Personality correlates of hopelessness in depressed inpatients 50 years of age and older

Resistance to Sunk Cost Propensity Moderate Relationship between Negative Life Event and Hopelessness

Previous research has found that a negative life event is a main risk factor for hopelessness, which in turn is considered to be a proximal cause of major depression disorder and a suicide risk factor. Unfortunately, very little attention has been paid to the role of decision-making constructs between negative life events and hopelessness. To fill this gap, the present study aims to test the moderation role of sunk cost propensity in this relationship, which is an over-generalized tendency to persist, based on past investment. A total of 495 university students completed assessment of their resistance to sunk cost propensity, whereas the negative life events, hopelessness, mental health state (depression, anxiety) and big-five personality traits were measured by various questionnaires. Participants' tendency to resist sunk cost propensity moderated the relationship between negative life events and hopelessness. Individuals who tended to resist sunk cost bias are more vulnerable to the adverse effects of negative life events. This effect is still significant, even after controlling for individuals' psychological well-being (depression, anxiety) and big-five personality traits. The current findings provide preliminary evidence that resistance to sunk cost propensity may be an important characteristic associated with an individual's hopelessness when exposed to a negative life event.

The Impact of the COVID-19 Pandemic on Youth with Chronic Pain and Their Parents: A Longitudinal Examination of Who Are Most at Risk

Objectives: Chronic pain and mental illness in youth and parents are poised to reach new heights amidst the societal and healthcare impacts of the COVID-19 pandemic. Evidence from natural disasters (i.e., hurricanes) suggests that a degree of personal impact and individual personality may moderate the effects of high stress events, such as the COVID-19 pandemic, on mental health. Methods: In a pre-existing cohort of 84 youth with chronic pain (M_age = 14.39; 12–18 years; 67.8% female) and 90 parents (86.7% female), we examined changes in youth pain interference and youth and parent mental health (depression, anxiety) from before to during the first wave of the COVID-19 pandemic, and the influence of personal impact of the pandemic (i.e., financial, familial, health, social, occupational, and educational domains) and individual personality (neuroticism, conscientiousness, extroversion). Results: Overall, youth reported significantly lower pain interference and anxiety as compared to pre-pandemic; however, those more personally impacted by the pandemic reported worsening pain interference and anxiety symptoms. Overall, parents reported greater depressive symptoms as compared to pre-pandemic; however, those more personally impacted by the pandemic reported increased anxiety symptoms. Personality traits (high neuroticism, and low conscientiousness and extroversion) predicted worsened pain and mental health, and exacerbated effects of COVID-19-related personal impact on youth and parent anxiety symptoms. Discussion: Identifying risk and resilience profiles in youth and parents at high risk for worsening pain and mental health may better inform matching interventions to individual need.

Personality and Perceived Health in Spousal Caregivers of Patients with Lung Cancer: The Roles of Neuroticism and Extraversion

Purpose. Family members' responsibilities for patients with cancer have increased dramatically over the past decade and will likely continue to rise. Given that caregiving is associated with declines in self-care, there is a need for research on caregivers' perceptions of their own health. The purpose of this study was to examine whether personality is associated with four self-report perceived health items from the SF-36. Methods. The sample consisted of 114 spouses of lung cancer patients who completed cross-sectional measures as part of a larger cohort study on adjustment to the diagnosis and treatment of lung cancer. Predictors of interest were Neuroticism and Extraversion scores from the NEO-FFI. Covariates were age, gender, conscientiousness, depressive symptoms, and objective illness burden. Results. Multivariate analyses revealed that caregivers with higher Extraversion scores were less likely to respond affirmatively to the item "I expect my health to get worse" (OR = 0.90, p < 0.05). Neuroticism was associated with poorer perceived health (ORs from 1.11 to 1.12, p's < 0.05). Conclusions. The present cross-sectional findings suggest that personality is associated with responses to SF-36 perceived health items beyond what can be accounted for by objective illness burden and other covariates. The potential overestimation of health among extraverted caregivers may have implications for their health outcomes.

Personality diatheses and Hurricane Sandy: effects on post-disaster depression

BACKGROUND

According to diathesis-stress models, personality traits, such as negative emotionality (NE) and positive emotionality (PE), may moderate the effects of stressors on the development of depression. However, relatively little empirical research has directly examined whether NE and PE act as diatheses in the presence of stressful life events, and no research has examined whether they moderate the effect of disaster exposure on depressive symptoms. Hurricane Sandy, the second costliest hurricane in US history, offers a unique opportunity to address these gaps.

