Personality & Health Lecture Notes PDF

Summary

This document is a lecture on personality and physical health, discussing various personality types and their potential links to health conditions. It covers topics such as Type A and Type D personality, the role of psychosocial factors in illness, and the relationship between coping mechanisms and health outcomes. The lecture references multiple studies and research findings by authors such as Smith, MacKenzie, Murray, and Booth.

Full Transcript

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

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