Personality, health, and aging: prolegomenon for the next generation

The associations between personality traits and quality of life, satisfaction with life, and well-being over time in people with dementia and their caregivers: findings from the IDEAL programme

BACKGROUND

Cross-sectional evidence indicates that certain personality traits may influence how well people with dementia and their caregivers are able to live alongside the condition. However, no studies to date have explored these associations longitudinally. The present study aimed to explore whether each of the Five-Factor personality traits were associated with change over two years in perceptions of 'living well' for people with dementia and their caregivers. 'Living well' was conceptualized as a composite of quality of life, satisfaction with life, and subjective well-being.

METHODS

Data were analyzed from 1487 people with dementia and 1234 caregivers who took part in the IDEAL cohort. Participants were categorized into low, medium, and high groups for each trait using stanine scores. Latent growth curve models investigated associations between these groups and 'living well' scores for each trait at baseline and at 12 and 24 months. Covariates included cognition in people with dementia and stress in caregivers. A Reliable Change Index was calculated against which to evaluate changes in 'living well' scores over time.

RESULTS

At baseline, neuroticism was negatively associated with 'living well' scores for people with dementia, while conscientiousness, extraversion, openness, and agreeableness were positively associated. For caregivers, neuroticism was negatively associated with 'living well' scores at baseline while conscientiousness and extraversion were positively associated. 'Living well' scores were mostly stable over time with no influence of personality traits on observed changes.

CONCLUSIONS

Findings suggest that personality traits, particularly neuroticism, have a meaningful impact on how people with dementia and caregivers rate their capability to 'live well' at baseline. Over time 'living well' scores for each personality trait group were largely stable. Studies utilizing longer follow-up periods and more appropriate measures of personality are needed to corroborate and extend the findings of the present study.

The Distressed personality type: replicability and general health associations

The Distressed personality type, identified in a cardiac population, confers risk for worse cardiac outcomes. Whether such a class of persons is identifiable in general patient populations, as well as its health correlates, remains unknown. We investigated these questions in a sample of 482 older primary care patients. Mixture structural equation modelling revealed that a Distressed Type was identifiable in Five Factor Model (FFM) personality data and associated with higher levels of medically documented multimorbidity, and worse subjective health ratings, physician assessed physical functioning and interviewer rated psychosocial functioning. In models including paths from outcomes to both traits and types, traits and types were independently associated with health outcomes, pointing towards the value of considering both approaches in epidemiologic personology research. Copyright © 2007 John Wiley & Sons, Ltd.

Assessing Level of Personality Organization With the Psychodiagnostic Chart: A Validity Study

Heterogeneity within diagnostic types and comorbidity across diagnostic groups render a specific personality disorder anything but specific, leading researchers and clinicians to increasingly focus on the general severity of personality pathology. Personality pathology severity is reflected in one's level of personality organization (LPO) and research has demonstrated that LPO is a significant predictor of treatment response. This investigation examined the reliability and validity of the Psychodiagnostic Chart (PDC) in assessing the LPO dimension of the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006). Among a sample of 88 urban-dwelling women seeking primary medical care, the LPO dimension of the PDC received fair to good interrater reliability among 6 psychodynamic psychologists. Convergent validity was demonstrated with contrast analysis and individual correlations that yielded statistically significant associations between LPO scores and conceptually related psychodynamic variables (e.g., defensive functioning, object relations) and self-reported personality pathology scores. Support for discriminant validity was limited by the modest power associated with the sample size. Exploratory analyses examining LPO scores and measures of physical health and intimate partner violence were conducted. Our results supported the reliability, validity, and practical use of the LPO dimension of the PDC.

The Relationship Between Personality and Neurocognition Among the American Elderly: An Epidemiologic Study

Background

Although different personality traits have often been associated with different levels of mental activity and cognitive functioning, no previous studies have evaluated the association in a sample that mirrors a nationally-representative sample of elderly individuals.

Objective

To evaluate the association between personality traits and neurocognitive functioning among individuals 51 years and older using the Cognition and Aging in the USA (CogUSA) database.

Methods

We analyzed the association between personality traits and neurocognitive scores derived from Waves I and II of the study. Neurocognitive functions were modeled as an outcome variable using the Big Five Personality Traits as predictors.

Results

All personality traits were associated with higher education except Conscientiousness. Older age was associated with higher levels of the Agreeableness and Openness traits. Extraversion, Conscientiousness and Openness were positively associated with increased neurocognitive function and self-rated present memory. Extraversion and Openness also had a positive association with long-term retrieval. Agreeableness was negatively associated with several neurocognitive functions, while Neuroticism was negatively associated with memory and cognitive effort.

