Health, Wealth and Happiness

Question 1

What is validity generalisation and what should it take into account?

Answer 1

Predicting job performance from tests
Performance and training
Within job changes - through technology and promotion

Question 2

Give an example of task analysis in general practice being used for selection.

Answer 2

Patterson, Ferguson et al. (2000) used the Critical Interview Technique (CIT) and consultations to evaluate GPs’ performance and how it related to personality. Found strong evidence for a competency model comprising 11 categories (e.g. empathy and communication skills), implying that a greater account of personal attributes needs to be considered in recruitment and training, rather than focusing on academic and clinical competency alone. This implication was supported by Patterson, Ferguson et al. (2005), who developed a competency based selection system to recruit GP registrars, which they found had job performance predictive validity and that those recruited by the competency system performed better than those selected by traditional methods.

Question 3

Outline the relationship between personality and illness.

Answer 3

Not everyone responds to illness in the same way, and some health outcomes can be explained by individual differences. According to Ferguson et al. (2013), personality affects the illness process through affecting bodily sensations, symptom reporting, associative processes, stress and coping, social cognitions, pathogenesis and communication, ultimately affecting mortality.

Question 4

What are some of the main methods of studying symptom reporting?

Answer 4

Viral challenge studies - best evidence:
- Expose half to pathogen, half to placebo
- Keep in isolation
- Examine for 1-2 weeks - medical examination, blood tests etc.
Quasi-experiments:
- Examine people at high and low stress e.g. students at exam time and holidays (within)
Case control designs:
- Compare high stressed to low stressed groups (between)

Question 5

What did Feldman et al. (1999) do?

Answer 5

A viral challenge study (50% of participants given a virus and observed and measured for objective and subjective markers of illness. Found that:

• High N = report more and more severe symptoms whether or not they’re actually ill
• High O = report more symptoms than low O only when symptoms are objectively present
• High C linked to illness reporting but not symptom reporting
• 25% variance of symptom reporting from actually having a cold

Question 6

What did Larsen (1992) study?

Answer 6

Encoding and/or recall of symptoms.

Question 7

What were the phases of Larsen (1992)’s experiment?

Answer 7

1. Encoding phase (had subjects record symptoms each day for 3 months)
2. Recall phase (had subjects recall number and severity of symptoms from past 3 months)

Question 8

What did Larsen (1992) find?

Answer 8

People high in N recall symptoms as worse than they actually were.

Question 9

Outline Lazarus’ transactional model of coping.

Answer 9

1 - Primary Appraisal – Is the situation threatening/challenging?
2 - Secondary Appraisal – Is it controllable, what can I do?
3 - Coping – What do I do?
4 - Outcome
Personality impacts all of these
High in N – more likely to negatively appraise situation

Question 10

What did Ferguson et al. (2006) state about personality and occupational stress?

Answer 10

N both indirectly and directly influences future symptom reports
More likely to see job as stressful - more likely to then report symptoms

Question 11

What did Connor-Smith & Flachsbart (2007) state about coping?

Answer 11

E, C and O are linked to overall engagement coping strategies (e.g. problem solving and goal setting) which are generally beneficial to health and more likely to solve problem.
N is associated with disengagement strategies (e.g. substance use) which aren’t beneficial to health.

Question 12

How does conditioned sickness work?

Answer 12

Basic Pavlovian conditioning model for illness. Symptom reporting becomes condition on environmental triggers

Question 13

What have lab studies on odours and illness found?

Answer 13

Learning stage - pair odour and symptoms (enriched in CO2 and release odour)
Odour not noticeable, CO2 causes respiratory problems
Test phase - odour causes symptoms
Effect stronger for those high in N

Question 14

What have field based studies on odours and illness found?

Answer 14

Using Gulf war syndrome, assess odour severity and duration (and sounds) and symptoms each day

• Find lagged effects for odour severity
  
  • More severe odours ‘cause’ increased symptoms on subsequent day.

Question 15

Define pathogenesis.

Answer 15

The mechanism that causes a disease.

