Personality pathways to mortality: Interleukin-6 links conscientiousness to mortality risk

Self-Acceptance and Purpose in Life Are Mechanisms Linking Adverse Childhood Experiences to Mortality Risk

OBJECTIVE

Adverse childhood experiences (ACEs) are associated with an increased risk of premature mortality, but it is not clear why. Individuals with ACEs tend to have lower self-acceptance and purpose in life, which may be pathways between ACEs and risk of premature mortality. As such, we tested whether purpose and self-acceptance are mechanisms that link ACEs to mortality risk.

METHODS

We used the Midlife in the United States Survey ( N = 6218; mean [standard deviation] = 46.89 [12.94] years) to test whether these factors were indirect pathways between ACEs and mortality hazards over 24 years of follow-up. We used a comprehensive ACE measure that included 20 possible childhood adversities including emotional and physical abuse, household instability, socioeconomic climate, and ill health.

RESULTS

ACEs significantly increased mortality risk (hazard ratio = 1.028, 95% confidence interval = 1.008-1.047, p = .006). Self-acceptance and purpose accounted for an estimated 15% and 4% of the ACEs-mortality relation, respectively. These effects withstood a range of adjustments and sensitivity analyses.

CONCLUSIONS

ACEs may affect mortality risk partially through lower self-acceptance and purpose during adulthood. Given that self-acceptance and purpose may change through intervention, these factors may be useful targets for individuals with ACEs that could lead to a longer life.

Personality and Cognition: The Mediating Role of Inflammatory Markers

OBJECTIVES

Five-Factor Model personality traits are associated consistently with cognition. Inflammation has been hypothesized as a biological pathway in this association, but this assumption has yet to be tested. The present study tested inflammatory markers as mediators between personality traits and cognition.

METHODS

Participants were from the Health and Retirement Study (HRS; N = 4,364; 60% women; mean age = 64.48 years, standard deviation = 8.79). Personality traits and demographic factors were assessed in 2010/2012. Data on inflammatory markers (high-sensitivity C-reactive protein [hsCRP], interleukin-6 [IL-6], soluble tumor necrosis factor 1 (sTNFR1), interleukin-10 [IL-10], interleukin-1 receptor antagonist [IL-1Ra], and transforming growth factor [TGF]-β1) were obtained in 2016 from the HRS Venuous Blood Study. Cognition was assessed in 2020 using the modified Telephone Interview for Cognitive Status.

RESULTS

Higher neuroticism was related to lower cognition at follow-up, whereas higher extraversion, openness, agreeableness, and conscientiousness were associated with better cognition. Higher extraversion and higher conscientiousness were related to lower hsCRP, IL-6, IL-10, IL-1Ra, and sTNFR1, and higher openness was associated with lower IL-10, IL-1Ra, and sTNFR1 and to higher soluble TGF-β1. Lower sTNFR1 partially mediated the associations between conscientiousness, extraversion, and openness and cognition at follow-up, explaining an estimated 4%-12% of these associations. The mediating role of sTNFR1 persisted when physical activity and depressive symptoms were included as additional mediators.

DISCUSSION

The present study provides new evidence on personality and inflammatory markers. Consistent with the inflammation hypothesis, the sTNFR1 finding supports a potential biological pathway between personality and cognition.

Neuroticism facets and mortality risk in adulthood: A systematic review and narrative synthesis

OBJECTIVE

This systematic review sought to summarize comprehensively the research investigating the association between facets of neuroticism and mortality risk.

METHODS

A systematic review of prospective cohort studies utilizing rigorous reporting methods was conducted. Six electronic bibliographic databases, MEDLINE [Ovid], Embase, PsycINFO, CINAHL, Web of Science, and SCOPUS, were searched for eligible studies using keywords encompassing personality traits and mortality. Articles from inception to January 2023 were reviewed. The risk of bias was also assessed.

RESULTS

Six of the 2358 identified studies met the inclusion criteria for extraction. Included studies had 335,715 participants, of whom 3.23% died. Participants ages at baseline ranged from 20 to 102, and 54% were female. Five of the six studies reported statistically significant associations between facets of neuroticism and mortality risk. Several underlying facets were reported to be associated with an increased mortality risk, namely vulnerability, cynicism, pessimistic, anxious, and depressive facets. Inadequacy, and worried-vulnerable were reported as protective. One study reported protective effects for impulsiveness, but this was not observed in a further follow-up study.

CONCLUSIONS

Various facets related to neuroticism are associated with an increased or decreased mortality risk. Encompassing all facets in a broad trait likely masks very important personality-health relations, which later impact longevity. Based on these findings, recommendations and future considerations are discussed.

