The Role of Frontline Leaders in Building Health Professional Support for a New Patient Portal: Survey Study.

BACKGROUND: Effective leadership and change management are thought to contribute to the successful implementation of health information technology innovations. However, limited attention has been paid to the role of frontline leaders in building health professional support for new technical innovations. OBJECTIVE: First, we examined whether frontline leaders' positive expectations of a patient portal and perceptions of its implementation were associated with their support for the portal. Second, we explored whether leaders' positive perceptions influenced the same unit's health professional support for the portal. METHODS: Data were collected through an online survey of 2067 health professionals and 401 frontline leaders working in 44 units from 14 health organizations in Finland. The participating organizations run a joint self-care and digital value services project developing a new patient portal for self-management. The survey was conducted before the piloting and implementation of the patient portal. RESULTS: The frontline leaders' perception of vision clarity had the strongest association with their own support for the portal (ß=.40, P<.001). Results also showed an association between leaders' view of organizational readiness and their support (ß=.15, P=.04). The leaders' positive perceptions of the quality of informing about the patient portal was associated with both leaders' own (ß=.16, P=.02) and subordinate health professionals' support for the portal (ß=.08, P<.001). Furthermore, professional participation in the planning of the portal was positively associated with their support (ß=.57, P<.001). CONCLUSIONS: Findings suggest that assuring good informing, communicating a clear vision to frontline leaders, and acknowledging organizational readiness for change can increase health professional support for electronic health (eHealth) services in the pre-implementation phase. Results highlight the role of frontline leaders in engaging professionals in the planning and implementation of eHealth services and in building health professionals' positive attitudes toward the implementation of eHealth services.

Social relationships in physicians' work moderate relationship between workload and wellbeing-9-year follow-up study.

Background: Increasing wellbeing problems among physicians may lead to serious consequences in health care and means to prevent such development are called for. This study examined longitudinal associations between workload and changes in distress, sleep quality and workability in physicians and whether positive social relations at work would protect from such problems. Methods: A baseline survey was conducted in 2006 for a random sample of 5000 physicians (n = 2841, response rate 57%). In 2015, the follow-up survey was sent to those 2 206 physicians who gave their consent (n = 1462, response rate 68.3%). The survey included scales for distress, sleeping problems, workability, workload, team climate, collegial support and questions for background information. Results: Increased workload was associated with increased psychological distress, sleeping problems and decreased workability during the 9-year follow-up. Good team climate and collegial support were related to decreased distress and sleep quality and enhanced workability. Good collegial support buffered the associations of workload changes on distress and sleep quality changes. Team climate was more strongly associated with changes in sleep quality and workability among younger and middle aged physicians than older physicians. Also collegial support had a stronger association with sleep quality change among younger or middle aged physicians than older physicians. These associations were robust to adjustments for age, gender, specialization, leadership position, marital status and baseline wellbeing. Conclusions: Health care organizations should take measures to decrease workload and to increase availability of social support for physicians in order to protect physicians from declining wellbeing.

Professionals' self-rated quality of care and its relation to competence, national guidelines and policies - a cross-sectional study among Finnish elderly care workers.

