Differences between individual and societal health state valuations: any link with personality?
OBJECTIVE
The concept of "adaptation" has been proposed to account for differences between individual and societal valuations of specific health states in patients with chronic diseases. Little is known about psychological indices of adaptational capacity, which may predict differences in individual and societal valuations of health states. We investigated whether such differences were partially explained by personality traits in chronic disease patients.


METHODS
Analysis of baseline data of randomized controlled trial.


METHODS
Three hundred seventy patients with chronic disease.


METHODS
The NEO-five factor inventory measure of personality, EuroQoL-5D (EQ-5D) societal-based, and the EQ visual analogue scale individually-based measures of health valuation.


RESULTS
Regression analyses modeled Dev, a measure of difference between the EQ-Visual Analogue Scale and EQ-5D, as a function of personality traits, sociodemographic factors, and chronic diseases. Individual valuations were significantly and clinically higher than societal valuations among patients in the second and third quartile of conscientiousness (Dev = 0.08, P = 0.01); among covariates, only depression (Dev = -0.04, P = 0.046) was also associated with Dev.


CONCLUSIONS
Compared with societal valuations of a given health state, persons at higher quartiles of conscientiousness report less disutility associated with poor health. The effect is roughly twice that of some estimates of minimally important clinical differences on the EQ-5D and of depression. Although useful at the aggregate level, societal preference measures may systematically undervalue the health states of more conscientious individuals. Future work should examine the impact this has on individual patient outcome evaluation in clinical studies.
Chapman
Benjamin P
BP
Laboratory of Personality and Development, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. ben_chapman@urmc.rochester.edu
Franks
Peter
P
Duberstein
Paul R
PR
Jerant
Anthony
A
D000368:Aged; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors