Article

Validity of the Grossarth-Maticek and Eysenck personality-stress model of disease: An empirical prospective cohort study

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Abstract

Personality-stress subtypes measured via the Short Interpersonal Reactions Inventory (SIRI) have been claimed to predispose to cancer, cardiovascular disease, or overall good health. We examined such associations in a 1993–1996 study on health risk factors in Australians aged over 50 years. 2197 women and 919 men completed the questionnaire, with nine subscores calculated. After a median 23.4 years, protocols were matched against dates/causes of death (1108 out of 3027 respondents with useable SIRI scores had died). Survival analysis tested for associations between subscores and mortality from all causes, mortality from cancers (30% of deaths), cardiovascular disease (23% of deaths), and other known causes (35% of deaths). Type 2 (CHD-prone) and Type 4 (healthy) scores were significantly associated (p < 0.05) with all-cause and cardiovascular mortality but not with any-cancer mortality. Despite criticisms of the Grossarth-Maticek and Eysenck data, we found empirical support for some SIRI subtypes. In accord with the Grossarth-Maticek and Eysenck personality-stress model, and consistent with two previous SIRI studies, inverse associations of Type 4 (healthy) scores with all-cause mortality were found and also Type 2 scores predicted CVD mortality. However, no significant relationship was found between Type 1 scores and cancer mortality.

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... In a new analysis of almost 3000 participants from their own cohort study, Whitfield, Landers, Martin, and Boyle (2020) explored the strengths of association between the Eysenck and Grossarth-Maticek personality typology and death due to cancer or heart disease. Personality types had been assessed using an amended version of the Short Interpersonal Relations Inventory (Grossarth-Maticek & Eysenck, 1990 [retracted]). ...
... Names and dates of birth for study participants were submitted to the Australian National Death Index (NDI; see https ://www.aihw.gov.au/about -our-data/our-data-colle ction s/natio nal-death -index /about -natio nal-death -index ) for matching against their records, as described in our previous publications 21,22 . The NDI records contain information about deaths in Australia from 1980 so deaths occurring outside Australia would not be matched through an NDI search. ...
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Scores on an optimistic-pessimistic personality scale have been associated with mortality, but optimism and pessimism scores are separable traits and it is unclear which has effects on health or longevity. The Life Orientation Test (LOT), containing items for optimism and pessimism, was included in a twin study on health of Australians aged over 50 in 1993–1995. After a mean of 20 years, participants were matched against death information from the Australian National Death Index. 1,068 out of 2,978 participants with useable LOT scores had died. Survival analysis tested for associations between separate optimism and pessimism scores and mortality from any cause, and from cancers, cardiovascular diseases or other known causes. Age-adjusted scores on the pessimism scale were associated with all-cause and cardiovascular mortality (Hazard Ratios per 1 standard deviation unit, 95% confidence intervals and p-values 1.134, 1.065–1.207, 8.85 × 10–5 and 1.196, 1.045–1.368, 0.0093, respectively) but not with cancer deaths. Optimism scores, which were only weakly correlated with pessimism scores (age-adjusted rank correlation = − 0.176), did not show significant associations with overall or cause-specific mortality. Reverse causation (disease causing pessimism) is unlikely because in that case both cardiovascular diseases and cancers would be expected to lead to pessimism.
... This issue is yet not resolved. On one side, there is some recent evidence to lend support to some of their claims (Whitfield, Landers, Martin, & Boyle, 2020), on the other, there are calls for a greater number of articles to be examined, including manuscripts where Eysenck is the sole author (Marks, 2019). Of the articles identified by Marks (2019) that are in our corpus, the bibliometric coupling analysis place them in the same cluster as those deemed "unsafe" by the enquiry at King's Collage London (2019), a result that adds further support to scrutinize Eysenck's work from this period of time and areas of study. ...
Article
We present a bibliometric analysis of a large corpus of research work by H. J. Eysenck (1916–1997), who was one of the most famous and productive psychologists of the 20th century. It utilizes new bibliometric tools to update an analysis of Rushton (2001), examining how articles cluster in terms of themes and co-authors. We present our analysis in the light of a recent investigation by King's College London, which concluded that a number of Eysenck's papers are ‘unsafe’ and they recommended that journal editors should consider their retraction. We enquire about the relationship between these personality and fatal disease papers and the wider body of Eysenck's work. Our analysis revealed that these papers are part of a research topic that stands apart from his many other seminal contributions to psychological knowledge; and, even if they were all retracted, this would have little impact on the main corpus of his work. Our analysis and presentation shines a new light on the contribution of Britain's most productive, but sometimes controversial, psychologist.
