Mental and physical health of spouse caregivers: The role of personality.

Although personal resources of caregivers, such as coping skills and social support, have been shown to be important in understanding caregiver stress and health outcomes, personality traits have not previously been considered. The purpose of this study was to examine the association between the personality traits of neuroticism and dispositional optimism and mental and physical health outcomes. It was predicted that personality would have direct effects, and indirect effects through perceived stress, on health outcomes. Participants were spouse caregivers of patients diagnosed with Alzheimer's disease (AD). Results show that neuroticism and optimism were significantly related to mental and physical health. Furthermore, neuroticism had significant direct effects on all of the health outcomes, and substantial indirect effects, through perceived stress, on mental health outcomes. Optimism showed stronger indirect than direct effects on all health outcomes. These findings demonstrate the importance of including personality of the caregiver in theoretical and empirical models of the caregiving process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of subjective health in older adults: A meta-analysis.

Age-associated changes of subjective health and associations of subjective health with physical health, functional health, and mental health were meta-analyzed in older adults (mean age > 60 yrs). An age-associated decline of subjective health, which was stronger in old-old samples than in young-old samples, was found. Subjective health was correlated with the indicators of objective health, but the association with physical health was stronger than with functional health. Correlations of subjective health with physical health and functional health were lower in the old-old than in the young-old samples, whereas associations of subjective health with mental health were stronger in older samples. Furthermore, the size of the association between subjective and objective health varied by the method of assessment of objective health, showing highest associations with symptom checklists and results of medical examinations due to strict protocols. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis.

Providing care for a frail older adult has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. In this meta-analysis, the authors integrated findings from 84 articles on differences between caregivers and noncaregivers in perceived stress, depression, general subjective well-being, physical health, and self-efficacy. The largest differences were found with regard to depression (g = .58), stress (g = .55), self-efficacy (g = .54), and general subjective well-being (g = -.40). Differences in the levels of physical health in favor of noncaregivers were statistically significant, but small (g = .18). However, larger differences were found between dementia caregivers and noncaregivers than between heterogeneous samples of caregivers, and noncaregivers. Differences were also influenced by the quality of the study, relationship of caregiver to the care recipient, gender, and mean age of caregivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intergenerational effects of high neuroticism in parents and their public health significance.

The article by Lahey (May–June 2009) provided a timely and important review of a growing body of evidence linking the personality trait of neuroticism to a host of health and psychosocial outcomes with public health significance. Lahey (2009) highlighted the links between high neuroticism and mental health, physical health, and quality of life and described the putative genetic and environmental causes of high neuroticism. He recommended screening for high neuroticism and interventions for those presenting this trait in order to reduce health care costs resulting from the associated conditions. We applaud his treatise but note that it failed to address the impact of high neuroticism among parents on their children’s long-term psychosocial functioning and mental health. In sum, Lahey (2009) provided a compelling argument for considering interventions for persons with high neuroticism as a public health initiative. We strongly support this call for action, as evidence does show that neuroticism adversely affects not only the individual and his or her social environment but the generations to follow. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of the physical health, health care use, and psychological well-being of spouses of people with fibromyalgia syndrome.

The present study compared the physical and mental health and the health care use of spouses of patients with fibromyalgia syndrome (FS group; n=135) with that of spouses of healthy individuals ( n=153). FS group participants reported lower health and affective states and scored higher on depression, loneliness, and subjective stress than comparison group participants ( p=.017). Husbands in the FS group who reported more illness impact and whose wives reported worse sleep quality and less self-efficacy had more psychological difficulties. No differences were found in health care costs between groups. These findings suggest that chronic illness in a partner may negatively affect an individual's physical and mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workers' perceptions of how jobs affect health: A social ecological perspective.