Adverse childhood experiences and all-cause mortality risk in adulthood

BACKGROUND

Adverse Childhood Experiences (ACEs) have been associated with mortality risk in adulthood. It is unclear, however, whether ACEs perpetrated beyond parents may be associated with mortality risk, if the risk is accumulative or plateaus at a certain frequency, whether associations differ dependent on ACE types, whether types interact with one another, or if observed effects differ by sex.

OBJECTIVE

To examine associations between ACEs and mortality risk.

PARTICIPANTS AND SETTING

6319 participants (age range 25-74 years, mean [SD] 46.91 [12.95] years; 51.6 % female) followed from 1995/96 to 2018 as part of the survey of Midlife Development in the United States.

METHODS

ACE variables were self-reported exposure to 20 ACE types from five categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Cox proportional hazards models were used to estimate mortality risk.

RESULTS

ACEs were accumulatively associated with increased mortality risk in adjusted models (HR = 1.033; p ≤ .001, 95 % CI, 1.014-1.053). The association was linear. Only physical abuse (HR = 1.05; p = .024, 95 % CI, 1.01-1.10) remained significantly predictive of increased mortality risk adjusting for other types. No interaction by sex or amongst ACE types was observed.

CONCLUSIONS

ACEs may be cumulatively associated with increased mortality risk, such that each individual ACE increases risk. Physical abuse may be an important ACE type within a mortality risk context. Individual ACE types warrant further study as each type may have their own differential impact on mortality risk.

Effects of Short- And Medium-Term Exposures to Lower Air Temperature on 71 Novel Biomarkers of Subclinical Inflammation: Results from the KORA F4 Study

Increasing evidence has revealed that exposure to low temperatures is linked to a higher risk of chronic diseases and death; however, the mechanisms underlying the observed associations are still poorly understood. We performed a cross-sectional analysis with 1115 participants from the population-based KORA F4 study, which was conducted in Augsburg, Germany, from 2006 to 2008. Seventy-one inflammation-related protein biomarkers were analyzed in serum using proximity extension assay technology. We employed generalized additive models to explore short- and medium-term effects of air temperature on biomarkers of subclinical inflammation at cumulative lags of 0-1 days, 2-6 days, 0-13 days, 0-27 days, and 0-55 days. We found that short- and medium-term exposures to lower air temperature were associated with higher levels in 64 biomarkers of subclinical inflammation, such as Protein S100-A12 (EN-RAGE), Interleukin-6 (IL-6), Interleukin-10 (IL-10), C-C motif chemokine 28 (CCL28), and Neurotrophin-3 (NT-3). More pronounced associations between lower air temperature and higher biomarker of subclinical inflammation were observed among older participants, people with cardiovascular disease or prediabetes/diabetes, and people exposed to higher levels of air pollution (PM2.5, NO2, and O3). Our findings provide intriguing insight into how low air temperature may cause adverse health effects by activating inflammatory pathways.

The more the neuroticism, the more the susceptibility to Alzheimer's disease. What inspiration can neuroticism provide?

Study of neuroticism can provide important insights. Before the inclusion of neuroticism in the study of Alzheimer's disease (AD), clinical and scientific researchers used relatively fixed models to treat AD, such as prescribing fixed doses of drugs and fixed research strategies. However, taking neuroticism into account affects drug use, the direction of scientific research, and even the mental health of the population, which translates into more immediate economic benefits.

Personality and aging-related immune phenotype

An aging-related immune phenotype (ARIP) has been defined as a decrease in naïve T cells (T_N) relative to the accumulation of memory T cells (T_M). Recent research implicates ARIP measures, such as CD4 +T_N/T_M and CD8 +T_N/T_M ratios, in multimorbidity and mortality. This study examined whether psychological dispositions that assess how people think, feel, and behave are related to CD4 +T_N/T_M and CD8 +T_N/T_M. Participants were adults aged 50-104 years (N = 4798; 58% women, Mean Age= 67.95, SD= 9.56) from the Health and Retirement Study. Data on CD4 +T_N/T_M and CD8 +T_N/T_M were obtained in 2016. Data on personality, demographic factors, and potential clinical (body mass index, disease burden), behavioral (smoking, alcohol, physical activity), psychological (depressive symptoms, stress), and biological (cytomegalovirus IgG antibodies) mediating factors were obtained in 2014/2016. Controlling for demographic factors, higher conscientiousness was related to higher CD4 +T_N/T_M and CD8 +T_N/T_M. To a lesser extent, higher neuroticism and lower extraversion were associated with lower CD4 +T_N/T_M. Physical activity, and to a lesser extent BMI and disease burden, were the most robust mediators between personality and ARIP measures. Cytomegalovirus IgG level mediated the association between conscientiousness and both CD4 +T_N/T_M and CD8 +T_N/T_M. This study provides novel evidence that personality is related to ARIP. Higher conscientiousness and, to a lesser extent, higher extraversion may be protective against age-related immunophenotype change, whereas neuroticism may be a risk factor.

