Lifetime trauma, personality traits, and health: A pathway to midlife health status.

OBJECTIVE: This study investigated whether lifetime experience of trauma is related to personality through instrumental and reactive trait processes, and whether lifetime trauma is a mechanism underlying the association between childhood conscientiousness and objectively assessed adult physical health. METHOD: Participants (N = 831) were 442 women and 389 men from the Hawaii longitudinal study of personality and health. Teacher assessments of personality were obtained when the participants were in elementary school. Self-reported adult personality assessments, lifetime histories of trauma experience, and objectively assessed physiological dysregulation were obtained between ages 45-55. RESULTS: Women tended to report more high-betrayal trauma than men, whereas men reported more low-betrayal trauma than women. Women who were judged by their teachers to be less agreeable and less conscientious in childhood reported more lifetime trauma, suggesting instrumental trait processes. For both genders, neuroticism and openness/intellect/imagination in adulthood, but not in childhood, were associated with lifetime trauma, suggesting reactive trait processes. For both genders, trauma experience was correlated with dysregulation and with Body Mass Index (BMI). The indirect paths from childhood conscientiousness to adult dysregulation and BMI through total teen and adult trauma were significant for women, but not for men (indirect effect for women's dysregulation = -.025, p = .040, 95% confidence interval [CI] = -.048, -.001; indirect effect for women's BMI = -.037, p = .009, 95% CI = -.067, -.008). CONCLUSION: Teen and adult trauma experience appears to be a hitherto unidentified mechanism in women underlying the association between conscientiousness and health. (PsycINFO Database Record

Harsh Environments, Life History Strategies, and Adjustment: A Longitudinal Study of Oregon Youth.

We modeled the effects of harsh environments in childhood on adjustment in early emerging adulthood, through parenting style and the development of fast Life History Strategies (LHS; risky beliefs and behaviors) in adolescence. Participants were from the Oregon Youth Substance Use Project (N = 988; 85.7% White). Five cohorts of children in Grades 1-5 at recruitment were assessed through one-year post high school. Greater environmental harshness (neighborhood quality and family poverty) in Grades 1-6 predicted less parental investment at Grade 8. This parenting style was related to the development of fast LHS (favorable beliefs about substance users and willingness to use substances at Grade 9, and engagement in substance use and risky sexual behavior assessed across Grades 10-12). The indirect path from harsh environment through parenting and LHS to (less) psychological adjustment (indicated by lower life satisfaction, self-rated health, trait sociability, and higher depression) was significant (indirect effect -.024, p = .011, 95% CI = -.043, -.006.). This chain of development was comparable to that found by Gibbons et al. (2012) for an African-American sample that, unlike the present study, included perceived racial discrimination in the assessment of harsh environment.

A Big Five approach to self-regulation: personality traits and health trajectories in the Hawaii longitudinal study of personality and health.

Self-regulatory processes influencing health outcomes may have their origins in childhood personality traits. The Big Five approach to personality was used here to investigate the associations between childhood traits, trait-related regulatory processes and changes in health across middle age. Participants (N = 1176) were members of the Hawaii longitudinal study of personality and health. Teacher assessments of the participants' traits when they were in elementary school were related to trajectories of self-rated health measured on 6 occasions over 14 years in middle age. Five trajectories of self-rated health were identified by latent class growth analysis: Stable Excellent, Stable Very Good, Good, Decreasing and Poor. Childhood Conscientiousness was the only childhood trait to predict membership in the Decreasing class vs. the combined healthy classes (Stable Excellent, Stable Very Good and Good), even after controlling for adult Conscientiousness and the other adult Big Five traits. The Decreasing class had poorer objectively assessed clinical health measured on one occasion in middle age, was less well-educated, and had a history of more lifespan health-damaging behaviors compared to the combined healthy classes. These findings suggest that higher levels of childhood Conscientiousness (i.e. greater self-discipline and goal-directedness) may prevent subsequent health decline decades later through self-regulatory processes involving the acquisition of lifelong healthful behavior patterns and higher educational attainment.

Prospective Predictors of Novel Tobacco and Nicotine Product Use in Emerging Adulthood.

PURPOSE: The purpose of this study was to investigate whether risk factors for cigarette smoking assessed in adolescence predict the use of novel tobacco and nicotine products (hookah, little cigars, and e-cigarettes) in early emerging adulthood. METHODS: In a longitudinal study (N = 862), risk factors were measured in middle and high school, and novel product use was measured in emerging adulthood (mean age 22.4 years). Structural equation modeling was used to test a model predicting lifetime use of any of hookah, little cigars, and e-cigarettes in early emerging adulthood from distal predictors (gender, maternal smoking through Grade 8; already tried alcohol, cigarettes, or marijuana by Grade 8; and sensation seeking at Grade 8) and potential mediators (intentions to smoke cigarettes, drink alcohol or smoke marijuana at Grade 9, and smoking trajectory across high school). RESULTS: The most prevalent novel tobacco product was hookah (21.7%), followed by little cigars (16.8%) and e-cigarettes (6.6%). Maternal smoking, having already tried substances, and sensation seeking each predicted the use of at least one of these products via an indirect path through intentions to use substances and membership in a high-school smoking trajectory. CONCLUSIONS: Risk factors for cigarette smoking were found to predict novel tobacco use, suggesting that interventions to prevent cigarette smoking could be extended to include common novel tobacco products.

Personality Stability from Childhood to Midlife: Relating Teachers' Assessments in Elementary School to Observer- and Self-Ratings 40 Years Later.

We report on the longitudinal stability of personality traits across an average 40 years in the Hawaii Personality and Health Cohort relating childhood teacher assessments of personality to adult self- and observer- reports. Stabilities based on self-ratings in adulthood were compared to those measured by the Structured Interview for the Five-Factor Model (SIFFM; Trull & Widiger, 1997), and trait ratings completed by interviewers. Although convergence between self-reports and observer-ratings was modest, childhood traits demonstrated similar levels of stability across methods in adulthood. Extraversion and Conscientiousness generally showed higher stabilities, whereas Neuroticism showed none. For Agreeableness and Intellect/Openness, stability was highest when assessed with observer-ratings. These findings are discussed in terms of differences in trait evaluativeness and observability across measurement methods.

Smoking trajectories across high school: sensation seeking and Hookah use.

INTRODUCTION: This study investigated the associations of trajectories of cigarette smoking over the high school years with the prior development of childhood sensation seeking and the subsequent use of cigarettes and hookah at age 20/21. METHODS: Participants (N = 963) were members of a cohort-sequential longitudinal study, the Oregon Youth Substance Use Project. Sensation seeking was assessed across 4th-8th grades and cigarette smoking was assessed across 9th-12th grades. Cigarette and hookah use was assessed at age 20/21 for 684 of the 963 participants. RESULTS: Four trajectory classes were identified: Stable High Smokers (6%), Rapid Escalators (8%), Experimenters (15%), and Stable Nonsmokers or very occasional smokers (71%). Membership in any smoker class versus nonsmokers was predicted by initial level and growth of sensation seeking. At age 20/21, there was a positive association between smoking and hookah use for Nonsmokers and Experimenters in high school, whereas this association was not significant for Stable High Smokers or Rapid Escalators. CONCLUSIONS: Level and rate of growth of sensation seeking are risk factors for adolescent smoking during high school (Stable High Smokers, Rapid Escalators, and Experimenters), suggesting the need for interventions to reduce the rate of increase in childhood sensation seeking. For those who were not already established smokers by the end of high school, hookah use may have served as a gateway to smoking.

Smokeless tobacco cessation in military personnel: a randomized controlled trial.

INTRODUCTION: Military personnel are twice as likely as civilians to use smokeless tobacco (ST). This study evaluated the efficacy of a minimal-contact ST cessation program in military personnel. METHODS: Participants were recruited from 24 military dental clinics across the United States during annual dental examinations. Participants were 785 active-duty military personnel who were randomly assigned to receive a minimal-contact behavioral treatment (n = 392) or usual care (n = 393). The behavioral treatment included an ST cessation manual, a videotape cessation guide tailored for military personnel, and three 15-min telephone counseling sessions using motivational interviewing methods. Usual care consisted of standard procedures that are part of the annual dental examination, including recommendations to quit using ST and referral to extant local tobacco cessation programs. Participants were assessed at 3 and 6 months after enrollment. RESULTS: Participants in the ST cessation program were significantly more likely to be abstinent from all tobacco, as assessed by repeated point prevalence at both 3 and 6 months (25.0%), and were significantly more likely to be abstinent from ST use for 6 months, as assessed by prolonged abstinence (16.8%), compared with participants in usual care (7.6% and 6.4%, respectively). DISCUSSION: These results indicate that a minimal-contact behavioral treatment can significantly reduce ST use in military personnel and has the potential for widespread dissemination. If ST users were identified in dental visits and routinely referred to telephone counseling, this could have a substantial benefit for the health and well-being of military personnel.

Women helping chewers: Effects of partner support on 12-month tobacco abstinence in a smokeless tobacco cessation trial.

INTRODUCTION: Social support has been relatively unstudied in smokeless tobacco cessation research; partner support could encourage quitting, buffer the stress of quitting and withdrawal, and counteract tobacco cues. METHODS: Using 12-month follow-up data, we examined the impact of social support provided by female partners (n = 328) of male participants in a smokeless tobacco cessation program. RESULTS: The ratio of positive support to negative support that participants reported receiving from their partners was significantly related to point prevalence 12-month tobacco abstinence (odds ratio [OR] = 1.43, 95% CI = 1.11-1.84, p < .01)-a finding consistent with the 6-month follow-up-and it was related to repeated point prevalence tobacco abstinence at both 6 and 12 months (OR = 1.43, 95% CI = 1.09-1.88, p < .05). DISCUSSION: These 12-month follow-up results provide additional evidence that partner support can help encourage long-term tobacco abstinence among participants in smokeless tobacco cessation programs.

Childhood predictors of adolescent marijuana use: early sensation-seeking, deviant peer affiliation, and social images.

This study examined psychosocial mechanisms by which children's early sensation-seeking may influence their later marijuana use. In a longitudinal study, 4th and 5th grade elementary school children (N=420) were followed until they were in 11th and 12th grades in high school with annual or biennial assessments. Sensation-seeking (assessed over the first 4 assessments) predicted affiliating with deviant peers and level of favorable social images of kids who use marijuana (both assessed over the subsequent 3 assessments). Affiliation with deviant peers and the growth in social images predicted marijuana use in 11th and 12th grades. Affiliation with deviant peers mediated the effect of early sensation-seeking on subsequent marijuana use. The theoretical and applied significance of this influence of early sensation-seeking is discussed.

The effect of subjective normative social images of smokers on children's intentions to smoke.

This paper expands the literature on peers' influence on a youth's behaviors through the examination of the effect of subjective normative social images of smokers (perceived peers' social images of smokers) on subsequent intentions to smoke and the relation between subjective normative social images and the youth's own social images, or prototypes. Data are from the two oldest cohorts (4th and 5th graders at the first assessment) and from the first five assessments of the Oregon Youth Substance Use Project, an ongoing longitudinal study. Results showed that both children's subjective normative social images and prototypes uniquely predicted intentions to smoke cigarettes at the subsequent assessment. Across time, subjective normative social images were more positive than the youth's own prototypes, and subjective normative social images and children's own prototypes were reciprocally related over time. Results provide support for subjective normative social images as a risk factor for children's smoking and suggest targeting this mechanism in smoking prevention programs for children.

