply to you, and you may skip these.

Read the statements carefully before responding, but do not try to "over-analyze" them. You will
get more accurate results if you answer spontaneously rather than think of extreme situations in which
both statements might possibly be true of you Remember that there are no "right" answers and that no
personality type is better than any other. Furthermore, the Enneagram typology does not indicate how
healthy or unhealthy a person is, so relax and answer the statements simply and honestly. If you have
difficulty discovering your personality type because two or more top scores are very close, you might find
it helpful to discuss your responses with someone who knows you well, such as a spouse, close friend, or
therapist.

Nevertheless, your core self will remain the same since you do not actually change your
personality type. By responding to the statements as you have been most of your life, you are attempting
to find out what your "core" self is.

38

1. I've been
romantic and imaginative.
pragmatic and down to earth.
2. I have tended to
take on confrontations.
avoid confrontations.
3. I have typically been
diplomatic, charming, and ambitious.
direct, formal, and idealistic.
4. I have tended to be
focused and intense.
spontaneous and fun-loving.
5. I have been a
hospitable person and have enjoyed
welcoming new friends into my life.
private person and have not mixed
much with others.
6. Generally, it's been
easy to "get a rise" out of me.
difficult to "get a rise" out of me.
7. I've been more of a
"street-smart" survivor.
"high-minded" idealist.
8. I have
needed to show affection to people.
preferred to maintain a certain distance
with people.
9. When presented with a new experience,
I've usually asked myself if it would be
useful to me.
enjoyable.
10. I have tended to focus too much on
myself.
others.
11. Others have depended on my
insight and knowledge.
strength and decisiveness.
12. I have come across as being too
unsure of myself.
sure of myself.
13. I have been more
relationship-oriented than goal-
oriented.
goal-oriented than relationship-
oriented.
14. I have
not been able to speak up for myself
very well.
been outspoken--I've said what others
wished they had the nerve to say.
15. It's been difficult for to be
hesitant and procrastinating.
take it easy and be more flexible.
16. I have tended to be
hesitant and procrastinating.
bold and domineering.
17. My
reluctance to get too involved has
gotten me into trouble with people.
eagerness to have people depend on me
has gotten me into trouble with them.
18. Usually, I have
been able to put my feelings aside to
get the job done.
needed to work through my feelings
before I could act.
19. Generally, I have been
methodical and cautious.
adventurous and taken risks.
20. I have tended to be a
supportive, giving person who enjoys
the company of others.
serious, reserved person who likes
discussing issues.
39
21. I've often felt the need to 30. I have generally been an
be a "pillar of strength." outgoing, sociable person.
perform perfectly. earnest, self-disciplined person.
22. I've typically been interested in 31. I've usually
asking tough questions and been shy about showing my abilities.
maintaining my independence.
liked to let people know what I can do
maintaining my stability and peace of well.
mind.
23. I've been too
Pursuing my personal interests has been
hard-nosed and skeptical. more important to me than having comfort
and security.
soft-hearted and sentimental.
24. I've often worried that Having comfort and security has been
more important to me than pursuing my
I'm missing out on something better. personal interests.
if I let down my guard, someone will 32. When I've had conflict with others, I've
take advantage of me. tended to withdraw.
25. My habit of
rarely backed down.
being "stand-offish" has annoyed 33. I have
people.
given in too easily and let others push
telling people what to do has annoyed me around.
people.
26. Usually, when troubles have gotten to been too uncompromising and
me, I have demanding with others.
34. I've been appreciated for my
been able to "tune them out."
unsinkable spirit and great sense of
treated myself to something I've humor.
enjoyed.
27. I have quiet strength and exceptional
generosity.
depended upon my friends and they 35. Much of my success has been
have known that they can depend on me.
due to my talent for making a favorable
not depended on people; I have done impression.
things on my own.
28. I have tended to be achieved despite my lack of interest in
developing "interpersonal skills."
detached and preoccupied. 36. For statistical purpose only:
moody and self-absorbed. 37. I am
29. I have liked to male.
challenge people and "shake them up." female.
comfort people and calm them down.

APPENDIX C

ENNEAGRAM PERSONALITY TEST SCORE SHEET

40
 Directions

Type 1 Type 2 Type 3 Type 4 Type 5 Type 6 Type 7 Type 8 Type 9

Question 1
Answer 1 x
Answer 2 x
Question 2
Answer 1 x
Answer 2 x
Question 3
Answer 1 x
Answer 2 x
Question 4
Answer 1 x
Answer 2 x
Question 5
Answer 1 x
Answer 2 x
Question 6
Answer 1 x
Answer 2 x
Question 7
Answer 1 x
Answer 2 x
Question 8
Answer 1 x
Answer 2 x
Question 9
Answer 1 x
Answer 2 x
Question 10
Answer 1 x
Answer 2 x
Question 11
Answer 1 x
Answer 2 x
Question 12
Answer 1 x
Answer 2 x
Question 13
Answer 1 x
Answer 2 x
Question 14
Answer 1 x
Answer 2 x
Question 15
Answer 1 x
Answer 2 x
Question 16
Answer 1 x
Answer 2 x
Question 17
Answer 1 x

