The Influence of Personality on Illness - Essay Example

? Personality and Illness: Critically Evaluate the Influence of Personality on Illness Critically Evaluate the Influence of Personality on Illness The advent of the biopsychosocial model of disease which identifies psychosocial determinants of disease besides the traditional biomedical model has led to focus on the role of personality on illness and health outcomes. Here, scholars argue that the psychosocial dimensions of persona, emotions, family and community act alongside biological aspects that are primarily concerned with disease causation to influence illness and illness behaviour (Smith, 2002). Hence, studying and appraising the influence of a patient’s personality on illness offers helpful insights that may enhance health outcomes and help to achieve healthcare goals. This study reviews empirical literature to critically analyse the role played by personality on illness before arriving at a conclusion on the issue. The guiding thesis to this study is that personality plays a crucial role in determining illness and, thus, health outcomes. Concepts and Definitions Disambiguating between health and illness is a significant step in understanding the psychosocial determinants such as personality. Whereas health is usually defined as the absence of disease and infirmity signifying well being, illness is defined as a state of not being well as self-reported by a patient (Wikman, Marklund and Alexanderson, 2004). The view that illness is patient-defined brings forth a scenario where psychosocial issues may mediate self-reports. One of these psychosocial factors in personality, which Bradberry (2007) defines as a set of personal characteristics that influence an individual’s emotions, cognition and behaviours when in different situations. Personality theory details the Big Five Personality Factors; openness, conscientiousness, agreeableness, extraversion and neuroticism (Poropat, 2009). The dimension of openness entails imagination, insight and a wide range of interests; conscientiousness involves well-managed impulse control and objective-directed behaviours; agreeableness details prosocial behaviours such as trust and altruism; extraversion involves emotional expressiveness and assertiveness; lastly, neuroticism depicts emotional instability and other manifestations of negative affects (Matthews, Deary and Whiteman, 2003). The aspects of personality that have been associated with illness include optimism versus pessimism; negative affectivity and neuroticism; and resilience and conscientiousness among others. Smith (2006) argues that individual differences in experience of negative affects such as sadness and anxiety may mediate poor physical health. Neuroticism is defined as the experience of negative emotions, also referred to as negative affectivity; this concept has been associated with mediating an individual’s vulnerability to disease. Neuroticism has also been associated with reduced longevity among patients and increased incidence of objectively diagnosed diseases. Personality resilience is indicated by holding optimistic beliefs about outcomes/future, as opposed to holding pessimistic/hopeless dispositions. Such optimism may be manifested through a patient’s optimistic explanatory styles including reduced symptom reporting and less depressed moods. Optimism among physically ill patients has been associated with better health outcomes (Affleck, Tennen and Apter, 2001). Critical Appraisal of Influence of Personality on Illness: Empirical Evidence The discussion already undertaken indicates that personality plays a critical role in determining illness and physical health outcomes. An optimistic and resilient personality leads to better outcomes while neuroticism and pessimism result in deterioration of physical health. This part of the study evaluates these statements basing on critical review of empirical research evidence sourced from peer-reviewed journals. The first under review was undertaken by Kivimaki et al. (2005), investigating optimism and pessimism as significant predictors of changes in health. The scholars approach entailed prospective examination of changes in health after a major life event (serious illness or death in the family) among 5,007 employees averaging 44.8 years. The optimism and pessimism levels among these employees was measured over a period of five years while health was given by sickness absences 36 months before and 18 months after the major life event. The instrument used to measure the employees’ dispositional optimism and pessimism was a structured survey questionnaire referred to as the Life Orientation Test. The tests for optimism and pessimism involved three positively and negatively worded statements respectively. The participants were required to rate how much they felt the statements described them on a four point likert scale. The results indicated that highly optimistic individuals experienced lesser sick days after the major life event, quickly returning to the pre-event levels than their pessimistic counterparts. Hence, the scholars concluded that optimism played a fundamental role in reducing physical health problems and quickening recovery after major life events. The sufficient sample size (5,007), formidable research design (time series analysis) and approved data collection instrument (Life Orientation Test) make this study valid, reliable and representative. The length of the time series study allows for objectivity and thus increases the reliability of the research findings. Thus, the results and conclusions may be used to draw implications in support of the position that personality influences illness. Carver, Lehman and Antoni (2003) investigated the influence of disposition pessimism in health outcomes among breast cancer patients through illness-related disruption of their social and recreational undertakings. The scholars employed a cross-sectional research design to investigate the role played by pessimism in the withdrawal of women treated for breast cancer from social activities. A sample of 235 post-surgery women was evaluated over a period of 3 to 12 months using the Sickness Impact Profile instrument alongside measurements for on-going pessimism through the Life Orientation Test- Revised (LOT-R). Social disruption