New Voices: Personality - at the heart of health

'Wake up, Páraic, wake up, it's time for mass.' My eyes slowly opened. It was eight o'clock on a bright rural Connemara Sunday morning in 1991; I was seven. 'Mom, I learned in school that God has our lives planned out, is this true do you think?'. My mother replied, 'Of course, son, he has our entire lives planned out.' With the feeling that I had all my ducks in a row I replied, 'Well then he knows already,
I'm not going to mass today.'

Needless to say, I found myself at mass in great haste. As a Catholic child in rural Ireland, questioning societal norms wasn't something that was encouraged. In particular, religious interactions were frequently subconsciously viewed as a form of holy X-Factor – 'Jesus Idol' perhaps – where the most outrageous genuflecting was the social currency of the day.

When the yearly pilgrimage was being organised, I remember wondering why so many critically ill people were travelling to Lourdes, when they had a perfectly good hospital nearby. I was informed that many individuals had been miraculously cured of their life-threatening illnesses while on religious pilgrimage there. To my disappointment, evidence of a growing limb was not forthcoming, but this was the earliest stage of my fascination regarding the questioning of apparent norms. It also ignited my interest in how people interacted with and perceived their surroundings. I remember finding it fascinating that various people would report a dramatic improvement in their health following their trip. An opposite outcome would certainly have been more likely, given the huge numbers attending.

Following a number of years of employment and a growing frustration at not being able to satisfy my fascination with human thought and behaviour, I decided to return to education to study psychology. During my undergraduate study, I began to develop a keen interest in the interactions between biological, health and personality psychologies. As part of my undergraduate study, I was required to complete a final-year piece of experimental research, examining the impact of personality and stress on cardiovascular reactivity. I found it both riveting and consuming.

Over a number of decades the reactivity hypothesis has played a central role regarding the link between health and stress. The reactivity hypothesis states that cardiovascular reactivity to stressors, if exaggerated or prolonged, can promote the development of cardiovascular disease (Obrist, 1981; Phillips & Hughes, 2011). This model is thought of as an all-encompassing mechanism within cardiovascular stress research, with a considerable body of evidence to support its relationship to health associations (Phillips & Hughes, 2011): a norm, if you like, to be questioned.  

While the aforementioned reactivity hypothesis dominates the literature, research suggests that cardiovascular stress responses are susceptible to adaptation, or change over time (Hughes et al., 2011). Cardiovascular reactivity alone is not representative of an individual's daily responses to stress. For example, research conducted by Frankish and Linden (1991) suggests that an individual's cardiovascular responses to stressors are relatively stable across varying contexts. Similarly to the reactivity hypothesis, research suggests that adaptation is also a biopsychosocial phenomenon (Hughes et al., 2011). Therefore, it is reliant on cognitive appraisals, coping mechanisms and autonomic response systems (Lovallo, 2005). As highlighted by Hughes et al. (2011), styles of appraisal and coping have a tendency to be somewhat stable within individuals, but also differ significantly between them (Hewitt & Flett, 1996).

All this suggests that personality is of central concern to understanding health within this context. Research demonstrates that personality traits are relatively accurate predictors of both positive and negative health outcomes (Ferguson, 2013). One such piece of research found that neuroticism played a significant role in variances observed in cardiovascular adaptation measures to repeated stress (Hughes et al., 2011). Findings reported within this study add to previous research suggesting healthful correlates of short-term stress, and the relevance of adaptation to prolonged stress. Therefore, failure to habituate – for cardiovascular responses to decrease in the face of repeated stress – has been considered a reflection of an inability to adapt, a marker for negative health associations (McEwen, 1998; Schmaus et al., 2008; Turner et al., 2005). It is intriguing to consider the potential benefits of short-term stress to immune function, with the potential of one's personality influencing if or when an individual adapts to lengthy periods of stress.

The personality–health relationship, then, is a complex one. It impacts upon a wide spectrum of indices from coronary heart disease and susceptibility to infections, to healthcare utilisation and doctor–patient interaction. Some personality traits are suggested as possibly being protective with respect to mortality, while others reported as potentially possessing a similar negative clinical outcome to poor exercise tolerance, smoking and older age (Denollet & Brutsaert, 1998; Denollet et al., 2000). This current area of research is one which possesses a plethora of substantial avenues. My own doctoral study is centred on cardiovascular adaptation, and in particular the impact of personality variables on an individual's evaluation of recurring stress and execution of psychophysiological responses. I will also be developing further experimental methodologies related to eliciting stress responses within the laboratory.

In my study I will be going beyond the more popular personality dimensions such as neuroticism. Whereas its impact is fairly well established, openness to experience appears to not be examined as strenuously. A limited number of publications have investigated this dimension with respect to stress reactivity, with fewer examining
stress adaptation. Some research has indicated the potential significant impact of openness to experience on health; for example, facets of openness as being associated with patient longevity, independently of other risk factors (Jonassaint et al., 2007). This research found that those who scored higher on the openness scale displayed a 15 per cent decrease in cardiac risk of death. Recent research, a meta-analysis conducted by Ferguson and Bibby (2012) found that openness to experience was a protective factor with respect to all-cause mortality. This research provides a valuable insight into the potential impact of this personality dimension.

A further investigation on patterns of adaptation to recurring stress would provide a valuable insight and is the specific focus of my current research. My thoughts are that the findings may be quite revealing, especially with respect to uncovering potential underlying mechanisms as to why openness to experience may be a substantial factor regarding if and when an individual adapts to stress.

Research suggests that personality is heavily influenced by genetics, with one's environment also playing a significant role (Yamagata et al., 2006). An individual's perception and reaction to stress is potentially open to being manipulated, through various moderating and mediating factors. Should this be accomplished within my current research, it could ultimately provide an avenue to further our understanding of our own mortality.

It is worth bearing in mind that research has found that personality is a good predictor of mortality, in some cases better than obesity, alcohol consumption, and socio-economic status (Ferguson, 2013). Similarly to other research conducted relating to vaccinations and cancer screening attendance, my own work has the potential to significantly impact a wide range of both research and public avenues.

While I sit here attempting to write this piece, I notice a quote I have posted on my partition wall. I will certainly keep it at the forefront of my mind throughout my doctoral journey:
At the heart of science is an essential balance between two seemingly contradictory attitudes – an openness to new ideas, no matter how bizarre or counterintuitive they may be, and the most ruthless sceptical scrutiny of all ideas, old and new. This is how deep truths are winnowed from deep nonsense. (Sagan, 1996)

Páraic Ó Súilleabháin is a PhD candidate, at the National University of Ireland, Galway
[email protected]

References

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