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Learning Objectives

• Define individual differences in behavior and personality
• Identify various theories and models explaining individual differences
• Describe the 5-Factor personality dimensions
• Identify the implications of individual differences in dental practice
• Apply concepts of personality into the context of healthcare delivery

Individual Differences in Behavior

• Individual differences refer to the unique variations in behavior, cognition, personality, and other psychological traits among individuals
• These differences are influenced by genetic factors, environmental experiences, and interactions between the two

Theories for Individual Differences

• Trait Theory focuses on identifying and measuring stable traits that differentiate individuals
• Psychodynamic Theory emphasizes unconscious motives and conflicts shaping behavior
• Social Learning Theory highlights the role of observational learning and social influences on behavior

Trait Theory

• Traits are enduring characteristics that influence behavior across situations
• Common traits include extraversion, neuroticism, openness to experience, conscientiousness, and agreeableness
• Trait assessments such as the Big Five Personality Inventory can help identify individuals' trait profiles

Psychodynamic Theory

• Sigmund Freud developed the psychodynamic theory which posits that unconscious processes drive behavior
• Concepts such as the id, ego, and superego influence personality development
• Personality is formed from seeking, releasing and inhibiting behavior conflicts
• Understanding unconscious motives aids in uncovering patients' underlying concerns and fears related to dental treatment

Social Learning Theory

• Albert Bandura proposed the Social Learning Theory
• The theory emphasizes observational learning and modeling
• Individuals acquire behaviors by observing others and experiencing reinforcement or punishment
• Dentists can leverage social learning principles to model positive behaviors and alleviate patients' dental anxiety

Personality

• Individual differences are characteristic patterns of thinking, feeling, and behaving
• Personality gives a description of an individual's tendencies when acting or reacting to others and is an ongoing interaction of temperament, character and environment

Development of Personality

• Personalities develop around the basic psychological needs to:

  • Predict the the world
  • Act within our word with competence
  • Have acceptance from others

• Additional needs emerge later on as a product of the basic needs

• Infants develop beliefs about the world and their role within it by determining it safe or unsafe by seeing if their needs are met and if they can act to meet those needs

• The BEATS theory helps explain why way might choose a certain behavior

  • Beliefs > Emotions > Action > Tendencies

Visible and Invisible Parts of Personality

• Invisible Parts (BEATs) are the basis that drives & guides actions, goals, beliefs, how something is done, and choosing what one wants to pursue

• Visible Parts are what actions people do and the personality they display as they pursue their goals

Beliefs Regarding Abilities

• More 'fixed' beliefs can cause an individual to feel at risk if a task challenges their ability or sense of competence
• They might choose a simpler route such as avoiding the task or modify the task to fit their skills
• More 'fluid' beliefs drive that abilities can be developed
• One is more likely to challenge themself, risk and face possible setbacks for the sake of improving / broadening their competence

Biological and Psychosocial Variables of Personality

• Biological variables include temperament plus excitatory/inhibitory neurological systems
• Psychosocial variables include family, peer and social environment/cultural influences

Models for the Development of Personality

• Psychoanalytic Perspective emphasis is on childhood experiences and the unconscious mind
• Humanistic Perspective emphasis is on psychological growth, free will, and personal awareness
• Trait Perspective emphasis on dimensions and categories
• Social Cognitive Perspective emphasis is on the role of mental processes of social behaviors

Biological Model

• Genetic predispositions contribute to individual differences in temperament, behavior, and susceptibility to psychological disorders
• Neurobiological factors such as neurotransmitter levels and brain structures influence personality traits and behavioral tendencies

Environmental Model

• Family dynamics, cultural norms, and social experiences shape personality development
• Early childhood experiences play a critical role in forming attachment styles and coping mechanisms
• Environmental stressors can exacerbate or mitigate genetic predispositions toward certain behaviors

Interactionist Model

• Recognizes the interplay between genetic predispositions and environmental influences in shaping personality
• Individuals' responses to environmental stimuli are moderated by their genetic makeup
• The interactionist perspective underscores the complexity of understanding individual differences

