Personality and breast cancer screening in women of the GAZEL cohort study

Association between personality types and low anterior resection syndrome in rectal cancer patients following surgery

PURPOSE

Low anterior resection syndrome (LARS) has had many impacts on the lives of patients and substantial differences in emotional and social functions. The aim of this study was to investigate the correlation analysis of different personality traits in rectal cancer patients with LARS after undergoing curative surgery.

METHODS

This study was designed as a prospective cohort study. The inclusion criteria included (1) participants diagnosed with rectal cancer who underwent surgical resection of malignant tumors and (2) ECOG 0-1. The primary outcome was the correlation between different personality traits and low anterior resection syndrome in rectal cancer patients after radical surgery. Low anterior resection syndrome incidence rates were estimated by questionnaires and personality groups by the Type A and Type D Scale-14 Personality Inventory.

RESULTS

For all 161 participants in this study, the presence of a tumor at the lower anal verge and the receipt of neoadjuvant CCRT had a statistically significant positive correlation with the LARS score at 1 month, 6 months, and 1 year (Pearson correlation coefficient = -0.283, -0.374, and - 0.205, respectively), with a p value of less than 0.05. Personalities with Type A, Type D, and Type D-SI scores had a statistically significant positive correlation with LARS score at 1 month (Pearson correlation coefficient = 0.172, 0.162, and 0,164, p value = 0.03, 0.04, and 0.04).

CONCLUSION

Type A and Type D personalities are highly linked to LARS. Personalized support approaches can ultimately assist rectal cancer patients in overcoming difficulties after surgery and recovery and enhance their functional outcomes.

Using temperament and character dimensions (TCI) to analyze the personality profiles of adults and older adults with cancer managed in outpatient settings

Introduction

This study aimed to investigate profiles of personality evaluated by temperament and character dimensions (TCI) in 638 adult and older adult patients (CP) who had recently been diagnosed with breast, colon, lung, and other kinds of cancer (female and male subjects were assessed). Tests: Temperament and Character Inventory (TCI). Statistical analysis: cluster K-means analysis for personality traits.

Results

Two different personality profiles emerged: "Low self-determination and pessimism" (Profile 1) and "Self-determination and self-caring (medium)" (Profile 2). The following significant differences were observed in the TCI dimensions between the two profiles: Temperament-Novelty-Seeking (NS) (p < 0.001); Harm-Avoidance (HA) (p < 0.001); Reward-Dependence (RD) (p < 0.001); Persistence (PS) (p < 0.001); Character-Self-Directness (SD) (p < 0.001); Cooperativeness (C) (p > 0.001); Self-Transcendence (ST) (p < 0.001). No differences in the two profiles were found between adult and elderly patients. Profile 1 - "Low self-determination and pessimism": Patients with this profile present low resistance to frustration, poor search for novelty and solutions (NS), anxiety and pessimism (medium HA), high social attachment and dependence on the approval of others (medium-high RD), and low self-determination (PS) as temperament dimensions; and medium-low self-direction, low autonomy and ability to adapt (SD-medium-low), medium cooperativeness (C), and low self-transcendence (ST) as character dimensions. Profile 2 - "Self-determination and self-caring (medium)": Patients with this profile have resistance to frustration, ability to search for novelty and solutions (medium-NS), low anxiety and pessimism (HA), low social attachment and dependence on approval (medium-low-RD), and determination (medium-high PS) as dimensions of temperament; and autonomy and capacity for adaptation and self-direction (SD), capacity for cooperation (high-CO), and self-transcendence (medium-high-ST) as character dimensions.

Conclusion

Personality screening allows a better understanding of the difficulties of the individual patient and the planning of targeted psychotherapeutic interventions that promote quality of life and good adaptation to the disease course.

Factors Promoting Breast, Cervical and Colorectal Cancer Screenings participation: A Systematic Review

Objective

The present study aims at systematically reviewing research conducted on factors promoting breast, cervical and colorectal cancer screenings participation.

Methods

A literature search in MEDLINE/PubMed and PsycInfo from January 2017 to October 2021 was performed. Data extraction, researchers' full agreement and the inclusion criteria produced 102 eligible studies. Data were narratively synthesized and critically interpreted.

