Psychosocial Predictors Of Mental And Physical Health

Aging

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Linked publications & trials

Abstract

Highlights of our research involve relation of personality dimensions to physical diseases and outcomes, including longevity and mortality. A project recently completed involves examination of personality predictors of all-cause mortality among Medicare patients aged 65 to 100. Previous research suggested that Conscientiousness is related to mortality, mixed findings for the personality factors of Neuroticism and Agreeableness and weak or null findings for Extraversion and Openness to Experience. This study extends the prior research by examining the relationship between personality and mortality in functionally impaired and undereducated men and women aged 65 to 100. A Cox regression survival analysis indicated that, after controlling for 10 demographic and health-related covariates, over a five-year follow-up period, participants scoring high on Neuroticism, Agreeableness, and Conscientiousness were at reduced risk for mortality. Conscientiousness was the largest of these protective factors; participants scoring high were approximately half as likely to die as participants scoring low or average. A follow-up Cox regression survival analysis in a sub-sample of participants revealed that Neuroticism, Agreeableness, or Conscientiousness facets accounted for the relationship between these domains and all-cause mortality This analysis indicated that after controlling for the 10 demographic and health covariates, participants scoring high on the Impulsiveness, Straightforwardness, and Self-Discipline facets of Neuroticism, Agreeableness, and Conscientiousness, respectively, were less likely to die over the three-year follow-up period. Personality traits are important indicators of risk for mortality even in a population of undereducated, frail elderly. Given that these personality traits are mostly stable throughout the lifespan, knowledge of them may help identify high-risk patients. Personality traits may be risk or vulnerability factors for anxiety and depressive disorders. A recentlycompleted study employed the Five-Factor Model of personality which allowed examining the links betwen Axis I mood and anxiety disorders and higher- and lower-order personality trait factors in a community sample (HEPS-ECA). Broad-based personality traits have been demonstrated to distinguish people with anxiety and depressive disorders from the general population. Unfortunately, much more work remains in clarifying and detailing the relations between lower-order or more specific traits and these disorders. This study investigated the specific, lower-order traits as measured by the Revised NEO Personality Inventory in a sample of community subjects (examined by psychiatrists for anxiety and depressive disorders) in order to understand better the links between these more specific traits and disorders of anxiety and depression. All lifetime disorders of interest (simple phobia, social phobia, agoraphobia, panic disorder, obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), major depressive disorder (MDD), and dysthymia) were found to be associated with high Neuroticism (N). Social phobia, agoraphobia, and dysthymia were associated with low Extraversion (E), and OCD was associated with high Openness to Experience (O). Lower-order facets revealed that the N facets of depression and vulnerability were elevated for all 8 disorders studied, the anxiety and self-consciousness facets with 7 of the 8, and the angry hostility facet with 5 disorders. Social phobia, agoraphobia, and dysthymia were consistently low on E facets, though most noticeably on warmth and positive emotions. Subjects with MDD were elevated on O facet openness to feelings, and those with social phobia and agoraphobia were low on the Agreeableness (A) facet of trust. Finally, the Conscientiousness (C) facets of self-discipline (in all the phobias, MDD, and GAD) and competence (in social phobia) were shown to be below average. This study confirmed previous research, but also expanded knowledge of how specific, lower-order traits are associated with anxiety and depressive disorders. Although questions remain about the etiological relationships between personality and these disorders, this research continues to advance towards a comprehensive understanding of these very important disorders. Personality dimensions are also important predictors of psychopathology, especially DSM-IV AXIS II personality disorder symptoms. This study examined personality disorder symptoms in psychiatric patients and how well they could be predicted by the domains and facets of the FFM. The results on a sample of 115 psychiatric patients showed that personality disorder symptoms as measured by the Structured Clinical Interview for DSM-IV Personality Disorders Questionnaire (SCID-II) corresponding to the 10 personality disorders (PDs) on Axis II were successfully predicted by the domain and facet traits of the FFM. This study demonstrates the ability of the FFM general personality dimensions to provide a unifying, integrative model that can capture the complexity of personality psychopathology in the current conceptualization of PDs while also suggesting that it has the capacity to transcend the limitations and flaws of the current DSM categorical system for personality disorders. Finally, a crucial step in the diagnosis of personality disorders (PDs), Axis II of the Diagnostic and Statistical Manual of Mental Disorders (DSM), involves the determination of clinical severity of problems or impairments in functioning that are related to personality and not life circumstances. To date, this has been problematic because of the lack of a systematic guide to assessing problems and dysfunctions. In previous work, we have outlined an alternative approach to PD assessment that is based on the Five-Factor Model of Personality (FFM). Our approach advocates four steps: (1) personality assessment using an FFM-based instrument, (2) identification of problems in living that are likely associated with a given personality profile, (3) assessment of problem severity, (4) comparison of the observed personality profile to recognized patterns associated with specific conditions (e.g., DSM PDs). The present research sought to determine whether any clinically significant problems related to personality traits were overlooked in a previously developed list oif personality related problems. Examining five leading instruments for the assessment of clinical problems, Comparison and categorization of problem content of five leading instruments according to theirwas compared and categorized according to its association with different personality factors was performed. Of the 608 items classified from the five instruments, all but 72 or 12% were previously classified confirming the comprehensiveness of the previous five-factor model FFM- based catalog. The analyses also resulted in a small but significant number of additions to the earlier catalogue of personality-related problems in living. The updated list of personality-related problems could help to streamline clinical assessments by allowing clinicians to focus their questions towards areas in which clients are most likely to experience problems.