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Personality, Choices

Personality specifies a stable set of individual psychological characteristics that influence thinking, motivation, and behavior in various situations. Personality has to be distinguished from individual differences due to, for example, cultural heritage or socioeconomic class. Rather than being solely determined by the psychosocial environment, personality is thought to be the result of an interaction between genetic and environmental factors that lead to an underlying behavioral disposition and thus constitutes the psychological uniqueness of a human being. A current personality concept is the Big Five, a set of five independent traits describing a person's character: (1) openness to experience, (2) conscientiousness, (3) extraversion, (4) agreeableness, and (5) neuroticism. Personality has been proposed as a factor affecting the behavior of patients seeking medical treatment, especially with regard to treatment adherence, participation in healthcare decision making, and treatment choice. The following sections describe the extent to which personality plays a role in these areas of treatment delivery.

Selected Personality Traits

Comprehensive personality concepts such as the Big Five that claim to be able to describe all relevant personality differences have to be distinguished from single, usually theory-based personality traits that describe a specific attribute such as generalized self-efficacy, locus of control, or optimism. Of the Big Five traits, openness to experience describes imaginative, intellectually curious people versus straightforward, conservative people less interested in change. Conscientious people are disciplined, hardworking, orderly, and thorough. Extraversion describes people seeking stimulation and the company of others as well as showing initiative and being action oriented. An agreeable person is someone who is compassionate, cooperative, and interested in the well-being of others but may shy away from conflict. Neuroticism describes a person who often experiences negative feelings and views situations as potentially threatening and difficult, which impedes his or her capacity to deal with emotional difficulties. With regard to single personality traits, generalized self-efficacy describes the ability to generally handle difficult situations well. Internal locus of control describes the belief that one personally can influence situations, whereas external locus of control stands for the conviction that others have a greater control over a given situation than oneself. Optimism describes the tendency of an individual to have a positive outlook on events and the belief that things will take a positive turn.

Personality and Behavior

Personality is only one factor affecting a person's behavior in a given situation. In addition, a person's behavior is also determined by factors such as beliefs, expectations, prior experiences, roles, and situational constraints or incentives. Thus, the importance of personality in determining an individual's behavior in a given situation will be limited. On the other hand, personality does predict general behavioral tendencies such as stress-coping behavior. An active, problem-focused coping style, for instance, is far more likely in individuals high in extraversion and low in neuroticism. Health behaviors such as exercise typically are determined by beliefs regarding the benefits of this particular behavior, the opinion of peers with regard to it, and the extent to which the individual experiences control over the behavior. With the exception of generalized self-efficacy and conscientiousness, personality generally plays less of a role in predicting health behaviors.

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