A national sample of 2,048 workers was asked to rate the impact of their job on their physical and mental health. Ordered logistic regression analyses based on social ecology theory showed that the workers' responses were significantly correlated with objective and subjective features of their jobs, in addition to personality characteristics. Workers who had higher levels of perceived constraints and neuroticism, worked nights or overtime, or reported serious ongoing stress at work or higher job pressure reported more negative effects. Respondents who had a higher level of extraversion, were self-employed, or worked part time or reported greater decision latitude or use of skills on the job reported more positive effects. These findings suggest that malleable features of the work environment are associated with perceived effects of work on health, even after controlling for personality traits and other sources of reporting bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public health significance of neuroticism.

The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss. Individuals in the population vary markedly on this trait, ranging from frequent and intense emotional reactions to minor challenges to little emotional reaction even in the face of significant difficulties. Although not widely appreciated, there is growing evidence that neuroticism is a psychological trait of profound public health significance. Neuroticism is a robust correlate and predictor of many different mental and physical disorders, comorbidity among them, and the frequency of mental and general health service use. Indeed, neuroticism apparently is a predictor of the quality and longevity of our lives. Achieving a full understanding of the nature and origins of neuroticism, and the mechanisms through which neuroticism is linked to mental and physical disorders, should be a top priority for research. Knowing why neuroticism predicts such a wide variety of seemingly diverse outcomes should lead to improved understanding of commonalities among those outcomes and improved strategies for preventing them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Job Strain, Job Insecurity, and Health: Rethinking the Relationship.

Job strain (high demands and low control) is a widely used measure of work stress. The authors introduce a new way of looking at work stress by combining job strain with job insecurity, a combination increasingly prevalent in contemporary economies, using data from a cross-sectional survey (N = 1,188) of mid-aged Australian managers and professionals. Those reporting both strain and insecurity showed markedly higher odds for mental and physical health problems (depression: odds ratio [OR] 13.88, 95% confidence interval [CI] 5.67-34.01; anxiety: OR 12.88, CI 5.12-32.39; physical health problems: OR 3.97, CI 1.72-9.16; and poor self-rated health: OR 7.12, CI 2.81-18.01). Job strain and insecurity showed synergistic associations with health, and employees experiencing both could be at heightened health risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuroticism and depressive symptoms among spouse caregivers: Do health behaviors mediate this relationship?

This study examined the mediating role of health behaviors in the relationship between neuroticism and depressive symptoms among spouse caregivers. Path analysis was used to test a model of the caregiver stress process among 233 caregivers of people with dementia. Results indicate that neuroticism has a significant direct effect on depressive symptoms and also indirectly influences depressive symptoms through health behaviors and perceived stress. When individual health behaviors were examined in the path model, only physical activity served a significant mediating role. These findings suggest that neuroticism may lead to depressive symptoms among caregivers partly through declines in physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting longitudinal changes in caregiver physical and mental health: A stress process model.

Alzheimer's family caregivers (N?=?122) reported on physical and mental health, as well as stress process variables, at baseline and at a 1-year follow-up. Hierarchical regression analyses of stress process models revealed that increases in primary stressors (e.g., patient self-care and behavioral problems) did not directly affect changes in the mental and physical health outcome variables. However, analyses of models of direct, mediated, and moderated effects revealed that psychosocial resource variables (appraisals, coping responses, and social support) were related to caregiver outcomes over time through several mechanisms. In particular, benign appraisals of stressors, the use of approach coping, and greater levels of social support were associated with more positive caregiver health outcomes over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical health 25 years later: The predictive ability of neuroticism.

Objective: Neuroticism, a personality trait related to distress and emotional stability, is often correlated with physical symptoms and disease presence. Theorists have posited that chronic emotional instability creates physiological changes detrimental to health, yet most findings are based on cross-sectional analyses. The objective of the current study was to examine neuroticism assessed in 1973 and the likelihood of reporting physical conditions 25 years later. Design: Participants included 21676 adult twins (n = 8143 intact twin pairs) ranging from 15 to 47 years old in 1973 who were assessed again between 1998 and 2002. Main Outcome Measures: Thirteen physical conditions, including chronic fatigue syndrome, ulcers, and coronary heart disease, were selected based on their prior theoretical and empirical links to personality traits. Results: Results indicate that the likelihood of having a physical condition is related to higher levels of prior neuroticism, with some associations attenuated when controlling for familial similarity. Conclusion: Familial influences are most pronounced for conditions most related to systemic pain, suggesting genetic pathways between neuroticism and these pain experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality is associated with perceived health and functional status in older primary care patients.