was measured through the Social Disruption Index; emotional distress through the Profile of Moods State (POMS); and lastly, fatigue was measured through three items in the POMS forming the Fatigue scale. Withdrawal from social activities was found to be significantly correlated to levels of pessimism defined through emotional distress and fatigue among the post-surgery patients. Correlation analysis revealed that disposition pessimism significantly influenced the disruption of social and recreational activities among the women under study. Hence, the researchers concluded that pessimism places patients at the risk of adverse and regrettable outcomes and thus such pessimism should be managed by health care givers or carers. This study also applies a sizable sample, effective cross-sectional research design and data collection instruments verified for validity and reliability. The study also investigates a serious physical condition in terms of determining the health outcomes for post-breast cancer surgery patients. The conclusions drawn by the study support the view that personality traits such as pessimism have significant influences on illness. A research into the influence of personality on coronary heart disease patient outcomes among the elderly was undertaken by Kuzbansky, Sparrows, Vokonas and Kawachi (2001). These scholars prospectively examined optimistic and pessimistic explanation styles among coronary heart disease patients. Using a longitudinal research design, the researchers employed the bipolar Optimism-Pessimism Scale to collect data from 1306 participants who were followed up for ten years. The data collected focused on explanation styles and incidence of coronary heart disease and the conditions complications such as myocardial infarction and angina pectoris. The scholars then used multivariate techniques to analyse the data, finding out a dose-response relationship between optimism and health outcomes among the participants. Hence, the scholars conclude that optimistic explanation styles have the capacity to protect against coronary heart disease risks among older patients. The inferences and implications of this study readily agree with the present study’s position on personality and illness. Giltay et al. (2006) also investigated the relationship between personality and illness, focusing on the role of disposition optimism in determining the risk of cardiovascular deaths. The design of the study followed a cohort model followed up for 15 years and took into consideration 545 participants of the 887 sampled men. The requirements for participation included being between an age of 64 and 84 who were devoid of cardiovascular diseases and cancer and whose socio-demographic data was available. Measurement of dispositional optimism was undertaken through a four-item data collection instrument. The results indicated an inverse relationship between optimism and the risk of cardiovascular attack. The results were confirmed through adding the aspect of depression through the Zung Self Rating Depression Scale. Thus, this empirical study is in consonance with the position of this paper on the influence of personality and health outcomes. Conclusion The appreciation of the psychosocial determinants of illness besides the traditional biomedical disease model places focus on the role played by personality in influencing illness. As a result, there has been a focus on the personal, emotional, family and community dimensions as determinants of illness and illness behaviour. Here, illness refers to self-reported health dispositions that may be subjective and psychosocially influenced. Personality aspects that may have influence on illness include optimisms and pessimism or neuroticism. This study has reviewed a number of empirical research efforts into the issue; personality and a major life event, breast cancer recovery, coronary heart disease and cardiovascular complications. All the studies reviewed use formidable research designs including longitudinal/times series and cross-sectional ones. The instruments employed have valid and reliable scores on the Cronbach’s Alpha for the data collection instruments. The sample sizes also support the representativeness and generalizability of the findings from this study. Hence, the view that personality plays a crucial role in determining illness and, thus, health outcomes is upheld. References Affleck, G., Tennen, H., & Apter, A. (2001). Optimism & pessimism: Implications for theory, research, and practice. APA, US. Bradberry, T. (2007). Self-awareness. Putnam, UK. Bogg, T., & Roberts, B. W. (2004). Conscientiousness and health-related behaviors: A meta-analysis of the leading behavioral contributors to mortality. Psychological Bulletin, 130, 887-919. Carver, C. S., Lehman. J. M., & Antoni, M. H. (2003). Dispositional pessimism predicts illness-related disruption of social and recreational activities among breast cancer patients. Journal of Personality and Social Psychology, 84(4), 813-821. Giltay, E. J. et al. (2006). Dispositional optimism and the risk of cardiovascular death: the Zutphen Elderly Study. Archives of Internal Medicine, 166(4), 431-6. Kivimaki, et al., (2005). Optimism and pessimism as predictors of change in health after death or onset of severe illness in family. Health Psychology, 24 (4), 413-421. Kuzbansky, L. D., Sparrows, D, Vokonas, P., & Kawachi, I. (2001). Is the glass half empty or half full? A prospective study of optimism and coronary heart disease in the normative aging study. Psychosomatic Medicine, 63, 910-916. Matthews, G., Deary, I. J., & Whiteman, M. C. (2003). Personality traits. Cambridge University Press, UK. Poropat, A. E. (2009). A meta-analysis of the five-factor model of personality and academic performance. Psychological Bulletin, 135 (2), 322–338 Smith, R. C. (2002). The biopsychosocial revolution interviewing and provider-patient relationships becoming key issues for primary care. Journal of Internal Medicine, 17(4), 309-310. Smith, T. W. (2006). Personality as risk and resilience in physical health. Association for Psychological Science, 15(4), 226-230. Wikman, A., et al, (2005). Illness, disease, and sickness absence: an empirical l test of differences between concepts of ill health. Journal of Epidemiology & Community Health, 59, 450-454. Read More