Question 16

What did Marsland et al. (2001) find?

Answer 16

Higher trait negative affect among people with low antibody responses compared to those with high antibody responses.

Question 17

What did Cohen et al. (2003) find?

Answer 17

Positive affect is related to better sleep and diet and lower cortisol, negative affect is related to the opposite.
High negative affect - greater reporting of symptoms but not more actual colds
Positive affect - fewer actual colds and fewer symptoms

Question 18

What is ‘Type D’ personality?

Answer 18

Distressed - defined by high negative affect (NA) and social inhibition (SI) trait scores.
Linked to heart disease and cancer

Question 19

Are the different personality domains risk factors or protective in terms of mortality risk?

Answer 19

C, O and E are protective, while N and low A are risk factors. However their risk/ protective value is much lower than the effects of smoking or inactivity.

Question 20

What are the outcomes of symptom reporting?

Answer 20

Disease verification - signs, symptoms
Covariates - age, time of year, nutrition etc. all affect susceptibility and progression of diseases
Sub-clinical and clinical infection - may have infection but no symptoms
Counts or Reactivity to Antigen - number of immune cells and their reactivity

Question 21

What abilities positively correlate with job performance and training

Answer 21

Cognitive abilities, perceptual, numerical, verbal, spatial

Question 22

Which personality traits predict job performance?

Answer 22

All positive correlation except for N

Conscientiousness is biggest predicter but still smaller than cognitive abilities (.25 vs .48)

Question 23

What outcome are we trying to predict when selecting who should study medicine?

Answer 23

What are the qualities of a good doctor?

Identify these qualities and how to assess them in ways which are fair and conform to equal opportunities laws

Question 24

Predicting Medical School Performance - Ferguson et al. 2000; 2003

Answer 24

Conscientiousness is initially a positive predictor of exams but as the role changes and become less order and more stressful it becomes a negative predictor
Positive correlation for pre-clinical, negative correlation for clinical
Need flexibility of thinking and quick decision making in clinical setting – application of knowledge
A Levels only predict early exam performance and not clinical ability
Personal statements had no predictive validity

Question 25

Ferguson et al. 2014 - PloS One

Answer 25

IQ enhance GCSE and Pre-clinical performance
Conscientiousness enhance A level (.17) and pre-clinical performance (.15) but inhibits clinical knowledge (-.27)
A little anxiety enhances clinical skills – Emotional stability to clinical skills (-.15)

Question 26

Patterson, Ferguson et al. 2005

Answer 26

Found core skills of being a GP
Selection those that demonstrate these skills
Criteria put into place in 2006
Criteria:
Empathy and sensitivity
Communication skills
Problem solving
Professional integrity
Coping with pressure
Clinical expertise

Question 27

Training in Medicine: Ultrasound-Guided Regional Anaesthesia - Shafqat, Ferguson et al. 2015

Answer 27

Use needle to deliver anaesthesic using ultrasound as a guide
Can assess ability using mental rotation task
Turkey breast task - perform UGRA while observed for errors and good performance
Those who have good mental rotation skills perform well in UGRA task
However, if select based on mental rotation skills - known gender bias

Question 28

Compliance - Molloy, O’Carroll, & Ferguson 2014

Answer 28

Compliance in taking medication
Various traits and circumstances impact com-pliance:
Conscientiousness
Social support
Marriage
Depression

Question 29

Personality traits and pathogenesis

Answer 29

High in N - lower antibody responses, not as good at fighting disease

Question 30

Links between behaviours and personality traits

Answer 30

N - traffic risk
E - exercise, sex
O - drug-taking, sex
A - accident control
C - wellness behaviours

Question 31

What are the mechanisms of IQ relating to health behaviours?

Answer 31

Physical and social disadvantage
Physiological system integrity
Health behaviours
Entry to safe jobs

Question 32

Links between IQ, personality and lifespan

Answer 32

High C live longer - 2/3 years
High IQ live longer - 5 years
Positive attitude to aging - 8 years
Having a plant to look after - 2 years
High N die sooner