Evaluating the causal primacy of the five-factor model of personality in relation to health status, physician utilization, restriction of activities, health behaviours, and negative life events

Korotkov, Dave (2000) Evaluating the causal primacy of the five-factor model of personality in relation to health status, physician utilization, restriction of activities, health behaviours, and negative life events. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Two questions were posed in this dissertation: first, to what extent is the Five-Factor Model of Personality related to health status, illness behaviour, and sick-role behaviour? And second, how are the five factors connected to these variables, through stress moderation, mediation, both moderation and mediation, or neither? To answer these questions, eight non-process and process models were developed. For each of the four non-process models, two of the models included statistical controls and personality by personality interaction terms. The process or path models were similarly constructed: two models were constructed with controls and personality by life stress product-terms while the remaining two omitted the latter variables. Questionnaire data were gathered from 706 adults (Mean Age = 37 years) in a two-wave prospective study. The participants were administered a 79-item trait adjective checklist to measure the five factors, a measure of negative life stress, the Alameda Country Health Practices Index, a demographics questionnaire, and 10 measures of health status, illness behaviour, and sick-role behaviour Principle Components .Analyses at waves one and two reduced the health and health-related measures to three interpretable components: General Health. Physician Utilization, and Restriction of Activities. Multiple regression and observed variable path analyses (i.e.. structural equation modelling: EQS) were used to analyze the models. The multiple regression analyses suggested that (1) despite some redundancy, the five factors were found to be related to health status independently as opposed to interactively. (2) the relationships found between the five factors and health status were found more often with the subjective or well-being measures of health status. and (3) these latter relationships were attenuated when the wave one controls, specifically the autoregressive variables, were implemented. However, the five factors (e.g.. openness to experience, neuroticism. extraversion) were still variously related to a number of well- being measures (e.g.. general health). The regression analyses highlight the importance of accounting for other variables when interpreting correlational data. -- The results from the path analyses indicated that the five-factors had little effect on the mediators and health status variables when the outcome was objective (e.g.. number of chronic conditions) and when the controls were implemented. However, neuroticism was consistently related to greater levels of life stress and general health despite the controls. When the models were evaluated without the controls, four of the five factors had an additive effect on health status (i.e.. general health): no personality by life events interactions were observed save for an openness to experience by stress interaction: however, this interaction disappeared when the controls were taken into account. The control variable stress/health behaviour mediator model was found to be the most parsimonious model. -- Based on the results from the path analyses, two new models were constructed from the control variable stress/health behaviour mediator model and the no control variable stress/health behaviour mediator model. In general, the results suggested that neuroticism may directly and indirectly impact on health status, illness behaviour, and sick-role behaviour, depending on whether control variables are incorporated into the models. The findings support Stone and Costa. Jr/s (1990) notion of the distress-prone personality. Little support was found for Booth-Kewley and Friedman's (1987) disease-prone personality model. -- While the present study replicated several past researches, it also shed new light on the complexities associated with the use of a multivariate model of personality* set within a biopsychosocial context. Future research will need to further the usefulness of the five- factor model of personality in stress-health research programs.

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