Structural Equation Modeling of the Relationships Between Executive Functions and the Percentage of Artery Blockage in Patients With Cardiovascular Disease: Mediation by the Big Five Personality Characteristics

Document Type : Original Article

Authors

1 Department of Psychology, Azad University, Karaj Branch, Alborz, IR Iran.

2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: This study aimed to determine the relationship between executive functions and the percentage of artery blockage as mediated by the big 5 personality characteristics in patients with cardiovascular disease (CVD). Accordingly, we used structural modeling to test a hypothesized model.
 
Methods: The research method was descriptive and correlational, and the statistical population was comprised of 183 patients with CVD selected via the available sampling method from those who referred to Rajaie Cardiovascular Medical and Research Center in Tehran, Iran. The percentage of artery blockage was recorded by coronary angiography. The measuring instruments were the Subjective Neurocognition Inventory (SNI) and the NEO Five-Factor Inventory (NEO-FFI). The data were analyzed using structural equation modeling. In this regard, the data were calculated using the Spearman correlation coefficient among the factors (the SPSS software) and the path analysis (the LISREL software).
 
Results: The results showed that the personality mediated the relationship between executive functions and the percentage of artery blockage.
 
Conclusions: Executive functions were associated with the percentage of artery blockage, and a part of this relationship was mediated by the big 5 personality characteristics. Therefore, personality traits should be considered in treating patients with CVD. (Iranian Heart Journal 2020; 21(3): 73-86)

Keywords

References

  1. Sarafino, E. P., & Smith, T. W. (2014). Health psychology: Biopsychosocial interactions. John Wiley & Sons.
  2. Samavat,T., Hojatzadeh,A., Shams,M., Afqami,A., Mahdavi, A., Bashti, Sh.,…& Rezvani,A.(2013). Ways of Prevention and Control of Cardiovascular Disease, Tehran: javan
  3. Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., ... & de Ferranti, S. D. (2018). Heart disease and stroke statistics-2018 update: a report from the American Heart Association. Circulation, 137(12), e67.
  4. Gaziano, T. A., Bitton, A., Anand, S., Abrahams-Gessel, S., & Murphy, A. (2010). Growing epidemic of coronary heart disease in low-and middle-income countries. Current problems in cardiology, 35(2), 72-115.
  5. Borhani-Haghighi, A., Safari, R., Heydari, S. T., Soleimani, F., Sharifian, M., Kashkuli, S. Y., ... & Lankarani, K. B. (2013). Hospital mortality associated with stroke in southern Iran. Iranian journal of medical sciences, 38(4), 314.
  6. Sarrafzadegan, N., & Mohammadifard, N. (2019). Cardiovascular Disease in Iran in the Last 40 Years: Prevalence, Mortality, Morbidity, Challenges and Strategies for Cardiovascular Prevention. Archives of Iranian Medicine (AIM), 22(4).
  7. Porter, A., Fischer, M. J., Brooks, D., Bruce, M., Charleston, J., Cleveland, W. H., ... & Hiremath, L. (2012). Quality of life and psychosocial factors in African Americans with hypertensive chronic kidney disease. Translational Research, 159(1), 4-11.
  8. Maddahi, M. E., Nikpajouh, A., Khalatbari, J., Malihia Zakerini, S., & Hashemi, S. (2018). Effects of metacognitive training and mindfulness-based cognitive therapy on couple communication patterns with the mediation of perceived stress, perceived social support, and emotion regulation in patients with coronary heart disease. Iranian Heart Journal, 19(1), 6-14.
  9. Hengartner, M. P. (2015). The detrimental impact of maladaptive personality on public mental health: a challenge for psychiatric practice. Frontiers in psychiatry, 6, 87.
  10. Hampson, S. E., Goldberg, L. R., Vogt, T. M., & Dubanoski, J. P. (2007). Mechanisms by which childhood personality traits influence adult health status: Educational attainment and healthy behaviors. Health psychology, 26(1), 121.
  11. Chapman, B. P., Roberts, B., & Duberstein, P. (2011). Personality and longevity: knowns, unknowns, and implications for public health and personalized medicine. Journal of aging research, 2011.
  12. Smith, T. W. (2006). Personality as risk and resilience in physical health. Current Directions in Psychological Science, 15, 227–231.
  13. Roberts, B. W., & DelVecchio, W. F. (2000). The rank-order consistency of personality traits from childhood to old age: a quantitative review of longitudinal studies. Psychological bulletin, 126(1), 3.
  14. Laurenssen, E. M., Eeren, H. V., Kikkert, M. J., Peen, J., Westra, D., Dekker, J. J., & Busschbach, J. J. (2016). The burden of disease in patients eligible for mentalization-based treatment (MBT): quality of life and costs. Health and quality of life outcomes, 14(1), 145.
  15. Ibrahim, N., Teo, S. S., Din, N. C., Gafor, A. H. A., & Ismail, R. (2015). The role of personality and social support in health-related quality of life in chronic kidney disease patients. PloS one, 10(7), e0129015.
  16. Karlsson, M. R., Edström-Plüss, C., Held, C., Henriksson, P., Billing, E., & Wallén, N. H. (2007). Effects of expanded cardiac rehabilitation on psychosocial status in coronary artery disease with focus on type D characteristics. Journal of behavioral medicine, 30(3), 253-261.
  17. Charles, S. T., Gatz, M., Kato, K., & Pedersen, N. L. (2008). Physical health 25 years later: the predictive ability of neuroticism. Health Psychology, 27(3), 369.
  18. Shipley, B. A., Weiss, A., Der, G., Taylor, M. D., & Deary, I. J. (2007). Neuroticism, extraversion, and mortality in the UK Health and Lifestyle Survey: A 21-year prospective cohort study. Psychosomatic Medicine, 69, 923–931.
  19. Rasmussen, H. N., Scheier, M. F., & Greenhouse, J. B. (2009). Optimism and physical health: A meta-analytic review. Annals of behavioral medicine, 37(3), 239-256.
  20. Fry, P. S., & Debats, D. L. (2009). Perfectionism and the five-factor personality traits as predictors of mortality in older adults. Journal of Health Psychology, 14(4), 513-524.
  21. Westlake, C., Dracup, K., Creaser, J., Livingston, N., Heywood, J. T., Huiskes, B. L., ... & Hamilton, M. (2002). Correlates of health-related quality of life in patients with heart failure. Heart & Lung: The Journal of Acute and Critical Care, 31(2), 85-93.
  22. Kumar,S., Yadava, A., & Sharma, N.R. (2016).  Exploring the Relations between Executive Functions and Personality. Indian Psychology, 7(3), 161-171.
  23. DeMaso, D. R., Labella, M., Taylor, G. A., Forbes, P. W., Stopp, C., Bellinger, D. C., ... & Newburger, J. W. (2014). Psychiatric disorders and function in adolescents with d-transposition of the great arteries. The Journal of pediatrics, 165(4), 760-766.
  24. Koziol, L. F., Budding, D. E., & Chidekel, D. (2012). From movement to thought: executive function, embodied cognition, and the cerebellum. The Cerebellum, 11(2), 505-525.
  25. Wolters, F. J., Segufa, R. A., Darweesh, S. K., Bos, D., Ikram, M. A., Sabayan, B., ... & Sedaghat, S. (2018). Coronary heart disease, heart failure, and the risk of dementia: a systematic review and meta-analysis. Alzheimer's & Dementia, 14(11), 1493-1504.
  26. Hjelm, C., Dahl, A., Broström, A., Mårtensson, J., Johansson, B., & Strömberg, A. (2012). The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older. Journal of clinical nursing, 21(7‐8), 994-1003.
  27. Carlson, S. R., Thai, S., & McLarnon, M. E. (2009). Visual P3 amplitude and selfreported psychopathic personality traits: Frontal reduction is associated with self centered impulsivity. Psychophysiology, 46, 100-113.
  28. Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689.
  29. Lieberman, M.D. (2000). Introversion and working memory: Central executive differences. Personality and Individual Differences, 28, 479–486.
  30. Radcliffe, A. M., Lumley, M. A., Kendall, J., Stevenson, J. K., & Beltran, J. (2010). Written Emotional Disclosure: Testing Whether Social Disclosure Matters. Journal of social and clinical psychology, 26(3), 362.
  31. Zimmermann, P., Messner, C., Poser, U., & Sedelmeier, P. (1991). Ein Fragebogen erlebter Defizite der Aufmerksamkeit (FEDA). Unpublished manuscript.
  32. Moritz, S., Ferahli, S., & Naber, D. (2004). Memory and attention performance in psychiatric patients: lack of correspondence between clinician-rated and patient-rated functioning with neuropsychological test results. Journal of the International Neuropsychological Society, 10(4), 623-633.
  33. Malekirad, A. A., Faghih, M., Mirabdollahi, M., Kiani, M., Fathi, A., & Abdollahi, M. (2013). Neurocognitive, mental health, and glucose disorders in farmers exposed to organophosphorus pesticides. Archives of Industrial Hygiene and Toxicology, 64(1), 1-8.
  34. Moritz, S., Kuelz, A. K., Jacobsen, D., Kloss, M., & Fricke, S. (2006). Severity of subjective cognitive impairment in patients with obsessive-compulsive disorder and depression. Journal of anxiety disorders, 20(4), 427-443.
  35. Costa Jr, P. T., & McCrae, R. R. (1992). Revised NEO personality inventory (NEO-PI-R) and NEO five-factor (NEO-FFI) inventory professional manual. Odessa, Fl: PAR.
  36. Chapman, B. P., Shah, M., Friedman, B., Drayer, R., Duberstein, P. R., & Lyness, J. M. (2009). Personality traits predict emergency department utilization over 3 years in older patients. The American Journal of Geriatric Psychiatry, 17(6), 526-535.
  37. Babaei, M., Mohammadian, M., Abdollahi, M., & Hatami, A. (2018). Relationship between big five personality factors, problem solving and medical errors. Heliyon, 4(9), e00789.
  38. Fox, R. (2017). Research in psychotherapy. Routledge.
  39. Kumar, S., Yadava, A., & Sharma, N. R. (2016). Positive personality attributes and executive functions among postgraduates. Indian Journal of Health and Wellbeing, 7(1), 24.
  40. Prigatano, G. P. (1999). Principles of neuropsychological rehabilitation. Oxford University Press.Psychological Science in the Public Interest, 11, 53–79.
  41. Alosco, M. L., Brickman, A. M., Spitznagel, M. B., Garcia, S. L., Narkhede, A., Griffith, E. Y., ... & Josephson, R. (2013). Cerebral perfusion is associated with white matter hyperintensities in older adults with heart failure. Congestive heart failure, 19(4), E29-E34.
  42. Carlson, M. C., Xue, Q. L., Zhou, J., & Fried, L. P. (2009). Executive decline and dysfunction precedes declines in memory: the Female's Health and Aging Study II. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64(1), 110-117.
  43. Luu, P., Collins, P., & Tucker, D. M. (2000). Mood, personality, and self-monitoring: negative affect and emotionality in relation to frontal lobe mechanisms of error monitoring. J Exp Psychol Gen, 129(1), 43-60.
  44. Murdock, K. W., Oddi, K. B., & Bridgett, D. J. (2013). Cognitive correlates of personality. Journal of Individual Differences.
  45. Campbell, A. M., Davalos, D. B., McCabe, D. P., & Troup, L. J. (2011). Executive functions and extraversion. Personality and Individual Differences, 51(6), 720-725.
  46. Vollrath, M., Knoch, D., & Cassano, L. (1999). Personality, risky health behaviour, and perceived susceptibility to health risks. European journal of personality, 13(1), 39-50.
  47. Geraghty, M. (2002). Connection between personality, death among chronically ill.
  48. Smith, D. (2003). Angry thoughts, at-risk hearts. Monitor on Psychology, 34(3), 46.
  49. Pietrzak, R. H., Sprague, A., & Snyder, P. J. (2008). Trait impulsiveness and executive function in healthy young adults. Journal of Research in personality, 42(5), 1347-1351.
  50. Rike, P., Johansen, H. J., Ulleberg, P., Lundqvist, A., & Schanke, A. (2015). Exploring associations between self-reported executive functioning, impulsive personality traits, driving self-efficacy, and functional abilities in driver behaviour after brain injury. Transportation Research Part F: Traffic Psychology and Behaviour, 29, 34-47.
  51. Krieger, V. & Amador, J. A. (2014). Executive functions, five-factor model personality dimensions and cognitive style in adolescents. Personality and Individual Differences, 60, S57.
  52. Demir, B., Ucar, G., Ulug, B., Ulusoy, S., Sevinc, I., & Batur, S. (2002). Platelet Monoamine Oxidase Activity In Alcoholism Subtypes: Relationship To Personality Traits And Executive Functions. Alcohol and Alcoholism. 37(6), 597-602.
  53. Bergeron, T. K., & Valliant P. M. (2001) Executive Function and Personality in Adolescent and Adult Offenders vs. Non-Offenders. Journal of Offender Rehabilitation, 33(3), 27-45.
