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Facets of Openness Predict Mortality in Patients With Cardiac Disease

From the Department of Psychology (C.R.J.), Duke University, Durham, North Carolina; Department of Psychiatry (S.H.B., R.B.W., I.C.S., J.C.B.), Duke University Medical Center, Durham, North Carolina; and Division of Cardiology (D.B.M.), Department of Medicine, Durham, North Carolina.

Address correspondence and reprint requests to John Barefoot, Department of Psychiatry, Behavioral Medicine Research Center, Duke University Medical Center, Durham, NC 27710. E-mail: John.Barefoot{at}duke.edu

Objective: To examine the NEO Personality Inventory (NEO PI) Openness to Experience (O) domain and its facets as predictors of cardiac deaths and all-cause mortality.

Methods: The NEO PI was administered to a sample of 977 coronary catheterization patients with significant coronary artery disease. Over an average 15-year follow-up period, 266 cardiac deaths and 463 total deaths occurred. The relationships of O scores to mortality were examined with Cox proportional hazard models. Each model included age, left ventricular ejection fraction, severity of congestive heart failure, and number of diseased vessels as covariates.

Results: The O domain score was not associated with all-cause mortality and only approached significance for decreased cardiac deaths (p = .055). However, a higher score for Openness to Feelings was associated with a decreased risk of cardiac death (p < .01) and all-cause mortality (p < .01). High Openness to Actions was also associated with decreased cardiac mortality (p < .01) and all-cause mortality (p = .03) risk. Higher Openness to Aesthetics and Ideas were only associated with decreased cardiac death risk (both p values <.04). In contrast, Openness to Fantasy and Values were not associated with longevity. Previous evidence suggested that educational achievement may account for the effects of Openness to Experience on mortality; however, controlling for educational achievement did not change the results.

Conclusion: These findings suggest that greater emotional awareness and high curiosity, as indicated by the NEO PI Feelings and Actions facets, are associated with increased patient longevity independently of other risk factors and educational achievement.

Key Words: mortality • coronary artery disease • personality

Abbreviations: CAD = coronary artery disease; FFM = Five-Factor Model; O = Openness to Experience domain