9.

Emotion and personality in health and healthcare

9. Emotion and personality in health and healthcare

Personality – the Big 5

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 9. Emotion and personality in health and healthcare
Neuroticism
ɞ Neuroticism is linked to
o Medically unfounded somatic complaints
o Catastrophic thoughts – medical service use (burden on NHS)
o Physical and mental health are highly correlated
o Anxiety and disrupted immune functioning
o Cardiac functioning
o More sedentary behaviour
ɞ Less happy, less healthy, and less successful lives
ɞ People with high neuroticism are more likely to experience daily hassles, have conflicted and
unstable relationships with friends, divorce more frequently – less social support in dealing with
physical health problems.
ɞ Respond more negatively and more intensely when they experience stressful life events.
ɞ More likely to develop anxiety and depression after stressful life event.
ɞ Utilise emotion-focused (rather than problem-focused) coping skills
ɞ More likely to smoke, take drugs, become dependent on alcohol – links to physical health
conditions.
ɞ Large scale screening could identify those more at risk of developing mental and physical condition
ɞ False positives might increase worry

Conscientiousness
ɞ Associated with longevity.
ɞ Negatively correlated with drug use, alcohol use, unhealthy eating, risky driving, suicide, tobacco
use, and violence.
ɞ Positively correlated with exercise.
ɞ Less sedentary behaviour (age did not moderate the finding; Allen et al., 2016).
Projecting health from childhood – see lecture slides for link
ɞ Longitudinal study over 40 years Hampson et al., 2013
o Child personality assessments at 10 years of age.
o Health assessment at 41 years of age.
o Analyses controlled for ethnicity, parental home ownership, adult conscientiousness,
and other childhood big 5 factors.
o Lower conscientiousness in childhood predicted more physiological dysregulation (e.g.,
higher cholesterol, poor BMI, blood pressure etc.), obesity, and worse lipid profiles.
o Gender did not moderate the effect.
o None of the other big five predicted health outcomes.

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 9. Emotion and personality in health and healthcare
Meta-synthesis on personality and health - 440,000-530,000 people included Strickhouser et al., 2017

Limitations of the personality –

physical health association
☼ Personality and subjective health and mental health are
assessed by self-report, so more likely to correlate.
☼ Physical health is normally assessed by an objective assessment (i.e., diagnosis of disease).
☼ Association between personality and physical health may be mediated by health behaviours.
☼ Associations may be stronger in clinical populations.
☼ Even though ES are small, other important predictors, such as socioeconomic status and IQ, have links
with physical health of similar or lesser magnitudes than personality and even a small effect of
personality can accumulate over time, resulting in premature death (Roberts et al., 2007).

What is an emotion?

Basic emotions:
 Disgust
 Anger
 Fear
 Sadness
 Happiness
 Surprise
What is the link between physical health?

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 9. Emotion and personality in health and healthcare
Mood and cardiovascular diseases
 Large sample of people hospitalised for CVD.
 Patients with arrhythmia experienced anxiety more often than patients with coronary artery
disease and heart failure (9.1% vs 5.8% vs 4.3%, p < 0.05),
 Those with coronary artery disease experienced anger more often than those with heart failure and
arrhythmia (35.0% vs 21.4% vs 29.5%, p < 0.05).
 The prevalence of depression in patients with coronary artery disease, heart failure, and
arrhythmia was 11.1%, 10.7%, and 9.1%, respectively, and the differences were not statistically
significant.
 People with higher depressive symptomology were more likely to remain in hospital due to CVD
symptoms.
 Depression is an independent risk factor of hospitalisation and death, beyond anger and anxiety.
Nakamura et al., 2013

Negative emotion on immune functions

 Secretory immunoglobulin A (S-IGA) antibody is the first line of defence before getting a cold
 Negative emotions and events negatively impact this antibody – more susceptible to common cold
(Stone et al., 1996).

Worry/anxiety on interpretation of symptoms

Eccleston & Crombez., 2007

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 9. Emotion and personality in health and healthcare

Negative emotions and physical symptoms

 Daily diary study assessed emotion, pain,
a fatigue every 2 hours for 30 days in
health adults.
 Participants rated valence of emotion,
and positive/negative emotion.
 Found positive correlations between pain
and fatigue
 Negative correlations between emotion
and fatigue
 Authors proposed emotion negatively
impacts pain via fatigue
Lee et al., 2017

Negative affect on physical symptoms

o A blinded group of volunteers were infected with a respiratory virus.
o Assessed state and trait negative affect, mucus, bloods, and, symptoms.
o Results
o State and trait NA was significantly associated with more symptoms
o Higher trait NA people: symptom report was unrelated to illness severity
o Higher state NA people: symptom report was associated with objective indices of illness severity
o Conclusion: State NA is more closely linked to objective disease indicators than trait NA.
Cohen et al., 1995

Positive emotions and health

 The same way that negative
emotions negatively impact our
health, positive emotions may
positively influence our health.
 Decrease stress and burden on
physiological systems.
 Growing popularity of “positive psychology”.

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 9. Emotion and personality in health and healthcare

5 processes of emotion regulation

1. Situation selection – changing the situation to one that we will experience positive emotions
2. Situation modification – modify physical environment to better emotions
3. Attentional deployment – redirect or give attention to stimuli that will give you positive emotions
4. Cognitive change – changing one or more of the appraisals that provide different emotions.
5. Response modulation – influence behavioural and physiological responses from emotions

Positive emotions (Tugade et al., 2004)

o Laughter and humour improves immune system functioning.
o Positive emotions in elderly patients were less likely to be readmitted to hospital.
o People who reported positive emotional disclosure were more likely to have fewer emotional
complaints, exercise more, and sleep better.
o Positive emotions are associated with longevity.

Optimism and health

o Optimistic patients with fibromyalgia were less likely to give up on goals even when pain made this
challenging (Affleck et al., 2001)
o Optimism following cancer diagnosis predicted more positive adjustment in the subsequent 12
months possibly by reducing disease-related threat appraisals and avoidant coping (Schou et al.,
2005)
o Optimistic children reported more hope in relation to goal attainment, greater global and social
self-competence and fewer depressive symptoms (Ey et al., 2005)

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