Conclusion

Extraversion, Conscientiousness and Openness personality traits are associated with good cognitive health. Individuals scoring high in Neuroticism and Agreeableness might benefit from tailored cognitive interventions to prevent age-related cognitive decline.

Does personality affect health-related quality of life? A systematic review

Background

Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear.

Methods

This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study.

Results

Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%.

Conclusions

Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation.

A personality trait contributes to the occurrence of postoperative delirium: a prospective study

BACKGROUND

Although various physical risk factors for delirium have been identified, the effect of psychological aspects is currently unknown. This study aimed to examine psychological risk factors for postoperative delirium and to identify hidden subgroups of delirium in clinical and psychological feature space.

METHODS

Among 200 patients with hip fracture, 78 elderly patients were prospectively evaluated for clinical and psychological assessments before surgery. As delirium was assessed from the next day to the 7th day after surgery, postoperative delirium was found in 40 patients, but not in 38 patients. Univariate and multivariate logistic regression analyses were used to explore risk factors for postoperative delirium. Phenotypic subgroups of delirium were assessed using Topological Data Analysis, in which the significant risk factors were used for evaluating filter and distance metrics.

RESULTS

Mini-Mental State Examination, neuroticism, conscientiousness, and regional anesthesia were identified as a predictive risk factor for postoperative delirium. The filter metric showed significant negative correlations with nutrition-related factors such as total protein and albumin. When filter metric and Euclidean distances were entered, delirious patients were bifurcated as a function of personality traits and anesthesia method in the patient-patient network.

CONCLUSIONS

A personality trait of neuroticism and conscientiousness may predispose elderly patients to postoperative delirium and this influence may be amplified by regional anesthesia. This study verifies the contribution of psychological risk factors to delirium and provides new insight for complex etiologies of delirium by mapping various clinical variables in the topological space.

Brief report: Self-compassion, physical health and the mediating role of health-promoting behaviours

To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours ( R² = 0.13, b = -8.98, p = 0.015), which was partially mediated through health-promoting behaviours ( R² = 0.06, b = -3.16, 95 per cent confidence interval [-6.78, -0.86]). Findings underscore the potential health-promoting benefits of self-compassion.

Personality and physician-assessed illness burden in older primary care patients over 4 years

BACKGROUND

Personality traits have been associated with physician-rated illness burden cross-sectionally, but longitudinal associations between personality and objective medical morbidity remain unclear.

PURPOSE

To examine associations between personality and physician-rated illness burden 4 years prospectively in older primary care patients.

METHOD

At baseline, patients (average age: 75, SD: 6.6, 62% female) completed the NEO-Five Factor Inventory. At baseline and 4 yearly follow-ups, a physician completed the Cumulative Illness Rating Scale on the basis of medical records.

RESULTS

Linear mixed-effects models revealed that higher neuroticism and lower conscientiousness predicted worse average illness burden longitudinally. Relatively disagreeable persons (25th percentile) accumulated morbidity at a 33% faster rate than agreeable (75th percentile) peers. At the final follow-up, a person at the 75th percentile of neuroticism and the 25th percentile of conscientiousness and agreeableness showed morbidity comparable to a peer of average personality but 10 years older. An individual at the 25th percentile of neuroticism and 75th percentile of conscientiousness and agreeableness showed end-point illness burden comparable to a peer of average personality but 10 years younger. Twenty-one percent of the morbidity associated with neuroticism was explained by total cholesterol. History of hypertension, smoking, alcohol/drug abuse, and affective symptoms of depression each explained 10% or less of the other observed personality effects.

CONCLUSION

Personality plays a nontrivial role in healthy aging among older persons. Brief personality assessment may identify at-risk older persons for closer monitoring, enhance the accuracy of medical prognosis, and provide clues for clinical interventions to promote better health.

Adaptive midlife defense mechanisms and late-life health

A growing body of research suggests that personality characteristics relate to physical health; however, this relation ship has primarily been tested in cross-sectional studies that have not followed the participants into old age. The present study utilizes data from a 70-year longitudinal study to prospectively examine the relationship between the adaptive defense mechanisms in midlife and objectively assessed physical health in late life. In addition to examining the direct effect, we test whether social support mediates this relation ship. The sample consisted of 90 men who were followed for over seven decades beginning in late adolescence. Health ratings from medical records were made at three time points (ages 70, 75, and 80). Defense mechanisms were coded from narratives by trained independent raters (Vaillant, Bond, & Vaillant, 1986). Independent raters assessed social supports between ages 50 and 70. More adaptive defenses in midlife were associated with better physical health at all three time points in late life. These relationships were partially mediated by social support. Findings are consistent with the theory that defense maturity is important for building social relationships, which in turn contribute to better late-life physical health. Psychological interventions aimed at improving these domains may be beneficial for physical health.