Using data collected on 265 primary care medical patients 60 years of age and older, the authors examined the personality bases of subjective health (perceived health, functional status) after controlling for observer-rated depression and medical burden. Four hypotheses were tested: High Neuroticism is associated with poorer perceived health, low Extraversion is associated with poorer perceived health, low Openness to Experience is associated with worse functional status, and age moderates the relationships between personality and subjective health. Findings supported the notion that personality is associated with subjective health, moreover, this effect appeared to grow more pronounced with increasing age. This study underscores the conceptual and heuristic value of examining moderators of the links between personality variables and health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endorsement of proactively aggressive caregiving strategies moderates the relation between caregiver mental health and potentially harmful caregiving behavior.

This research tested the proposition that the oft-reported relation between caregiver mental health outcomes (i.e., resentment, depression) and potentially harmful caregiver behavior (PHB) would be mediated or moderated by caregiver endorsement of proactively aggressive caregiving strategies (PA). Caregiver resentment was the strongest predictor of PHB in the sample of 417 informal caregivers who resided with their care recipients; in fact, resentment mediated the impact of caregiver depression, thus suggesting that depressed affect was associated with PHB only if depressed caregivers resented their caregiving burdens. As predicted, caregiver endorsement of PA moderated the relation between resentment and PHB, such that links between these two constructs were strongest when caregivers were high in both resentment and PA. Endorsement of PA also mediated the relations between demographic or contextual variables (i.e., income, care recipient dementia) and PHB. Implications of these results for research and intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of neuroticism and mastery in spouse caregivers' assessment of and response to a contextual stressor

Data from more than 300 spousal caregivers and their care recipients were analyzed to demonstrate the effects of caregivers' personality attributes--neuroticism and mastery--on their assessment of a contextual stressor (the care recipient's behavioral and functional impairment) and on their experience of distress associated with that stressor. Caregivers who were high in neuroticism and/or low in mastery reported higher levels of behavioral and functional impairment in their disabled spouse and experienced more strain and depressive symptoms associated with caregiving relative to caregivers with lower neuroticism or higher mastery scores. We further showed that the widely reported association between caregiver-assessed impairment of the care recipient and caregiver outcomes can in part be explained by caregivers' personality attributes, such as neuroticism and mastery. Our findings that caregivers' personality variables are related to their assessment of a given objective stressor and their response to a given level of stress have implications for interventions targeting caregivers and for the use of caregivers as proxy informants.     

Personality and leader effectiveness: A moderated mediation model of leadership self-efficacy, job demands, and job autonomy.

The trait theory of leadership is advanced by a joint investigation of the mediating role of (a) leadership self-efficacy (LSE = leader's perceived capabilities to perform leader roles) in linking neuroticism, extraversion, and conscientiousness with leader effectiveness and (b) the moderating role of job demands and job autonomy in influencing the mediation. Using K. J. Preacher, D. D. Rucker, and A. F. Hayes' (2007) moderated mediation framework, the authors tested the model (over a 2-year period) with matched data from 394 military leaders and their supervisors. Results showed that LSE mediated the relationships for neuroticism, extraversion, and conscientiousness with leader effectiveness. Moderated mediation analyses further revealed that LSE mediated the relationships for (a) all 3 personality variables for only those leaders with low job demands; (b) neuroticism and conscientiousness for only those leaders with high job autonomy; and (c) extraversion, regardless of a leader's level of job autonomy. Results underscore the importance of accounting for leaders' situational contexts when examining the relationships between personality, LSE, and effectiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of mental and physical health service utilization among Vietnam veterans.

