Skip to main content
PMC home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2010 Jul 7.
Published in final edited form as: Ethn Dis. 2010 Winter;20(1):11–14.

Personality and Inflammation: The Protective Effect of Openness to Experience

Charles R Jonassaint 1, Stephen H Boyle 1, Cynthia M Kuhn 1, Ilene C Siegler 1, William E Copeland 1, Redford Williams 1
PMCID: PMC2898189  NIHMSID: NIHMS209467  PMID: 20178176

Abstract

Prior research found reduced mortality in coronary heart patients with higher scores on the Openness to Experience (O) domain and its facets. Decreased C-reactive protein level (CRP) levels may be one mechanism by which higher O leads to decreased mortality. Thus, the current study aimed to test the association between the O domain and its facets, as assessed by the NEO Personality Inventory-Revised, and CRP in a sample of 165 healthy black and white, male and female community volunteers.

Methods

Blood samples were taken before and after a 40-minute mental stress protocol. BMI and education were significant predictors of CRP and, in addition to age, were included as covariates in all analyses. Race and sex were tested as possible moderating variables.

Results

In a mixed effects model the main effect of Time (pre/post-stress), O and their interaction were not significant predictors of CRP. However, results showed a significant race x O effect on CRP (p =.03). In blacks, higher O domain (r = -.41, p<.01), Aesthetics facet (r = -.30, p=.01), Feelings facet (r = -.41, p<.01), and Ideas facet (r = -.38, p<.01) scores were associated with lower mean CRP levels. In contrast, among white participants, neither the O domain nor its related facets were associated with CRP.

Discussion

The O domain and its facets may be associated with markers of the inflammatory process among blacks but not whites.

Among the big five personality domains, Openness to Experience has received the least attention. Individuals high in Openness are characterized as being more willing to entertain novel ideas and interests and experience positive and negative emotions more intensely. In contrast, low scorers tend to behave more conservatively, hold more conventional values, and experience a narrower range of affect than high scorers 1. Recently, our group showed that Openness to Experience and its lower-order facets Feelings and Actions, were related to cardiac deaths and all cause mortality 2. These findings warrant exploring the biological correlates of the broad Openness domain as well as its facets—investigations that may potentially unveil mechanisms linking Openness to mortality.

Contemporary models of atherogenesis emphasize the importance of the inflammatory process in the etiology and progression of coronary artery disease 3. C-reactive protein (CRP) is one of the several acute phase proteins that increase during systemic inflammation. Patients with elevated levels of CRP are at an increased risk for diabetes 4-6, hypertension 7, 8 and early cardiovascular disease (CVD) 9-13. Various negative personality traits such as depression, anger and hostility that predict coronary artery disease, have been associated with increased CRP 14-16; however, little is known about how positive factors such as Openness are related to the inflammatory process. High Openness to Experience could contribute to lower mortality via its association to lower levels of CRP.

Another prominent index of CVD risk is race. Black men and women in the United States have among the highest prevalence of hypertension in the world 17. Compared to their white counterparts, black men and women have a greater rate of nonfatal stroke, fatal stroke, heart disease death and end-stage kidney disease, differences that are not better accounted for by education or socioeconomic status 17. Research helping to elucidate mechanisms contributing to racial differences in CVD risk is needed. Our previous study showing an association between Openness and mortality was in a homogenous white (94.5%), male (74.5%) sample that did not allow for an adequate examination of race and sex interaction effects 2.

Therefore, the present study aimed to explore the association between the Openness to Experience domain and CRP in approximately equal groups of black and white, males and females. Race and sex differences in the effect of Openness on CRP were also examined.

Methods

This study used data collected in a research program that aims to identify biobehavioral factors involved in the etiology and pathogenesis of CVD 18-21. The Openness to Experience domain and its related facets (see Table 1 for description of the facets) were assessed using the NEO Personality Inventory-Revised 1 in a sample of 165 healthy black (n = 94) and white (n = 71), male (n = 91) and female (n = 74) community volunteers. Blood samples were taken before and after a 40-minute mental stress protocol for C-reactive protein level (CRP) analysis. CRP measurements were done using EIA (ELISA) Kit from ALPCO Diagnostics (Cat No 30-9710s). The detection limit of the assay was 0.12 ng/ml. CRP data was missing for 26 participants; missingness was associated with sex (17 females, 9 males; χ2= 5.26, p=.02) but not race. Participants who were missing CRP data were excluded from analyses.

Table 1.