BACKGROUND: In the future, elderly care workers need to have competence of various different conditions due to greater amount of multimorbid elderly. Further, knowledge of national level guidelines is important since they are closely linked to improving quality of care and implementing better practices at work places. The impact of national level guidelines on quality of care at care units is, however, not widely examined in the Finnish context. In this study, the aim was to find out if worker's experience of his/her own competence is associated with quality of care. Secondly, we aimed to see how common is addressing national guidelines and policies at workplaces, and if they are associated with quality of care. Thirdly, we aimed to see whether there are differences between different occupational statuses in competence and addressing national guidelines and policies. METHODS: Total number of respondents was 1997 from 273 different units. Xtreg procedure was used for examining the associations of age, occupational status, unit type, professional competence and addressing the guidelines and policies with quality of care. RESULTS: Higher grade for QoC was associated with age, supervisor position, working in institutionalized care, better competence in supporting the self-determination of a person with memory disorders and falls prevention and addressing the act for elderly care and memory policy. CONCLUSION: This study demonstrated that national policies and guidelines are not widely addressed among Finnish elderly care workers. The study also showed that experienced competence of workers and discussion of policies and guidelines are related to quality of care. Especially competence related to memory disorders was associated with higher QoC. However, the relationship between quality of care and things influencing it seems complex and a major part of the variation in QoC remained unexplained. Although the relationships between guidelines, competences and quality of care are weak, national policies and competences seem to have impact on actual care provided. Therefore, sufficient time to address the guidelines should be provided at workplace and competences developed, which can be seen as a supervisor's task. With knowledge about the guidelines, workers are able to change their practices at work places.

Accumulation of Depressive Symptoms and Carotid Intima-Media Thickness: the Cardiovascular Risk in Young Finns Study.

BACKGROUND: The association between depressive symptoms and subclinical atherosclerosis has been inconsistent. PURPOSE: We sought to replicate our previous study, which demonstrated a positive relation between depressive symptoms and subclinical atherosclerosis assessed with carotid intima-media thickness (IMT) in men, using a newer measurement of carotid IMT and a cumulative loading of depressive symptoms over three follow-ups. METHODS: The sample comprised 996 adults (352 men) aged 30 to 45 years in 2007 from a prospective population-based Finnish sample. The participants completed a modified version of Beck Depression Inventory in 1992, 1997, and 2001. Carotid IMT was assessed with ultrasound in 2001 and 2007. Cardiovascular risk factors (i.e., body mass index, systolic blood pressure, low-density lipoprotein cholesterol, and smoking) were measured in childhood (1980) and in adulthood (2007). RESULTS: We found no association between the accumulative depression index and carotid IMT before or after controlling for the traditional risk factors (all p values ≥0.67). Depressive symptoms did not predict IMT progression over two time points and the highest level of carotid wall thickening. Imputed and non-imputed data sets provided similar results. Results remained the same when men and women were analyzed separately. Additional analyses revealed no significant interactions between depressive symptoms and cardiovascular risk factors (i.e., body mass index and systolic blood pressure) on carotid IMT (all p values >0.15). CONCLUSIONS: The findings of this population-based study did not indicate any direct association between depressive symptoms and carotid IMT in asymptomatic, young adults.

Frequency of visits and examinations in the Public Dental Service in Finland - a retrospective analysis, 2001-2013.

BACKGROUND: This study aimed to investigate longitudinally examination and visiting patterns in the Finnish Public Dental Service (PDS) and to relate these to patients' treatment needs and international recommendations on examination intervals. METHODS: Data on patients and their dental visits in the period 2001-2013 were collected from five municipal PDS-units serving a total population of 320,000 inhabitants and using the same database system. Ethical approval was given by the National Institute for Health and Welfare (THL) and permissions to use local data by the directors of health services in each unit. For each year, the numbers of visitors, those examined and those in need of basic periodontal or caries treatment (CPI >2 and D + d > 0) were calculated separately for young people (< 18 years), the working-aged (18-64 years) and the elderly (65+ years). Each individual's examination and visiting intervals were counted. Multilevel modelling was used to study probabilities of being examined or in need of treatment and differences in examination and visiting intervals between groups and over time. RESULTS: From 2001 to 2013, the number of visitors increased by 39.3% and the working-aged became the biggest patient group rather than the young. Compared with adults, the young were five times more likely to be examined (OR = 4.97) and three times less likely to require treatment (OR = 0.31). On average, 37% of the young, 73% of the working-aged and 63% of the elderly needed basic treatment. Multi-level analysis showed that the young had the shortest examination intervals and the working aged the longest (0.50 years longer). Most examination intervals of the young and the elderly were 1 year (65.2 - 77.0%), but only half (49.5%) of the working-aged were re-examined within 1 year. Over time, the examination intervals increased slightly in all groups. Most visiting intervals remained at 1 year. CONCLUSION: Young patients had mostly annual or biannual examinations, in line with recommendations. The examination intervals of working aged adults were considerably longer, and more of them needed treatment. The share of elderly among visitors remained low. The PDS seems to have access barriers for adults.

