Benjamin P. Chapman

Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine

We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or “distressed” personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine.

The Relationship Between Gender and Postconcussion Symptoms After Sport-Related Mild Traumatic Brain Injury

The authors sought to define the relationship between gender and postconcussion symptoms (PCSx) at 3 months after sport‐related mild traumatic brain injury (mTBI) and, further, to examine whether age (minors vs. adults), source of PCSx reporting (self‐reported vs. proxy), previous head injury or loss of consciousness, or the sport type in which the mTBI was incurred explain any observed gender differences in PCSx.

Personality and Medical Illness Burden Among Older Adults in Primary Care

Objective: To examine the association between Five Factor Model personality traits (Neuroticism, Extraversion, Openness to experience, Agreeableness, Conscientiousness) and physician-quantified aggregate morbidity in a sample of older adults in primary care. Methods: A total of 449 primary care patients, ranging in age from 65 to 97 years (75 ± 6.9 (mean ± standard deviation)), completed the Neo-Five Factor Inventory (NEO-FFI) and extensive interviews. A physician-investigator completed the Cumulative Illness Rating Scale (CIRS), a well-validated measure of aggregate morbidity based on a review of medical records. Results: Bivariate analyses demonstrated that all five domains of the NEO-FFI were associated with CIRS scores. Multivariate regression controlling for age, gender, education, depression, smoking, hypertension, total cholesterol, alcohol or substance misuse, and other personality traits showed that greater Conscientiousness was independently associated with lower CIRS scores (&bgr; = −0.10, t(435) = −1.96, p = .05). Other independent predictors of less morbidity were younger age, absence of hypertension, and lower levels of depression. Conclusion: Our results point toward the necessity of considering Conscientiousness and other personality traits in studies of risk factors for aggregate morbidity. More detailed characterization of at-risk populations will increase the likelihood of constructing informed and effective prevention, intervention, and policy initiatives. FFM = Five Factor Model; NEO-FFI = Neo Five Factor Inventory; CIRS = Cumulative Illness Rating Scale; SCID-IV TR = Structured Clinical Interview for the Diagnosis of DSM-IV disorders.

Mindfulness-Based Stress Reduction for Older Adults: Effects on Executive Function, Frontal Alpha Asymmetry and Immune Function

Background/Aims: Mindfulness-based stress reduction (MBSR) has enhanced cognition, positive emotion, and immunity in younger and middle-aged samples; its benefits are less well known for older persons. Here we report on a randomized controlled trial of MBSR for older adults and its effects on executive function, left frontal asymmetry of the EEG alpha band, and antibody response. Methods: Older adults (n = 201) were randomized to MBSR or waiting list control. The outcome measures were: the Trail Making Test part B/A (Trails B/A) ratio, a measure of executive function; changes in left frontal alpha asymmetry, an indicator of positive emotions or approach motivation; depression, mindfulness, and perceived stress scores, and the immunoglobulin G response to a protein antigen, a measure of adaptive immunity. Results: MBSR participants had a lower Trails B/A ratio immediately after intervention (p < 0.05); reduced shift to rightward frontal alpha activation after intervention (p = 0.03); higher baseline antibody levels after intervention (p < 0.01), but lower antibody responses 24 weeks after antigen challenge (p < 0.04), and improved mindfulness after intervention (p = 0.023) and at 21 weeks of follow-up (p = 0.006). Conclusions: MBSR produced small but significant changes in executive function, mindfulness, and sustained left frontal alpha asymmetry. The antibody findings at follow-up were unexpected. Further study of the effects of MBSR on immune function should assess changes in antibody responses in comparison to T-cell-mediated effector functions, which decline as a function of age.

