RESUMO
OBJECTIVE: The suggestion from cross-review comparison that lower levels of social integration (social isolation, loneliness) and cigarette smoking are equally powerful predictors of premature mortality has been promulgated by policy organisations and widely reported in the media. For the first time, we examined this assertion by simultaneously comparing these associations using data from two large cohort studies. STUDY DESIGN: Individual-participant analyses of two large prospective cohort studies. METHODS: Participants in UK Biobank and the English Longitudinal Study of Ageing reported loneliness, social-isolation and smoking behaviours using standard scales at baseline. Cause-specific mortality was ascertained via linkage to national registries. We used Cox regression analyses to compute a relative index of inequality to summarise the relation between these baseline characteristics and mortality experience. RESULTS: Mean age at baseline was 56.5 years in the 466,876 (273,452 women) Biobank participants and 66.1 years in the 7505 (4123 women) English Longitudinal Study of Ageing members. In Biobank, a mean duration of mortality surveillance of 6.6 years gave rise to a total of 13,072 deaths, while in the English Longitudinal Study of Ageing, 1183 deaths occurred after a mean of 7.7 years. In ascending magnitude, loneliness, social isolation then cigarette smoking were associated with an increased risk of mortality from all-causes and all cancers combined. When cardiovascular disease mortality was the endpoint of interest, both smoking and social isolation, though not loneliness, revealed similar relationships. CONCLUSIONS: Contrary to cross-review comparisons, in the present datasets it appears that poor social integration is in fact less strongly linked to total mortality than cigarette smoking.
RESUMO
OBJECTIVE: The aim of this study was to examine (a) whether adventurous and explosive temperament profiles (presumed precursors of antisocial and borderline personality) are associated with character traits over a 15-year follow-up and (b) whether social support and attachment security modify the relationship between temperament profiles and character development. METHODS: 2,028 subjects of the Young Finns study completed the Temperament and Character Inventory, the Multidimensional Scale of Perceived Social Support, and the Relationship Questionnaire at 3 assessment points between 1997 and 2012. RESULTS: Both explosive and adventurous temperament profiles seemed to predispose individuals to have less mature personalities; that is, these profiles were consistently associated with lower cooperativeness (P < .001), and explosive temperament also with lower self-directedness (P < .001), over the entire follow-up period. These relationships did not vary significantly at the individual level and were sustained after controlling for age, gender, and socioeconomic status. However, the presence of high social support and secure attachment was found to decrease the likelihood that explosive temperament would lead to an immature adulthood character (P < .001). In contrast, persons with the adventurous temperament were likely to have a more mature character under low social support and an immature one under high experienced social support (P < .05). CONCLUSIONS: Individuals with the explosive temperament benefit from high social support and secure attachment. From the point of view of the therapy process, this knowledge might be of importance. In contrast, individuals with the adventurous temperament were able to direct their behavior better in social environments that were not likely to support their basic temperaments.