Personality Traits Predict Emergency Department Utilization Over 3 Years in Older Patients
Open accessAbstract
Background Emergency department (ED) utilization by older patients has major implications for morbidity, mortality, and health costs, yet its behavioral determinants remain poorly understood. Powerfully tied to health in older adults, the "Big Five" personality traits of neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness may predict ED use.Objectives Investigate the role of personality in prospective ED use among older patients.Research design Prospective cohort.Subjects Adults aged 65 and older.Measures Participants completed the NEO Five Factor Inventory of personality at baseline, and interviewers administered the Cornell Services Index assessing ED use at baseline and 3 yearly follow-ups.Results Controlling for income, education, gender, age, physician-assessed medical burden and physical functioning, and interviewer-assessed impairments in basic activities of daily living and physical self-maintenance, and depression, lower agreeableness and higher extroversion were each associated with increased odds of an ED visit over the follow-up period. A 1 sample deviation (SD) increase in extroversion (i.e., 50th versus 83rd population percentile) increased the odds of ED use by 51% (adjusted odds ratio [AOR] [95% CI] = 1.51 [1.03-2.21], z = 2.12, N = 923, p = 0.034). A 1-SD decrease in agreeableness (i.e., 50th versus 17th population percentile) increased odds of ED use by 54% (AOR [95% CI] = 1.54 [1.05-2.22], z = -2.25, N = 923, p = 0.034).Conclusion The greater assertiveness and social confidence signified by lower agreeableness and higher extroversion may help older adults overcome potential barriers to the ED. Overly introverted and agreeable older adults may require special encouragement to access the ED--particularly for time--sensitive conditions--to reduce morbidity and mortality.
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Health service utilization determinants may include personality.
“An example is health service utilization, the many determinants of which [214] may include personality [215–217].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [217]
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Cites
Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?
Andersen, R. M. (1995) · Journal of Health and Social Behavior · doi:10.2307/2137284 · Cited by 9,831 · see citing works
An alternative "description of personality": The Big-Five factor structure.
Goldberg, L. R. (1990) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.59.6.1216 · Cited by 6,652 · see citing works
The structure of phenotypic personality traits.
Goldberg, L. R. (1993) · American Psychologist · doi:10.1037//0003-066x.48.1.26 · Cited by 4,816 · see citing works
The structure of phenotypic personality traits.
Goldberg, L. R. (1993) · American Psychologist · doi:10.1037/0003-066x.48.1.26 · Cited by 4,816 · see citing works
Indicators of socioeconomic position (part 1): Figure 1
Galobardes, B., Shaw, M., Lawlor, D. A., Lynch, J. W., & Smith, G. D. (2005) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2004.023531 · Cited by 2,880 · see citing works
Personality in Adulthood: A Five-Factor Theory Perspective
McCrae, R., & Costa, P. (2005) · doi:10.4324/9780203428412 · Cited by 2,355 · see citing works
CUMULATIVE ILLNESS RATING SCALE
Linn, B. S., Linn, M. W., & Gurel, L. (1968) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1968.tb02103.x · Cited by 2,319 · see citing works
Wilamowska (2010) · doi:10.1001/archpsyc.1988.01800320058007 · Cited by 2,115 · see citing works
Bogg, T., & Roberts, B. W. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.6.887 · Cited by 1,632 · see citing works
Nonlinear Models for Repeated Measurement Data
Young, D. A., Davidian, M., & Giltinan, D. M. (1997) · Journal of the American Statistical Association · doi:10.2307/2965730 · Cited by 1,226 · see citing works
Aminzadeh, F., & Dalziel, W. B. (2002) · Annals of Emergency Medicine · doi:10.1067/mem.2002.121523 · Cited by 1,119 · see citing works
Neuroticism, Somatic Complaints, and Disease: Is the Bark Worse than the Bite?
Costa, P. T., & McCrae, R. R. (1987) · Journal of Personality · doi:10.1111/j.1467-6494.1987.tb00438.x · Cited by 1,010 · see citing works
Indicators of socioeconomic position (part 2)
Galobardes, B., Shaw, M., Lawlor, D. A., Lynch, J. W., & Smith, G. D. (2006) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2004.028092 · Cited by 649 · see citing works
Long‐Term Relations of Personality and Health: Dynamisms, Mechanisms, Tropisms
Friedman, H. S. (2000) · Journal of Personality · doi:10.1111/1467-6494.00127 · Cited by 514 · see citing works
Personality judgment: A realistic approach to person perception.