  54. Puric, D., & Pavlovic, M.(2012). Executive function of shifting: Factorial structure and relations to personality and intelligence domains. Suvremena Psihologija. 15(2), 177-191.
  55. Adrian, J., Postal, V., Moessinger, M., Rascle, N., & Charles, A. (2011). Personality traits and executive functions related to on-road driving performance among older drivers. Accident Analysis & Prevention, 43(5), 1652-1659.
  56. Dolan, M., & Park, I. (2002). The neuropsychology of antisocial personality disorder. Psychological Medicine, 32, 417-427.
  57. Matheson, S., & Langdon, R. (2008). Schizotypal traits’ impact upon executive working memory and aspects of IQ. Psychiatry Research, 159, 207-214.
  58. DeYoung, C. G., Peterson, J. B., & Higgins, D. M. (2005). Sources of openness/intellect: Cognitive and neuropsychological correlates of the fifth factor of personality. Journal of Personality, 73, 825–858.
  59. Salthouse, T. A., Berish, D. E., & Siedlecki, K. L. (2004). Construct validity and age sensitivity of prospective memory. Memory & Cognition, 32(7), 1133-1148.
  60. Deary, I. J., Weiss, A., & Batty, G. D. (2010). Intelligence and personality as predictors of illness and death: How researchers in differential psychology and chronic disease epidemiology are collaborating to understand and address health inequalities.
  61. Booth-Kewley, S., & Friedman, H. S. (1987). Psychological predictors of heart disease: a quantitative review. Psychological Bulletin, 101, 343–362.
  62. Kubzansky, L. D., & Kawachi, I. (2000). Going to the heart of the matter-do negative emotions cause coronary heart disease? Journal of Psychosomatic Research, 48, 323–338.
  63. McCarron, P., Gunnell, D., Harrison, G. L., Okasha, M., & Smith, G. D. (2003). Temperament in Young adulthood and later morality: prospective observational study. Journal of Epidemiology and Community Health, 57, 888–892.
  64. Steptoe, A., & Chida, Y. (2009). The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. Journal of the American College of Cardiology, 53, 936–946.
  65. Martin, L. R., Friedman, H. S., & Schwartz, J. E. (2007). Personality and mortality risk across the life span: The importance of conscientiousness as a biopsychosocial attribute. Health Psychology, 26, 428–436.
  66. Terracciano, A., Lockenhoff, C. E., Zonderman, A. B., Ferrucci, L., & Costa, P. T. (2008). Personality predictors of longevity: Activity, emotional stability, and conscientiousness. Psychosomatic Medicine, 70, 621–627.
  67. Bogg, T., & Roberts, B. W. (2004). Conscientiousness and healthrelated behaviors: A meta-analysis of the leading behavioral contributors to mortality. Psychological Bulletin, 130, 887–919.
  68. Lodi-Smith, J., Jackson, J., Bogg, T., Walton, K., Wood, D., Harms, P., & Roberts, B. W. (2010). Mechanisms of health: Education and health-related behaviours partially mediate the relationship between conscientiousness and self-reported physical health. Psychology and Health, 25(3), 305-319.
  69. Watson, D., & Clark, L. A. (1992). On traits and temperament: General and specific factors of emotional experience and their relation to the 5-factor model. Journal of Personality, 60, 441–476.
  70. Connor-Smith, J. K., & Flachsbart, C. (2007). Relations between personality and coping: A meta-analysis. Journal of Personality and Social Psychology, 93, 1080–1107.
  71. Watson, D., & Hubbard, B. (1996). Adaptational style and dispositional structure: Coping in the context of the five-factor model. Journal of Personality, 64, 737–774.
  72. Jonassaint, C. R. M. A., Boyle, S. H. P., Williams, R. B. M. D., Mark, D. B. M. D., Siegler, I. C. P. M. P. H., & Barefoot, J. C. P. (2007). Facets of openness predict mortality in patients with cardiac disease. Psychosomatic Medicine, 69, 319–322.
  73. Smith, T. W., & MacKenzie, J. (2006). Personality and risk of physical illness. Annual Review of Clinical Psychology, 2,435–467.
  74. Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Z., Verschuren, M., et al. (2012). European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). European Heart Journal, 33, 1635–1701.
  75. Kung, H. C., Hoyert, D. L., Xu, J. Q., & Murphy, S. L. (2008). Deaths: Final data for 2005. National Vital Statistics Reports, 56.
  76. Puddu, P., Puddu, G. M., Bastagli, L., Massarelli, G., & Muscari, A. (1995). Coronary and cerebrovascular atherosclerosis: two aspects of the same disease or two different pathologies? Archives of Gerontology and Geriatrics, 20, 15–22.
  77. Goldstein, L. B., Bushnell, C. D., Adams, R. J., Appel, L. J., Braun, L. T., Chaturvedi, S., et al. (2011). Guidelines for the primary prevention of stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 42, 517–584.
  78. Wilhelmsen, L., Koster, M., Harmsen, P., & Lappas, G. (2005). Differences between coronary disease and stroke in incidence, case fatality, and risk factors, but few differences in risk factors for fatal and non-fatal events. European Heart Journal, 26, 1916–1922.
  79. Nakaya, N., Tsubono, Y., Hosokawa, T., Hozawa, A., Kuriyama, S., Fukudo, S., et al. (2005). Personality and mortality from ischemic heart disease and stroke. Clinical and Experimental Hypertension, 27, 297–305.

 

Iranian Heart Journal
Volume 21, Issue 3
July 2020
Pages 64-77

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