The influence of personality on reported pain and self-efficacy for pain management in older cancer patients

This study examines the relationship of personality traits and affect on cancer-related pain in 150 older adults receiving outpatient treatment at a comprehensive cancer center. Regression analyses revealed extraversion as a significant predictor of current pain, with openness to experience as a significant indicator of average pain. Similarly, positive affect and negative affect were significant predictors of self-efficacy for pain management. Moderation models showed that conscientiousness and extraversion were significant moderators in the relationship between self-efficacy for pain management and worst pain. These findings suggest that different personality types may influence perceptions of pain severity.

Big 5 personality traits and interleukin-6: evidence for "healthy Neuroticism" in a US population sample

The current study investigated if the Big 5 personality traits predicted interleukin-6 (IL-6) levels in a national sample over the course of 5years. In addition, interactions among the Big 5 were tested to provide a more accurate understanding of how personality traits may influence an inflammatory biomarker. Data included 1054 participants in the Midlife Development in the U.S. (MIDUS) biomarkers subproject. The Big 5 personality traits were assessed in 2005-2006 as part of the main MIDUS survey. Medication use, comorbid conditions, smoking behavior, alcohol use, body mass index, and serum levels of IL-6 were assessed in 2005-2009 as part of the biomarkers subproject. Linear regression analyses examined personality associations with IL-6. A significant Conscientiousness*Neuroticism interaction revealed that those high in both Conscientiousness and Neuroticism had lower circulating IL-6 levels than people with all other configurations of Conscientiousness and Neuroticism. Adjustment for health behaviors diminished the magnitude of this association but did not eliminate it, suggesting that lower comorbid conditions and obesity may partly explain the lower inflammation of those high in both Conscientiousness and Neuroticism. Our findings suggest, consistent with prior speculation, that average to higher levels of Neuroticism can in some cases be associated with health benefits - in this case when it is accompanied by high Conscientiousness. Using personality to identify those at risk may lead to greater personalization in the prevention and remediation of chronic inflammation.

Smoking mediates the effect of conscientiousness on mortality: The Veterans Affairs Normative Aging Study

This study examined the relationship between conscientiousness and mortality over 18 years and whether smoking behavior mediated this relationship. We utilized data from the Veterans Affairs Normative Aging Study on 1349 men who completed the Goldberg (1992) adjectival markers of the Big Five. Over the 18-year follow-up, 547 (41%) participants died. Through proportional hazards modeling in a structural equation modeling framework, we found that higher levels of conscientiousness significantly predicted longer life, and that this effect was mediated by current smoking status at baseline. Methodologically, we also demonstrate the effectiveness of using a structural equation modeling framework to evaluate mediation when using a censored outcome such as mortality.

Personality typology in relation to muscle strength

BACKGROUND

Physical inactivity plays a central role in the age-related decline in muscle strength, an important component in the process leading to disability. Personality, a significant determinant of health behaviors including physical activity, could therefore impact muscle strength throughout adulthood and affect the rate of muscle strength decline with aging. Personality typologies combining "high neuroticism" (N ≥ 55), "low extraversion" (E < 45), and "low conscientiousness" (C < 45) have been associated with multiple risky health behaviors but have not been investigated with regards to muscle strength.

PURPOSE

The purpose of this study is to investigate associations between individual and combined typologies consisting of high N, low E, and low C and muscle strength, and whether physical activity and body mass index act as mediators.

METHOD

This cross-sectional study includes 1,220 participants from the Baltimore Longitudinal Study of Aging.

RESULTS

High N was found among 18%, low E among 31%, and low C among 26% of the sample. High levels of N, particularly when combined with either low E or low C, were associated with lower muscle strength compared with having only one or none of these personality types. Facet analyses suggest an important role for the N components of depression and hostility. Physical activity level appears to partly explain some of these associations.

CONCLUSION

Findings provide support for the notion that the typological approach to personality may be useful in identifying specific personality types at risk of low muscle strength and offer the possibility for more targeted prevention and intervention programs.

Personality profiles and health: longitudinal evidence among Finnish adults

This study investigates the associations of longitudinal Big Five personality profiles with long-term health in 304 adults (53% males). Personality traits (Neuroticism, Extraversion, Openness, Conscientiousness, Agreeableness) were assessed at ages 33, 42, and 50. Subjective (self-rated health, symptoms, psychological distress) and objective (body mass index, waist-to-hip ratio, blood pressure, cholesterol, triglycerides) indicators of health were measured at ages 42 and 50. Five longitudinally stable personality profiles were extracted over 17 years by latent profile analysis. The levels of traits were the same in each profile at each age. Resilient individuals (N = 65; Neuroticism low, other traits high) had the best subjective health and Overcontrolled individuals (N = 40; Neuroticism high, other traits low) the poorest health over eight years. Reserved individuals (N = 25; high Conscientiousness, other traits low), Undercontrolled (N = 41; high Openness and Extraversion, low Conscientiousness), and Ordinary (N = 133; all traits scored medium) individuals were in the middle of these extremes in subjective health. No differences between the profiles were found in the objective indicators of health. Thus, overcontrol and resilience were most discriminative in terms of good health. Moreover, personality profiles revealed associations with health to be more nuanced than simply being composed of single traits. High Extraversion needed to be combined with high Conscientiousness (Resilients) in order to be associated with the best health; high Extraversion with low Conscientiousness (Undercontrolled) was associated with average health; and low Extraversion with high Neuroticism (Overcontrolled) was associated with the poorest health.

Personality predicts cognitive function over 7 years in older persons

OBJECTIVES

To determine whether Neuroticism as well as the less-studied dimensions the Five Factor Model of personality (Extraversion, Openness to Experience, Agreeableness, and Conscientiousness) were associated with 7-year trajectories of cognitive functioning in older persons.

DESIGN

Primary analysis of existing clinical trial data.

PARTICIPANTS

602 persons of average age 79 at baseline.

MEASUREMENTS

The NEO-Five Factor Inventory of personality, completed at baseline, and the Modified Mini-Mental State Examination measured every 6 months for 7 years.

RESULTS

Controlling for demographics, baseline morbidities including depression, health behaviors, apolipoprotein E4 genotype, and self-rated health, higher Neuroticism was associated with worse average cognitive functioning and a steeper rate of decline over follow-up. Higher Extraversion and lower Openness were both associated with worse average cognitive functioning prospectively, while persons higher in Conscientiousness showed a slower rate of cognitive decline.

CONCLUSIONS

In addition to Neuroticism, other dispositional tendencies appear prognostically relevant for cognitive functioning in older persons. More work is needed to understand the mechanisms by which traits operate, as well as whether mitigation of certain dispositional tendencies can facilitate a better course of cognitive function.

Development and validation of a personality assessment instrument for traditional korean medicine: sasang personality questionnaire

Objective. Sasang typology is a traditional Korean medicine based on the biopsychosocial perspectives of Neo-Confucianism and utilizes medical herbs and acupuncture for type-specific treatment. This study was designed to develop and validate the Sasang Personality Questionnaire (SPQ) for future use in the assessment of personality based on Sasang typology. Design and Methods. We selected questionnaire items using internal consistency analysis and examined construct validity with explorative factor analysis using 245 healthy participants. Test-retest reliability as well as convergent validity were examined. Results. The 14-item SPQ showed acceptable internal consistency (Cronbach's alpha = .817) and test-retest reliability (r = .837). Three extracted subscales, SPQ-behavior, SPQ-emotionality, and SPQ-cognition, were found, explaining 55.77% of the total variance. The SPQ significantly correlated with Temperament and Character Inventory novelty seeking (r = .462), harm avoidance (r = −.390), and NEO Personality Inventory extraversion (r = .629). The SPQ score of the So-Eum (24.43 ± 4.93), Tae-Eum (27.33 ± 5.88), and So-Yang (30.90 ± 5.23) types were significantly different from each other (P < .01). Conclusion. Current results demonstrated the reliability and validity of the SPQ and its subscales that can be utilized as an objective instrument for conducting personalized medicine research incorporating the biopsychosocial perspective.

Personality and reduced incidence of walking limitation in late life: findings from the Health, Aging, and Body Composition Study

OBJECTIVES

To examine the association between openness to experience and conscientiousness and incident reported walking limitation.

METHOD

The study population consisted of 786 men and women aged 71-81 years (M = 75 years, SD = 2.7) participating in the Health, Aging, and Body Composition-Cognitive Vitality Substudy.