Factor Analytic Model

• In the 1930s, Psychologists Allport and Odbert first studied this model, starting with 18,000 words from a Webster's dictionary that could be used to describe a person
• In the 1960's-1970's, an abundance of research via Air Force, NIH, with Univ of Michigan and Oregon, used thousands of surveys, finding personality could be described along 5 dimensions
• This model is well-studied across cultures, ages, and other groupings of people and is a favored model in personality research
• The model uses the NEO Personality Inventory and asserts that factors represent continuous dimensions
• The factors are:
• Openness
• Conscientiousness
• Extraversion
• Agreeableness
• Neuroticism

5-Factor Model: Openness

• Involves willingness to try new activities, open to unconventional/new ideas
• Higher levels can cause one to travel to new places, have an interst in different cultures and question established systems/processes
• Lower levels can cause one to be skeptical about the unknown and have an aversion to question the status quo

5-Factor Model: Conscientiousness

• Deals with impulse control
• Higher levels cause one to be dependable, orderly, persevering, use a paper calendar in addition to phone e-calendar, organize notes by color and be high achieving
• Lower levels lead one to have low organization, procrastinate and to have less internal motivation

5-Factor Model: Extraversion

• Deals with how people gain energy
• Extraversion causes one to gain energy from doing activities & being around people and gives one special ability to advance projects quickly
• Introversion is the gaining of energy from internal thoughts, developing ideas and gives one special ability to pick up the dynamics of groups or a particular situation

5-Factor Model: Agreeableness

• A degree of cooperativeness
• Higher levels cause one to care deeply about other people, more than themselves, be more likely to consider the feelings of others before making decision and work well with others
• Lower levels cause on eto have low scores in agreeableness, cause one to be 'competitive' or self-promoting and less flexible

5-Factor Model: Neuroticism

• Deals with emotional stability
• Higher levels cause on eto have moods and feeling fluctuate over a period of time, a poor response to stress, easily upset, impulsiveness
• Lower levels cause one to have mood tend to remain pretty constant, be calm, even tempered, hardy, could be unemotional

5-Factor Psychometric Testing

• Includes different exercises including a Self-reporting questionnaire
• A test taker reads several short descriptions or adjectives, then rates the accuracy using a Likert scale of those descriptions pertaining to their own personality
• Results can be compared to others who have taken the test
• A downside is that subjects might want to manipulate answers, providing what they consider to be “desirable" responses giving rise to a "Social desirability bias"

Limitations of 5-Factor Tests

• Does not address core constructs of personality beyond the level of traits
• Cannot predict specific behavior, provide compelling causal explanations for human behavior and experience and disregards context and conditional nature of human experience
• It is not a program for studying personality organization and integration
• Results rely on simple, noncontingent, and implicitly comparative statements about persons

Professional Applications of Psychometric Testing

• Many organizations use tests to help them better understand their employees, students or colleagues
• Large-scale surveys such as the World Bank looking at the IT industry in India, help understand desirable employee traits and education gaps, as identified by employers
• Staff can be allocated to certain tasks, work to employee's strengths and staff development of leadership skills can occur
• A Creighton Univ School of Dentistry study from 1964-1984 found that D1-D2 students predominant features were:
  • Increase in introverts that build energy from ideas and like to reflect
  • Increased numbers of thinkers that perform well at analysis, categorization and evaluation
  • More judging by individuals that exhibited excellent decision-making ability

The 5-Factor Model Takeaways

• This is one important model to study personality and there are many personality types, all equally acceptable which provide with feedback about ourselves
• It is not an integrative/wholistic model on personality
• This model can provide information on a person, how to understand them better and how to support them
• However, it should not be used to categorize, 'box', judge or blame people or make final determinations about employment for example

Cultural Understanding

• The differences between “culture” at large seem bigger than actual differences between individuals within these same cultures
• The universal human biological predispositions are often opposed by cultural traditions, with the outcome being somewhat of a compromise between the two
• Differences between individuals in different cultures are larger in behavior than in thoughts or feelings
• Behavior is easily socialized than mental events
• Many cultural differences are expressed in terms of different default responses or interpretations or preference for the same situation
• Dominant responses in one culture are usually a less salient portion of the repertoire of individuals in another culture
• The effect of culture and our impression of cultural differences results from the physical/social artifacts created by the culture
• There is a strong tendency by psychologists to under-rate or ignore the effects of the physical environment
• In the contemporary world, differences between individuals in two cultures will be larger in older generations because cultural differences may be markedly reduced in the most recent generations, on account of globalization