Funder, D. C. (1999) · Cited by 472 · see citing works
Nonlinear models for repeated measurement data: An overview and update
Davidian, M., & Giltinan, D. M. (2003) · Journal of Agricultural Biological and Environmental Statistics · doi:10.1198/1085711032697 · Cited by 418 · see citing works
Validation of a Measure of Physical Illness Burden at Autopsy: The Cumulative Illness Rating Scale
Conwell, Y., Forbes, N. T., Cox, C., & Caine, E. D. (1993) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1993.tb05945.x · Cited by 355 · see citing works
The Use of the Karnofsky Performance Scale in Determining Outcomes and Risk in Geriatric Outpatients
Crooks, V. C., Waller, S., Smith, T., & Hahn, T. J. (1991) · Journal of Gerontology · doi:10.1093/geronj/46.4.m139 · Cited by 336 · see citing works
Heritabilities of Common and Measure-Specific Components of the Big Five Personality Factors
Loehlin, J. C., McCrae, R. R., Costa, P. T., & John, O. P. (1998) · Journal of Research in Personality · doi:10.1006/jrpe.1998.2225 · Cited by 329 · see citing works
Weiss, A., & Costa, P. T. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000181272.58103.18 · Cited by 311 · see citing works
Raad, D. B., & Perugini, M. (2002) · Hogrefe Publishing eBooks · Cited by 248 · see citing works
The five-factor model of personality as a framework for personality-health research.
Marshall, G. N., Wortman, C. B., Vickers, R. R., Kusulas, J. W., & al, E. (1994) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.67.2.278 · Cited by 243 · see citing works
Honda, K., & Jacobson, J. S. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2004.05.001 · Cited by 208 · see citing works
Determinants of Emergency Department Visits by Older Adults: A Systematic Review
McCusker, J., Karp, I., Cardin, S., Durand, P. J., & Morin, J. (2003) · Academic Emergency Medicine · doi:10.1197/s1069-6563(03)00539-6 · Cited by 207 · see citing works
The five-factor model of personality as a framework for personality-health research.
Marshall, G. N., Wortman, C. B., Vickers, R. R., et al. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.67.2.278 · Cited by 185 · see citing works
Neuroticism, Extraversion, and Mortality in a Defined Population of Older Persons
Wilson, R. S., Krueger, K. R., Gu, L., Bienias, J. L., de Leon, C. F. M., & Evans, D. A. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000190615.20656.83 · Cited by 184 · see citing works
Personality, health, and aging: prolegomenon for the next generation
Smith, T. W., & Spiro, III (2002) · Journal of Research in Personality · doi:10.1016/s0092-6566(02)00014-4 · Cited by 118 · see citing works
Duberstein, P. R., Sörensen, S., Lyness, J. M., King, D. A., Conwell, Y., Seidlitz, L., & Caine, E. D. (2003) · Psychology and Aging · doi:10.1037/0882-7974.18.1.25 · Cited by 118 · see citing works
Self-citationThe Cornell Service Index as a Measure of Health Service Use
Sirey, J. A., Meyers, B. S., Teresi, J. A., BRUCE, M. L., Ramirez, M. M., Raue, P. J., PERLICK, D. A., & Holmes, D. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.12.1564 · Cited by 91 · see citing works
Personality and Medical Illness Burden Among Older Adults in Primary Care
Chapman, B. P., Lyness, J. M., & Duberstein, P. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3180313975 · Cited by 86 · see citing works
Self-citationMental health service utilization in the United States
Goodwin, R. D., Hoven, C. W., Lyons, J. S., & Stein, M. B. (2002) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-002-0563-6 · Cited by 84 · see citing works
ten Have, M., Oldehinkel, A. J., Vollebergh, W., & Ormel, J. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0916-z · Cited by 76 · see citing works
The effects of neuroticism and extraversion on self-assessed health and health-relevant cognition
Williams, P., O'Brien, C. D., & Colder, C. R. (2003) · Personality and Individual Differences · doi:10.1016/j.paid.2003.08.001 · Cited by 74 · see citing works
Parboosingh, E. J., & Larsen, D. E. (1987) · Medical Care · doi:10.1097/00005650-198712000-00003 · Cited by 71 · see citing works
Emergency Department Utilization by Noninstitutionalized Elders
Shah, M. N., Rathouz, P. J., & Chin, M. H. (2001) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2001.tb01303.x · Cited by 66 · see citing works
Self-citationA Comprehensive Model of Stress