Book
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Measures of Personality and Social Psychological Constructs assists researchers and practitioners by identifying and reviewing the best scales/measures for a variety of constructs. Each chapter discusses test validity, reliability, and utility. Authors have focused on the most often used and cited scales/measures, with a particular emphasis on those published in recent years. Each scale is identified and described, the sample on which it was developed is summarized, and reliability and validity data are presented, followed by presentation of the scale, in full or in part, where such permission has been obtained. Measures fall into five broad groups. The emotional disposition section reviews measures of general affective tendencies, and/or cognitive dispositions closely linked to emotion. These measures include hope and optimism, anger and hostility, life satisfaction, self-esteem, confidence, and affect dimensions. Emotion regulation scales go beyond general dispositions to measure factors that may contribute to understanding and managing emotions. These measures include alexithymia, empathy, resiliency, coping, sensation seeking, and ability and trait emotional intelligence. The interpersonal styles section introduces some traditional social�psychological themes in the context of personality assessment. These measures include adult attachment, concerns with public image and social evaluation, and forgiveness. The vices and virtues section reflects adherence to moral standards as an individual characteristic shaped by sociocultural influences and personality. These measures include values and moral personality, religiosity, dark personalities (Machiavellianism,narcissism, and subclinical psychopathy), and perfectionism. The sociocultural interaction and conflict section addresses relationships between different groups and associated attitudes. These measures include cross-cultural values, personality and beliefs, intergroup contact, stereotyping and prejudice, attitudes towards sexual orientation, and personality across cultures.
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Some individuals are prone to illness, decline, and premature mortality while others recover quickly, maintain health, and live long lives. Personality, an individual’s biopsychosocial pattern of reactions and behaviors, is related to health across time, but the pathways are complex, with interrelated causal and non-causal links. Causal pathways linking personality and health include: health behaviors and habits; number and quality of social relationships; reactions to challenges and psychophysiological stress; and situation selection and evocation. Important but non-causal (spurious) links include: genes and early experiences; and disease-caused personality changes. Attending to the multiple links between personality and health within a lifespan perspective will aid causal understanding and facilitate the most appropriate interventions.
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Several prospective studies conducted by H. Eysenck and R. Grossarth-Maticek have demonstrated that personality can be considered as a risk factor in cancer and coronary heart disease. It was found that persons being prone to certain kinds of illness showed different types of reactions to interpersonal stress. A questionnaire developed by Grossarth-Maticek and Eysenck to measure 6 different reaction types was applied to a sample of persons who were suffering from different kinds of psychosomatic complaints and who were attending relaxation training programs, and to a sample of students. In addition, data concerning personality, coping-styles and health behavior were collected in both samples. It was found (1) that Grossarth-Maticek and Eysenck's behavior types were markedly correlated with basic personality dimensions, such as Neuroticism, Extraversion, Psychoticism and open vs closed mindedness (Rokeach, 1960, The open and closed mind. New York: Basic Books), (2) that these behavior types were connected with different types of coping, and (3) that finally these behavior types were associated with different kinds of psychosomatic complaints and diseases, as well as cancer and coronary heart disease.
Article
The Short Interpersonal Reactions Inventory [SIRI (Grossarth-Maticek, Eysenck, Vetter & Schmidt, Topics in Health, 1988)] is a questionnaire designed to measure personality traits predisposing to disease, notably ischaemic heart disease and cancer. It has been criticized by several authors in terms of design, scoring and validity. In a sample of 762 Australian twins taking part in a genetic study of asthma, we have examined the psychometric properties of the SIRI, and its relationship with the Eysenck Personality Questionnaire. Asthma was not significantly associated with any of the items or subscales of the SIRI. Scores on the seven subscales as defined by the SIRI authors (Types 1–3, 4 + and 4−, 5–6) were heavily skewed or truncated in six cases. Disturbingly, the two alternative forms of the Type 4 subscale were poorly intercorrelated (r = 0.17). A factor analysis using polychoric correlations partially replicated these subscales, but with important differences, similar to those found by other authors (Ranchor, Sanderman & Bouma, Personality and Individual Differences, 14, 483–484 1992). Scores on the SIRI and EPQR/S personality types were found to correlate broadly, as predicted by Eysenck (Perceptual and Motor skills, 71, 216–218, 1990). Attempts to assign each subject to a single major type were unsuccessful, whether by maximum subscale score, or membership of the upper quartile of a subscale distribution. Finally, we found that the questionnaire could be shortened from 70 to 25 items with little loss of internal reliability. We conclude that the SIRI has a number of shortcomings as currently formulated, but that it may serve as the basis for shorter instruments with superior internal and construct validity.