METHOD

A total of 318 women completed measures of NE and PE 5 years prior to Hurricane Sandy. They were also assessed for lifetime depressive disorders on two occasions, the latter occurring an average of 1 year before the hurricane. Approximately 8 weeks after the disaster (mean = 8.40, s.d. = 1.48 weeks), participants completed a hurricane stress exposure questionnaire and a measure of current depressive symptoms.

RESULTS

Adjusting for lifetime history of depressive disorders, higher levels of stress from Hurricane Sandy predicted elevated levels of depressive symptoms, but only in participants with high levels of NE or low levels of PE.

CONCLUSIONS

These findings support the role of personality in the development of depression and suggest that personality traits can be useful in identifying those most vulnerable to major stressors, including natural disasters.

Five factor model traits as a predictor of suicide ideation and interpersonal suicide risk in a college sample

Research has demonstrated an inconsistent relationship between suicide ideation and personality traits. This is the first study to empirically examine the relationship of the Five Factor Model of personality with current, past and no suicide ideation, and with the two interpersonal risk factors of suicide: thwarted belongingness and perceived burdensomeness (Joiner, T., 2005. Why people die by suicide. Cambridge, MA, US: Harvard University Press). Results indicate that high neuroticism was associated with both current ideation and a history of suicide ideation and extraversion was associated with current ideation. Neuroticism was positively related to thwarted belongingness and perceived burdensomeness, while extraversion was negatively related to these interpersonal predictors of suicide. Agreeableness was negatively related to thwarted belongingness but not perceived burdensomeness, indicating differentiated patterns of relationships between this personality domain and the two suicide constructs. Furthermore, these personality domains predicted 23.82% of variance for thwarted belongingness and 15.07% of the variance for perceived burdensomeness, above and beyond demographic variables associated with suicide ideation. This study, which was conducted with a college sample, demonstrates the potential benefit of identifying predispositional risk factors for suicide ideation and interpersonal predictors of suicide. This may have implications for the development of upstream preventative measures against suicide.

Temperament, hopelessness, and attempted suicide: direct and indirect effects

This study evaluated whether hopelessness mediated the relations between temperament and recent suicide attempter status in a psychiatric sample. Negative temperament and positive temperament (particularly the positive emotionality subscale) uniquely predicted levels of hopelessness. Although these temperament constructs also demonstrated significant indirect effects on recent suicide attempter status, the effects were partially (for the broad temperament scales) or fully (for the positive emotionality subscale) mediated by the levels of hopelessness. These findings indicate that a tendency to experience excessive negative emotions as well as a paucity of positive emotions may lead individuals to experience hopelessness. Although temperament may also indirectly influence suicide attempter status, hopelessness mediates these relations.

Personality factors and suicide risk in a representative sample of the German general population

Objective

Previous research has shown an association between certain personality characteristics and suicidality. Methodological differences including small sample sizes and missing adjustment for possible confounding factors could explain the varying results. The aim of this study was to assess the impact of the Big Five personality dimensions on suicidality in a representative population based sample of adults.

Method

Interviews were conducted in a representative German population-based sample (n=2555) in 2011. Personality characteristics were assessed using the Big Five Inventory-10 (BFI-10) and suicide risk was assessed with the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Multivariate logistic regression models were calculated adjusting for depression, anxiety, and various sociodemographic variables.

Results

Neuroticism and openness were significantly associated with suicide risk, while extraversion and conscientiousness were found to be protective. Significant sex differences were observed. For males, extraversion and conscientiousness were protective factors. Neuroticism and openness were found to be associated with suicide risk only in females. These associations remained significant after adjusting for covariates.

Conclusion

The results highlight the role of personality dimensions as risk factors for suicide-related behaviors. Different personality dimensions are significantly associated with suicide-related behaviors even when adjusting for other known risk factors of suicidality.

Neuroticism and extroversion in suicide attempters aged 75 and above and a general population comparison group

Personality traits have been shown to influence suicidal behaviour but the literature on 'older' elderly is sparse. The aim was to compare neuroticism and extroversion in hospitalized suicide attempters aged 75 and above and a general population comparison group. Seventy-two hospitalized suicide attempters (mean age 81 years) were interviewed. Comparison subjects were drawn from participants in population studies on health and ageing. Participants completed the Eysenck Personality Inventory (EPI) and symptoms of depression were rated with the Montgomery-Asberg Depression Rating Scale (MADRS). Depression diagnoses were made in accordance with Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Attempters scored higher on the neuroticism scale than comparison subjects (mean = 9.9 vs. 7.6, t = 3.74, df = 358, p < 0.001) and lower on the extroversion scale (mean = 10.8 vs. 12.0; t = -2.76, df = 358, p = 0.006). While these differences did not remain after adjustment for major depression, attempters with minor depression were less neurotic than comparison subjects with this diagnosis (mean = 6.6 vs. 11.1, t = -3.35, df = 63, p = 0.001) and a negative association with neuroticism remained in a multivariate model. In conclusion cases scored higher on neuroticism and lower on extroversion compared to comparison subjects. The finding that attempters with minor depression were less neurotic than comparison subjects with this diagnosis was unexpected and needs to be examined in larger samples.

