Translating personality psychology to help personalize preventive medicine for young adult patients.

The rising number of newly insured young adults brought on by health care reform will soon increase demands on primary care physicians. Physicians will face more young adult patients, which presents an opportunity for more prevention-oriented care. In the present study, we evaluated whether brief observer reports of young adults' personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the cohort of 1,000 individuals from the Dunedin Multidisciplinary Health and Development Study (Moffitt, Caspi, Rutter, & Silva, 2001), we show that very brief measures of young adults' personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness to Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for health care professionals to personalize preventive medicine. Adding personality information to existing health care electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor-patient communication, health service use, and patient outcomes.

[1]  W. Bailey,et al.  Medical Section Of The American Lung Association , 2015 .

[2]  S. Hampson,et al.  Personality-informed interventions for healthy aging: conclusions from a National Institute on Aging work group. , 2014, Developmental psychology.

[3]  S. Israel,et al.  Assessing conscientious personality in primary care: an opportunity for prevention and health promotion. , 2014, Developmental psychology.

[4]  J. Eccles,et al.  Conscientiousness, health, and aging: the life course of personality model. , 2014, Developmental psychology.

[5]  W. Manning,et al.  Is personality associated with health care use by older adults? , 2013, The Milbank quarterly.

[6]  M. Jokela,et al.  Systematic Reviews and Meta- and Pooled Analyses Personality and All-Cause Mortality: Individual-Participant Meta-Analysis of 3,947 Deaths in 76,150 Adults , 2012 .

[7]  R. Saunders,et al.  Best Care at Lower Cost: The Path to Continuously Learning Health Care in America , 2013 .

[8]  B. Roberts,et al.  The Case for Conscientiousness: Evidence and Implications for a Personality Trait Marker of Health and Longevity , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[9]  M. Back,et al.  The dual lens model: a comprehensive framework for understanding self-other agreement of personality judgments at zero acquaintance. , 2013, Journal of personality and social psychology.

[10]  P. Conrod,et al.  Effectiveness of a selective, personality-targeted prevention program for adolescent alcohol use and misuse: a cluster randomized controlled trial. , 2013, JAMA psychiatry.

[11]  Alan D. Lopez,et al.  A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[12]  D. Simons-Morton,et al.  Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2011, Pediatrics.

[13]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[14]  I. Deary.  Edinburgh Research Explorer Intelligence and personality as predictors of illness and death: How researchers in differential psychology and chronic disease epidemiology are collaborating to understand and address health inequalities , 2013 .

[15]  G. Bodenhausen,et al.  Personalized Persuasion , 2012, Psychological science.

[16]  B. Sommers,et al.  The Affordable Care Act and insurance coverage for young adults. , 2012, JAMA.

[17]  E. Ozer,et al.  Young adult preventive health care guidelines: there but can't be found. , 2012, Archives of pediatrics & adolescent medicine.

[18]  P. Bibby,et al.  Openness to experience and all-cause mortality: a meta-analysis and r(equivalent) from risk ratios and odds ratios. , 2012, British journal of health psychology.

[19]  Sarah E Hampson,et al.  Personality processes: mechanisms by which personality traits "get outside the skin". , 2012, Annual review of psychology.

[20]  Avron Spiro,et al.  Openness to Experience and Mortality in Men , 2012, Journal of aging and health.

[21]  S. Daniels.  Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report , 2011, Pediatrics.

[22]  B. Roberts,et al.  Conscientiousness and longevity: an examination of possible mediators. , 2011, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[23]  L. Ferrucci,et al.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Personality and Obesity Across the Adult Life Span , 2011 .

[24]  Lora E Burke,et al.  Value of primordial and primary prevention for cardiovascular disease: a policy statement from the American Heart Association. , 2011, Circulation.

[25]  B. Roberts,et al.  Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine , 2011, Journal of aging research.

[26]  T. Marteau,et al.  Deflating the Genomic Bubble , 2011, Science.

[27]  David Ogilvie,et al.  Judging nudging: can nudging improve population health? , 2011, BMJ : British Medical Journal.

[28]  C. Carver,et al.  Personality and coping. , 2020, Annual review of psychology.

[29]  Daniel J Buysse,et al.  The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. , 2010, Journal of clinical epidemiology.

[30]  L. Ferrucci,et al.  Trait Antagonism and the Progression of Arterial Thickening: Women With Antagonistic Traits Have Similar Carotid Arterial Thickness as Men , 2010, Hypertension.

[31]  Ian J. Deary,et al.  Edinburgh Research Explorer Intelligence and personality as predictors of illness and death: How researchers in differential psychology and chronic disease epidemiology are collaborating to understand and address health inequalities , 2013 .

[32]  T. Nettelbeck,et al.  Openness to experience, intelligence, and successful ageing , 2010 .

[33]  Donald Lloyd-Jones,et al.  Screening for cardiovascular risk in asymptomatic patients. , 2010, Journal of the American College of Cardiology.