Results

Multiple factors favoring or hindering breast, cervical and colorectal cancer screenings were identified and summarized as factors operating at the individual level (background information, individual characteristics, emotions related to screening procedure and to cancer, knowledge and awareness), at the relational level (relationships with healthcare staff, significant others, community members), and at the healthcare system level (systems barriers/policy, lack of staff). A critical appraisal of studies revealed a fragmentation in the literature, with a compartmentalization of studies by type of cancer screening, country and specific populations of destination.

Conclusions

Overall findings indicated that greater integration of research results obtained independently for each cancer diagnosis and within the different countries/populations could foster a more comprehensive understanding of factors potentially enhancing the participation in breast, cervical and colorectal cancer screenings worldwide. This review, which is grounded in the current context of globalization and superdiversification in population, can help to enhance a better integration between research and practices, by supporting the development of more effective and inclusive evidence‐based interventions and health‐promotion campaigns worldwide. Research and practical implications are highlighted and discussed.

Structural Analysis of Social Behavior: Using Cluster Analysis to Examine Intrapsychic Personality Traits Associated With Depression in Women With Breast Cancer

Background

This study aimed to investigate personality traits associated with depression in breast cancer women (BCW).

Methods

Sample: 236 BCW recently diagnosed (early stages). Tests: SASB-Structural-Analysis of Social-Behavior; IPAT-CDQ-Depression. Statistical analysis: cluster K-Means analysis to explore SASB personality-traits considering the 8 SASB clusters (Cl); CDQ scores dichotomized by 50th percentile cutoff (high/low); Pearson’s chi square test to compare CDQ levels and SASB traits.

Results

Cluster analysis results supported two distinguishable SASB personality traits (for all SASB Cl-Scales P < .001) classified as “Love and Autonomy” (62.2%) and “Control and Hate” (37.8%). Patients with Love/Autonomy traits are spontaneous, accept their deepest feelings and desire to be close to other people (Cl1, Cl2, Cl3, Cl4). They show a medium value of self-control and a low tendency to self-abusive and self-critical behaviors (Cl5, Cl6). They pay attention to themselves and to their needs at emotional and physical levels also if may be occasionally engaged in self-destructive behaviors (Cl7, Cl8). Women with Control/Hate traits are not spontaneous and do not always express emotions (C1, Cl2, Cl3, Cl4) and flexibility in their relationship with others (Cl5, Cl6). In stressful situations, they may ignore the option of choices for self-growth and neglect their needs and those of others (Cl7, Cl8). BCWs with Control/Hate traits scored higher in depression (P <.001) than those with the Love/Autonomy profile.

Conclusions

Healthcare professionals should be aware of these personality traits and their association with depression to identify the psychologically most vulnerable BCW and improve the care they provide them. The psychotherapeutic intervention should be planned to face on the personality problems.

Approche qualitative des motifs à accepter ou à refuser la réalisation d’une mammographie : l’apport de la théorie du renversement

Objectif : Examiner les motifs conduisant les femmes à accepter ou à refuser la réalisation d’une mammographie et la manière dont ceux-ci s’organisent autour des états motivationnels de la théorie du renversement.

Méthode : Seize entretiens semi-directifs ont été réalisés. Des analyses lexicométriques et de contenu ont été effectuées en prenant appui sur les dix états motivationnels de la théorie du renversement.

Résultats : Consentir à réaliser une mammographie peut répondre à la volonté d’atteindre un objectif et/ou de suivre les règles communément admises à l’égard de cet examen. Refuser de réaliser une mammographie peut être influencé par la volonté d’atteindre un objectif, par un besoin de liberté, par des préoccupations personnelles et/ou par une aspiration à être au centre du soin. Ainsi, respectivement, les motifs facilitateurs les plus impliqués se rapportent aux états motivationnels télique et conformisme. Les motifs barrières les plus impliqués se rapportent aux états télique, négativiste, intra-autique (et plus modérément à l’état autocentrique).

Conclusion : Les résultats de cette étude, et plus particulièrement le rapport qu’entretiennent les femmes avec les normes établies en matière de dépistage du cancer du sein, peuvent amorcer de nouvelles réflexions dans le champ de la santé publique.