Descriptions of High and Low Scorers on NEO PI-R Openness to Experience Domain Sub Facets

Facet Description
high scorers: have vivid imaginations and an active fantasy life, daydream not simply to escape but as a way of creating for themselves an interesting inner world
Fantasy low scorers: are more prosaic and prefer to keep their minds on the task at hand
high scorers: have a deep appreciation for art and beauty, they are moved by poetry, absorbed in music, and intrigued by art.
Aesthetics low scorers: are relatively insensitive to and uninterested in art and beauty
high scorers: experience deeper and more differentiated emotional states and feel both happiness and unhappiness more intensely than do others
Feelings low scorers: have somewhat blunted affects and do not believe that feeling states are of much importance
high scorers: prefer novelty and variety to familiarity and routine; overtime, may engage in a series of different hobbies
Actions low scorers: find change difficult and prefer to stick with the tried-and-true
high scorers: enjoy both philosophical arguments and brain teasers; does not necessarily imply high intelligence, although it can contribute to the development of intellectual potential
Ideas low scorers: have limited capacity and, if highly intelligent, narrowly focus their resources on limited topics
 
high scorers: are ready to reexamine social, political, and religious values; may be considered the opposite of dogmatic
Values low scorers: tend to accept authority and honor tradition and as a consequence are generally conservative, regardless of political party affiliation
Open in a new tab

Analysis

Mixed effects models were used to model change in log transformed CRP levels over time, from baseline to post stress. In addition, mixed effects models allow for the simultaneous test of the between subjects effects, or differences in mean CRP levels between individuals. Age, BMI and participants’ self-reported education were tested as possible covariates. Race and sex were included in mixed effects models as moderating variables. All non-significant higher order interaction terms were dropped from the final model.

Results

Although blacks had lower Openness domain scores than whites, only the Values facet was significantly different between the groups (Table 1). BMI (r = .31, p<.01) and education (r = -.22, p<.01) were significant predictors of CRP; however, age was not associated with CRP (p =.07). Similarly, sex was also a non-significant predictor of CRP and race differences in CRP only approached significance (p =.07), Blacks tending to have lower mean CRP than whites.

In a mixed effects model, the main effect of Time (pre/post-stress), Openness and their interaction were not significant predictors of CRP. Further, the sex x Openness interaction effect was also not significant. However, results showed a significant race x Openness effect on CRP (F(1,130) = 4.61, p = .034). To simplify the interpretation of the findings, mixed effects model analyses were followed by Pearson partial correlations using age, BMI and education as covariates, which show the association between the Openness domain (and its facets) and mean CRP. In blacks, higher Openness domain (r = -.41, p<.01), Aesthetics facet (r = -.30, p=.01), Feelings facet (r = -.41, p<.01), and Ideas facet (r = -.38, p<.01) scores were associated with lower mean CRP levels (Table 2). In contrast, among white participants, neither the Openness domain nor its facets were associated with mean CRP.

Table 2.

Mean Openness Domain and Facet T-Scores by Race

blacks whites
Label Mean Std Dev Mean Std Dev pvalue
OPENNESS Domain 51.48 9.67 54.08 9.45 0.08
FANTASY 50.88 9.85 53.76 9.36 0.06
AESTHETICS 54.03 8.77 54.80 9.27 ns
FEELINGS 50.40 8.68 51.45 9.57 ns
ACTIONS 50.90 8.55 53.03 9.17 ns
IDEAS 51.67 9.64 51.89 9.39 ns
VALUES 46.75 9.4 50.07 10.52 0.04
Open in a new tab

Discussion

In a healthy sample of men and women, higher Openness to Experience was associated with lower levels of C-reactive protein (CRP); however, this effect was only in blacks. For whites, Openness was not associated with CRP. These effects were independent of age, BMI, and education. These findings suggest that, for blacks, Openness to Experience may be a protective factor against inflammatory conditions that increase risk for cardiovascular disease (CVD) or confer a poorer prognosis once CVD is present.

It is unclear at present what mechanisms may link Openness to Experience with CRP levels. Our previous study examining the effects of this domain on mortality identified the Feelings Facet as being a particularly significant factor in longevity 2. Similarly, in the present study, the Feelings Facet had the most pronounced effect on CRP among all the facets. Constructs conceptually similar to low Openness to feelings, such as alexithymia and the repressive coping style, have been associated with impairments in the recognition of both pleasant and unpleasant emotion 22. Deficits in emotional awareness may be a central aspect of the Openness domain linking it to health.

There are several possible physiological, behavioral, social or cognitive mechanisms through which low emotional awareness may lead to disease 23. Low emotional awareness may predispose individuals to an excessive stress-induced sympathetic activation, a factor shown to influence circulating inflammatory markers 24. Difficulty identifying feelings and restricted range in affective experience has been linked to heightened physiological arousal 25 and other known behavioral risk factors such as social isolation 26 and heavy alcohol use 27. Furthermore, deficits in emotional awareness may contribute to negative affective states such as depression and anxiety, psychological factors that are associated with elevated CRP 23, 28.