Personality Characteristics in Organizations

• Positive Affect is an persons propensity to accentuate the positive aspects of oneself, other people and the world in general
• Negative Affect is an persons propensity to accentuate the negative aspects of oneself, other people and the world in general
• A strong situation can overwhelm the effects of individual personalities and provide strong cues for appropriate behaviour
• 'Strong' personalities tend to dominate in difficult situations

Social Perception

• Is the interpreting of information about another person
• Barriers consist of selective perception, stereotyping, first-impression error, projection and self-fulfilling prophecies
• Elements include:
  • Perceiver Characteristics
  • Target Characteristics
  • Situational Characteristics

Impression Management

• The process by which one tries to control the impression others have
• Involves name dropping, proper appearance, self-description, flattery, doing favors and agreeing with opinion

Attribution Theory

• Explains how individuals pinpoint the causes of their own behavior or that of others
• Information cues for attribution information gathering incluse:
• Consensus
• Distinctiveness
• Consistency

Attribution Biases

• Fundamental Attribution Error is making attributions to internal causes when focusing on someone else's behavior
• Self-serving Bias is attributing one's own successes to internal causes and one's failures to external

Summary

• There are real human predispositions of many types, and culture is a powerful force
• Someone else's “reality” might be the less preferred alternative from our own repertoire
• It is easier to understand the viewpoint of others from other cultures when we are aware of this circumstance and remain open to learning and reshaping our own beliefs

Understanding Our Patients

• Everybody is different, our own personality traits might be similar or different to our patients
• Our goal as healthcare providers is to:
• Establish a safe and trusting relationship with our patient, find common connections and celebrate who they are as a person
• Do not categorize individuals, avoid judgment, assume they are on their own journey and assume positive intent

Personality Implications for Dental Treatment

• Assess the dental problem, decision factors and then select a solution
• Personality concepts have applications to healthcare. When assessing personality, traits might predict the behavioral choices for the patient, engaging in health-promoting or health-detrimental behaviors
• It is important to understand that personality in patients affects their ability to show self-efficacy to execute behaviors necessary to produce a specific behavioral performance

Personality in Healthcare Delivery

• Clear communications with the patient are essential
• Note patient "Readiness to change", and assess stages of change aka Transtheoretical Model to see if they will share their history, struggles, values, dreams, goals
• Treatment acceptance and ultimately improved health outcomes that are driven via respect and empathy

Practice Guidelines

• Center the patient as a way of practice is a basic behavioral principle
• Communicate with the patient by utilizing active listening techniques to understand patients' concerns and preferences
• It imperative to adjust communication styles to match patients' preferences and offer clear explanations to alleviate anxiety and build trust
• Assess the patients coping mechanisms and implement pharmacological interventions

Dentistry Case Study

• Goal is assess the use of understanding of a patients individual differences so it informs treatment planning and patient management

  • Highlight the importance of considering personality traits, coping mechanisms, and anxiety levels in delivering personalized care

• Case study:

  • Woman named Sara, 35 year old teacher with chief complain for dental anxiaty and fear of needles presenting to the dental clinic for a routine check-up since it's been several year of avoiding visits
  • Reveals previous traumatic experience during childhood when she received a painful injection without adequate numbing

• Patient Assessment includes:

• Personality Traits - Heightened sensitivity to dental-related stressors and avoidance of dental visits, and seeking professional dental care despite her fears indicating traits of high neuroticism

• Coping mechanism - Avoiding dental appointment and using distraction

• Anxiety Levels - Elevated due to fear of needles stemming from a previous traumatic experience

• Treatment Planning and Patient Management includes:

• Establishing trust and rapport with patient

• Conducting comprehensive assessment

• Devoloping personalized treament plan that uses non-pharmacological interventions via gradual desensitization and relaxation, by utilising topical anesthesia methods and allowing Sarah to have control over her treatment by offering breaks

• Providing patient education and support

• Monitoring progress and adjust interventions via follow-up appointments along with reassessing anxiety levels

Recommendations

• Understanding individual differences in behavior is essential for providing patient-centered dental care
• Incorporating insights from various theories and models can enhance can alleviate anxiety, and improve patient outcomes
• Awareness of patients and and own bias is important by embracing diversity and tailoring the dental approach to meet each unique needs