Article
This article introduces a new personality inventory dealing with self-regulation. This is in some ways the opposite of neuroticism, and measures personal autonomy or independence, particularly as far as emotional dependence is concerned. Our concern was the relation between self-regulation and health, and large samples of healthy men and women were tested and followed up to demonstrate high predictability of mortality from cancer, coronary heart disease and other causes of death from scores on the questionnaire. It was also demonstrated that psychological risk factors were largely independent from physical risk factors, and could be changed by behavioural-cognitive treatment, reducing mortality.
Article
An English translation of the Differentiation and Self-regulation extension scales has been used in conjunction with a reduced form of the Short Interpersonal Reactions Inventory (SIRI) in a sample of 2844 Australian twins aged over 50. Significant correlation was found between Type 1 (cancer-prone) and Type 2 (coronary heart disease prone), and between Self-regulation and Type 4 (healthy). The low correlations reported in other studies between the two alternative subscales of Type 4 are also observed. The Differentiation scales of Agitation and Inhibition were not found to significantly improve discrimination between Grossarth-Maticek's personality Type 1 and 2 subjects in this study.
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The relationship between personality and life span is not well understood, and no study to date has examined genetic influences underlying this relationship. The present study aimed to explore the phenotypic and genetic relationship between personality and life span, as well as genetic influences on all-cause mortality. Prospective community-based study including 3752 twin individuals older than 50 years. Neuroticism, psychoticism, extraversion, and social desirability and pessimism/optimism were measured at baseline using the Revised Eysenck Personality Questionnaire and the Revised Life Orientation Test, respectively. Information on age at death was obtained 16 years after the initial assessment of personality. Extraversion was inversely related to mortality with the risk of death decreasing 3% per unit increase of the extraversion score. Psychoticism and pessimism were positively related to mortality with a 36% and 39% increase in risk of death per unit increase in the respective personality score. Heritability of life span was 7%. Cross-twin cross-trait hazard ratios (HRs) were only significant for optimism/pessimism in monozygotic (MZ) twins with no significant differences in HRs between MZ and dizygotic twins in all traits; however, there was a trend for slightly higher HRs in MZ compared with dizygotic twins in psychoticism and optimism/pessimism. Extraversion, psychoticism, and optimism/pessimism are significant predictors of longevity; extraversion is associated with a reduction, and pessimism and psychoticism are associated with an increase in mortality risk. Genetic influences on longevity in Australian twins are very low (7%). Our data also suggest a small, albeit nonsignificant, genetic influence on the relationship of pessimism and psychoticism with life span.
Article
The findings of a repressed expression of emotions in cancer patients contributed to the hypothesis developed by Lydia Temoshok of a type C personality ('cancer-prone'). To the Authors' knowledge, the associations between the 'cancer-prone personality' characteristics in commitment test and the risk of breast cancer (BC) have rarely been considered together in a prospective study. In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for commitment test before any diagnostic procedures were carried out. The clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients and 28 individuals were shown to be healthy study subjects (HSS). The BC group reported significantly more commitment to own children (Function A) (mean Commitment score, 3.14) than the patients in the BBD group (mean Commitment score, 3.51) and in the HSS group (mean Commitment score, 3.77) (p=0.05). The women in the BC group also reported more commitment to own husband (Function B) (mean Commitment score, 3.30) than the patients in the BBD group (mean Commitment score, 3.83) and the patients in the HSS group (mean Commitment score, 3.76). The BC group reported significantly more commitment to own work and own body (Function D and G) (mean Commitment scores, 3.20 and 3.50) than the patients in the BBD group (mean Commitment scores, 3.75 and 3.71) or HSS group (mean Commitment scores, 3.46 and 3.50). The mean sum (mean, SD) of the scores were significantly lower in the BC group (31.1, 5.8) than in the BBD (35.2, 6.9) and HSS group (36.4, 5.6) (p=0.02), showing more commitment in the BC group. In summary, patients with BC tended to have an increased risk for bearing the 'high commitment' characteristic and this pattern could contribute to cancer risk through immune and hormonal pathways.