Childhood Psychosocial Cumulative Risks and Carotid Intima-Media Thickness in Adulthood: The Cardiovascular Risk in Young Finns Study.

OBJECTIVE: Adverse experiences in childhood may influence cardiovascular risk in adulthood. We examined the prospective associations between types of psychosocial adversity and having multiple adversities (e.g., cumulative risk) with carotid intima-media thickness (IMT) and its progression among young adults. Higher cumulative risk score in childhood was expected to be associated with higher IMT and its progression. METHODS: Participants were 2265 men and women (age range, 24-39 years in 2001) from the ongoing Cardiovascular Risk in Young Finns study whose carotid IMTs were measured in 2001 and 2007. A cumulative psychosocial risk score, assessed at the study baseline in 1980, was derived from four separate aspects of the childhood environment that may impose risk (childhood stressful life events, parental health behavior family, socioeconomic status, and childhood emotional environment). RESULTS: The cumulative risk score was associated with higher IMT in 2007 (b = 0.004, standard error [SE] = 0.001, p < .001) and increased IMT progression from 2001 to 2007 (b = 0.003, SE = 0.001, p = .001). The associations were robust to adjustment for conventional cardiovascular risk factors in childhood and adulthood, including adulthood health behavior, adulthood socioeconomic status, and depressive symptoms. Among the individual childhood psychosocial risk categories, having more stressful life events was associated with higher IMT in 2001 (b = 0.007, SE = 0.003, p = .016) and poorer parental health behavior predicted higher IMT in 2007 (b = 0.004, SE = 0.002, p = .031) after adjustment for age, sex, and childhood cardiovascular risk factors. CONCLUSIONS: Early life psychosocial environment influences cardiovascular risk later in life, and considering cumulative childhood risk factors may be more informative than individual factors in predicting progression of preclinical atherosclerosis in adulthood.

Educational attainment and health transitions over the life course: testing the potential mechanisms.

BACKGROUND: It has been shown that higher education associates with health outcomes, but the less is known about the specific mechanisms mediating this association. We examined whether higher education would associate with long-term health transitions from childhood to adulthood and whether health behaviors, self-esteem, social support and work-related health hazards could mediate or confound this association. METHODS: The participants were from a population-based sample of 3596 men and women from the Young Finns study aged 3-18 years at the beginning of the study in 1980, and who responded to repeated surveys of educational attainment and self-rated health in four study phases from 1997 to 2012. The associations were tested using multistate Markov models for the health-state transition intensities. RESULTS: Our results suggested that a 1-year difference in education was related to a 16% higher transition probability from mediocre to good self-rated health over the 5-year follow-up. Depressive symptoms and job strain seemed to partly mediate or confound the association, but self-esteem and social support did not. CONCLUSIONS: These results suggest that educational attainment is associated with good self-rated health transitions from childhood to adulthood, and multiple processes rather than a single underlying mechanism are likely to drive the educational differences in self-rated health.

Maturity and change in personality: developmental trends of temperament and character in adulthood.

We studied the developmental trends of temperament and character in a longitudinal population-based sample of Finnish men and women aged 20-45 years using the Temperament and Character Inventory model of personality. Personality was assessed in 1997, 2001, and 2007 (n = 2,104, 2,095, and 2,056, respectively). Mean-level changes demonstrated qualitatively distinct developmental patterns for character (self-directedness, cooperativeness, and self-transcendence) and temperament (novelty seeking, harm avoidance, reward dependence, and persistence). Character developed toward greater maturity, although self-transcendence decreased with age. However, self-transcendence was the strongest predictor of overall personality change. Cohort effects indicated lower level of self-transcendence and higher level of self-directedness and cooperativeness in younger birth cohorts. Regarding temperament, novelty seeking decreased and persistence increased slightly with age. Both high novelty seeking and high persistence predicted overall personality change. These findings suggest that temperament and character traits follow different kinds of developmental trajectories.

