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Validity of the Grossarth-Maticek and Eysenck personality-stress model of disease: An empirical prospective cohort study
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.
... Frontiers in Psychology 08 frontiersin.org behaviors and reactions to psychosocial stress and physical wellbeing (Hernández and Froján, 2005;Whitfield et al., 2020). The healthy personality to psychosocial stress demonstrated causal relationships with the three enneatypes of the combative social style (types 3, 7, and 8) which is identified by problem solving, active coping style, assertiveness, and greater identity with the self, compared to the other personal styles of the Enneagram (Nettmann, 2013). ...
Introduction
Enneagram typologies may impact psychological well-being and stressful situations in college students. However, the literature is still limited in the study of dynamic personality models such as the Enneagram in Spanish-speaking university students, and a better understanding is needed.
Objective
To analyze network associations and centrality measures of Enneagram personality typologies in Peruvian university students.
Methods
A total of 859 Peruvian university students responded to two instruments assessing: The Pangrazzi’s Enneagram personality types and healthy personality to psychosocial stress. All instruments showed good psychometric values (validity and consistency). A regularized cross-sectional network structure was estimated with Gaussian graphical model and the graphical LASSO.
Results
Enneagram types 4, 5, and 6 presented the highest and positive associations in the network structure. Type 6 emerged as the node with the highest predictability. The healthy personality and type 7 acted as bridges between the communities, with types 6, 7, and 8 being the most central nodes.
Conclusion
The findings suggest that Enneagram type 7 with healthy personality to psychosocial stress plays an important role in the development of the causal activation of the network model. The network shows causal associations between psychosocial stress and types 6, 7, 8, and 9.
... 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. ...
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. ...
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.
During the 1980s and 1990s, Hans J Eysenck conducted a programme of research into the causes, prevention and treatment of fatal diseases in collaboration with one of his protégés, Ronald Grossarth-Maticek. This led to what must be the most astonishing series of findings ever published in the peer-reviewed scientific literature with effect sizes that have never otherwise been encounterered in biomedical research. This article outlines just some of these reported findings and signposts readers to extremely serious scientific and ethical criticisms that were published almost three decades ago. Confidential internal documents that have become available as a result of litigation against tobacco companies provide additional insights into this work. It is suggested that this research programme has led to one of the worst scientific scandals of all time. A call is made for a long overdue formal inquiry.
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.
Background:
The putative role of personality in cancer risk has been controversial, and the evidence remains inconclusive.
Methods:
We pooled data from six prospective cohort studies (British Household Panel Survey; Health and Retirement Study; Household, Income, and Labour Dynamics in Australia; Midlife in the United Survey; Wisconsin Longitudinal Study Graduate; and Sibling samples) for an individual-participant meta-analysis to examine whether personality traits of the Five Factor Model (extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience) were associated with the incidence of cancer and cancer mortality in 42 843 cancer-free men and women at baseline (mean age 52.2 years, 55.6% women).
Results:
During an average follow-up of 5.4 years, there were 2156 incident cancer cases. In random-effects meta-analysis adjusted for age, sex, and race/ethnicity, none of the personality traits were associated with the incidence of all cancers or any of the six site-specific cancers included in the analysis (lung, colon, breast, prostate, skin, and leukaemia/lymphoma). In the three cohorts with cause-specific mortality data (421 cancer deaths among 21 835 participants), none of the personality traits were associated with cancer mortality.
Conclusions:
These data suggest that personality is not associated with increased risk of incident cancer or cancer-related mortality.
In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD. Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive. Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD. Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study. Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.
In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD.
• Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD.
• Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort–reward imbalance and job loss is inconclusive.
• Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD.
• Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes.
• Acute emotional stress may trigger MI or takotsubo (“stress”) cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low.
• Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study.
• Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning.
• Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.
https://www.mja.com.au/journal/2013/199/3/psychosocial-risk-factors-coronary-heart-disease
With the rise of cultural diversity in populations, researchers are faced with new issues, such as working with participants from other cultures that speak different languages. This research note presents a methodology developed by R. J. Vallerand (1989) in the psychological field that translates and validates questionnaires and inventories developed for a specific culture. This cross-cultural technique has 7 steps and insures that the instrument will provide data that are valid and reliable in the targeted population. The 7 steps are defined, and examples of results from a study using this methodology are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Solid scientific evidence supporting the adverse effects of stress on
health began to emerge nearly 30 years ago with the report by Rosenman et
al1 showing that men with type A behavior (time
urgency, hostility, achievement striving) were twice as likely as their counterparts
with type B behavior (lacking type A characteristics) to develop coronary
heart disease (CHD) over an 8-½ year period.1 Failure
to replicate this finding in another large-scale prospective study2 raised questions about the validity of type A behavior
as a CHD risk factor. However, subsequent research makes a strong case that
of the 3 components of the global type A behavior pattern, hostility is the
one most reliably associated with increased CHD risk.3- 5
Extract: In this study, we have looked at the long-term health effects of a type of stress probably more severe than any yet studied in this connection, namely being sent to a Hitlerian concentration camp, living there for a lengthy period of time, and having members of one's family killed. There are many written testimonies to the incredible sufferings of concentration camp inmates, and there can be no doubt about the high stress level imposed by starvation, torture, and the constant threat of death, combined with fear for the fate of loved ones. Theory would predict that such a high degree of stress would produce a high level of cancer and coronary heart disease, and our study was designed to test this hypothesis.
This study examines the predictive accuracy of four different methods of administration of a questionnaire designed to predict cancer and coronary heart disease (CHD) in healthy probands. The method of administration uses the establishment of trust and the explanation of questions as variables in all four possible combinations, i.e. trust and explanation, trust only, explanation only, and neither, the prediction being that the combination of trust and explanation would produce the most accurate prediction, the treatment using neither the worst prediction, with methods using either trust alone or explanation alone intermediate. The criterion was the successful prediction of cancer and CHD. A total population of 3563 men and women was used, and followed up over 15 years, death certificates being used to establish cause of death. As predicted, the combination of trust and explanation did best, use of neither worst. Explanation seemed more important than trust, and the combination seemed to have a synergistic effect. It is apparent that method of administration had an important effect on the outcome of the experiment.
To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants.
Prospective cohort study (Whitehall II study). At the baseline examination (1985-8) and twice during follow up a self report questionnaire provided information on psychosocial factors of the work environment and coronary heart disease. Independent assessments of the work environment were obtained from personnel managers at baseline. Mean length of follow up was 5.3 years.
London based office staff in 20 civil service departments.
10,308 civil servants aged 35-55 were examined-6895 men (67%) and 3413 women (33%).
New cases of angina (Rose questionnaire), severe pain across the chest, diagnosed ischaemic heart disease, and any coronary event.
Men and women with low job control, either self reported or independently assessed, had a higher risk of newly reported coronary heart disease during follow up. Job control assessed on two occasions three years apart, although intercorrelated, had cumulative effects on newly reported disease. Subjects with low job control on both occasions had an odds ratio for any subsequent coronary event of 1.93 (95% confidence interval 1.34 to 2.77) compared with subjects with high job control at both occasions. This association could not be explained by employment grade, negative affectivity, or classic coronary risk factors. Job demands and social support at work were not related to the risk of coronary heart disease.
Low control in the work environment is associated with an increased risk of future coronary heart disease among men and women employed in government offices. The cumulative effect of low job control assessed on two occasions indicates that giving employees more variety in tasks and a stronger say in decisions about work may decrease the risk of coronary heart disease.
Some 8059 healthy women (mean age 58 years) were studied in 1973 with the aim of establishing the presence or absence of a variety of physical and psychological risk factors for mammary cancer. Mortality was established in 1988. factor predictors were highly significant. Physical risk factors were more predictive than psychological ones, but both interacted synergistically to predict mortality. Alone, psychological (stress) factors had little effect, while-physical factors did. However, psychological factors seemed to potentiate the effect of physical factors, particularly in the middle range. The causal relevance of psychological factors was established in a special intervention study using autonomy training as a method of prophylactic therapy and comparing outcome with the effects of no therapy (control).