Fewer Type A personality traits in type 2 diabetes patients with diabetic foot ulcer

AIM

Type A personality-characterized by time urgency, strong drive, and a need for achievement and competitiveness-has been shown to be associated with reduced mortality in patients with diabetes. However, it is not known whether a Type A personality might protect against diabetic foot ulcer (DFU). This prompted our present analysis of the association between Type A personality and DFU.

METHODS

The Bortner Scale questionnaire was used to assess Type A personality in 386 patients with type 2 diabetes (T2D), including 104 patients also presenting with, and 282 presenting without, DFU. Additional questionnaires were used to assess perceived stress and depression.

RESULTS

Type A Bortner scores were significantly lower in T2D patients with vs without DFU (166.64 ± 38.76 vs 178.79 ± 36.61, respectively; P = 0.005). In patients with DFU, the prevalence of Type A personality traits was significantly lower than in those without DFU (48% vs 64.5%, respectively; P = 0.005) whereas, in contrast, Type B personality traits (the opposite of Type A) were more prevalent (52% vs 35.5%, respectively; P = 0.005). On multivariate analysis, Type A Bortner scores were negatively associated with DFU (P = 0.008) independently of age, gender, BMI, depression scores or perceived stress.

CONCLUSION

The Type A personality, characterized by competitiveness and a need for achievement, is significantly less frequently seen in T2D patients with DFU. On the other hand, the Type B personality is much more prevalent in such patients. It may be that the Type B personality, which is characterized by fewer problem-focused coping strategies and a decreased adherence to care, might favour the development of DFU.

Personality Types as Predictors of Breast Cancer Screening Compliance in Korean Patients: A Mixed-Method Approach

OBJECTIVE

The purpose of this study is to identify personality types that can influence breast cancer screening (BCS) compliance among Korean women with breast cancer using a mixed-method approach.

METHODS

The participants consisted of 93 women who underwent surgery for breast cancer between July 2010 and March 2012. The demographic and medical characteristics of the participants were evaluated through structured interviews. To identify personality types, in-depth interviews were performed and the transcribed interviews were evaluated using interpretive phenomenological analysis. The participants were categorized into two groups (compliance and non-compliance) based on compliance with the Korean Breast Cancer Society recommendations for BCS.

RESULTS

Five personality types were identified through phenomenological analysis. There were significant differences in the chi-square test results for the BCS compliance and non-compliance groups according to age (p=0.048), cancer stage (p<0.001), and personality types (p=0.018). Logistic regression showed that the odds ratio for compliance with BCS was 9.35 (p=0.01) for individuals with a cautious-organized personality type, 9.38 (p=0.02) for those with a cautious-dependent personality, and 10.58 (p=0.04) for those with a sensitive-downcast personality compared to those with a cautious personality type.

CONCLUSION

Participants with cautious-organized, cautious-dependent, and sensitive-downcast personality types were less likely to follow the BCS recommendations than those with a cautious personality type. This study provides a basis for the future development of an effective questionnaire to investigate the personality types of individuals with breast cancer in order to predict compliance with BCS.

Combined Effect of Health Status and Primary Care Use on Participation in Cancer Screening: The CONSTANCES Cohort

Background:

The combined association between primary care utilization and health status with breast cancer screening (BCS) and cervical cancer screening (CCS) remains unclear. Our aim was to identify women's profiles based on their health status and primary care utilization and study their associated adherence to BCS and CCS recommendations.

Methods:

Using data from the cohort of people visiting health screening centers (CONSTANCES) in France (2012–2015), we first identified women's profiles based on their health status (self-perceived health, physical, and mental health) and primary care utilization (visit to the General Practitioner [GP], uptake of blood tests) using a multiple correspondence analysis and a hierarchical cluster analysis. We then investigated the association of these profiles to BCS and CCS using logistic regression models adjusted for age, smoking status, sociodemographic and socioeconomic characteristics, and the regularity of gynecologist consultation.