[34]  S. Grundy,et al.  The metabolic syndrome. , 2008, Endocrine reviews.

[35]  S. Vazire.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Who Knows What About a Person ? The Self – Other Knowledge Asymmetry ( SOKA ) Model , 2010 .

[36]  B. Lahey,et al.  Public health significance of neuroticism. , 2009, The American psychologist.

[37]  B. Uchino.  Understanding the Links Between Social Support and Physical Health: A Life-Span Perspective With Emphasis on the Separability of Perceived and Received Support , 2009, Perspectives on psychological science : a journal of the Association for Psychological Science.

[38]  George Loewenstein,et al.  Strategies for Promoting Healthier Food Choices. , 2009, The American economic review.

[39]  B. Roberts,et al.  Back to the Future: Personality and Assessment and Personality Development. , 2009, Journal of research in personality.

[40]  J. Ioannidis.  Personalized Genetic Prediction: Too Limited, Too Expensive, or Too Soon? , 2009, Annals of Internal Medicine.

[41]  Phil A. Silva,et al.  Sex differences in antisocial behaviour , 2006 .

[42]  Vicente Bertomeu Martínez,et al.  Markers of Inflammation and Cardiovascular Disease , 2009, American journal of cardiovascular drugs : drugs, devices, and other interventions.

[43]  Margaret L. Kern,et al.  Do conscientious individuals live longer? A quantitative review. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[44]  Luigi Ferrucci,et al.  Personality Predictors of Longevity: Activity, Emotional Stability, and Conscientiousness , 2008, Psychosomatic medicine.

[45]  R. Thaler,et al.  Nudge: Improving Decisions About Health, Wealth, and Happiness , 2008 .

[46]  A. Caspi,et al.  How should we construct psychiatric family history scores? A comparison of alternative approaches from the Dunedin Family Health History Study , 2008, Psychological Medicine.

[47]  Majid Ezzati,et al.  Comparative Risk Assessment , 2008 .

[48]  A. Caspi,et al.  The Power of Personality: The Comparative Validity of Personality Traits, Socioeconomic Status, and Cognitive Ability for Predicting Important Life Outcomes , 2007, Perspectives on psychological science : a journal of the Association for Psychological Science.

[49]  I. Deary,et al.  Neuroticism, Extraversion, and Mortality in the UK Health and Lifestyle Survey: A 21-Year Prospective Cohort Study , 2007, Psychosomatic medicine.

[50]  P. Greenland,et al.  Framingham risk score and prediction of coronary heart disease death in young men. , 2007, American heart journal.

[51]  R. Poulton,et al.  Systemic inflammation and lung function in young adults , 2007, Thorax.

[52]  Ian J Deary,et al.  Premorbid (early life) IQ and later mortality risk: systematic review. , 2007, Annals of epidemiology.

[53]  Timothy W. Smith.  Personality as Risk and Resilience in Physical Health , 2006 .

[54]  R. Poulton,et al.  Changes in periodontal disease experience from 26 to 32 years of age in a birth cohort. , 2006, Journal of periodontology.

[55]  Denis A. Evans,et al.  Neuroticism, Extraversion, and Mortality in a Defined Population of Older Persons , 2005, Psychosomatic medicine.

[56]  B. Starfield,et al.  Contribution of primary care to health systems and health. , 2005, The Milbank quarterly.

[57]  R. McCrae,et al.  Universal features of personality traits from the observer's perspective: data from 50 cultures. , 2005, Journal of personality and social psychology.

[58]  H. Minuk,et al.  Metabolic syndrome. , 2005, Journal of insurance medicine.

[59]  B. Roberts,et al.  Conscientiousness and health-related behaviors: a meta-analysis of the leading behavioral contributors to mortality. , 2004, Psychological bulletin.

[60]  Sheldon Cohen.  Social relationships and health. , 2004, The American psychologist.

[61]  I. Deary,et al.  Early life intelligence and adult health , 2004, BMJ : British Medical Journal.

[62]  D. Bennett,et al.  Personality and mortality in old age. , 2004, The journals of gerontology. Series B, Psychological sciences and social sciences.

[63]  B. Starfield,et al.  The medical home, access to care, and insurance: a review of evidence. , 2004, Pediatrics.

[64]  J. Gerberding,et al.  Actual causes of death in the United States, 2000. , 2004, JAMA.

[65]  Ian J. Deary,et al.  Intelligence Predicts Health and Longevity, but Why? , 2004 .

[66]  H. Mcgill,et al.  Starting earlier to prevent heart disease. , 2003, JAMA.

[67]  Sidney C. Smith,et al.  MARKERS OF INFLAMMATION AND CARDIOVASCULAR DISEASE: APPLICATION TO CLINICAL AND PUBLIC HEALTH PRACTICE: A STATEMENT FOR HEALTHCARE PROFESSIONALS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND THE AMERICAN HEART ASSOCIATION , 2003 .