RESULTS

Nearly 20% of participants (155/786) developed walking limitation during 6 years of follow-up. High openness was associated with a reduced risk of walking limitation (hazard ratio [HR] = 0.83, 95% confidence interval [CI] = 0.69-0.98), independent of sociodemographic factors, health conditions, and conscientiousness. This association was not mediated by lifestyle factors and was not substantially modified by other risk factors for functional disability. Conscientiousness was not associated with risk of walking limitation (HR = 0.91, 95% CI = 0.77-1.07).

DISCUSSION

Findings suggest that personality dimensions, specifically higher openness to experience, may contribute to functional resilience in late life.

Personality and longevity: knowns, unknowns, and implications for public health and personalized medicine

We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or "distressed" personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine.

[New trends in research on personality traits: contributions to economics and epidemiology]

Research has shown that personality traits have strong predictive validity for economic variables (e.g., income, work attainment) and epidemiological variables (e.g., longevity, physical health), as well as for psychological variables such as problem behaviors, and mental disorders. Importantly, personality traits are predictive even after controlling for socioeconomic status and cognitive abilities. The authors believe that current personality research in Japan almost completely overlooks this perspective. In this article, the authors review these new trends in personality psychological research. They propose a model for research involving A (accurate assessments), B (big samples), C (controlling for covariates and confounders), D (developmental trajectories), and E (economic and epidemiological variables). They outline three future directions to embody personality psychology for prediction, prevention, public wealth, and population health.

Personality and health, subjective well-being, and longevity

Personality traits can be employed to guide understanding of trajectories to health and longevity, but long-term longitudinal study and multifaceted assessment of healthy aging are crucial. Following up on the life span study initiated by Lewis Terman, we assessed 4 validated factors of personality in young adulthood in 1940, constructed a multifactor measure of participants' healthy aging in 1986, and collected death certificates through 2007 (to determine longevity) on a sample of 1,312 Terman participants (732 men). Neuroticism predicted worse physical health and subjective well-being in old age and, for women, higher mortality risk, but for men, neuroticism predicted decreased mortality risk. For both sexes, extraversion predicted old-age social competence, whereas conscientiousness predicted men's old-age productivity. Differential patterns of association between personality traits and healthy aging components are informative about individual personality characteristics and long-term health outcomes.

Effect of honey on serum cholesterol and lipid values

Small studies have suggested that honey benefits patients with high cholesterol concentrations. The present study aimed to confirm this finding in a larger group of subjects. Sixty volunteers with high cholesterol, stratified according to gender and hydroxymethylglutaryl-coenzyme A reductase inhibitor (statin) treatment (yes/no), were randomized to receive 75 g of honey solution or a honey-comparable sugar solution once daily over a period of 14 days. Baseline measurements, including body mass index (BMI) and lipid profile, were obtained, and subjects also completed dietary questionnaires and the Inventory for the Assessment of Negative Bodily Affect-Trait form (INKA-h) questionnaire. Measurements were repeated 2 weeks later. BMI and high-density lipoprotein (HDL) cholesterol values were significantly correlated (r = -0.487; P < .001) as were BMI and a lower ratio of low-density lipoprotein (LDL) cholesterol to HDL cholesterol (r = 0.420; P < .001), meaning that subjects with a high BMI had a lower HDL cholesterol value. INKA-h scores and LDL cholesterol values were also significantly correlated (r = 0.273, P = .042). Neither solution influenced significantly cholesterol or triglyceride values in the total group; in women, however, the LDL cholesterol value increased in the sugar solution subgroup but not in the women taking honey. Although ingesting honey did not reduce LDL cholesterol values in general, women may benefit from substituting honey for sugar in their diet. Reducing the BMI lowers the LDL cholesterol value, and psychological interventions also seem important and merit further investigation.

Do Health Behaviors Explain the Effect of Neuroticism on Mortality? Longitudinal Findings from the VA Normative Aging Study

Studies have shown that higher levels of neuroticism are associated with greater risk of mortality. Yet what accounts for this association? One major theoretical position holds that persons higher in neuroticism engage in poorer health behaviors, such as smoking and excessive drinking, thus leading to earlier death. We tested this hypothesis using 30-year mortality in 1,788 men from the VA Normative Aging Study. Using proportional hazards (Cox) models we found that one health behavior, smoking, attenuated the effect of neuroticism on mortality by 40%. However, 60% remained unexplained, suggesting that the effects of other pathways (e.g., biological) also influence the relationship between neuroticism and mortality.