Why Openness was associated with CRP among blacks and not whites is unclear. Previous research suggests that psychological factors such as depressive symptoms, hostility, self-identify, coping behaviors, mastery and control, may have more of an impact on physiological outcomes among blacks than whites 19, 29, 30. These previous studies did not specifically focus on the Openness domain. Therefore, future studies replicating the effects of the Openness domain on CRP levels will be needed to determine the significance of these race specific findings. Nevertheless, these preliminary yet exciting results provide further documentation of the Openness domain's importance in relation to health.

Table 3.

Pearson Partial Correlations by Race for Openness Domain and Facet scores with CRP Level at Baseline and Post-Stress Controlling for Age, BMI, and Education

OPENNESS Fantasy Aesthetics Feelings Actions Ideas Values
Blacks
Mean CRP -0.411 -0.154 -0.304 -0.412 -0.201 -0.377 -0.113
p-value <.01 0.19 0.01 <.01 0.09 <.01 0.34
whites
Mean CRP 0.138 0.095 0.068 0.100 0.006 0.187 0.008
p-value 0.30 0.48 0.61 0.46 0.96 0.16 0.95
Open in a new tab

Acknowledgments

This research was supported by the National Heart, Lung and Blood Institute grant P01-HL36587, and by the Duke Behavioral Medicine Research Center.