Article
A method based on the non-central chi-square distribution is developed for the calculation of sample sizes required to reject, with given probability, models of variation when they are 'wrong'. The method is illustrated with reference to simple alternative models of variation in MZ and DZ twins reared together. Simulation of twin experiments finds the empirical power in good agreement with that predicted by the method. Tables are produced showing the sample sizes required for 95 per cent rejection at the 5 per cent level of inappropriate models of variation. For equivalent cases it is always found easier to reject an inappropriate simple genetical model of variation than an inappropriate simple environmental model. For several frequently encountered cases, more than 600 pairs of twins would be required to reject inappropriate alternative models. The optimum proportion of MZ and DZ twins in a sample will vary with the 'true' model of variation but is most likely to be between two-thirds and one-half of DZ twin pairs. The possibility of detecting genetical non-additivity with the classical twin study is investigated by theoretical power calculations and simulation. In the absence of genotype-environment interactions, distributional skewness and mean-variance regression in DZ twins are found to be more powerful tests of directional dominance (or unequal gene frequencies) than the standard model fitting procedure and these tests may be worthwile in future studies.
Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).
Article
Alcohol consumption is a well-known risk factor for cancer, coronary heart disease (CHD), and various other diseases. It is here suggested that motivational factors may be important in mediating any effects of drinking on health. In particular, the hypothesis was tested that drinking to drown one's sorrows (S-type) was much more a risk factor than pleasure drinking (P-type). A total of 1,706 men were tested and followed for 13 years, when death and cause of death were established. The hypothesis was supported for all levels of drinking. In addition, subjects were divided into those 900 who were under stress at the beginning of the study and those 806 who were not. Stress and drinking combined in a complex fashion to form a risk factor for disease, and motivation combined with both in the predicted direction.
Article
The construction of a new Personality-Stress Inventory is discussed, based on previous research and other types of inventory constructed on the same principles. Scores on the inventory divide people into six types, selectively prone to different types of disease. The instrument is administered twice, with six months intervening, and changes in the inventory scores are prognostic of the probability of contracting different diseases. Evidence is presented to show the validity of the questionnaire and the method used.
Article
In this study, 6,386 males and 5,990 females, with a mean age of 55 years, constituting a random sample, were administered questionnaires by interviewers relating to amount of self-regulation and drinking status. They were then followed up over a 20-yr. period, and health status (living well, chronically ill, or deceased) was ascertained. It was hypothesized that the deleterious effect of alcohol would be worse for those low on self-regulation; that health status would be worse for those in whom drinking diminished self-regulation, as compared with those for whom drinking improved self-regulation; and that smoking would have greater effects in lowering health status in those in whom drinking diminished self-regulation than in those in whom drinking improved self-regulation. All predictions were borne out by the data at high statistical significance. The results confirmed findings from an earlier study to the effect that psychological factors like self-regulation powerfully influence the kind of effects drinking has with respect to health.
Article
Grossarth-Maticek and colleagues have shown, in their prospective studies, a strong relationship of their personality types, Types 1 and 2, to cancer and coronary heart disease (CHD), respectively. Relevant information is limited from replication studies, and little is known about psychosocial factors in relation to cancer or CHD in Japan. Subjects included 95 cases of lung cancer (LC), 94 cases of myocardial infarction (MI) and 596 controls. The controls were men and women who visited a clinic for a health checkup. The Grossarth-Maticek personality types, Types 1 to 6, were assessed using the Short Interpersonal Reactions Inventory. The distributions of the 6 personality types were compared between the case and control groups, adjusting for sex and age class. The relation of each of the 6 types to LC and MI were examined in terms of odds ratio, using a logistic regression model controlling for age, sex, job status, education level, and smoking status. As regards the distribution analysis, Types 1 and 2 in the LC and MI groups each were not more prevalent than the controls, respectively. High score of the Type 1 scale was associated with a statistically nonsignificant decrease in LC risk. MI risk was significantly, positively associated with the Type 2 and 5 scales, and unexpectedly, positively related to the Type 3 scale. The present findings partly supported the Grossarth-Maticek theory, but there remain some conflicting issues to be confirmed in future studies.