Personality traits predict emergency department utilization over 3 years in older patients

BACKGROUND

Emergency department (ED) utilization by older patients has major implications for morbidity, mortality, and health costs, yet its behavioral determinants remain poorly understood. Powerfully tied to health in older adults, the "Big Five" personality traits of neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness may predict ED use.

OBJECTIVES

Investigate the role of personality in prospective ED use among older patients.

RESEARCH DESIGN

Prospective cohort.

SUBJECTS

Adults aged 65 and older.

MEASURES

Participants completed the NEO Five Factor Inventory of personality at baseline, and interviewers administered the Cornell Services Index assessing ED use at baseline and 3 yearly follow-ups.

RESULTS

Controlling for income, education, gender, age, physician-assessed medical burden and physical functioning, and interviewer-assessed impairments in basic activities of daily living and physical self-maintenance, and depression, lower agreeableness and higher extroversion were each associated with increased odds of an ED visit over the follow-up period. A 1 sample deviation (SD) increase in extroversion (i.e., 50th versus 83rd population percentile) increased the odds of ED use by 51% (adjusted odds ratio [AOR] [95% CI] = 1.51 [1.03-2.21], z = 2.12, N = 923, p = 0.034). A 1-SD decrease in agreeableness (i.e., 50th versus 17th population percentile) increased odds of ED use by 54% (AOR [95% CI] = 1.54 [1.05-2.22], z = -2.25, N = 923, p = 0.034).

CONCLUSION

The greater assertiveness and social confidence signified by lower agreeableness and higher extroversion may help older adults overcome potential barriers to the ED. Overly introverted and agreeable older adults may require special encouragement to access the ED--particularly for time--sensitive conditions--to reduce morbidity and mortality.

Conscientiousness, career success, and longevity: a lifespan analysis

BACKGROUND

Markers of executive functioning, such as prudent planning for the future and impulse control, are related to conscientiousness and may be central to both occupational success and health outcomes.

PURPOSE

The aim of the study was to examine relations among conscientiousness, career success, and mortality risk across a 65-year period.

METHODS

Using data derived from 693 male participants in the Terman Life Cycle Study, we examined associations among childhood personality, midlife objective career success, and lifelong mortality risk through 2006.

RESULTS

Conscientiousness and career success each predicted lower mortality risk (N = 693, relative hazard (rh) = 0.82 [95% confidence interval = 0.74, 0.91] and rh = 0.80 [0.71, 0.91], respectively), with both shared and unique variance. Importantly, childhood personality moderated the success-longevity link; conscientiousness was most relevant for least successful individuals.

CONCLUSION

Conscientiousness and career success predicted longevity, but not in a straightforward manner. Findings highlight the importance of lifespan processes.

A Theory of the Emergence, Persistence, and Expression of Geographic Variation in Psychological Characteristics

Volumes of research show that people in different geographic regions differ psychologically. Most of that work converges on the conclusion that there are geographic differences in personality and values, but little attention has been paid to developing an integrative account of how those differences emerge, persist, and become expressed at the geographic level. Drawing from research in psychology and other social sciences, we present a theoretical account of the mechanisms through which geographic variation in psychological characteristics emerge and persist within regions, and we propose a model for conceptualizing the processes through which such characteristics become expressed in geographic social indicators. The proposed processes were examined in the context of theory and research on personality traits. Hypotheses derived from the model were tested using personality data from over half a million U.S. residents. Results provided preliminary support for the model, revealing clear patterns of regional variation across the U.S. and strong relationships between state-level personality and geographic indicators of crime, social capital, religiosity, political values, employment, and health. Overall, this work highlights the potential insights generated by including macrolevel perspectives within psychology and suggests new routes to bridging theory and research across several disciplines in the social sciences.

The Predictive Validity of Optimism and Affectivity in a Longitudinal Study of Older Adults

The current study tested the independence of dispositional optimism and pessimism from negative and positive affectivity in the prediction of older adults' well-being, concurrently and five years later, using structural equation modeling. As hypothesized, in a community sample, both optimism/pessimism and affectivity were correlated cross-sectionally and prospectively with outcomes representing general health and well-being (self-rated health, somatic depression and life satisfaction). However, with both sets of predictors in the model, affectivity eliminated the relationships of optimism/pessimism with the outcomes. Our proposed explanation for these findings, derived from the theoretical self-regulation model, also explains the seemingly contradictory previous findings of an independent contribution of dispositional optimism in patient samples coping with specific stressors.

