ABSTRACT

The aim of this study was to compare the relationship between two health outcomes (pain and self-reported health) and personality while accounting for heterogeneity in arthritic disease. Traditionally health research has treated patients’ disease experiences as homogeneous but stratified medicine suggests that doing so might over-generalise findings and miss important effects. We present a longitudinal analysis over 14 years, on a subsample of 443 arthritic respondents from the English Longitudinal Study of Ageing (ELSA). Using linear regressions, we modelled how the Big Five domains of personality (wave 5) moderated the relationship between past (at wave 1) and present health (at wave 7). Then, to model heterogeneity in arthritis experience we included assignment to 4 different sub-groups based on their experience of pain progression. The results showed that modelling heterogeneity led to the identification of specific stratified effects for personality (neuroticism, agreeableness, and extraversion) not observed when these data are treated as homogenous. Higher agreeableness was associated with worse pain for those in a sub-group reporting the greatest pain, and higher extraversion was protective against pain among those whose pain improved. The results highlight the importance of modelling heterogeneity of disease.

摘要

本研究的目的是比较两种健康结果（疼痛和自我报告的健康）与人格之间的关系，同时考虑关节炎疾病的异质性。传统上，健康研究将患者的疾病经历视为同质但分层的医学表明这样做可能会过度概括研究结果并错过重要影响。我们对来自英国老龄化纵向研究 (ELSA) 的 443 名关节炎受访者的子样本进行了 14 年的纵向分析。使用线性回归，我们模拟了人格的大五域（第 5 波）如何调节过去（第 1 波）和现在的健康（第 7 波）之间的关系。然后，为了模拟关节炎经历的异质性，我们根据疼痛进展的经历将其分配到 4 个不同的亚组。结果表明，建模异质性导致识别出在将这些数据视为同质数据时未观察到的人格（神经质、宜人性和外向性）的特定分层效应。对于报告最大疼痛的亚组中的那些人来说，更高的宜人性与更严重的疼痛相关，而更高的外向性对疼痛改善的那些人具有保护作用。结果强调了建模疾病异质性的重要性。在疼痛改善的人中，更高的外向性可以防止疼痛。结果强调了建模疾病异质性的重要性。在疼痛改善的人中，更高的外向性可以防止疼痛。结果强调了建模疾病异质性的重要性。