Personality & Health Lecture Notes PDF

PERSONALITY PSYU/X2234 Lecture 5: Personality & physical health A/Prof Simon Boag email: [email protected] 1 Readings (suggested) Smith, T. W., & MacKenzie, J. (2006). Personality & risk of physical illness. Annual Review of Clinical Psych...

PERSONALITY PSYU/X2234 Lecture 5: Personality & physical health A/Prof Simon Boag email: [email protected] 1 Readings (suggested) Smith, T. W., & MacKenzie, J. (2006). Personality & risk of physical illness. Annual Review of Clinical Psychology, 2, 435-467 Murray, A. L., & Booth, T. (2015). Personality & physical health. Current Opinion in Psychology, 5, 50-55 2 Outline 1. Personality & physical health Type A personality & heart disease Type D personality & heart disease 2. Is there a cancer-prone personality? Type C personality & cancer 3. Repressive coping & physical health 4. Dementia & personality Dementia & personality change 5. Personality & longevity 3 Introduction Leading underlying causes of death in Australia: Coronary Heart Disease Dementia Strokes Cancers Does personality help predict & explain physical health? https://www.aihw.gov.au/reports/life- expectancy-deaths/deaths-in- 4 australia/contents/about How might personality be relevant to physical health? 5 Personality & health: some research considerations Methodological issues Complexity: personality is only one factor amongst many (eg. SES) Methodological heterogeneity: diverse samples & methods can make comparing studies difficult Correlational evidence & causal interpretation Time frame issues (eg. fast/slow growing cancers) 6 Personality & health 1850s: Psychosomatic illnesses 1895: Freud & hysteria 1950s: Type A personality & coronary heart disease (CHD) highly competitive ambitious work-driven time-conscious stressed aggressive 7 Personality types A & B 8 Type A personality Theory: High blood pressure + high levels of stress hormones lead to CHD Contrada (1989): 68 male undergrad Ss Examined Type A/B, Systolic & diastolic blood pressure (SBP/DBP) & heart rate while Ss performed a difficult mirror-tracing task Personality assessment: Both structured interviews & survey Only Type A interviews associated with elevated SBP & DBP (not the surveys) Type B showed the least DBP reactivity 9 Type A personality today Kuper et al. (2002): systematic review Inconsistent evidence b/w Type A & CHD No association found b/w Type A & CHD in subsequent studies across different world regions (Sykes et al, 2002; Nadi et al, 2008; Ikeda et al, 2008) Nevertheless, Type A remains in popular psychology 10 Type D personality & CHD Type D personality: distressed personality Negative affect Socially inhibited Type D: c.20% pop’n Type D & CHD link? 11 Type D personality & CHD Kupper & Denollet (2018): Review report General findings: Type D personality prospectively associated with worse clinical & patient-reported CHD outcomes eg. Matsuishi et al (2019): Type D personality predicts longer acute brain dysfunction (delirium/coma) in cardiovascular patients Kupper, N., & Denollet, J. (2018). Type D personality as a risk factor in coronary heart disease: a review of current evidence. Current Cardiology Reports, 20, 1-8 Matsuishi et al (2019). Type D personality is a predictor of prolonged acute brain dysfunction (delirium/coma) after cardiovascular surgery. BMC Psychology, 7, 1-10 12 Type D personality & progression of Cardiovascular Disease O’Dell et al. (2011): meta-analysis Examined Type-D personality &: (a) major adverse cardiac events (MACE) (b) health-related quality of life (HRQOL) Findings: Positive association b/w Type D & MACE Negative association b/w Type D & HRQOL Type D as vulnerability factor in the progression of CVD O'Dell et al. (2011). Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic review. Journal of Psychosomatic 13 Research, 71, 199-206 Type D personality & CHD: possible mechanisms i) Psychophysiological stress ii) Type D associated with unhealthy lifestyle: smoking, alcohol, not exercising (O’Connor et al, 2008) iii) Pessimism & poorer treatment-adherence Combined Health behaviour/Interactional stress models 14  2. Is there a cancer-prone personality? Kissin & Eysenck (1962) Compared lung cancer patients with controls Cancer Ss: ↓Neuroticism (N) & ↑Extraversion (E) compared to controls Anxiety & neuroticism might protect against cancer (Limbic/endocrine systems) Limitation: Non-prospective; correlational Kissen, D. M., & Eysenck, H. J. (1962). Personality in male lung 15 cancer patients. Journal of Psychosomatic Research, 6, 123-127 Is there a cancer-prone personality? Swedish prospective twin study (Hansen et al, 2005) Follow-up with 29,595 Swedish twins assessed in 1973 with EPQ & physical health Finding: no association b/w N/E & cancer Hansen, et al (2005). Personality traits, health behavior, & risk for cancer: a prospective study of a Swedish twin cohort. Cancer: Interdisciplinary International Journal of the American Cancer Society, 103, 1082-1091 16 Is there a cancer-prone personality? Swedish/Finnish epidemiological study (Nakaya et al, 2010) 30-year follow-up with 59,548 Swedish/Finnish Ss Assessed EPQ & cancer outcomes Results: N/E unrelated to cancer risk or cancer survival Nakaya, et al. (2010). Personality traits & cancer risk & survival based on Finnish & Swedish registry data. American Journal of Epidemiology, 172, 377-385 17 Is there a cancer-prone personality? Type-C personality (Temoshok, 1987) Cancer-prone personality overly cooperative unassertive suppresses negative emotions (particularly anger) accepts/complies with external authorities has attitude of helplessness or hopelessness Theory: Ongoing state of heightened arousal reduces immune system functioning 18 Is there a cancer-prone personality? Price et al (2001) N = 2,224 older women Screening & breast carcinoma outcomes Defense style & Emotional expression Helplessness/hopelessness No evidence of association b/w Type-C traits & cancer outcomes Inconsistent findings (Blatný & Adam, 2008) Price, et al. (2001). The role of psychosocial factors in the development of breast carcinoma: Part I: The cancer prone personality. Cancer, 91, 679-685 19 Is there a cancer-prone personality? FFM (OCEAN) & cancer risk/mortality? Meta-analysis of 6 prospective studies; N = 42,843 cancer-free Ss (Jokela et al. 2014) 5 year follow-up: 2156 incident cancer cases No evidence of association b/w FFM & cancer risk & cancer mortality Jokela et al. (2014). Is personality associated with cancer incidence & mortality? British Journal of Cancer, 110, 1820-1824 20 3. Repressive coping & physical health Repressive coping: diverting attention from threatening stimuli (eg. health threats) Repressors: Low trait anxiety/High defensiveness (Weinberger et al, 1979) Low levels of distress/anxiety BUT high physiological arousal (Myers, 2000) Relation to physical health? 21 Repressive coping & cancer McKenna et al (1999): meta-analysis of psychosocial factors & breast cancer (46 studies) “Strongest support was found for the hypotheses that breast cancer patients use a coping strategy based on denial/repression in response to life stressors, have experienced separation & loss, & have a history of stressful life experiences” BUT: Couldn’t determine if cause or effect McKenna, et al. (1999). Psychosocial factors & the development of breast cancer: a meta-analysis. Health Psychology, 18, 520-531 22 Repressive coping & Coronary Heart Disease Denollet et al. (2008): longitudinal study Followed up 731 CHD patients at 5 & 10 years Over 20% of patients classified as repressors Findings: after controlling for other variables, repressors at increased risk for death & myocardial infarction (MI) Repressive coping associated with a two-fold increased risk of death, MI, & other cardiac events Denollet et al, (2008). Clinical events in coronary patients who report low distress: adverse effect of repressive coping. Health Psychology, 27, 302-308 23 Repressive coping & Coronary Heart Disease: mechanisms? Repressors less likely to report distress so…. Possible mechanisms: underestimation of the effect of stress on the heart? Non-compliance? Physiological stress? Denollet et al, (2008). Clinical events in coronary patients who report low distress: adverse effect of repressive coping. Health 24 Psychology, 27, 302-308 Repressive coping & heart attack outcomes (Frasure-Smith et al, 2002) Montreal Heart Attack Readjustment trial High-contact psychosocial support intervention 5 year follow up (N = 1,376 patients) High anxious men: improved survival outcomes Repressors (M/F): poorer survival outcomes Information-overload & over-arousal? Frasure-Smith, et al. (2002). Long-term survival differences among low-anxious, high-anxious & repressive copers enrolled in the Montreal heart attack readjustment trial. Psychosomatic Medicine, 64, 571-579 25 Repressive coping & physical health: general outcomes Mund & Mitte (2012): Meta-analysis of association b/w repressive coping & cancer, cardiovascular diseases, asthma & diabetes 22 studies; 6,775 Ss Significant associations b/w repressive coping & cardiovascular diseases (esp. hypertension) Repressive coping appears to be a consequence of cancer diagnosis Mund, M., & Mitte, K. (2012). The costs of repression: A meta-analysis on the relation between repressive coping & somatic diseases. Health Psychology, 31, 640-649 26 4. Personality & dementia Dementia: a syndrome of cognitive & social symptoms that interferes with daily functioning DSM-5: Neurocognitive disorders Frequently present features include personality change eg. disinhibition, apathy, suspiciousness, aggression 27 Dementia & personality change? Balsis et al (2005): Longitudinal study Annually assessed ‘personality change’ with 108 non-demented Ss b/w 1979-2001 82/108 Ss developed dementia Findings: 47% demented Ss exhibited personality change prior to dementia diagnosis Most commonly: increased rigidity, egocentricity, impaired emotional control 23% personality change in non-demented Ss Balsis et al, (2005). Personality change precedes clinical diagnosis of dementia of the Alzheimer type. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60, 98-101 28  Dementia & personality risk factors Cipriani et al (2015): Review of published research since 1980 Main findings: ↑ neuroticism: ‘substantial impact on increasing dementia risk’ ↑ conscientiousness ‘is protective against dementia’ Openness? Possibly protective Personality change commonly found Personality change sometimes precedes other early symptoms (eg cognitive impairment) Cipriani et al. (2015). Personality & dementia. The Journal of Nervous & Mental 29 Disease, 203, 210-214 Personality risk factors & dementia Aschwanden et al (2020): 2 longitudinal studies English Longitudinal Study of Ageing (N = 6,887; Follow-up mean: 6 years) Household, Income & Labour Dynamics in Australia (N = 2,778; Follow-up mean: 11 years) Findings: higher Neuroticism was associated with increased dementia risk in both samples Lower Conscientiousness non-sig but in predicted direction Aschwanden, et al. (2020). Personality & dementia risk in England & Australia. GeroPsych: The Journal of Gerontopsychology & Geriatric Psychiatry, 33, 197- 208 30 Personality risk factors & dementia Why might N & C be relevant to dementia? Individuals with ↑ N & ↓ C: … tend to be less physically active … tend to be more likely to be obese or smoke … are more likely to achieve lower education … are at greater risk for depression ….have a worse health profile These factors are all correlated with dementia risk (Aschwanden et al, 2020) 31  5. Personality & longevity Conscientiousness is a consistent predictor of longevity (Murray & Booth, 2015) Impulse control, responsibility, task- & goal- directed action, planning, delaying gratification Bogg & Roberts (2004): Meta-analysis (194 studies) Conscientiousness-related traits: Negatively related to all risky health-related behaviours Positively related to all beneficial health-related behaviours Bogg, T & Roberts, BW (2004). Conscientiousness & health-related behaviors: a meta- 32 analysis of the leading behavioral contributors to mortality. Psych Bulletin, 130, 887-919  Personality & longevity Bogg, T & Roberts, BW (2004). Conscientiousness & health-related behaviors: a meta- 33 analysis of the leading behavioral contributors to mortality. Psych Bulletin, 130, 887-919  Questions? 34