Gender Differences in Five Factor Model Personality Traits in an Elderly Cohort: Extension of Robust and Surprising Findings to an Older Generation

In college and adult samples, women score higher then men on the Five Factor Model (FFM) personality traits of Neuroticism and Agreeableness. The present study assessed the extent to which these gender differences held in a sample of 486 older adults, ranging in age from 65-98 (M = 75, SD = 6.5), using the NEO-Five Factor Inventory. Mean and Covariance Structure models testing gender differences at the level of latent traits revealed higher levels of Neuroticism (d = .52) and Agreeableness (d = .35) in older women than older men. The consistency of these findings with prior work in younger samples attests to the stability of gender differentiation on Neuroticism and Agreeableness across the lifespan. Gender differences on these traits should be considered in personality research among older, as well as middle age and younger adults.

Personality and risk of physical illness

Several personality characteristics have been linked in multiple well-designed prospective studies to subsequent physical health outcomes, such as longevity and the development and course of cardiovascular disease. The evidence is strongest for negative affectivity/neuroticism, anger/hostility and related traits, and optimism. Models of mechanisms underlying these associations have emphasized physiological effects of stress, exposure to stressors, and health behavior. Preliminary evidence supports the viability of some mechanisms, but formal mediational tests are lacking. In addition to addressing limitations and inconsistencies in this literature, future research should address developmental aspects of these psychosocial risk factors, contextual moderators of their health effects, and intervention applications in the prevention and management of disease. In these efforts, greater incorporation of concepts and methods in the structural, social-cognitive, and interpersonal perspectives in the field of personality are needed.

Personality and health care decision-making style

Using the Wisconsin Longitudinal Study Graduate Survey (N = 5,830), a population-based cohort of older adults (most aged 63-66 years), we explored relationships between five factors of personality and four preference types that account for multiple components of the health care decision-making process (information exchange, deliberation, and selection of treatment choice). After adjustment for personal, health, social, and economic factors, we found that increased conscientiousness and openness to experience and decreased agreeableness and neuroticism corresponded to preferring the most active decision-making style compared with the least active. A better understanding of how personality traits relate to patient decision-making styles may help clinicians tailor treatment discussions to the needs and preferences of individual patients.

Contact allergy to propolis in beekeepers

BACKGROUND

Some toothpastes, cosmetics and ointments contain propolis, a bee product, and it is increasingly popular as a dietary supplement. Although propolis is known to cause contact allergy, there have been no studies of the prevalence of this.

OBJECTIVES

This study aimed to determine the prevalence of contact allergy to propolis in beekeepers and any relationship between propolis allergy and environmental and physical and mental health characteristics in this group.

SUBJECTS AND METHODS

A specially developed instrument which included a validated questionnaire on emotional stability was included in the issues of three German beekeeping journals sent to subscribers in a number of regions (potential readership 35,000). A reference group also completed questionnaire.

RESULTS

1051 questionnaires were returned and 37 cases of allergic reactions to propolis were reported (3.6%). Only 10 of the 37 (27%) beekeepers had recognised the allergy before participating in this study. Propolis contact allergy was significantly associated with lung diseases and other allergic reactions. Only some affected beekeepers protected their hands more while working with bees and showed significantly greater emotional instability than those not sensitised to propolis.

CONCLUSIONS

Contact allergy to propolis is common among beekeepers, but they do not seem to recognise the problem or protect themselves properly.

Personality and medical illness burden among older adults in primary care

OBJECTIVE

To examine the association between Five Factor Model personality traits (Neuroticism, Extraversion, Openness to experience, Agreeableness, Conscientiousness) and physician-quantified aggregate morbidity in a sample of older adults in primary care.

METHODS

A total of 449 primary care patients, ranging in age from 65 to 97 years (75 +/- 6.9 (mean +/- standard deviation)), completed the Neo-Five Factor Inventory (NEO-FFI) and extensive interviews. A physician-investigator completed the Cumulative Illness Rating Scale (CIRS), a well-validated measure of aggregate morbidity based on a review of medical records.

RESULTS

Bivariate analyses demonstrated that all five domains of the NEO-FFI were associated with CIRS scores. Multivariate regression controlling for age, gender, education, depression, smoking, hypertension, total cholesterol, alcohol or substance misuse, and other personality traits showed that greater Conscientiousness was independently associated with lower CIRS scores (beta = -0.10, t(435) = -1.96, p = .05). Other independent predictors of less morbidity were younger age, absence of hypertension, and lower levels of depression.

CONCLUSION

Our results point toward the necessity of considering Conscientiousness and other personality traits in studies of risk factors for aggregate morbidity. More detailed characterization of at-risk populations will increase the likelihood of constructing informed and effective prevention, intervention, and policy initiatives.