References

  • 1.Costa PT, McCrae RR. Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI) Professional Manual. Psychological Assessment Resources;; Odessa, Fl.: 1992. [Google Scholar]
  • 2.Jonassaint CR, Boyle SH, Williams RB, Mark DB, Siegler IC, Barefoot JC. Facets of openness predict mortality in patients with cardiac disease. Psychosom Med. 2007 May;69(4):319–322. doi: 10.1097/PSY.0b013e318052e27d. [DOI] [PubMed] [Google Scholar]
  • 3.Ross R. Atherosclerosis is an inflammatory disease. Am Heart J. 1999 Nov;138(5 Pt 2):S419–420. doi: 10.1016/s0002-8703(99)70266-8. [DOI] [PubMed] [Google Scholar]
  • 4.Han TS, Sattar N, Williams K, Gonzalez-Villalpando C, Lean ME, Haffner SM. Prospective study of C-reactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes Care. 2002 Nov;25(11):2016–2021. doi: 10.2337/diacare.25.11.2016. [DOI] [PubMed] [Google Scholar]
  • 5.Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001 Jul 18;286(3):327–334. doi: 10.1001/jama.286.3.327. [DOI] [PubMed] [Google Scholar]
  • 6.Sattar N, Gaw A, Scherbakova O, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation. 2003 Jul 29;108(4):414–419. doi: 10.1161/01.CIR.0000080897.52664.94. [DOI] [PubMed] [Google Scholar]
  • 7.Bautista LE, Lopez-Jaramillo P, Vera LM, Casas JP, Otero AP, Guaracao AI. Is C-reactive protein an independent risk factor for essential hypertension? J Hypertens. 2001 May;19(5):857–861. doi: 10.1097/00004872-200105000-00004. [DOI] [PubMed] [Google Scholar]
  • 8.Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of developing hypertension. JAMA. 2003 Dec 10;290(22):2945–2951. doi: 10.1001/jama.290.22.2945. [DOI] [PubMed] [Google Scholar]
  • 9.Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998 May 13;279(18):1477–1482. doi: 10.1001/jama.279.18.1477. [DOI] [PubMed] [Google Scholar]
  • 10.Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005 Jul 20;294(3):326–333. doi: 10.1001/jama.294.3.326. [DOI] [PubMed] [Google Scholar]
  • 11.Michowitz Y, Arbel Y, Wexler D, et al. Predictive value of high sensitivity CRP in patients with diastolic heart failure. Int J Cardiol. 2008 Apr 25;125(3):347–351. doi: 10.1016/j.ijcard.2007.02.037. [DOI] [PubMed] [Google Scholar]
  • 12.Alizadeh Dehnavi R, de Roos A, Rabelink TJ, et al. Elevated CRP levels are associated with increased carotid atherosclerosis independent of visceral obesity. Atherosclerosis. 2008 Feb 18; doi: 10.1016/j.atherosclerosis.2007.12.050. [DOI] [PubMed] [Google Scholar]
  • 13.Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003 Jan 28;107(3):499–511. doi: 10.1161/01.cir.0000052939.59093.45. [DOI] [PubMed] [Google Scholar]
  • 14.Suarez EC. C-reactive protein is associated with psychological risk factors of cardiovascular disease in apparently healthy adults. Psychosom Med. 2004 Sep-Oct;66(5):684–691. doi: 10.1097/01.psy.0000138281.73634.67. [DOI] [PubMed] [Google Scholar]
  • 15.Graham JE, Robles TF, Kiecolt-Glaser JK, Malarkey WB, Bissell MG, Glaser R. Hostility and pain are related to inflammation in older adults. Brain Behav Immun. 2006 Jul;20(4):389–400. doi: 10.1016/j.bbi.2005.11.002. [DOI] [PubMed] [Google Scholar]
  • 16.Coccaro EF. Association of C-reactive protein elevation with trait aggression and hostility in personality disordered subjects: a pilot study. J Psychiatr Res. 2006 Aug;40(5):460–465. doi: 10.1016/j.jpsychires.2005.04.005. [DOI] [PubMed] [Google Scholar]
  • 17.Thom T, Haase N, Rosamond W, et al. Heart Disease and Stroke Statistics--2006 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006 February 14;113(6):85–151. doi: 10.1161/CIRCULATIONAHA.105.171600. 2006. [DOI] [PubMed] [Google Scholar]
  • 18.Burroughs AR, Visscher WA, Haney TL, et al. Community recruitment process by race, gender, and SES gradient: lessons learned from the Community Health and Stress Evaluation (CHASE) Study experience. J Community Health. 2003 Dec;28(6):421–437. doi: 10.1023/a:1026029723762. [DOI] [PubMed] [Google Scholar]
  • 19.Surwit RS, Williams RB, Siegler IC, et al. Hostility, race, and glucose metabolism in nondiabetic individuals. Diabetes Care. 2002 May;25(5):835–839. doi: 10.2337/diacare.25.5.835. [DOI] [PubMed] [Google Scholar]
  • 20.Williams RB, Barefoot JC, Schneiderman N. Psychosocial risk factors for cardiovascular disease: more than one culprit at work. Journal of the American Medical Association. 2003 Oct 22;290(16):2190–2192. doi: 10.1001/jama.290.16.2190. [DOI] [PubMed] [Google Scholar]
  • 21.Williams RB, Marchuk DA, Gadde KM, et al. Central nervous system serotonin function and cardiovascular responses to stress. Psychosom Med. 2001 Mar-Apr;63(2):300–305. doi: 10.1097/00006842-200103000-00016. [DOI] [PubMed] [Google Scholar]
  • 22.Lane RD, Sechrest L, Riedel R, Shapiro DE, Kaszniak AW. Pervasive emotion recognition deficit common to alexithymia and the repressive coping style. Psychosom Med. 2000 Jul-Aug;62(4):492–501. doi: 10.1097/00006842-200007000-00007. [DOI] [PubMed] [Google Scholar]
  • 23.Lumley MA, Stettner L, Wehmer F. How are alexithymia and physical illness linked? A review and critique of pathways. J Psychosom Res. 1996 Dec;41(6):505–518. doi: 10.1016/s0022-3999(96)00222-x. [DOI] [PubMed] [Google Scholar]
  • 24.Steptoe A, Hamer M, Chida Y. The effects of acute psychological stress on circulating inflammatory factors in humans: a review and meta-analysis. Brain Behav Immun. 2007 Oct;21(7):901–912. doi: 10.1016/j.bbi.2007.03.011. [DOI] [PubMed] [Google Scholar]
  • 25.Taylor GJ, Bagby RM, Parker JD. The alexithymia construct. A potential paradigm for psychosomatic medicine. Psychosomatics. 1991;32(2):153–164. doi: 10.1016/s0033-3182(91)72086-0. Spring. [DOI] [PubMed] [Google Scholar]
  • 26.Kauhanen J, Kaplan GA, Julkunen J, Wilson TW, Salonen JT. Social factors in alexithymia. Compr Psychiatry. 1993 Sep-Oct;34(5):330–335. doi: 10.1016/0010-440x(93)90019-z. [DOI] [PubMed] [Google Scholar]
  • 27.Kauhanen J, Julkunen J, Salonen JT. Coping with inner feelings and stress: heavy alcohol use in the context of alexithymia. Behav Med. 1992;18(3):121–126. doi: 10.1080/08964289.1992.9936962. Fall. [DOI] [PubMed] [Google Scholar]
  • 28.Hendryx MS, Haviland MG, Shaw DG. Dimensions of alexithymia and their relationships to anxiety and depression. Journal of Personality Assessment. 1991;56(2):227–237. doi: 10.1207/s15327752jpa5602_4. [DOI] [PubMed] [Google Scholar]
  • 29.Williams DR. Race and health: basic questions, emerging directions. Ann Epidemiol. 1997 Jul;7(5):322–333. doi: 10.1016/s1047-2797(97)00051-3. [DOI] [PubMed] [Google Scholar]
  • 30.Boyle SH, Surwit RS, Georgiades A, et al. Depressive symptoms, race, and glucose concentrations: the role of cortisol as mediator. Diabetes Care. 2007 Oct;30(10):2484–2488. doi: 10.2337/dc07-0258. [DOI] [PubMed] [Google Scholar]

RESOURCES