41
 Answer 2 x
Question 18
Answer 1 x
Answer 2 x
Question 19
Answer 1 x
Answer 2 x
Question 20
Answer 1 x
Answer 2 x
Question 21
Answer 1 x
Answer 2 x
Question 22
Answer 1 x
Answer 2 x
Question 23
Answer 1 x
Answer 2 x
Question 24
Answer 1 x
Answer 2 x
Question 25
Answer 1 x
Answer 2 x
Question 26
Answer 1 x
Answer 2 x
Question 27
Answer 1 x
Answer 2 x
Question 28
Answer 1 x
Answer 2 x
Question 29
Answer 1 x
Answer 2 x
Question 30
Answer 1 x
Answer 2 x
Question 31
Answer 1 x
Answer 2 x
Question 32
Answer 1 x
Answer 2 x
Question 33
Answer 1 x
Answer 2 x
Question 34
Answer 1 x

42
 Answer 2 x
Question 35
Answer 1 x
Answer 2 x
Question 36
Answer 1 x
Answer 2 x
TOTAL
SCORE

APPENDIX D

PERSONALITY TYPE INTERPRETATION

43
 The Nine Personality Types of the Enneagram

1. The Reformer. The principled, idealistic type. Ones are conscientious and ethical, with a strong
sense of right and wrong. They are teachers, crusaders, and advocates for change: always
striving to improve things, but afraid of making a mistake. Well-organized, orderly, and fastidious,
they try to maintain high standards, but can slip into being critical and perfectionistic. They
typically have problems with resentment and impatience. At their Best: wise, discerning, realistic,
and noble. Can be morally heroic.

2. The Helper. The caring, interpersonal type. Twos are empathetic, sincere, and warm-hearted.
They are friendly, generous, and self-sacrificing, but can also be sentimental flattering, and
people-p leasing. They are well-meaning and driven to be close to others, but can slip into doing
things for others in order to be needed. They typically have problems with possessiveness and
with acknowledging their own needs. At their Best: unselfish and altruistic, they have
unconditional love for others.

3. The Achiever. The adaptable, success-oriented type. Threes are self-assured, attractive, and
charming. Ambitious, competent, and energetic, they can also be status-conscious and highly
driven for advancement. They are diplomatic and poised, but can also be overly concerned with
their image and what others think of them. They typically have problems with workaholism and
competitiveness. At their Best: self-accepting, authentic, everything they seem to be—role
models who inspire others.

4. The Individualist. The introspective, romantic type. Fours are self-aware, sensitive, and
reserved. They are emotionally honest, creative, and personal, but can also be moody and self -
conscious. Withholding themselves from others due to feeling vulnerable and defective, they can
also feel disdainful and exempt from ordinary ways of living. They typically have problems with
melancholy, self-indulgence, and self-pity. At their Best: inspired and highly creative, they are
able to renew themselves and transform their experiences.

5. The Investigator. The perceptive, cerebral type. Fives are alert, insightful, and curious. They are
able to concentrate and focus on developing complex ideas and skills. Independent, innovative,
and inventive, they can also become preoccupied with their thoughts and imaginary constructs.
They become detached, yet high-strung and intense. They typically have problems with
eccentricity, nihilism, and isolation. At their Best: visionary pioneers, often ahead of their time,
and able to see the world in an entirely new way.

6. The Loyalist. The committed, security-oriented type. Sixes are reliable, hard-working,
responsible, and trustworthy. Excellent "troubleshooters," they foresee problems and foster
cooperation, but can also become defensive, evasive, and anxious—running on stress while
complaining about it. They can be cautious and indecisive, but also reactive, defiant and
rebellious. They typically have problems with self-doubt and suspicion. At their Best: internally
stable and self-reliant, courageously championing themselves and others.

7. The Enthusiast. The busy, productive type. Sevens are extroverted, optimistic, versatile, and
spontaneous- Playful, high-spirited, and practical, they can also misapply their many talents,
becoming over-extended, scattered, and undisciplined. They constantly seek new and exciting
experiences, but can become distracted and exhausted by staying on the go. They typically have

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 problems with impatience and impulsiveness. At their Best: they focus their talents on worthwhile
goals, becoming appreciative, joyous, and satisfied.

8. The Challenger. The powerful, aggressive type. Eights are self-confident, strong, and assertive.
Protective, resourceful, straight-talking, and decisive, but can also be ego-centric and
domineering. Eights feel they must control their environment, especially people, sometimes
becoming confrontational and intimidating. Eights typically have problems with their tempers and
with allowing themselves to be vulnerable. At their Best: self-mastering, they use their strength to
improve others’ lives, becoming heroic, magnanimous, and inspiring.

9. The Peacemaker. The easy-going, self-effacing type. Nines are accepting, trusting, and stable.
They are usually creative, optimistic, and supportive, but can also be too willing to go along with
others to keep the peace. They want everything to go smoothly and be without conflict, but they
can also tend to be complacent, simplifying problems and minimizing anything upsetting. They
typically have problems with inertia and stubbornness. At their Best: indomitable and all-
embracing, they are able to bring people together and heal conflicts.

APPENDIX E

VISUAL ANALOG SCALE

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 Name: ____________________________________________

Handedness: _____________ Personality Type: ________________

Pain Threshold: (to be filled by the researchers) ____________

Modified VAS:
(place an “X” mark on the line below corresponding to your initial and end level of pain with
intensity increasing by number)

1 2 3 4 5 6 7 8 9 10

Pain Tolerance: (to be filled by the researchers) ____________

VISUAL ANALOG SCALE

Name: ____________________________________________

Handedness: _____________ Personality Type: ________________

Pain Threshold: (to be filled by the researchers) ____________

Modified VAS:
(place an “X” mark on the line below corresponding to your initial and end level of pain with
intensity increasing by number)

1 2 3 4 5 6 7 8 9 10

Pain Tolerance: (to be filled by the researchers) ____________

46