Daily interpersonal events in pain patients: applying action theory to chronic illness

Action theory proposes that individuals actively shape and then respond to their environments, highlighting the role of stable person characteristics in the development and maintenance of life's interpersonal difficulties. In this study, the authors adopt the action perspective in their examination of predictors of daily interpersonal events among chronic pain patients with rheumatoid arthritis. They probe the extent to which stable symptoms of illness explained between-person variation, and fluctuating symptoms explain day-to-day variation in both positive and negative events. Their evaluation of patients' daily diary reports indicate that between-person differences accounted for more variance in the occurrence of positive events relative to negative events (48% vs. 31%, respectively). Likewise, between-person factors accounted for more variance in appraisals of positive compared to negative events across relationship domains. Both intractable illness symptoms and disability, and daily fluctuations in pain and fatigue, were only weakly related to patients' reports of their interpersonal experiences. Consistent with action theory, these results suggest that stable person characteristics are strongly related to daily stressors and particularly daily positive events in pain patients, but still account for less than 50% of the variance in events and their appraisals. In contrast, elevations in illness-related features, both between individuals and within individuals from day-to-day, are not robust predictors of positive or negative social exchanges. These findings point to the value of capturing the experiences of individuals intensively over time, an approach that can help to elaborate the contributions of both stable factors and circumstance in shaping social contexts in chronic illness.

Hostility and pain are related to inflammation in older adults

Chronically elevated systemic inflammation has a dramatic impact on health for older individuals. As stress-related responses, both hostility and pain perception may contribute to inflammation which in turn may maintain negative emotion and pain over time. We used structural equation modeling to examine the degree to which trait hostility and pain were uniquely associated with C-reactive protein (CRP) and serum IL-6 levels over a 6-year span in a sample of older adults. The sample included 113 present or former caregivers of a spouse with dementia and 101 non-caregivers. After accounting for depression, health behaviours, and other risk factors, which were also assessed longitudinally, pain and, to a lesser extent, hostility were uniquely associated with plasma levels of CRP but not IL-6. When examined separately, the association between pain and CRP was significant only for caregivers, while the association between hostility and CRP was comparable for the two groups. These findings suggest that hostility may play a role in a cycle of inflammation among older adults, and that pain may be particularly problematic for those under chronic stress. Our results also shed light on inflammation as a mechanism underlying the effects of hostility on cardiovascular disease morbidity and mortality.

Forty years on: teachers' assessments of children's personality traits predict self-reported health behaviors and outcomes at midlife

A life span health-behavior model was investigated in this longitudinal study of personality influences on health. Teachers assessed 963 elementary schoolchildren on traits that formed scales assessing the dimensions of the five-factor (Big Five) model of personality. Smoking, alcohol use, body mass index (BMI), and self-rated health were assessed 40 years later in midlife. Childhood personality traits were significantly associated with all 4 outcomes, and the effects were consistently larger for women than men. For men and women, childhood Conscientiousness was associated with less adult smoking and better adult self-rated health and, for women only, with lower adult BMI. Mediation analyses suggested that the effects of Conscientiousness on self-rated health were partially mediated by smoking and BMI. These findings add to the growing evidence that childhood personality traits predict adult health outcomes and are discussed in terms of future testing of the life span health-behavior model.

Personality and the Prediction of Consequential Outcomes

Personality has consequences. Measures of personality have contemporaneous and predictive relations to a variety of important outcomes. Using the Big Five factors as heuristics for organizing the research literature, numerous consequential relations are identified. Personality dispositions are associated with happiness, physical and psychological health, spirituality, and identity at an individual level; associated with the quality of relationships with peers, family, and romantic others at an interpersonal level; and associated with occupational choice, satisfaction, and performance, as well as community involvement, criminal activity, and political ideology at a social institutional level.

Personality development: stability and change

In this review, we evaluate four topics in the study of personality development where discernible progress has been made since 1995 (the last time the area of personality development was reviewed in this series). We (a) evaluate research about the structure of personality in childhood and in adulthood, with special attention to possible developmental changes in the lower-order components of broad traits; (b) summarize new directions in behavioral genetic studies of personality; (c) synthesize evidence from longitudinal studies to pinpoint where and when in the life course personality change is most likely to occur; and (d) document which personality traits influence social relationships, status attainment, and health, and the mechanisms by which these personality effects come about. In each of these four areas, we note gaps and identify priorities for further research.