Are you an open book?

A

Ever wandered if the type of person you are increased your risk of developing MS? Often a trip down memory lane takes after the fact, but is there truly an unbiased way of looking at which personalities more or less likely result in a diagnosis of MS?

In this study conducted entirely in the UK using data from the UK Household Longitudinal Study (UKHLS), data on personality traits were collected at the start and then 7 years later they were asked whether or not they developed MS.

The personalities were determined using a questionnaire; personalities were divided broadly into Neuroticism, Agreeableness, Openness, Conscientiousness, and Extraversion.

There were 17,791 participants in total with an average age of 47, and 43% of them were males.

In terms of demographic data they found that being female and having the least college education increased the risk of developing MS (Odds ratio [OR] 2.37 and 2.42; information on interpreting odds ratio can be found in the table below). Whilst the personality traits ‘Openness’ and ‘Conscientiousness’ reduced the risk of MS later on (OR 0.68 and 0.70, respectively).

Figure: What are Odds ratios (source: slideshare: Dr Alazabee Tarek)

This is one of the largest studies of this kind that I’ve come across, another bonus is that it’s a prospectively collected data set. But this isn’t to say that the entire world needs a personality transplant to avoid the risk of developing MS!

Even though we do accept now that stress with it’s negative impact on the immune system is a trigger for MS and certain personalities handle stress less well than others. But, this data in itself doesn’t provide the answer for the question it seeks. The crux of the matter is that everything about this data set relies on self-reporting and who in their right mind will admit to being neurotic.

Abstract

J Clin Med

Personality Traits Predict 7-Year Risk of Diagnosis of Multiple Sclerosis: A Prospective Study

Weixi Kang 

    Objective: The objective of the current study is to investigate how Big Five personality traits could predict the risk of multiple sclerosis (MS) diagnosis in 7 years.

    Methods: A binary logistic regression was used to analyze data from 17,791 participants who responded to questions at Wave 3 (collected between 2011 to 2012) and Wave 10 (collected between 2018 to 2019) using a binary logistic regression from UKHLS with a mean age of 47.01 (S.D. = 16.31) years old with 42.62% males.

    Results: The current study found that Openness (OR = 0.68, p < 0.01, 95% C.I. (0.51, 0.89)) and Conscientiousness (OR = 0.70, p < 0.05, 95% C.I. (0.52, 0.93)) are positively associated with a reduced risk of MS diagnosis in 7 years.

    Conclusion: Health professionals can use findings from the current study as evidence for developing tools for assessing the risk of MS, and providing interventions for people who may be at high risk of MS based on their personality traits.

    About the author

    Neuro Doc Gnanapavan

    15 comments

    • The more I learn, the less fair it all seems! My main risk factor was growing up far from the equator, under the ozone hole and being kept out of the sun.

      I have three degrees, have never smoked and have always been open and conscientious – known in my family for never telling a lie.

    • Does the study demand a clinical diagnosis by a neurologist or suspected or self reporting?

      I am assuming that people with MS at time of the survey have been excluded from the study. As living with MS is likely to influence personality even without neurological damage.

      With the influence of the internet and social media do people with certain personality traits actively seek out an explanation for their problems while others just get on with their lives and go undiagnosed until a catastrophic event happens and an unexpected diagnosis is given?

      In other words is it the time to diagnosis that is quicker?

      • This is a diagnosis of MS, not suspected. The idea of a prospective study is that you avoid retrospective bias which is heavily reliant on a person’s recall of their life – this directly leads to increased reporting. And yes those with diagnosis of MS are excluded. This is a large population based study – I suspect the outcomes would have been less positive with a lesser sample size. Essentially, you’re looking for a needle in a hay stack. With your last question, it’s not possible with this study. I would say that a 7 year gap is very quick. We know from serum NfL that levels start to rise 6y before the presentation of MS on average (a large armed forces study) so maybe these change are happening in this time gap in a person’s behaviour.

        • Thanks to Lisa for posting a link to the paper.

          The diagnosis criteria is actually somewhat loose and talks about a doctor or other healthcare professional rather than a specialist neurologist as requested in documentation for the MS Register. paper

          The self reporting of medical opinion is justified by reference to two US papers

          These are the results from the paper are
          Table 2
          The odd ratios of the probability of demographic and personality traits predictors in predicting the chance of MS diagnosis in 7 years.

          OR P 95% C.I.
          Age 1.00 0.72 (0.99, 1.02)
          Sex 2.37 <0.01 (1.29, 4.36)
          Monthly income 1.00 0.59 (1.00, 1.00)
          Highest educational qualification 2.42 <0.01 (1.41, 4.15)
          Marital status 0.74 0.25 (0.45, 1.23)
          Residence 1.11 0.72 (0.63, 1.97)
          Neuroticism 0.88 0.40 (0.67, 1.17)
          Agreeableness 1.09 0.56 (0.81, 1.47)
          Openness 0.68 <0.01 (0.51, 0.89)
          Conscientiousness 0.70 <0.05 (0.52, 0.93)
          Extraversion 1.09 0.55 (0.82, 1.44)are

          The well known male female result is shown, but the higher educational qualification is also very significant and more so than consciousness. Being a highly educated female outweighs any advantage of being open and conscientious!