Combined effects of neuroticism and extraversion: findings from a matched case control study of suicide in rural China

Neuroticism and extraversion are potentially important markers of personality vulnerability to suicide. Whereas previous studies have examined these traits independently, we examined their combined effects. Data were collected from family members and/or friends of individuals 18 years or older who died by suicide (n = 64) in rural China and from age-, sex-, and geographically matched controls (n = 64). Personality was assessed with the NEO-Five Factor Inventory. Individuals with a personality style characterized by high neuroticism and low extraversion were at 3.07 (95% confidence interval [CI], 1.44-6.55) times greater risk for suicide than were individuals without this personality style; in contrast, a style characterized by low neuroticism and high extraversion conferred decreased suicide risk (odds ratio, 0.41; 95% CI, 1.44-6.55). We conclude that it may be clinically inadequate to conceptualize neuroticism, by itself, as a risk marker for suicide. However, when the negative affect characteristic of neuroticism is combined with the joylessness, pessimism, and hopelessness characteristic of low extraversion, risk for suicide is elevated.

Chronic medical problems and distressful thoughts of suicide in primary care patients: mitigating role of happiness

OBJECTIVE

Chronic medical problems might amplify suicide risk in later life. Feelings of happiness may reduce this risk. We tested the hypothesis that happiness attenuates the association between number of self-reported chronic diseases and suicidal distress.

METHODS

A sample of 1,801 depressed, primary care patients, 60 years of age or older, entering a clinical trial, were assessed for the presence of positive emotion, suicidal distress and self-reported chronic medical problems.

RESULTS

Chronic medical problems are associated with suicide ideation and, as hypothesized, happiness attenuates the relationship between self-reported diseases and suicidal distress.

CONCLUSIONS

Decreased risk for distressing thoughts of suicide in the context of medical illness is predicted by the presence of positive emotions. Our results suggest that treatments designed to help older primary care patients identify sources of joy and enhance happiness might decrease suicide risk.

Positive affect and suicide ideation in older adult primary care patients

Suicide is a significant public health problem for older adults. Identification of protective factors associated with reduced risk is important. The authors examined the association of positive affect and suicide ideation in 462 primary care patients ages 65 and older. Positive affect distinguished suicide ideators from nonideators, after controlling for age, gender, depression, negative affect, illness burden, activity, sociability, cognitive functioning, and physical functioning. There was a trend toward age moderation of this relationship. Clinical and theoretical formulations of late-life suicide should consider the role of positive affect, including the possibility that its protective effects grow more pronounced with age.

Deliberate self-harm in older adults: a review of the literature from 1995 to 2004

BACKGROUND

The prevention of suicide is a national and international policy priority. Old age is an important predictor of completed suicide. Suicide rates in old age differ markedly from country to country but there is a general trend towards increasing rates with increasing age. In 1996 Draper reviewed critically the evidence on attempted suicide in old age in the 10 years between 1985 and 1994. The review highlighted a need for prospective controlled studies in older people with more representative samples as well as studies examining the interaction of risk factors, precipitants, motivations, psychopathology and response to treatment. The aim of this paper is to update this review and to summarise the advances in our understanding of DSH in later life.

METHOD

We have critically reviewed relevant studies published between 1995 and 2004 to summarise the advances in our understanding of factors associated with deliberate self-harm in later life.

RESULTS

The main advances in understanding have been to clarify the effect of personality and cultural factors, service utilisation pre and post attempt, and the (lesser) impact of socio-economic status and physical illness. Methodological weaknesses continue to include inadequate sample sizes performed on highly selected populations, inconsistent age criteria and lack of informant data on studies relating to role of personality.

CONCLUSIONS

Future studies should include prospective, cross-cultural research with adequate sample sizes and which are population-based. Such approaches might confirm or refute the results generated to date and improve knowledge on factors such as the biological correlates of deliberate self-harm, service utilisation, costs and barriers to health care, and the interaction of these factors. Intervention studies to elucidate the impact of modifying these factors and of specific treatment packages are also needed.