Results:

We identified five distinct profiles of women with contrasted participation in BCS (n = 14,122) and CCS (n = 27,120). In multivariate analyses, cancer screening participation increased from women with very good health and poor primary care utilization, to those with poor health and frequent visits to the GP, and those with very good health and average primary care utilization. The most favorable profiles regarding cancer screening rates were women with average-to-poor health and regular visits to the GP and uptake of blood tests.

Conclusions:

Our results suggest that policies aiming at increasing cancer screening participation should simultaneously account for women's use of primary care and health and consider more specific subgroups than what is usually done. Further research should investigate factors motivating cancer screening practice, such as women's beliefs regarding cancer screening and women's psychological characteristics.

The prediction of cervical cancer screening beliefs based on big five personality traits

Aim

The present study was designed with the aim to predict Pap smear screening beliefs based on Big Five personality traits.

Design

The present cross-sectional study was conducted with 235 women over 18 years of age in Tehran (Iran) in 2018.

Methods

The data collection tools included the demographic information questionnaire, Pap Smear Belief Questionnaire (PSBQ) and the 10-item measure of the Big Five personality traits.

Results

People with Agreeableness personality trait were more faced with risks and Barriers and factors associated with Pap smear screening beliefs; and those with Conscientiousness personality trait were more faced with risks and Barriers. Results of the present study can help to understand how the personality affects decision-making and interactions. Therefore, consequences of counselling about screening beliefs and behavioural changes can be improved by personality-based education.

Personality types in individuals with type 1 and type 2 diabetes

OBJECTIVE

The Type A personality, characterized by impatience, strong career ambition and competitiveness, is associated with greater sensitivity to external stress. Type 1 diabetes (T1D) is an auto-immune disease, which is potentially influenced by stress, unlike type 2 diabetes (T2D). The aim of this study was to assess whether individuals with T1D and T2D exhibited significant differences on the Type A personality scale. We also assessed the personality in patients with thyroid auto-immune diseases to validate potential links between auto-immune disease and Type A.

DESIGN AND METHODS

The Bortner questionnaire was used to assess Type A personality in 188 patients with T1D, 430 patients with T2D and 85 patients with auto-immune thyroid disease (Graves' disease or Hashimoto thyroiditis).

RESULTS

Type A Bortner scores were significantly higher in T1D patients than in T2D patients (188±34 vs 177±36, p<0.0001). Patients with auto-immune thyroid diseases and T1D patients had similar Type A Bortner scores (189±33 vs 188±34, p=0.860).

CONCLUSION

Patients with auto-immune T1D have higher Type A scores than T2D patients. Furthermore, patients with auto-immune thyroid disease also have elevated Type A scores similar to those observed in type 1 diabetes, suggesting that an elevated Type A score in T1D is potentially related to its autoimmune origin. This suggests a possible link between Type A personality and auto-immune diseases via stress-triggering psychobiological pathways. The different personality score between T1D and T2D is an important factor to consider that could influence the diabetes self-care coping strategies and long-term prognosis.

Depressive symptoms, neuroticism, and participation in breast and cervical cancer screening: Cross-sectional and prospective evidence from UK Biobank

Objective

To assess the cross‐sectional and prospective associations between depressive symptoms, neuroticism, and participation in breast and cervical screening in the UK.

Methods

Women in the UK Biobank cohort with complete data who were eligible for breast cancer screening (aged 50‐70 years, N = 143 461) and/or cervical screening (<65 years, N = 141 753) at baseline recruitment (2006‐2010) and those with follow‐up data (2014‐2019) were identified (N = 11 050 and N = 9780 for breast and cervical screening). Depressive symptoms and neuroticism were self‐reported at baseline (range 0‐12 with higher scores reflecting greater severity). Primary outcomes were reporting being up to date with breast and cervical screening. For prospective analyses, patterns of screening participation from baseline to follow‐up were identified. Logistic regression was used to analyse associations, adjusted for potential confounding factors.

Results

More severe depressive symptoms were associated with reduced likelihood of breast (OR = 0.960, 95% CI: 0.950,0.970) and cervical (OR = 0.958, 95% CI: 0.950,0.966) screening participation, in cross‐sectional analyses. Higher neuroticism scores were associated with reduced cervical screening participation, but the opposite was found for breast cancer screening. Examination of individual neuroticism items revealed that anxiety and worry were associated with increased breast screening. At follow‐up, higher baseline depressive symptoms were related to decreased cervical screening (OR = 0.955, 95% CI: 0.913,0.999), but not with breast screening.