de Jong, G. M., van Sonderen, E., & Emmelkamp, P. M. G. (1999) · Psychotherapy and Psychosomatics · doi:10.1159/000012346 · Cited by 61 · see citing works
Personality and Perceived Health in Older Adults: The Five Factor Model in Primary Care
Chapman, B. P., Duberstein, P. R., Sörensen, S., & Lyness, J. M. (2006) · The Journals of Gerontology: Series B · doi:10.1093/geronb/61.6.p362 · Cited by 58 · see citing works
Self-citationUse of Health Services by Medically Ill Depressed Elderly Patients After Hospital Discharge
Koenig, H. G., & Kuchibhatla, M. N. (1999) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-199902000-00007 · Cited by 51 · see citing works
Soo Borson, B., Bartels, S. J., Colenda, C. C., Gottlieb, G. L., & Meyers, B. S. (2001) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200108000-00002 · Cited by 50 · see citing works
Medical Illness Burden, Trait Neuroticism, and Depression in Older Primary Care Patients
Lyness, J. M., Duberstein, P. R., King, D. A., Cox, C., & Caine, E. D. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.7.969 · Cited by 47 · see citing works
Self-citationDubois, M., Raı̂che, M., Hébert, R., & Gueye, N. R. (2007) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.12.011 · Cited by 29 · see citing works
Personality correlates of outpatient mental health service utilization
McWilliams, L. A., Cox, B. J., Enns, M. W., & Clara, I. P. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0040-8 · Cited by 20 · see citing works
Use of Health Services by Medically Ill Depressed Elderly Patients After Hospital Discharge
Koenig, H. G., & Kuchibhatla, M. N. (1999) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-199924710-00007 · Cited by 11 · see citing works
Personality Factors in Mental Disorders of Later Life
Seidlitz, L. (2001) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200102000-00003 · Cited by 7 · see citing works
Special Issue on Mental Health Services Research
Bartels, S. J., & Unützer, J. (2003) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200309000-00002 · Cited by 4 · see citing works
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Research works printed but not linked: 1
- [33]Lawton MP Brody EM Instrumental activities of daily living (iadl) scale—self-rated version Psychopharmacol Bull 1988 24 789 791 3249786
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Sorted by citations
Chapman, B. P., Roberts, B., & Duberstein, P. (2011) · Journal of Aging Research · doi:10.4061/2011/759170 · Cited by 283 · see citing works
Self-citationPersonality, Socioeconomic Status, and All-Cause Mortality in the United States
Chapman, B. P., Fiscella, K., Kawachi, I., & Duberstein, P. R. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwp323 · Cited by 198 · see citing works
Self-citationPersonality traits and preventive cancer screenings in the health retirement study
Aschwanden, D., Gerend, M. A., Luchetti, M., Stephan, Y., Sutin, A. R., & Terracciano, A. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2019.105763 · Cited by 42 · see citing works
- Authors
- Chapman, B. P., Shah, M., Friedman, B., Drayer, R., Duberstein, P. R., & Lyness, J. M.
- Affiliations
- University of Rochester Medicine (US)
- Corresponding author
- Chapman, Benjamin P.
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 17
- Issue
- 6
- Pages
- 526-535
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC2745738
- OpenAlex
- W2135156283
- Cited by
- 41
- References
- 46
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 5
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01mh061429-05)
- National Institute on Aging (K08AG031328, L30 AG031021)
- National Institute of Mental Health (R01 MH-61429, R01 MH-061429, T32MH073452)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- emergency department utilization, older adults, Big Five personality traits, extraversion, agreeableness, neuroticism, conscientiousness, openness to experience, health care utilization
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Emergency Service, Hospital, Female, Forecasting, Hospitals, University, Humans, Male, New York, Personality, Personality Inventory, Prospective Studies, Severity of Illness Index, Socioeconomic Factors, Cohort Studies, Karnofsky Performance Status
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