Big 5 personality traits and interleukin-6: Evidence for “healthy Neuroticism” in a US population sample

The current study investigated if the Big 5 personality traits predicted interleukin-6 (IL-6) levels in a national sample over the course of 5years. In addition, interactions among the Big 5 were tested to provide a more accurate understanding of how personality traits may influence an inflammatory biomarker. Data included 1054 participants in the Midlife Development in the U.S. (MIDUS) biomarkers subproject. The Big 5 personality traits were assessed in 2005-2006 as part of the main MIDUS survey. Medication use, comorbid conditions, smoking behavior, alcohol use, body mass index, and serum levels of IL-6 were assessed in 2005-2009 as part of the biomarkers subproject. Linear regression analyses examined personality associations with IL-6. A significant Conscientiousness*Neuroticism interaction revealed that those high in both Conscientiousness and Neuroticism had lower circulating IL-6 levels than people with all other configurations of Conscientiousness and Neuroticism. Adjustment for health behaviors diminished the magnitude of this association but did not eliminate it, suggesting that lower comorbid conditions and obesity may partly explain the lower inflammation of those high in both Conscientiousness and Neuroticism. Our findings suggest, consistent with prior speculation, that average to higher levels of Neuroticism can in some cases be associated with health benefits - in this case when it is accompanied by high Conscientiousness. Using personality to identify those at risk may lead to greater personalization in the prevention and remediation of chronic inflammation.

One-year outcomes of minor and subsyndromal depression in older primary care patients

BACKGROUND Despite the high prevalence and morbidity of minor and subsyndromal depression in primary care elderly people, there are few data to identify those at highest risk of poor outcomes. The goal of this observational cohort study was to characterize the one-year outcomes of minor and subsyndromal depression, examining the predictive strength of a range of putative risks including clinical, functional and psychosocial variables. METHODS Patients aged > or = 65 years were recruited from primary care medicine and family medicine practices. Of 750 enrollees, 484 (64.5%) completed baseline and one-year follow-up assessments of depression diagnosis (major depression vs. minor and subsyndromal depression vs. non-depressed) by the Structured Clinical Interview for DSM-IV, depressive symptom severity (Hamilton Rating Scale for Depression), and validated measures of other predictors. RESULTS Patients with baseline minor and subsyndromal depression were more depressed than the non-depressed group at follow-up: They had a 7.0-fold (95% CI 4.5-10.8) risk of developing major depression, and a one-year adjusted Hamilton Depression Score of 11.0 (95% CI 10.2-11.8) compared with 7.8 (95% CI 7.1-8.5) for the non-depressed group; these outcomes were less severe than those of the major depression group. Independent predictors of depression outcomes included race, psychiatric and physical functioning, and social support. CONCLUSIONS Minor and subsyndromal depression are likely to persist, and pose an elevated risk of worsening over one year. Clinicians and preventive interventions researchers should focus on modifiable risks, such as psychiatric functioning or social support, in elders suffering clinically significant depressive symptoms.

Can the Influence of Childhood Socioeconomic Status on Men's and Women's Adult Body Mass Be Explained by Adult Socioeconomic Status or Personality? Findings From a National Sample

OBJECTIVES On the basis of a life-course risk-chain framework, the authors examined whether (a) residual associations between childhood socioeconomic status (SES) and adult obesity and body mass index (BMI) would be observed in women but not men after adjusting for adult SES, (b) adult Big Five personality traits would be associated with adult body mass in both genders, and (c) personality would explain unique variation in outcomes beyond child and adult SES. DESIGN National survey (Midlife Development in the United States study; N = 2,922). MAIN OUTCOME MEASURES BMI and obesity. RESULTS (a) In both genders, association between childhood SES and adult obesity were accounted for entirely by adult SES, but its effect on adult BMI was observed only in women; (b) higher conscientiousness was associated with lower obesity prevalence and BMI in both genders, although more strongly in women, and in men, greater obesity prevalence was associated with higher agreeableness and neuroticism; and (c) personality explained unique outcome variation in both genders. CONCLUSIONS Early social disadvantage may affect adult weight status more strongly in women owing to gender differences in the timing and nature of weight-management socialization. Personality may enhance or detract from risks incurred by childhood or adulthood SES in either gender, necessitating the consideration of dispositional differences in prevention and intervention programs.