[68]  P. Ackerman,et al.  Determinants of health knowledge: an investigation of age, gender, abilities, personality, and interests. , 2003, Journal of personality and social psychology.

[69]  Gary L Myers,et al.  Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. , 2003, Circulation.

[70]  F. Rasmussen,et al.  Risk factors for airway remodeling in asthma manifested by a low postbronchodilator FEV1/vital capacity ratio: a longitudinal population study from childhood to adulthood. , 2002, American journal of respiratory and critical care medicine.

[71]  S. Hampson,et al.  Perceived Risk, and Risk-Reduction Behaviors: A Preliminary Study , 2000 .

[72]  J. Danesh,et al.  Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses , 2000, BMJ : British Medical Journal.

[73]  G. Matthews,et al.  Intelligence and personality , 2004 .

[74]  J. Blumenthal,et al.  Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. , 1999, Circulation.

[75]  S. Srivastava,et al.  The Big Five Trait taxonomy: History, measurement, and theoretical perspectives. , 1999 .

[76]  O. John,et al.  Los Cinco Grandes across cultures and ethnic groups: multitrait multimethod analyses of the Big Five in Spanish and English. , 1998, Journal of personality and social psychology.

[77]  Carol A. Trujillo,et al.  The MOS 36-Item Short Form Health Survey: reliability, validity, and preliminary findings in schizophrenic outpatients. , 1998, Medical care.

[78]  J. M. Digman.  Higher-order factors of the Big Five. , 1997, Journal of personality and social psychology.

[79]  J. Larson.  The MOS 36-Item Short form Health Survey , 1997, Evaluation & the health professions.

[80]  Y. Benyamini,et al.  Self-rated health and mortality: a review of twenty-seven community studies. , 1997, Journal of health and social behavior.

[81]  Eric D. Heggestad,et al.  Intelligence, personality, and interests: evidence for overlapping traits. , 1997, Psychological bulletin.

[82]  D. Funder.  The Personality Puzzle , 1996 .

[83]  J. Kampert,et al.  Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. , 1996, JAMA.

[84]  John L. Hankinson,et al.  Standardization of Spirometry, 1994 Update. American Thoracic Society. , 1995, American journal of respiratory and critical care medicine.

[85]  Jeffrey W. Kusulas,et al.  The Five-Factor Model of Personality as a Framework for Personality-Health Research , 1994 .

[86]  D. Boninger,et al.  The consideration of future consequences: Weighing immediate and distant outcomes of behavior. , 1994 .

[87]  P. Blackman.  Actual causes of death in the United States. , 1994, JAMA.

[88]  C. Sherbourne,et al.  The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. , 1994 .

[89]  O. John,et al.  Determinants of interjudge agreement on personality traits: the big five domains, observability, evaluativeness, and the unique perspective of the self. , 1993, Journal of personality.

[90]  McGinnis Jm,et al.  Actual causes of death in the United States. , 1993 .

[91]  B. Morgenstern,et al.  Human blood pressure determination by sphygmomanometry. , 1993, Circulation.

[92]  L Wilhelmsen,et al.  Stressful life events, social support, and mortality in men born in 1933. , 1993, BMJ.

[93]  A. Caspi,et al.  The natural history of change in intellectual performance: who changes? How much? Is it meaningful? , 1993, Journal of child psychology and psychiatry, and allied disciplines.

[94]  L. A. Pervin.  Handbook of Personality: Theory and Research , 1992 .

[95]  Paula G. Williams,et al.  Personality and health: advantages and limitations of the five-factor model. , 1992, Journal of personality.

[96]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[97]  R. McCrae,et al.  An introduction to the five-factor model and its applications. , 1992, Journal of personality.

[98]  J. M. Digman.  PERSONALITY STRUCTURE: EMERGENCE OF THE FIVE-FACTOR MODEL , 1990 .

[99]  D. Watson,et al.  Health complaints, stress, and distress: exploring the central role of negative affectivity. , 1989, Psychological review.

[100]  J. House,et al.  Social relationships and health. , 1988, Science.

[101]  P. Costa,et al.  Neuroticism, somatic complaints, and disease: is the bark worse than the bite? , 1987, Journal of personality.

[102]  H. Friedman,et al.  The "disease-prone personality". A meta-analytic view of the construct. , 1987, The American psychologist.

[103]  H. Friedman,et al.  Psychological predictors of heart disease: a quantitative review. , 1987, Psychological bulletin.

[104]  J. Cuzick,et al.  A Wilcoxon-type test for trend. , 1985, Statistics in medicine.

[105]  C. Shagass,et al.  Intelligence and Personality , 1972 .

[106]  W. T. Norman,et al.  Toward an adequate taxonomy of personality attributes: replicated factors structure in peer nomination personality ratings. , 1963, Journal of abnormal and social psychology.