Article
Psychosocial factors have been reported to be independently associated with coronary heart disease. However, previous studies have been in mainly North American or European populations. The aim of the present analysis was to investigate the relation of psychosocial factors to risk of myocardial infarction in 24767 people from 52 countries. We used a case-control design with 11119 patients with a first myocardial infarction and 13648 age-matched (up to 5 years older or younger) and sex-matched controls from 262 centres in Asia, Europe, the Middle East, Africa, Australia, and North and South America. Data for demographic factors, education, income, and cardiovascular risk factors were obtained by standardised approaches. Psychosocial stress was assessed by four simple questions about stress at work and at home, financial stress, and major life events in the past year. Additional questions assessed locus of control and presence of depression. People with myocardial infarction (cases) reported higher prevalence of all four stress factors (p<0.0001). Of those cases still working, 23.0% (n=1249) experienced several periods of work stress compared with 17.9% (1324) of controls, and 10.0% (540) experienced permanent work stress during the previous year versus 5.0% (372) of controls. Odds ratios were 1.38 (99% CI 1.19-1.61) for several periods of work stress and 2.14 (1.73-2.64) for permanent stress at work, adjusted for age, sex, geographic region, and smoking. 11.6% (1288) of cases had several periods of stress at home compared with 8.6% (1179) of controls (odds ratio 1.52 [99% CI 1.34-1.72]), and 3.5% (384) of cases reported permanent stress at home versus 1.9% (253) of controls (2.12 [1.68-2.65]). General stress (work, home, or both) was associated with an odds ratio of 1.45 (99% CI 1.30-1.61) for several periods and 2.17 (1.84-2.55) for permanent stress. Severe financial stress was more typical in cases than controls (14.6% [1622] vs 12.2% [1659]; odds ratio 1.33 [99% CI 1.19-1.48]). Stressful life events in the past year were also more frequent in cases than controls (16.1% [1790] vs 13.0% [1771]; 1.48 [1.33-1.64]), as was depression (24.0% [2673] vs 17.6% [2404]; odds ratio 1.55 [1.42-1.69]). These differences were consistent across regions, in different ethnic groups, and in men and women. Presence of psychosocial stressors is associated with increased risk of acute myocardial infarction, suggesting that approaches aimed at modifying these factors should be developed.
Article
There is an enormous amount of literature on psychological stress and cardiovascular disease. This report reviews conceptual issues in defining stress and then explores the ramifications of stress in terms of the effects of acute versus long-term stressors on cardiac functioning. Examples of acute stressor studies are discussed in terms of disasters (earthquakes) and in the context of experimental stress physiology studies, which offer a more detailed perspective on underlying physiology. Studies of chronic stressors are discussed in terms of job stress, marital unhappiness, and burden of caregiving. From all of these studies there are extensive data concerning stressors' contributions to diverse pathophysiological changes including sudden death, myocardial infarction, myocardial ischemia, and wall motion abnormalities, as well as to alterations in cardiac regulation as indexed by changes in sympathetic nervous system activity and hemostasis. Although stressors trigger events, it is less clear that stress "causes" the events. There is nonetheless overwhelming evidence both for the deleterious effects of stress on the heart and for the fact that vulnerability and resilience factors play a role in amplifying or dampening those effects. Numerous approaches are available for stress management that can decrease patients' suffering and enhance their quality of life.
Smoking, personality and stress: Psychosocial factors in the prevention of cancer and coronary heart disease
  • H J Eysenck
Eysenck, H. J. (1991b). Smoking, personality and stress: Psychosocial factors in the prevention of cancer and coronary heart disease. New York: Springer-Verlag.
Personality and disease: Overview, review and preview
  • H S Friedman
Friedman, H. S. (1990). Personality and disease: Overview, review and preview. In H. S. Friedman (Ed.). Personality and disease (pp. 3-13). New York: Wiley.
  • J B Whitfield
J.B. Whitfield, et al. Personality and Individual Differences 157 (2020) 109797