Relationship transitions and change in health behavior: A four-phase, twelve-year longitudinal study.

RATIONALE: Extensive scientific evidence shows an association between involvement in social relationships and healthy lifestyle. Prospective studies with many participants and long follow-ups are needed to study the dynamics and change in social factors within individuals over time. OBJECTIVE: Our aim was to determine whether a change in relationship status (single, married, divorced, widow, cohabiting) is followed by a change in health behavior (smoking, alcohol consumption, physical activity, and body mass index). METHODS: We used data from 81,925 healthy adults participating in the prospective longitudinal Finnish Public Sector Study in the period 2000-2013. We analyzed 327,700 person-observations from four data collection phases. Missing data were multiply imputed. A within-individual methodology was used to minimize the possibility of selection effects affecting the interpretation. RESULTS: All four health behaviors showed associations with relationship status. The effects were very similar and in the same direction in women and men, although there were gender differences in the magnitudes of the effects. The end of a relationship was followed by a decrease in body mass index, increased odds of being a smoker, increase in physical activity, and increase in alcohol consumption (widowed men). The effects were reverse when forming a new relationship. CONCLUSION: A change in relationship status is associated with a change in health behavior. The association is not explained by socioeconomic status, subjective health status, or anxiety level. People leaving or losing a relationship are at increased risk of unhealthy behavior (smoking and alcohol consumption), but at the same time they have a lower BMI and show higher physical activity compared to the time they were in a relationship. It is not clear if the cumulative health effect of these health behavior changes is positive or negative.

Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study.

BACKGROUND: The associations of social isolation and loneliness with premature mortality are well known, but the risk factors linking them remain unclear. We sought to identify risk factors that might explain the increased mortality in socially isolated and lonely individuals. METHODS: We used prospective follow-up data from the UK Biobank cohort study to assess self-reported isolation (a three-item scale) and loneliness (two questions). The main outcomes were all-cause and cause-specific mortality. We calculated the percentage of excess risk mediated by risk factors to assess the extent to which the associations of social isolation and loneliness with mortality were attributable to differences between isolated and lonely individuals and others in biological (body-mass index, systolic and diastolic blood pressure, and handgrip strength), behavioural (smoking, alcohol consumption, and physical activity), socioeconomic (education, neighbourhood deprivation, and household income), and psychological (depressive symptoms and cognitive capacity) risk factors. FINDINGS: 466 901 men and women (mean age at baseline 56·5 years [SD 8·1]) were included in the analyses, with a mean follow-up of 6·5 years (SD 0·8). The hazard ratio for all-cause mortality for social isolation compared with no social isolation was 1·73 (95% CI 1·65-1·82) after adjustment for age, sex, ethnic origin, and chronic disease (ie, minimally adjusted), and was 1·26 (95% CI 1·20-1·33) after further adjustment for socioeconomic factors, health-related behaviours, depressive symptoms, biological factors, cognitive performance, and self-rated health (ie, fully adjusted). The minimally adjusted hazard ratio for mortality risk related to loneliness was 1·38 (95% CI 1·30-1·47), which reduced to 0·99 (95% CI 0·93-1·06) after full adjustment for baseline risks. INTERPRETATION: Isolated and lonely people are at increased risk of death. Health policies addressing risk factors such as adverse socioeconomic conditions, unhealthy lifestyle, and lower mental wellbeing might reduce excess mortality among the isolated and the lonely. FUNDING: Academy of Finland, NordForsk, and the UK Medical Research Council.

Coronary heart disease and risk factors as predictors of trajectories of psychological distress from midlife to old age.