Personality trait associations with quality-of-life outcomes following bariatric surgery: a systematic review

BACKGROUND

Obesity can be a significant challenge to health and quality of life (QoL). Bariatric surgery assists with weight loss and may help improve QoL. However, not all patients benefit from surgery. Personality traits may be related to QoL outcomes after bariatric surgery, but these associations are unclear.

PURPOSE

This research reviews the published literature on the associations between personality and QoL among post-operative bariatric patients.

METHOD

Four databases (CINAHL Complete, Medline with Full Text, APA PsycINFO, and Scopus) were searched from inception until March 2022. Forward searching was conducted using Google Scholar, and backward reference citation searches were also performed.

RESULTS

Five studies met inclusion criteria yielding data from N = 441 post-bariatric patients including both pre/post and cross-sectional designs. Higher agreeableness was related to lower overall health-related QoL (HRQol) and gastric HRQol and positively associated with psychological HRQol. Higher emotional stability was positively related to overall HRQol. Higher impulsivity was negatively associated with mental HRQol and was unrelated to physical HRQol. Effects for the remaining traits were either mainly mixed or null.

CONCLUSION

Personality traits may be associated with HRQol outcomes. However, it is difficult to reliably discern the role of personality traits for HRQol and QoL outcomes given the methodological issues and few published studies. More rigorous research is needed to address these issues and clarify possible associations.

Tryptophol Acetate and Tyrosol Acetate, Small-Molecule Metabolites Identified in a Probiotic Mixture, Inhibit Hyperinflammation

Probiotic fermented foods are perceived as contributing to human health; however, solid evidence for their presumptive therapeutic systemic benefits is generally lacking. Here we report that tryptophol acetate and tyrosol acetate, small-molecule metabolites secreted by the probiotic milk-fermented yeast Kluyveromyces marxianus, inhibit hyperinflammation (e.g., "cytokine storm"). Comprehensive in vivo and in vitro analyses, employing LPS-induced hyperinflammation models, reveal dramatic effects of the molecules, added in tandem, on mice morbidity, laboratory parameters, and mortality. Specifically, we observed attenuated levels of the proinflammatory cytokines IL-6, IL-1α, IL-1β, and TNF-α and reduced reactive oxygen species. Importantly, tryptophol acetate and tyrosol acetate did not completely suppress proinflammatory cytokine generation, rather brought their concentrations back to baseline levels, thus maintaining core immune functions, including phagocytosis. The anti-inflammatory effects of tryptophol acetate and tyrosol acetate were mediated through downregulation of TLR4, IL-1R, and TNFR signaling pathways and increased A20 expression, leading to NF-kB inhibition. Overall, this work illuminates phenomenological and molecular details underscoring anti-inflammatory properties of small molecules identified in a probiotic mixture, pointing to potential therapeutic avenues against severe inflammation.

Childhood abuse and neglect, and mortality risk in adulthood: A systematic review and meta-analysis

BACKGROUND

Research findings on the relationship between childhood abuse and neglect (CAN) and mortality risk in adulthood are inconsistent.

OBJECTIVE

To examine the association between CAN and mortality risk in adulthood.

PARTICIPANTS AND SETTING

Systematic review and meta-analysis.

METHODS

Six databases were searched up to November 2021 for studies reporting adult mortality outcomes associated with childhood physical abuse, emotional abuse, sexual abuse, physical neglect and/or emotional neglect. When feasible, results were pooled using a random-effects meta-analysis.

RESULTS

Nine studies met the inclusion criteria, involving 265,858 individuals. Abuse included physical (4/9), sexual (2/9), emotional (2/9), combined physical or sexual (2/9) and combined abuse and neglect (4/9). Only one study reported neglect separately. Three studies that examined the association between combined childhood abuse and neglect and mortality showed a pooled HR of 1.86 (95 % CI = 1.26-2.73, I² = 81 %). Specific types of abuse (physical, emotional, sexual) were unrelated to mortality risk, but subgroup analyses suggested that physical and emotional abuse were associated with greater mortality risk among women. There was high heterogeneity (I² of >75 %) between estimates for almost all predictors.

