Care Recipient Agreeableness Is Associated With Caregiver Subjective Physical Health Status

Theoretical models of the caregiving process (Pearlin, Mullan, Semple, & Skaff, 1990) have emphasized the influence of contextual factors and individual characteristics of the caregiver (CG) and care recipient (CR) on CG outcomes (Pinquart & Sorensen, 2007). One component that has received little attention, however, is CR personality. This is surprising given that personality has been linked to health outcomes for both the CR and the CG (Lockenhoff, Duberstein, Friedman, & Costa, 2011) and was shown to affect dyadic interactions within close relationships (Robins, Caspi, & Moffitt, 2000). This study expands upon the existing literature by exploring how five-factor personality traits of CRs may contribute to individual differences in CG mental and physical health. With regard to mental health, Monin and Schulz (2009) have proposed that, independent of illness attributes (e.g., disability), patient suffering along with CG compassion will affect CGs’ psychological morbidity. Based on this model, we expect that the effects of CR distress on CGs’ mental health are more pronounced if CRs are more likely to express their emotions. Notably, both neuroticism and extraversion are associated with greater catastrophizing and emotional expressiveness (Phillips & Gatchel, 2000). Therefore, CRs who score high on these traits may be more likely to communicate their feelings of anguish to their family members. In partial support of this notion, the single prior study investigating CR personality and CG mental health found that presurgical neuroticism among coronary artery bypass patients predicted postsurgical depression among their CGs (Ruiz, Matthews, Scheier, & Schulz, 2006). Although further research is required, these findings provide a foundation on which to argue that greater expressions of suffering, as conveyed by heightened levels of extraversion and neuroticism, may elicit greater psychological distress among CGs. Even less is known about the role of CR personality in CGs’ physical health. However, evidence from psychoneuroimmunology suggests that prolonged exposure to problematic interpersonal contexts poses challenges to endocrine and immune function, whereas supportive and less conflictual relationships promote physical wellness (Kiecolt-Glaser, Gouin, & Hantsoo, 2010). The physiological consequences of interpersonal experiences may be particularly pronounced in the close physical proximity and mutual dependence of caregiving contexts. Among the five-factor traits, agreeableness and conscientiousness are most closely linked with interpersonal processes and relationship satisfaction (White, Hendrick, & Hendrick, 2004).To date, only one study has examined the relationship between personality among cognitively intact CRs and the physical health of their CGs. Although this study did not consider the full range of CR five-factor personality, it revealed a positive association between CR conscientiousness and CG self-reported physical functioning (Roberts, Smith, Jackson, & Edmonds, 2009). Taken together, the limited research record suggests that CG physical health may be associated with CRs’ standing on agreeableness and conscientiousness. Based on these considerations, we hypothesize that high neuroticism and extraversion in CRs will confer poor emotional health in CGs because of their association with emotional disturbance and pain catastrophizing (Phillips & Gatchel, 2000). In contrast, we expect that high agreeableness and conscientiousness in CRs will promote better physical health among CGs because the prior literature links CR behavior with CG physical functioning (Pinquart & Sorensen, 2007). We expect that facet-level effects will show a similar pattern to the corresponding higher level traits. We also consider the circumplex combinations of factor pairs or personality styles (McCrae & Costa, 2010). For instance, CR styles characterized by high agreeableness (A+) and low neuroticism (N−) (i.e., “easygoing”) may be associated with better health outcomes among CGs, whereas styles characterized by high extraversion (E+) and low agreeableness (A−) (i.e., “leader”) may put CGs at risk for poor health. Given the limited research on personality styles and CG health, we do not propose specific hypotheses regarding styles. Several covariates that have been previously associated with CG health will also be explored: CG sociodemographic characteristics (i.e., age, gender, education), CG strain, and CR pain and physical impairment (Pinquart & Sorensen, 2007).