The effect of early cognitions on cigarette and alcohol use during adolescence.

The present study predicts cigarette and alcohol use in adolescence from the development of children's cognitions in the elementary years. Using latent growth modeling, the authors examined a model using data from 712 participants in the Oregon Youth Substance Use Project, who were in the 2nd through 5th grade at the 1st assessment and followed for 6 annual or semiannual assessments over 7 years. Growth in children's prototypes and subjective norms in the elementary years (Times 1 through 4) were related to their substance use in adolescence (Time 6) through their willingness and intentions (Time 5) to smoke and drink. Across the sample, for both substances, the intercept and slope of prototypes were either indirectly related to use through willingness or directly related to use. Both the intercept and slope of subjective norms were indirectly related to use of both substances through both willingness and intentions and directly related to cigarette use. Results suggest that elementary children have measurable cognitions regarding substance use that develop during the elementary years and predict use later in adolescence. These findings emphasize the need for prevention programs targeted at changing children's social images of substance users and encouraging more accurate perceptions of peers' use.

Predictors of the development of elementary-school children's intentions to smoke cigarettes: hostility, prototypes, and subjective norms.

Children's intentions to smoke are reliable predictors of subsequent smoking and precede smoking initiation; thus identifying predictors of intentions is important for preventing or delaying smoking initiation. Children's hostility and sociability, mediated by the development of prototypes (i.e., social images of children who smoke cigarettes) and subjective norms regarding smoking among peers, were expected to predict the development of their intentions to smoke cigarettes in the future. Children in 2nd through 5th grades (N = 809) from a western Oregon community participated in a longitudinal study. Hostility and sociability were assessed by teachers' ratings, and prototypes, subjective norms, and intentions were assessed by self-report at each of the first four annual assessments. Children's intentions to smoke predicted whether they had tried cigarettes by the fifth assessment. For both genders, latent growth modeling demonstrated that hostility, but not sociability, predicted the development of smoking intentions. Children who were more hostile were more likely to have higher initial levels of intentions to smoke, and for boys this effect was mediated by their higher initial levels of subjective norms about smoking. Sociability was not related to the development of smoking cognitions for boys or girls. These results are discussed in terms of opportunities to intervene in early influences on smoking intentions.

Trait Stability and Continuity in Childhood: Relating Sociability and Hostility to the Five-Factor Model of Personality.

We investigated the continuity of personality constructs in the Oregon Youth Substance Use Project, a cohort-sequential study encompassing development from early childhood to adolescence with five annual or biennial assessments. Sociability and Hostility, assessed by teachers' ratings of children's behaviors at each assessment, were related to the traits comprising the Five-Factor model assessed by teachers' ratings at the fifth assessment. Confirmatory factor analysis demonstrated that Sociability and Hostility were reliably measured at each assessment, and these constructs were relatively stable over time (mean rank-order stability coefficients over intervals of 1-5 years were .50 and .43, respectively). Sociability was most strongly associated (positively) with Extraversion, and Hostility was most strongly associated (negatively) with Conscientiousness and Emotional Stability. No differences were found for younger versus older children. Implications for measuring childhood personality traits using teachers' reports of early childhood behavior are discussed.

Personality predictors of the development of elementary school children's intentions to drink alcohol: the mediating effects of attitudes and subjective norms.

The authors tested a mediation model in which childhood hostility and sociability were expected to influence the development of intentions to use alcohol in the future through the mediating mechanisms of developing attitudes and norms. Children in 1st through 5th grades (N=1,049) from a western Oregon community participated in a longitudinal study involving 4 annual assessments. Hostility and sociability were assessed by teachers' ratings at the 1st assessment, and attitudes, subjective norms, and intentions were assessed by self-report at all 4 assessments. For both genders, latent growth modeling demonstrated that sociability predicted an increase in intentions to use alcohol over time, whereas hostility predicted initial levels of these intentions. These personality effects were mediated by the development of attitudes and subjective norms, supporting a model wherein childhood personality traits exert their influence on the development of intentions to use alcohol through the development of these more proximal cognitions.