CONCLUSIONS

Research suggests an association between CAN and adult mortality risk. However, more research is needed to address several limitations within the literature. These include standardising measures of CAN, representative sampling from vulnerable populations and differing geographical regions, and more detailed examination of the multi-faceted experience of abuse and neglect in childhood.

Five-Factor Model Personality Traits and 24-hour Urinary Cortisol in the Baltimore Longitudinal Study of Aging

Stress is implicated in models of personality and health as a mechanism that explains why traits like conscientiousness and neuroticism are associated with long-term health outcomes. Evidence for an association between personality and cortisol, a biological marker of stress, however, has been inconsistent. This study examined the association between Five-Factor Model personality traits and 24-h urinary cortisol (operationalised as a ratio of urinary free cortisol to creatinine) measured up to 12 times over intervals as long as 30 years in the Baltimore Longitudinal Study of Aging (M_age  = 61.21, SD = 15.46; 49% female). There was a modest association between conscientiousness and lower mean-level cortisol that was attenuated only slightly in the fully-adjusted model. Neuroticism and the other traits were unrelated to cortisol levels, and none of the traits was related to cortisol change over time. The null association for neuroticism suggests that its relation with long-term health may be primarily through pathways other than cortisol. The modest association between conscientiousness and 24-h urinary cortisol replicates a previous finding with a longer-term measure of cortisol measured from hair, which calls for more research on the robustness and replicability of this finding. Cortisol may be one pathway through which conscientiousness is associated with health outcomes.

Personality traits at age 16 and risk of metabolic syndrome at age 46

OBJECTIVE

To examine whether five-factor model personality traits at age 16 are associated with risk of metabolic syndrome 30 years later at age 46 and whether adolescent personality mediates the association between childhood social class and midlife metabolic health.

METHODS

Participants were from the British Cohort Study 1970, a birth cohort study of participants all born in the same week in 1970. Personality was assessed by participants' mothers (n = 3819) and participants' themselves (n = 2697) at age 16. The five components of the metabolic syndrome were measured at the age 46 assessment: elevated blood pressure, glucose, triglycerides, waist circumference and lower HDL cholesterol.

RESULTS

Mother-rated neuroticism and mother-rated conscientiousness at age 16 were associated with risk of metabolic syndrome at age 46 (OR = 1.19, 95% CI = 1.04, 1.36 and OR = 0.70, 95% CI = 0.62, 0.78, respectively). Self-reported neuroticism was also associated with metabolic syndrome risk (OR = 1.43, 95% CI = 1.08, 1.91). Mother-rated conscientiousness at age 16 accounted for 10% of the association between childhood social class and metabolic health at age 46. None of the other traits were significant mediators.

CONCLUSION

Consistent with lifespan models of personality and health, age 16 personality traits were associated with metabolic health measured 30 years later. Personality traits may also function as a mechanism through which early-life socioeconomic status contributes to midlife health.

Prospective self- and informant-personality associations with inflammation, health behaviors, and health indicators

OBJECTIVE

Personality influences many aspects of the health process. It is unclear to what extent self- and informant-reports of the Big Five offer incremental validity for the prediction of inflammatory biomarkers and whether inflammation provides a unique pathway between personality and indicators of physical health, independent of health behaviors.

METHOD

Using data from older adults (N = 1,630) enrolled in the St. Louis Personality and Aging Network study, we tested whether self- and informant-reported Big Five traits show unique associations with inflammation (IL-6, CRP, TNF-α). Further, we tested whether inflammation and health behaviors indirectly link personality to health-related quality of life, body mass index, and chronic disease burden using longitudinal mediation in a structural equation modeling framework.

RESULTS

Self-reports, informant-reports, and general trait factors of personality predicted future inflammatory biomarker levels (unstandardized regression coefficients ranged -.08 to .07 for self, -.13 to -.10 for informants, and -.16 to -.11 for general). Additionally, all assessment methods of personality were associated with the indicators of physical health through biomarker and health behavior pathways. Effects were primarily found for conscientiousness and neuroticism; IL-6 and CRP were the biomarkers with the most indirect effects; and indirect paths overall emerged more frequently through health behaviors, but this varied by outcome.