          Do you have a view as to why MS appears to be on the increase?
          My thoughts are
          We are more likely to look for it
          We believe that something can be done about it

          • The incidence seems to be up which exceeds ascertainment. Countries that never had a high case load are now also starting to report them. I don’t think that genes have changed much either. It is more likely an environmental shift that’s driving this similar to a multi-hit hypothesis.

    • Haha, well. I would admit to being slightly neurotic (at times). Maybe not fully!
      Weird study though, I consider myself open, extraverted and conscientious too.

    • Thanks for posting this.

      So much about getting MS seems to involve bad luck. My aunt died of MS in her 50s – so I must have inherited the MS risk gene/s from my father. I got a really bad case of glandular fever (mono) in my early teens. On my side (not that I knew it) were lots of sun exposure (holidays and hobbies), very fit (lots of sport) and very clean living (never smoked, drunk alcohol etc.). In my mid-30s my wife had to have a termination (severe spina bifida) relatively late into the pregnancy. This hit both of us hard and a few years later my first symptoms appeared (no signs before). I wonder if a traumatic event was the tipping point for me ie I was primed to get MS (genes + ebv) and the stress gave the disease the final push it needed.

    • I’m not sure what this accomplishes other than shaming people with ms with the message that they brought this onto themselves. Which is the last thing people need. And frankly could put them at risk for reduced empathy and urgency to treat if that is the perception.

      • And I appreciate both you and Lisa. Because we know how this would play out in a real-world situation: not well, lets’ just say, amirite? I can hardly see how this study could help anyone, even as just a starting point. But I can easily see how it could have some pretty bad unintended consequences.

        If I were still young and healthy, it’d be a cold day in hell and possibly not even then, before I would let anyone in healthcare “screen” my MS risk by doing a personality test of ANY sort on me. But of course, I have that wisdom from age, observation, and experience. The young and yet healthy don’t understand the downsides of giving away too much of their information (power). Yet.

        There are very real harms that can come from having the label of “neurotic” in some HCP’s notes, a label that unlike conditions of limited duration, will follow you around FOREVER, and which, as has been mentioned, is a label fraught with enough negative connotations that people don’t want to “admit” it. That word, potentially biasing all sorts of other doctors’ opinions going forward, would far outweigh any potential MS prevention benefits that might be had, IMO.

        I also would not trust any “intervention” devised, nor can I imagine one that would work in mitigating a personality trait to a degree (what degree??) necessary to measurably decrease a health risk. Such a heavy lift with such a gossamer premise, that a personality trait’s posited deleterious effects can be solved with an “intervention”. (And from what I’ve read, it’s not like the “Big Five” personality traits don’t have their critics and detractors even amongst the ranks of “WE understand you better than YOU do” crowd) Since the risk is supposedly due to your thought patterns, the assumption is that it is under your control and you should be able to somehow change your mind – positive thinking? mindfulness? – and pull yourself out of that portion of your risk. Mmm hmm.

        (read below in that sarcasm font we still desperately need)

        Hey! Here’s one: the REAL and simple reason that women get MS more than men is (wait for it) we’re more neurotic!

        You’re welcome. 😉

    • Full study text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861722/
      This study seems to be an example of the ‘correlation does not imply causation’ fallacy. Personality tests barely have any reproducibility, so making predictions based on their results seems unscientific. It seems very unlikely to me that something as fluid and subjective as ‘personality traits’ can be directly linked to a clinical disease. Humans learn and develop their personalities over time and it seems like a frivolous thing to use as a predictor for anything as serious as MS.

      • Yes! Especially true when talking about a disease that can change personality just from brain damage- and this can happen years before ms is detected!

    • I am/was a PhD psychologist from a good university and I’ve been exposed to a lot of this kind of research. Yes, people have different dispositions which can be observed (formally or informally) and sometimes measured. Then these measurements can be put into statistical calculations and hypotheses formed or proven. But the hard “A proves B” conclusions are difficult to make. Does having MS early on (perhaps prior to symptoms) lead to measurable behavioral/personality quirks, or vice-versa? I’ll stay with genes and harder environmental factors (EBV, Vit D, others) as the roots.

      I am currently going through an auto insurance debacle where I am asking myself if the stress (fighting it) is worth it (with MS and all)? I’m concluding that for me, sweeping things under the rug in an effort to not be bothered, won’t work for me (i.e. stressful life in the long run anyway; it comes back to bite you). But it all gets so very subjective. Some people are better at handling chronic illnesses than others and I’m sure personality is in there. But it all gets very difficult to analyze. If you are hyper negative excitable pessimistic person and are aware of it, perhaps do something about it. Otherwise, take your challenges as they come. MS is a biggy, but I am going to go out on a limb and suggest it can be handled,… at least managed, and you can be a happy for the most part person just like everyone else. Keep in mind, those people you see without MS (the ones I just mentioned)? A lot of them have some pretty serious crappy stuff going on too.

    • Gosh I hope they didn’t spend a lot of precious MS research money on this, so subjective and so ridiculous -let’s not spend too much effort reading into this!

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