Personality and perceived health in older adults: the five factor model in primary care

Responses to specific questions tapping perceived health are associated with morbidity, mortality, and the use of health services, yet there has been little research on their personality correlates. We examined the associations between Five Factor Model personality traits and responses to four items extracted from the Medical Outcomes Study Short Form-36 in 266 primary care patients who were 65 years of age or older. Multivariate analyses controlling for age, gender, depressive symptoms, and physical disease burden showed that having a higher Neuroticism score was associated with worse perceived health in response to all items except "I am as healthy as anybody I know." Having a lower Extraversion score was associated with worse perceived health in response to the item "I expect my health to get worse." We discuss implications for understanding personality influences on morbidity, mortality, and health services utilization.

Predisposing and Precipitating Factors for Suicide Among Alcoholics: Empirical Review and Conceptual Integration

Alcohol dependence is a potent risk factor for suicide. Accordingly, alcoholics should be targeted in suicide prevention efforts. This article reviews the literature on suicide among alcoholics and provides a model that may inform research, clinical work, and prevention efforts. In this model, we propose that aggression/impulsivity, severe alcoholism, negative affect, and hopelessness are key predisposing factors for suicide among alcoholics. We propose that major depressive episodes and stressful life events, particularly interpersonal difficulties, are key precipitating factors. We also integrate these constructs in a model that proposes that many acts of suicide among alcoholics may be viewed as acts of reactive aggression executed in the midst of distress over a lost or threatened relationship. Empirical evidence for the model is discussed along with its limitations. The next generation of research on alcoholism and suicide should include a focus on the interpersonal anlage of suicide in this population.

A psychometric analysis of the Geriatric Hopelessness Scale (GHS): towards improving assessment of the construct

BACKGROUND

Hopelessness increases vulnerability to late-life depression and risk for suicide. The present study examined the psychometric properties of the Geriatric Hopelessness Scale (GHS; Fry, 1984) among a heterogeneous sample of older adults and its association with depression and suicide ideation.

METHODS

Seventy-eight adults 65 years or older recruited from psychiatric, medical, residential, and community were administered the study measures. We examined the item-response characteristics, factor structure, and reliability of the GHS, its construct validity by way of associations with depression, hopelessness, and suicide ideation, and criterion validity in terms of differentiating psychiatric patients from non-psychiatric participants.

RESULTS

The GHS had poor item-response characteristics but acceptable internal consistency and construct validity. A factor analysis yielded three internally consistent factors assessing Fatalistic, Interpersonal, and Spiritual Hopelessness. An 11-item GHS-Suicide Risk subscale was identified with acceptable internal consistency, significant association with measures of hopelessness, depression, and suicide ideation, and that differentiated psychiatric patients from non-psychiatric participants.

LIMITATIONS

This study had a relatively small sample size, included a high proportion of female respondents (79%), and a relatively low proportion of patients in mental health care (17%).

CONCLUSIONS

The GHS had acceptable reliability and construct validity, but poor item-response characteristics and criterion validity with respect to differentiating psychiatric patients from non-psychiatric participants. Use of shortened GHS measures may improve upon the limitations of the full scale, and may be preferable when seeking to identify older adults at risk for suicide.

Psychological dimensions associated with suicidal ideation and attempts in the National Comorbidity Survey

Three important psychological dimensions in the suicide literature (neuroticism, self-criticism, and hopelessness) were examined in relation to suicidal ideation and attempts in the U.S. National Comorbidity Survey (Kessler et al., 1994; n = 5,877), after first controlling for the effects of previously identified sociodemographic and psychiatric variables related to suicidality in this nationally representative sample (Kessler, Borges, & Walters, 1999). Analyses were conducted separately for lifetime, current (12-month), and past history of suicidal ideation and attempts. Brief indices of self-criticism and hopelessness were robustly associated with suicide attempts across all three time frames. The results support the value of examining psychological individual differences over sociodemographic and psychiatric diagnoses alone in the comprehensive assessment of factors associated with suicidality in the general population.

Personality is associated with perceived health and functional status in older primary care patients

Using data collected on 265 primary care medical patients 60 years of age and older, the authors examined the personality bases of subjective health (perceived health, functional status) after controlling for observer-rated depression and medical burden. Four hypotheses were tested: High Neuroticism is associated with poorer perceived health, low Extraversion is associated with poorer perceived health, low Openness to Experience is associated with worse functional status, and age moderates the relationships between personality and subjective health. Findings supported the notion that personality is associated with subjective health; moreover, this effect appeared to grow more pronounced with increasing age. This study underscores the conceptual and heuristic value of examining moderators of the links between personality variables and health.