CONCLUSIONS

Self- and informant-reports provided unique predictive validity of inflammatory biomarkers. Findings highlight the benefits of using of multiple assessments of personality and the importance of examining multiple, distinct pathways by which personality might influence health to understand the mechanisms underlying this relationship more fully. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Prognostic Value of Histidine-Rich Glycoprotein for Community-Acquired Pneumonia

Purpose

Histidine-rich glycoprotein (HRG) is abundant in serum and has been implicated in several processes including blood coagulation and immune response. This prospective study is aimed at exploring HRG as a biomarker in patients hospitalized for community-acquired pneumonia (CAP).

Methods

A total of 160 patients (73 severe CAP, 57 nonsevere CAP), and 30 healthy controls were enrolled in 2019. Demographic and clinical data were recorded for all patients. Serum HRG concentration was measured upon admission using ELISA.

Results

HRG levels were significantly lower in severe CAP patients compared with other groups, regardless of etiology, and were negatively correlated with serum interleukin-6 and disease severity index scores. Combination of CURB-65, PSI, and APACHE II scores with HRG values significantly improved the accuracy of predicting 30-day mortality in these patients. Cox regression analysis showed that HRG could serve as an independent risk factor for 30-day mortality. Notably, patients with HRG ≤ 16.92 μg/mL had significantly lower cumulative survival than those with HRG > 16.92 μg/mL.

Conclusion

Serum HRG levels are lower in patients with severe CAP and are negatively correlated with disease severity scores. Measurement of HRG upon admission can provide valuable prognostic information for patients with CAP.

Personality Factors in Colorectal Cancer: A Systematic Review

Background: The role of personality in cancer incidence and development has been studied for a long time. As colorectal cancer (CRC) is one of the most prevalent cancer types and linked with lifestyle habits, it is important to better understand its psychological correlates, in order to design a more specific prevention and intervention plan. The aim of this systematic review is to analyze all the studies investigating the role of personality in CRC incidence. Methods: All studies on CRC and personality up to November 2020 were scrutinized according to the Cochrane Collaboration and the PRISMA statements. Selected studies were additionally evaluated for the Risk of Bias according to the Newcastle-Ottawa Scale (NOS). Results: Eight studies met the inclusion criteria and were eventually included in this review. Two main constructs have been identified as potential contributors of CRC incidence: emotional regulation (anger) and relational style (egoism). Conclusion: Strong conclusions regarding the influence of personality traits on the incidence of CRC are not possible, because of the small number and the heterogeneity of the selected studies. Further research is needed to understand the complexity of personality and its role in the incidence of CRC and the interaction with other valuable risk factors.

Pathways from early life SES to dementia risk in old age: The role of personality

OBJECTIVE

This study investigates the association between childhood socioeconomic status (cSES) and risk of cognitive impairment in older adulthood, and whether Five Factor Model personality traits mediated this association.

METHODS

A sample of 9,995 participants (mean age = 67.01 years) from the Health and Retirement Study were followed every two years from 2006 to 2018. cSES was tested as a predictor of risk of dementia and risk of cognitive impairment not dementia (CIND). Personality was tested as a mediator of these associations. Models were adjusted for age, gender, ethnicity, race, education, and baseline year.

RESULTS

Although effect sizes were modest, results indicated that lower cSES was associated with higher risk of dementia (HR=0.88, [0.775, 0.985]). Higher cSES was also associated with higher Conscientiousness and lower Neuroticism. Conscientiousness and Neuroticism each accounted for 7.9% of the total effect of cSES on dementia. Results were similar for CIND.

CONCLUSIONS

Early childhood socioeconomic factors may contribute to cognitive impairment in older adulthood, an association mediated, in part, through adult personality traits.

Coping with stress and personality: A study in pregnancies complicated by hypertension

OBJECTIVE

The objective of this work is to investigate the role of personality in pregnancies complicated by hypertension, thru analysis of structure and associations between negative affect and coping strategies, and their role towards psychological distress.

METHOD

A cross-sectional study with 343 women, where 192 pregnancies complicated by hypertension, was carried out by employing the following tools: the five-factor model (Big Five), Depression, Anxiety and Stress Scale (DASS-21), and Jalowiec's Coping Inventory. Two complementary strategies were carried out: an exploratory approach on the interactions between latent variables and a confirmatory technique.

RESULTS

Coping strategies seem to be dissociated in the hypertensive group, and these participants tend to use strategies according to their personality, mostly emotion focused, extraversion, and neuroticism. The extraversion model exclusively shows an acceptable goodness-of-fit after a structural equation modelling. A multigroup analysis reached a full metric invariance level for extraversion.

CONCLUSIONS

These results are of interest for both clinical and research settings. Prenatal screening and associated interventions may reduce perinatal negative affective states and related pregnancy complications.