Medical Psychology
24.03.2011
The role of personality
in changes of health status
Is there a Connection
Between Personality and
Disease?
►
Workaholics have heart
attacks?
► Worriers get ulcers?
► Uptight people get asthma?
Stress and Heart Disease:
Clinical Evidences
► Highly stressed workers were 2x as
likely to die from heart problems
(Kivimaki et al 2002)
► Stress-prone individuals with heart
problems 3x more likely to die from
heart attack (Sheps et al 2002)
► Stress-prone individuals: higher LDL
‘bad’ blood cholesterol (Steptoe et al 2005)
Stress & Heart Disease:
The „Type-A” Study
(Friedman & Rosenman 1974)
► 3200 healthy American men
► Characteristics of stress-prone
individuals (Type A-s):
– Anger & hostility
– Competitiveness
– Time-urgency
Follow-Up Study
(Friedman & Rosenman, 1982)
After 8½ years, participants were
reassessed
► 257 had developed CHD
► Of these, 70% were Type As
Association remained when smoking and other
lifestyle factors were accounted for
Type A & Heart Disease
(Miller, et al., 1991)
Characteristics of the
Type A Personality
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Strenuous work
Poor sleep pattern
Compulsive tendencies
Aggressive
Depressive and neurotic
tendencies
Angry, impatient
Low on introspection
Anxious
Hard driving
Little time for relaxation
Conscientious
Type A
Type B
Type A-s and Type B-s
Personality
Characteristics
Type A
Type B
Time Urgency
Not constantly in a
hurry
Easily aroused
hostility
Competitiveness
Can relax without
feeling guilty
Not easily hostile
Not overly
competitive
Heart Attack
Frequency
Twice that of
Type B
Half that of
Type A
Type A Behavior Patterns in
Stress and Illness
► respond more quickly, rapidly to
stressors, seeing them as threats.
► greater physiological reactivity
► tend to seek out demanding
situations which leads to stress.
► ignore early signs of heart attacks
► often fail to adhere to medical
regimens
Physical (Facial) Signs of
Type A Behaviour
Facial tension (tight lips, clenched jaw,
etc.)
► Tongue clicking or teeth grinding
► Dark circles under eyes
► Facial sweating (on forehead or upper
lip)
►
The key factor in the type A personality that
makes a person more susceptible
to heart disease is:
1. Competition
2. Ambition
3. Hostility
4. Fast pace
5. Upset easily
Hostility
is a form of
angry internal rejection or denial
in psychology
(George Kelly, 1957).
In everyday speech it is more commonly used
as a synonym for anger and aggression.
Hostility and
Coronary Heart Disease
Hostility is predictor of CHD and mortality,
especially when it is expressed outward and
involves cynicism. (Matthews et al. 1998)
200 females over 10 years, high initial hostility ->
more likely symptoms of CHD 10 years later
(Niaura et al., 2002)
– older males with coronary artery blockage:
8% L hostility, 18% H hostility
Higher resting blood pressure
poorer heart pumping efficiency,
and higher heart rate
Personality factors may
influence health behaviour
People high in neuroticism, hostility and
Type-A behaviors are more likely to:
► smoke and abuse alcohol
► eat less healthy foods
► avoid exercise
► sleep less
► use more caffeine
► more traffic risk taking behaviors
Personality factors, physiological
reactions to stress, and cardiovascular
response
Hostility: higher heart rates and
blood pressure – extreme cardiac
response to stress (Raikkonen et
al., 1999)
Hostile persons mistrust others and
are on guard – higher
physiological arousal and more
ware and tear on heart
Type D Personality
(Denollet et al 1996)
► Gloomy, socially inactive
►‘Distressed personality’ – associated
with depression and social alienation
Greater risk of heart attack!
► FOLLOW-UP STUDY: 300 male and
female heart attack sufferers. 10 years
later Type D-s 4x more likely to
have another heart attack (Denollet
et al 1996)
Type C (Cancer-Prone)
Personality (Temoshok, 1987)
Lydia Temoshok
Characteristics of Type C-s
► Suppress emotions – especially
negative ones
► Unassertive
► Likeable – non-argumentative, want to
please others
► Generally helpful to others
Effects of
Type-C Personality
Cope with stress in a way that ignores their
own needs (even physical ones).
Stresses suppressed.
More susceptible to cancer because more
chronic stressors affect the immune
system and increase risk of cancer.
Pessimistic explanatory style
and low perceived control
correlate with weaker
immune responses - poorer
DNA repair
Controversies in Cancer and
Personality Connections
• Population-based cohort study 59,548 Swedish
(1974–1999) and Finnish (1976–2004) participants
association of personality traits
extraversion and neuroticism with risk of
cancer
• 4,631 cancer cases for a maximum 30 years of
follow-up
• Extraversion and neuroticism were not
significantly associated with risk of cancers
at all sites
(Nakaya et al, 2010)
Is there a Disease-Prone
Personality?
► Some personality characteristics
make us more vulnerable to the
negative effects of stress, while others
makes us more resilient.
Evidences and Dilemmas
► It is proved that there is an “immuneprone” personality, a personality that is
“hardy” to the effects of stress.
► It is proved that emotions play a key
role in the outcome (recovery rate) of illness
but not in causing illness.
►It is still a question whether there is
any personality that predicts illness.
Research has so far proved
only that
personality
probably
plays an important role
in determining our health status.