This study investigated predictors of mental and physical health care service utilization among 1,632 male (n = 1,200) and female (n = 432) Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. Using Anderson's theory as a model (Anderson & Bartkus, 1973), the authors examined both direct and mediated relationships among predisposing factors (i.e., age, marital status, and combat exposure), enabling factors (e.g., household income and insurance), and need factors (e.g., medical and psychological symptomatology) and physical and mental health care utilization outcomes. Need factors were the most consistent and strongest mediators of predisposing variables for both physical and mental health care service utilization, although there were differences between male and female veterans. For men, combat exposure indirectly predicted mental health care utilization through the need variables (with the effects of posttraumatic stress disorder being greatest). For women, physical health problems mediated the relationship between combat exposure and physical health outpatient care utilization. These findings have implications for screening and outreach efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting behavioral intentions and physical exercise: A test of the health action process approach at the intrapersonal level.

Objective: Theories of health behavior are usually tested on the between-person level. Associations between variables on the between- and the within-person level, however, can differ substantially. Thus, in order to better understand intrapersonal processes in the domain of health behavior, studies applying within-person analyses are needed. This study tested the Health Action Process Approach (HAPA) on the within- and between-person level in the context of physical exercise. Design: Participants were 265 first-year students who completed nine online questionnaires every second week. Data were analyzed by focusing on intrapersonal associations applying multilevel modeling. Main Outcome Measures: Intentions for physical exercise and self-reported physical exercise served as main outcome measures. Results: Analyses mainly confirm associations specified by the HAPA at the intrapersonal level: outcome expectancies and self-efficacy, but not risk awareness, were positively associated with intentions for physical exercise. Physical exercise in turn was positively associated with intentions, self-efficacy, action control, but not with action planning. Conclusion: The HAPA could be confirmed on the within-person level. Future studies should focus on testing other theories of health behavior at the within-person level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding health outcomes: Physical secondary conditions in people with spinal cord injury.

Objective: To examine the association of predisposing characteristics and enabling characteristics with physical secondary conditions through health practices and health care use in people with spinal cord injury (SCI). Design: Cross-sectional survey mailed to adults in portions of the northeastern and northwestern United States. Participants: Two hundred seventy adults with SCI recruited through durable medical equipment supply companies. Main Outcome Measures: Self-reported health practices, health care use, and physical secondary conditions. Results: In the Andersen behavioral model, F increment tests supported findings that predisposing characteristics accounted for 12% of variance in secondary conditions, enabling characteristics accounted for 16%, and health practices and health care use accounted for another 13%. Path analysis revealed that health care use mediated self-efficacy and interpersonal support. Conclusions: Predisposing characteristics including self-efficacy, enabling characteristics, and health care use are associated with physical secondary conditions in complex ways. More research is needed on measures of health practices and their relation to secondary conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy as a health-protective resource in teachers? A biopsychological approach.

Objective: To examine the psychobiological correlates of self-efficacy in teachers. Design: Study 1 examined associations between teacher self-efficacy and cardiac activation on a working day and Study 2 assessed the cortisol morning response in teachers with varying levels of teacher self-efficacy. Main outcome measures: Teacher self-efficacy was assessed by questionnaire. In Study 1 heart rate, heart rate variability, and locomotor activity were recorded by 22 hours ambulatory monitoring and subjective measures of stress and strain were obtained. Study 2 assessed the cortisol response to awakening to obtain a measure of HPA-axis activation and teachers filled in a questionnaire on physical complaints. Results and Conclusion: Study 1 found that self-efficacy proved protective for psychological well-being. Moreover, after controlling for locomotor activity, demographic, and lifestyle variables, self-efficacy was associated with elevated heart rate and attenuated heart rate variability during school and leisure time, respectively, but not during the night, thus questioning the health-implications of self-efficacy. Study 2 found that teachers high in self-efficacy exhibited an attenuated cortisol response to awakening and fewer cardiac complaints. The results of both studies are compatible with the view that teacher self-efficacy might act as a physiological toughening agent with possibly favorable health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)