Incremental Validity of a Measure of Emotional Intelligence

After the Schutte Self-Report Inventory of Emotional Intelligence (SSRI; Schutte et al., 1998) was found to predict college grade point average, subsequent emotional intelligence (EI)-college adjustment research has used inconsistent measures and widely varying criteria, resulting in confusion about the constructs predictive validity. In this study, we assessed the SSRIs incremental validity for a wide range of adjustment criteria, pitting it against a competing trait measure, the NEO Five–Factor Inventory (NEO–FFI; Costa & McCrae, 1992), and tests of fluid and crystallized intelligence. At a broad bandwidth, the SSRI total score significantly and uniquely predicted variance beyond NEO–FFI domain scores in the UCLA Loneliness Scale, Revised (Russell, Peplau, & Cutrono, 1980) scores. Higher fidelity analyses using previously identified SSRI factors and NEO–FFI item clusters revealed that the SSRIs Optimism/Mood Regulation and Emotion Appraisal factors contributed unique variance to self-reported study habits and social stress, respectively. The potential moderation of incremental validity by gender did not reach significance due to loss of power from splitting the sample, and mediational analyses revealed the SSRI Optimism/Mood Regulation factor was both directly and indirectly related to various criteria. We discuss the small magnitude of incremental validity coefficients and the differential incremental validity of SSRI factor and total scores.

Replicability and 40-year predictive power of childhood ARC types.

We examined 3 questions surrounding the undercontrolled, overcontrolled, and resilient-or Asendorpf-Robins-Caspi (ARC)-personality types originally identified by Block (1971). In analyses of the teacher personality assessments of over 2,000 children in 1st through 6th grade in 1959-1967 and follow-up data on general and cardiovascular health outcomes in over 1,100 adults recontacted 40 years later, we found bootstrapped internal replication clustering suggesting that Big Five scores were best characterized by a tripartite cluster structure corresponding to the ARC types. This cluster structure was fuzzy rather than discrete, indicating that ARC constructs are best represented as gradients of similarity to 3 prototype Big Five profiles; ARC types and degrees of ARC prototypicality showed associations with multiple health outcomes 40 years later. ARC constructs were more parsimonious but, depending on the outcome, comparable or slightly worse classifiers than the dimensional Big Five traits. Forty-year incident cases of heart disease could be correctly identified with 67% accuracy by childhood personality information alone and stroke incidence with over 70% accuracy. Findings support the theoretical validity of ARC constructs, their treatment as continua of prototypicality rather than discrete categories, and the need for further understanding the robust predictive power of childhood personality for midlife health.

Gender, Race/Ethnicity, Personality, and Interleukin-6 in Urban Primary Care Patients

Gender, race/ethnicity, and personality are markers of significant psychosocial and biological variability. Each may have implications for allostatic load and resulting inflammatory processes, yet findings have been largely mixed. We investigated whether women, minorities, and those higher in Neuroticism and lower in Extraversion were at risk for elevated circulating levels of the pro-inflammatory cytokine interleukin (IL)-6 in a sample of 103 middle aged and older urban primary care patients. Regression analyses controlling for age, education, current depression levels, and chronic medical conditions revealed that women, minorities, and individuals lower in Extraversion had higher circulating levels of IL-6. Analyses of more specific personality traits revealed that the sociability and positive emotions components of Extraversion were unassociated with IL-6, but the activity facet-reflecting dispositional vigor and energy-was robustly associated with IL-6. The difference between high (+1 Standard Deviation (SD)) and low (-1 SD) trait activity was sufficient to shift IL-6 levels beyond a previously established high risk cut-point in both white and minority women. These findings suggest that while broad group differences between genders and races/ethnicities exist, personality represents an important source of individual differences in inflammation within groups. Future work should examine to what extent IL-6 levels are linked to temperament or genetic activity levels vs. physical activity itself, and whether IL-6 levels may be reduced by boosting regular activity levels in demographic segments such as women and minorities who appear susceptible to greater inflammation.