Conclusions

More severe depressive symptoms may be a barrier for breast and cervical screening and could be an indicator for more proactive strategies to improve uptake.

Personality traits and preventive cancer screenings in the Health Retirement Study

The Five-Factor model of personality has been associated with a wide range of health behaviors and health outcomes. However, few studies have examined whether personality traits are related to cancer screening in older adults. The present study investigated the cross-sectional associations between personality traits and the probability of obtaining a recent preventive screening for breast, cervical, prostate, and colorectal cancer. Participants from the Health and Retirement Study (N = 14,394, Mage = 68.14 years, range = 50-102 years, 58.6% female) completed a personality inventory and reported on cancer screenings in the 2010-2012 assessment. Logistic regression models were used to analyze the data, including age, race, ethnicity, gender, education, income, and wealth as covariates. Higher conscientiousness was associated with a higher likelihood of obtaining breast, cervical, and prostate screening. Higher extraversion was related to higher odds of breast, cervical, and colorectal screening. Higher neuroticism was linked to higher odds of colorectal screening, and conscientiousness moderated the link between neuroticism and cervical screening. These associations were significant in models that accounted for demographic and socioeconomic factors. The effect sizes were in the range of a 10-20% higher likelihood of cancer screening for 1 SD difference in personality. The present findings suggest that conscientiousness and extraversion were related to preventive cancer screenings, whereas neuroticism, openness and agreeableness were largely unrelated to the likelihood of such screenings. If these results are further replicated, health policy makers may consider personality traits when planning and implementing screening recommendations to improve preventive medicine.

Type A competitiveness traits correlate with downregulation of c-Fos expression in patients with type 1 diabetes

AIM

Type A personality has been associated with increased survival in people with type 1 diabetes (T1D). Systemic low-grade inflammation may play a critical role, as suggested in recent reports, although the links between the inflammatory circulating transcriptome and Type A remain unknown. This prompted our exploration of the potential associations between Type A personality and c-Fos gene expression, a candidate gene closely linked to inflammatory processes, in T1D.

METHODS

Type A personality was assessed by Bortner questionnaire in patients with T1D, and two subscales - 'speed' and 'competitiveness' - were used to measure these specific dimensions of Type A. Expression of the c-Fos gene was assessed by a quantitative real-time polymerase chain reaction technique.

RESULTS

This pilot study included 20 men with T1D. Multivariable analyses showed an independent inverse association between Type A competitiveness score and c-Fos expression, while a regression model adjusted for age, body mass index and HbA_1c levels revealed a significant inverse relationship between c-Fos transcripts and Type A competitiveness (P = 0.003).

CONCLUSION

This strong association between Type A competitiveness and reduced c-Fos expression is in line with recent data suggesting a psychobiological influence of the Type A profile in T1D via inflammatory pathways.

[Psychosomatic research in 2018: Lost illusions, renewed hopes]

A critical analysis of the basic hypotheses of psychosomatic research and the sometimes hasty assertions drawn from the previous works makes it possible to better discern the data confirmed by the most recent works or the most rigorous meta-analyses and to highlight the emerging tracks. If the hypothesis of behavioral patterns specifically related to the risk of certain pathologies seems abandoned, the predictive value of depression in the cardiovascular field, more than in that of oncology, becomes clearer. Negative affect and impaired emotional awareness emerge as two complementary factors of somatic vulnerability. Several vulnerability factors seem all the more effective as they affect individuals of lower socio-economic status. Social exclusion feeling and its links with the inflammatory response appear to be a possible common denominator, both for depression and for many somatic conditions. A series of studies on the cerebral regulation of emotions and stress, as well as on bidirectional brain-bowel relations and on the mediating role of the gut microbiota, complements the available epidemiological data. The same is true for certain advances in behavioral neuro-economics, which inform the decision-making processes of patients facing preventive health choices. Lastly, it appears that a significant part of the excess mortality associated with the existence of severe mental disorders is not due to factors inherent to the patients themselves, but to disparities in the quality of the care provided to them.