Cost effectiveness of changing health professionals' behavior: training dental hygienists in brief interventions for smokeless tobacco cessation.

OBJECTIVE: Disseminating effective interventions to health care professionals is a critical step in ensuring that patients receive needed advice and materials. This cost effectiveness analysis compared two methods of disseminating an effective protocol for smokeless tobacco cessation intervention. METHOD: Interested dental hygienists (N = 1051) were recruited in 20 Western and Midwestern U.S. communities and randomized by community to receive workshop training, self-study with mailed materials, and delayed self-study training, in 1996-98. Hygienists were surveyed about their smokeless tobacco-related activities with patients at baseline and post-intervention. Data on intervention costs were collected, and incremental costs per unit of behavior change were calculated. RESULTS: Self-study was more cost effective than workshop training under a wide range of assumptions: change in group versus individual behavior, hygienists' time and travel costs included or excluded, and hygienist wage rates at the national median or substantially lower. However, workshops may be as cost effective in producing behavior change among hygienists earning wages substantially higher than the national median. CONCLUSION: Self-study may be a more cost effective method than workshops to achieve behavior change among motivated health professionals.

Personality traits, perceived risk, and risk-reduction behaviors: a further study of smoking and radon.

Personality traits and risk perceptions were examined as predictors of changes in smoking behavior. Participants (N = 697) were part of a randomized controlled trial of interventions to reduce exposure to the combined hazard of radon and cigarette smoke. Participants with higher perceived risk at baseline for the combination of smoking and radon were more likely to have a more restrictive household smoking ban in place at 12-month follow-up (p < .05). Risk perceptions also predicted reductions in the total number of cigarettes smoked in the home for participants in the video intervention who had high or moderate levels of extraversion (p < .01). Greater perceived risk predicted whether highly or moderately conscientious women quit smoking (p < .05). The moderating effects of personality traits should be considered when evaluating risk-reduction interventions.

Assessing perceptions of synergistic health risk: a comparison of two scales.

Two approaches to measuring perceptions of synergistic risk were compared, one using the traditional Likert scale, the other using an anchored, relative scale. Perception of synergistic risk was defined as rating the combined hazard as more risky than each of its constituent single hazards. In a within-subjects design, a convenience sample from the community (N= 604) rated three hazard combinations and their constituents: Driving while Intoxicated (familiar, high synergy), Radon and Smoking (unfamiliar, high synergy), and Smoking and Driving (familiar, low synergy), on both scales. The relative scale was expected to be a more sensitive measure of synergy than the Likert scale. The effects of item order (single hazards rated first versus combined hazards rated first) were examined between subjects. Driving while Intoxicated was perceived by the large majority of participants as a synergistic risk on both scales, but neither of the other two combined hazards were rated synergistically on either scale. The relative scale demonstrated a slight advantage over the Likert scale, and presenting the single hazards first for the relative scale produced more synergistic ratings. It is recommended that anchored, relative scales be used to measure synergy and that single hazards be presented prior to the combined hazards when using relative scales.

Women helping chewers: partner support and smokeless tobacco cessation.

Data from 363 male smokeless tobacco users and their romantic partners were analyzed to discern the role of support in cessation. Women reported playing a part in enrollment (71%), and more than half examined program materials or discussed cessation activities with the chewers. Women's reports of delivered support correlated substantially with men's experience of received support. Men's received positive support predicted abstinence at 6-month follow-up (odds ratio = 1.29, confidence interval = 1.03-1.61) and more than 24 hr of abstinence for those still using tobacco at 6 months (odds ratio = 1.75, confidence interval = 1.30-2.36) and moderated the effect of baseline depression and addiction on abstinence. Women played a major role through all stages of cessation.