A study was carried out with 501 persons to analyze the predictive capacity of various psychosocial variables-symptom perception, neuroticism, Personality Types 2 and 4 of Grossarth-Maticek and Eysenck, beliefs about health, social support, or certain coping styles-on two health-related behaviors: the frequency of visits to the doctor and self-medication. The results were analyzed by two structural equation models that revealed that some of the variables have direct effects on the behaviors, whereas other variables, such as attribution style, coping styles, or the impact of the stressors, have indirect effects via the reported symptoms or neuroticism. In addition, self-medication and the frequency of health service visits are independent of each other, which shows that their determinants are different. It is concluded that to address these factors in the two health indicators, it is also necessary to take in account the psychosocial variables considered herein.
Majority of studies on personality and physical health have focused on one or two isolated personality traits. We aim to test the independent association of 10 personality traits, from three major conceptual models, with all-cause and cause-specific mortality in the French GAZEL cohort.
A total of 14,445 participants, aged 39-54 in 1993, completed the personality questionnaires composed of the Bortner Type-A scale, the Buss-Durkee Hostility Inventory (for total, neurotic and reactive hostility) and the Grossarth-Maticek-Eysenck Personality Stress Inventory that assesses six personality types [cancer-prone, coronary heart disease (CHD)-prone, ambivalent, healthy, rational, anti-social]. The association between personality traits and mortality, during a mean follow-up of 12.7 years, was assessed using the Relative Index of Inequality (RII) in Cox regression.
In models adjusted for age, sex, marital status and education, all-cause and cause-specific mortality were predicted by 'total hostility', its 'neurotic hostility' component as well as by 'CHD-prone', 'ambivalent' 'antisocial', and 'healthy' personality types. After mutually adjusting personality traits for each other, only high 'neurotic hostility' remained a robust predictor of excess mortality from all causes [RII = 2.62; 95% confidence interval (CI) = 1.68-4.09] and external causes (RII = 3.24; 95% CI = 1.03-10.18). 'CHD-prone' (RII = 2.23; 95% CI = 0.72-6.95) and 'anti-social' (RII = 2.13; 95% CI 0.61-6.58) personality types were associated with cardiovascular mortality and with mortality from external causes, respectively, but CIs were wider. Adjustment for potential behavioural mediators had only a modest effect on these associations.
Neurotic hostility, CHD-prone personality and anti-social personality were all predictive of mortality outcomes. Further research is required to determine the precise mechanisms that contribute to these associations.
We have tested the hypothesis in this study that different methods of administering a questionnaire produce differential approximations to truthful admission of undesirable personality traits and behaviours. Four different methods of administration produced different levels of trust and understanding, using the current prediction among healthy subjects of death by cancer or coronary heart disease 13 years later as the criterion. There were significant differences in the accuracy of the predictions, depending crucially on the method of administration of the questionnaires. Best predictions were achieved for subjects when both trust and understanding had been increased by interviewers’ suitable participation; worst results were achieved for subjects when no special effort was made to increase either. Intermediate results were found for procedures which increased either trust or understanding. It is argued that the success or failure of studies investigating the influence of personality and stress on diseases like cancer and coronary heart disease may depend crucially on the adopted method of interrogation.
This volume strives to give oncologists and other medical practitioners a thorough picture of the oncology patient. It’s designed to show that psychological needs of the patient are an important aspect that should be considered for optimizing the effects of cancer treatment, no less than genetic, immunological, physiological and other medical features that are often considered as necessary components of personalized medicine. Using evidence-based information, the book describes the different ways cancer touches upon a person’s life, including emotional, physical, and social changes, important decisions, and support structure. It also details the phases every cancer patient encounters along the way, from getting tested and waiting for the diagnosis, to treatments, survival, and confronting one’s mortality.
Psycho-oncology for the Clinician will serve to contribute to the further scientific development of psycho-oncology, expand its use as a treatment modality, strengthen its status as an essential component of cancer care, and promote the acceptance of psycho-oncology as the new evidence-based constituent of personalized medicine in oncology.
Extraversion has been recognized as a major personality variable in contemporary psychological writings. It may be viewed as a personality dimension that describes a number of more specific personality traits, ranging from sociability and liveliness to dominance and adventure seeking. Extraversion is thought to have a biological basis associated with both cortical arousal and the dopaminergic system. The lower level of cortical arousal and the lower dopaminergic responsiveness found in extraverts is used to explain their greater need for activity, excitement, and general stimulation. Extraversion has been linked with a wide range of human behaviors, from academic achievement and occupational performance to antisocial behaviors and risk taking.
