Department of Psychiatry, University of Rochester Medical Center.
Oregon Research Institute.
Dev Psychol. 2014 May;50(5):1426-41. doi: 10.1037/a0034135. Epub 2013 Aug 26.
We describe 2 frameworks in which personality dimensions relevant to health, such as Conscientiousness, can be used to inform interventions designed to promote health aging. First, contemporary data and theory do not suggest that personality is "immutable," but instead focus on questions of who changes, in what way, why, when, and how. In fact, the notion that personality could be changed was part and parcel of many schools of psychotherapy, which suggested that long-term and meaningful change in symptoms could not be achieved without change in relevant aspects of personality. We review intervention research documenting change in personality. On the basis of an integrative view of personality as a complex system, we describe a bottom-up model of change in which interventions to change basic personality processes eventuate in changes at the trait level. A 2nd framework leverages the descriptive and predictive power of personality to tailor individual risk prediction and treatment, as well as refine public health programs, to the relevant dispositional characteristics of the target population. These methods dovetail with, and add a systematic and rigorous psychosocial dimension to, the personalized medicine and patient-centeredness movements in medicine. In addition to improving health through earlier intervention and increased fit between treatments and persons, cost-effectiveness improvements can be realized by more accurate resource allocation. Numerous examples from the personality, health, and aging literature on Conscientiousness and other traits are provided throughout, and we conclude with a series of recommendations for research in these emerging areas.
我们描述了两种框架,在这两种框架中,与健康相关的人格维度,如尽责性,可以用来为旨在促进健康老龄化的干预措施提供信息。首先,当代的数据和理论并不认为人格是“不可改变的”,而是关注谁会改变、以何种方式、为什么、何时以及如何改变的问题。事实上,人格可以改变的观点是许多心理治疗学派的核心部分,这些学派认为,如果不改变人格的相关方面,就不可能实现症状的长期和有意义的改变。我们回顾了证明人格改变的干预研究。基于人格作为一个复杂系统的综合观点,我们描述了一种自下而上的改变模型,其中改变基本人格过程的干预措施最终导致特质水平上的改变。第二种框架利用人格的描述和预测能力来定制个体风险预测和治疗,以及根据目标人群的相关性格特征来改进公共卫生计划。这些方法与医学中的个性化医疗和以患者为中心的运动相吻合,并为其增加了系统和严格的社会心理维度。除了通过早期干预和增加治疗与患者之间的适应性来改善健康外,还可以通过更准确的资源分配来实现成本效益的提高。整篇文章提供了许多来自人格、健康和老龄化文献中关于尽责性和其他特质的例子,最后我们提出了一系列关于这些新兴领域研究的建议。