OBJECTIVE: To examine coronary heart disease (CHD) and its risk factors as predictors of long-term trajectories of psychological distress from midlife to old age. METHODS: In the Whitehall II cohort study, 6890 participants (4814 men, 2076 women; mean age 49.5 years) had up to seven repeat assessments of psychological distress over 21 years (mean follow-up 19 years). CHD and its risk factors (lifestyle-related risk factors, diabetes, hypertension and cholesterol) were assessed at baseline. Group-based trajectory modelling was used to identify clusters of individuals with a similar pattern of psychological distress over time. RESULTS: We identified four trajectories of psychological distress over the follow-up: 'persistently low' (69% of the participants), 'persistently intermediate' (13%), 'intermediate to low' (12%) and 'persistently high' (7%). The corresponding proportions were 60%, 16%, 13% and 11% among participants with CHD; 63%, 15%, 12% and 10% among smokers and 63%, 16%, 12% and 10% among obese participants. In multivariable adjusted multinomial regression analyses comparing other trajectories to persistently low trajectory, prevalent CHD was associated with intermediate to low (OR 1.70, 95% CI 1.08 to 2.68) and persistently high (OR 1.92, 95% CI 1.16 to 3.19) trajectories. Smoking (OR 1.33, 95% CI 1.07 to 1.64; OR 1.55, 95% CI 1.19 to 2.04) and obesity (OR 1.33, 95% CI 1.04 to 1.70; OR 1.47, 95% CI 1.07 to 2.01) were associated with persistently intermediate and persistently high trajectories, respectively. CONCLUSION: CHD, smoking and obesity may have a role in the development of long-lasting psychological distress from midlife to old age.

Teacher Awareness and Attitudes Regarding Adolescent Risk Behaviours: a Sample of Finnish Middle and High School Teachers.

Empirical evidence has shown that youth gamble on both regulated and unregulated games, despite legislative prohibitions. This study assesses middle and high school teachers' awareness and attitudes regarding adolescent gambling and other potentially high-risk behaviours in Finland. A convenience sample of teachers (N = 157) from 13 provinces participated in the survey. The results suggest that teachers in Finland were more knowledgeable of the age limits of other adolescent high-risk behaviours than the legal age for gambling. Teachers were somewhat familiar with the behaviours and consequences associated with adolescent gambling. All other risk behaviours were perceived as being more important than gambling. Teachers' awareness about gambling prevention material in Finnish schools was limited. Results suggest that initiatives are required to enhance teachers' knowledge of adolescent problem gambling and its harmful short- and long-term consequences. School policies and guidelines including gambling behavior should be implemented in middle and high schools globally.

Temperament and depressive symptoms: what is the direction of the association?

BACKGROUND: Temperament characteristics have been suggested to be associated with mental health outcomes, especially depression, but the direction of the association is unknown. In this study, we tested whether temperament characteristics, as defined by the Buss-Plomin adulthood emotionality-activity-sociability (EAS) temperament model, predict depressive symptoms or whether depressive symptoms predict changes in temperament characteristics. METHODS: Participants comprised a population-based sample of 719 men and 1020 women from the Young Finns study aged 20-35 years at baseline in 1997 and who responded to repeated surveys of temperament and depressive symptoms in four study phases from 1997 to 2012. The associations were tested using linear regression models, repeated cross-lagged structural equation models, parallel latent growth curve models and two-dimensional continuous-time state space model (Exact Discrete Model). RESULTS: Both low sociability (ß=-0.12, p<0.001) and high negative emotionality (ß=0.34, p<0.001) predicted subsequent increased depressive symptoms, whereas earlier depressive symptoms predicted increased negative emotionality (ß=0.50, p<0.001), but not low sociability. LIMITATIONS: The depressive symptoms scale applied may not be used for measuring clinically recognized depression. CONCLUSIONS: Our findings suggest that the direction of the association is from low sociability to depressive symptoms rather than the reverse, but the association between negative emotionality and depressive symptoms seems to be reciprocal.

Is dispositional optimism or dispositional pessimism predictive of ideal cardiovascular health? The Young Finns Study.

OBJECTIVE: We examined the independent association between dispositional optimism compared to dispositional pessimism and ideal cardiovascular health (defined by the American Heart Association). DESIGN: A prospective design with a study sample of 1113 participants aged 24-39 years from the longitudinal Young Finns Study. MAIN OUTCOME MEASURES: Ideal cardiovascular health (comprised of seven ideal cardiovascular health metrics) was measured in 2001. The ideal cardiovascular health metrics were reassessed in 2007. RESULTS: Low pessimism rather than high optimism was a better predictor of ideal cardiovascular health in 2007. When examining the association between optimism and pessimism and the seven ideal cardiovascular health metrics in 2007 (BMI, diet, physical activity, smoking status, blood pressure, total cholesterol and plasma glucose), low pessimism predicted non-smoking status, ideal physical activity and eating a healthy diet, while high optimism was associated with eating a healthy diet. CONCLUSION: Our findings suggest that low pessimism rather than high optimism is associated with ideal cardiovascular health, especially with health behaviours such as not smoking, being physically active and eating a healthy diet. Socio-economic status was the potential mediating or confounding factor. Future studies should examine the differential meaning of the optimism/pessimism concepts to further clarify their relation to health outcomes.

Parental care-giving and home environment predicting offspring's temperament and character traits after 18 years.

Although many personality theories emphasize the role of parental behaviors in shaping personality development, empirical data from longitudinal studies remain scarce. It is also not known, if parental behaviors affect character development more strongly than temperament or vice versa. In a prospective study, 1083 volunteer participants of the Young Finns study completed the Temperament and Character Inventory (TCI). Parents of the participants had answered questions about parenting attitudes, socioeconomic status, health behaviors, and role satisfaction 18 years before. We studied the univariate and the cumulative effects of parental care-giving and family environment on offspring's personality traits. Parental care-giving and home-environment were more strongly associated with offspring character traits reflecting personality maturity (Self-directedness and Cooperativeness) than with offspring temperament traits (Novelty seeking, Harm avoidance, Reward dependence and Persistence) reflecting emotional and behavioral tendencies. The differences were most evident in the cumulative effects model. Maternal variables were stronger predictors than paternal variables. The present findings suggest that not all personality traits are similarly predicted by parental care-giving and home-environment. In particular, character development is more strongly related to such measures than temperament. Parental care-giving and home-environment are more strongly related to psychological maturity (character) than emotional and behavioral tendencies (temperament).

Body-image dissatisfaction is strongly associated with chronic dysphoria.

BACKGROUND: Individual depressive symptoms may contribute to the risk of chronic depression. This study aimed to explore which symptoms predict chronic dysphoria, a hallmark of depression. METHODS: 1057 participants from the population-based Young Finns study were examined for four times during a 16-year period. Those with a modified Beck's Depression Inventory score in the upper third at all four screenings were considered to have chronic dysphoria (n=135). Participants with only one high depression score formed the reference group of transient dysphoria (n=179). Individual items of the Inventory were analyzed in terms of their association with dysphoria status and chronicity, controlling for potential confounding factors, such as personality assessed using the Temperament and Character Inventory. RESULTS: Body-image dissatisfaction was strongly associated with chronically elevated dysphoria (Bonferroni-corrected p=0.006). The degree of body-image dissatisfaction was associated with the probability for chronic dysphoria in a dose-response manner, with the estimated probability ranging from 0.01 to 0.60 as a function of item response. The association remained after adjustments for a wide range of personality characteristics. LIMITATIONS: The study relied on self-reports of mood and personality, and lacked information on external opinion on participants appearances. The requirement of full time-series data may have resulted in attrition-related bias. CONCLUSIONS: Body-image dissatisfaction was a strong predictor of chronic depression characterized by dysphoria. This finding suggests that dysfunctional attitude towards oneself might represent a potentially important target for cognitive therapies and preventive interventions.

