Personality in relation to health, psychosocial work environment and occupational health intervention adherence

Sammanfattning: Background: Personality is a well-studied topic within psychology and it has intrigued scientists and philosophers for centuries. It is a broad, complex and multidimensional phenomenon that constitute individuals’ typical behavioral patterns. One of the fields within personality psychology studies the relationships between personality, health and disease. Although the complete mechanisms have not been fully established, the associations with health and disease can be both direct or indirect through dysfunctional and unhealthy and risk-taking behaviors. Personality can also influence how health is perceived and reported. In addition, the current knowledge is mainly based on assessments of broad personality dimensions. Therefore, a better understanding of more specific and precise health-relevant personality traits could help clarify the mechanisms in more detail. Personality has also been found to be associated with various aspects of the psychosocial work environment, such as job satisfaction, stress and work performance, but no studies have investigated health-relevant personality traits in this context. Organizations may implement interventions, such as stress management or health promotion initiatives with the best intentions. However, there is limited knowledge about which interventions work for whom and why. Therefore, there is a need to better understand the characteristics of those who do and do not utilize (adhere to) an intervention. This knowledge could be used improve pedagogic features of the interventions and implementation procedures in order to optimize adherence. Aim: The overall aim of this thesis was to examine possible associations between healthrelevant personality traits and indicators of health, psychosocial work environment and occupational health intervention adherence. The specific aims of the four papers included in this thesis are stated below. Paper I aimed to investigate health-relevant personality in relation to one aspect of health, or ill-health, namely sensitivity to sound (hyperacusis). Paper II aimed to explore possible associations and differences in mean values between employee health-relevant personality traits and assessments of the psychosocial work environment and leadership behaviors. Paper III aimed to investigate possible associations between health-relevant personality traits and adherence to a web-based occupational health intervention. Paper IV aimed to investigate health-relevant personality traits in relation to health-related variables and indicators of the psychosocial work environment, using repeated assessments over time. The paper also investigated if these personality traits could predict changes in perceptions of health and psychosocial work environment over time. Methods: The present thesis is based on three separate studies and populations. Personality was assessed with the Health-relevant 5 inventory (HP5i) in all papers. Health-relevant personality consist of the following five traits: Hedonic capacity (a facet of Extraversion), Negative affectivity (a facet of Neuroticism), Antagonism (a facet of Agreeableness), Impulsivity (a facet of Conscientiousness) and Alexithymia (a facet of Openness). Papers I and II had cross-sectional designs whereas Papers III and IV had longitudinal designs. Sensitivity to sound (hyperacusis) in Paper I was assessed using questionnaires and the clinical test uncomfortable loudness levels. Perceptions of the psychosocial work environment and leadership behavior in Paper II were assessed using questionnaires. In Paper III, adherence to the web-based occupational health and stress management intervention was assessed using the number of logins, time spent logged in, and utilization of self-help exercises. This information was collected through database logs. In Paper IV, repeated measures with questionnaires were utilized to assess health, well-being, stress and aspects of the psychosocial work environment over time. Main findings: Health-relevant personality traits were associated with all the tested outcomes. In Paper I, those with higher levels of negative affectivity were more likely to suffer from hyperacusis. Higher levels of negative affectivity increased the odds (OR) of having hyperacusis on average 4.6 times for men and 2.4 times for women. Paper II found correlations between HP5i, perceived psychosocial work environment and leadership behaviors. More specifically, hedonic capacity correlated positively with perceptions of the psychosocial work environment and leadership behavior. Those with high levels of this trait had better perceptions compared to those with lower levels of hedonic capacity. Negative correlations were found for negative affectivity, antagonism, impulsivity and alexithymia. This implies that those with higher levels of negative affectivity, etc. had worse perceptions of the psychosocial work environment and leadership behavior compared to those with lower levels of that trait. In Paper III, higher levels of antagonism and impulsivity were associated with fewer logins to the intervention, whereas higher levels of negative affectivity were associated with higher utilization of self-help exercises. Alexithymia negatively predicted the use of self-help exercises, whereas antagonism was a positive predictor. Negative affectivity positively predicted time spent logged in. Paper IV found that health-relevant personality traits were associated with repeated measures of health, well-being, stress and indicators of the psychosocial work environment. Some of these changes over time were partly explained by higher levels of negative affectivity. Health-relevant personality traits also predicted individuals’ typical ratings of these health and psychosocial work environment indicators. Moreover, the repeated measures displayed seasonal variations over time. Conclusions: The results of Papers I – IV illustrate that health-relevant personality traits, to some extent, are associated with indicators of health and the psychosocial work environment. Although some of these associations have been previously studied, the present thesis clearly illustrates that the findings are systematic and consistent for different samples and using both cross-sectional and longitudinal designs. Hence, health-relevant personality traits should be considered in clinical practice, both when assessing and interpreting results from questionnaires and when optimizing the design and implementation procedures for occupationa