Objective
Large-scale prospective studies do not support an association between neuroticism and extroversion with cancer incidence. However, research on other personality constructs is inconclusive. This longitudinal study examined the associations between four personality measures, Type 1, "suppressed emotional expression"; Type 5, "rational/antiemotional"; hostility; and Type A with cancer incidence.Methods
Personality measures were available for 13,768 members in the GAZEL cohort study (baseline assessment in 1993). Follow-up for diagnoses of primary cancers was obtained from January 1, 1994 to December 31, 2009. Associations between personality and cancer incidence were evaluated using Cox proportional hazards analyses and adjusted for potential confounders.ResultsDuring a median follow-up of 16.0 years (range, 9 days-16 years), 1139 participants were diagnosed as having a primary cancer. The mean duration between baseline and cancer diagnosis was 9.3 years. Type 1 personality was associated with a decreased risk of breast cancer (hazard ratio per standard deviation = 0.81, 95% confidence interval = 0.68-0.97, p = .02). Type 5 personality was not associated with prostate, breast, colorectal, or smoking-related cancers, but was associated with other cancers (hazard ratio per standard deviation = 1.17, 95% confidence interval = 1.04-1.31, p = .01). Hostility was associated with an increased risk of smoking-related cancers, which was explained by smoking habits, and Type A was not associated with any of the cancer endpoints.Conclusions
Several personality measures were prospectively associated with the incidence of selected cancers. These links may warrant further epidemiological studies and investigations about potential biobehavioral mechanisms.
This study attempts to investigate the relationship between personality, stress and disease, particularly cancer and cardiovascular disease, both from the correlational and the causal points of view. It is concluded that there is good ecidence linking these diseases with different patterns of personality, and that these links suggest a causal relation. Hypotheses are suggested as to the nature of these causal relations, and it is also suggested that these hypotheses can be used to good advantage in constructing effective methods of behaviour therapy, both prophylactic and curative.
The aim of this study was to scrutinize the relationship between personality type as described by Grossarth-Maticek and Eysenck, health-related behaviours, and indicators of transitory ill health in a community sample. The sample consisted of all per sons aged 40 years (45 men and 35 women) in a Swedish municipality who agreed to take part in a health examination at the primary health care centre of the municipality. The Short Interpersonal Reactions Inventory (Grossarth-Maticek and Eysenck, 1990) was used to measure personality type. Self-report data were obtained regarding seven health-related behaviours. Health was assessed in three ways; self-report (paper and pencil), self-report (interview response to physician), and measures of 36 biological variables including immune system indicators. The allocation of persons to the different personality types proved problematic using the established methods. By combining the types, according to Eysenck's personality model, and performing a cluster analysis on this combination, a ‘healthy’ and a ‘stressed’ profile were identified within both the male and the female group of subjects. Persons in the healthy personality cluster showed more favourable scores on the health-related behaviour indices and on the self-report health scales than the persons in the stressed cluster. They also tended to score lower than those in the stressed cluster on most of the biological markers known to increase during acute stress. The possibility that this implies a higher level of strain for the persons in the stressed cluster on various bodily systems is discussed.
Measures of hardiness and the health typology of Grossarth-Maticek and Eysenck (Grossarth-Maticek, R., & Eysenck, H. J. (1990). Personality, stress, and disease: description and validation of a new inventory. Psychological Reports, 66, 355–373) were administered to 94 Iranian managers along with scales recording stress and psychopathology. Hardiness displayed expected and sometimes strong linkages with the health types. Control, for example, correlated −0.62 (p<0.001) with the coronary-prone type. Of the hardiness factors, Commitment served as the most reliable predictor of four stress measures, with relationships ranging from −0.21 (p<0.01) to −0.36 (p<0.001). Commitment and Control also predicted lower depression and anxiety, with linkages of −0.20 (p<0.05) to −0.44 (p<0.001). Among the health types, the coronary-prone scale yielded the strongest pattern of results, displaying hypothesized relationships with three of four stress and four of five psychopathology measures. These correlations ranged from 0.18 (p<0.05) to 0.32 (p<0.01). These data most importantly demonstrated that constructs developed in the West for understanding the role of personality in stress and health apparently have a cross-cultural validity in Iran as well.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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