Temperament and character predict body-mass index: a population-based prospective cohort study.

OBJECTIVE: Personality is a potential factor determining individual differences in body-weight change. The current study examines associations between personality traits and change in body-mass index (BMI) over six years. METHOD: The participants were 762 women and 648 men aged 24-39 years at the base-line. Personality was assessed with the Temperament and Character Inventory (TCI). For calculating BMI, height and weight were assessed at a clinic. RESULTS: Longitudinal analyses conducted with linear regressions showed that in men and women, higher Novelty seeking predicted higher BMI (p<.05), whereas lower Reward dependence predicted higher BMI in women (p<.05) when baseline BMI was taken into account. In addition, cross-sectional associations for several TCI traits were found in age and education adjusted analyses. In women, higher Self transcendence (p<.05) was associated with higher BMI. In men, higher Novelty seeking (p<.001) and Self transcendence (p<.01) and lower Self directedness (p<.01) and Cooperativeness (p<.05) were associated with higher BMI. In addition, analyses of variance were conducted for multidimensional trait profiles (trait combinations). Significant temperament profile related differences in BMI were found in all analyses in women. Associations with character profiles and in men were less consistent. CONCLUSION: The results give support for personality playing a role in weight gain. Knowledge on personality may be used for motivating weight loss and designing weight management interventions.

Personality Profiles Identify Depressive Symptoms over Ten Years? A Population-Based Study.

Little is known about the relationship between temperament and character inventory (TCI) profiles and depressive symptoms. Personality profiles are useful, because personality traits may have different effects on depressive symptoms when combined with different combinations of other traits. Participants were from the population-based Young Finns study with repeated measurements in 1997, 2001, and 2007 (n = 1402 to 1902). TCI was administered in 1997 and mild depressive symptoms (modified Beck's depression inventory, BDI) were reported in 1997, 2001, and 2007. BDI-II was also administered in 2007. We found that high harm avoidance and low self-directedness related strongly to depressive symptoms. In addition, sensitive (NHR) and fanatical people (ScT) were especially vulnerable to depressive symptoms. high novelty seeking and reward dependence increased depressive symptoms when harm avoidance was high. These associations were very similar in cross-sectional and longitudinal analysis. Personality profiles help in understanding the complex associations between depressive symptoms and personality.

Associations of personality profiles with various aspects of well-being: a population-based study.

BACKGROUND: Well-being consists of affective and non-affective components. Personality traits measure individual differences in adaptive functioning and mental health. In a previous Israeli study personality was strongly associated with well-being. However, it is not well known which aspects of this association are culture-specific, and which are common to most cultures. METHODS: 1940 volunteer participants of the Cardiovascular Risk in Young Finns (CRYF) study completed the Temperament and Character Inventory (TCI), and the Multidimensional Scale of Perceived Social Support (PSS). Questions about positive and negative affect, satisfaction with life, and subjective health were also included. Multidimensional personality profiles were used to evaluate the linear and non-linear effects of interactions among dimensions on different aspects of well-being. RESULTS: Self-directedness was strongly associated with all aspects of well-being regardless of interactions with other dimensions. Cooperativeness was also associated with several aspects of well-being but especially strongly with perceived social support. Self-transcendence was associated with both positive and negative affect when the influence of the other character dimensions was taken into account. Personality explained half the variance in non-affective well-being and two thirds of the variance in affective well-being. LIMITATIONS: The same assessment instruments were not used in the two countries we compared. Our data were cross-sectional. CONCLUSIONS: Self-directedness and Cooperativeness are positively associated with well-being regardless of culture. The effect of Self-transcendence, however, seems to be culture-specific. Self-transcendence increases positive affect but, based on culture, it can also increase negative affect.