The Doctor-Patient Relationship, Personality, Mood and Functioning in Older Adults

• Published in: Professional psychology, research and practice research and practice, 2022-10, Vol.53 (5), p.436-445
• Main Authors: Atlas, Lauren S., Zweig, Richard A.
• Format: Article
• Language: English
• Subjects: Adjustment; Agreeableness; Clinical outcomes; Emotional States; Female; Geriatric Patients; Health status; Human; Interpersonal problems; Major Depression; Male; Medical personnel; Medical records; Mental depression; Mental health; Neuroticism; Older Adulthood; Older people; Outpatient; Pathology; Personality; Personality Disorders; Personality tests; Personality traits; Physician patient relationships; Physicians; Self report; Social Adjustment; Social functioning; Therapeutic Processes; Trust (Social Behavior)
• ISSN: 0735-7028; 1939-1323
• DOI: 10.1037/pro0000419

Is it important for older adults to build a trusting relationship with their physician and how is this affected by their personality and mood? Personality pathology (PP) has been tied to both mental and physical health in older adulthood. The present study explored the relationships between personality, mood, and trust in physicians. A sample (N = 170) of medical outpatient older adults between the ages of 60 and 99 completed self-report measures of personality traits (NEO-five factor inventory, NEO-FFI) and processes (Inventory of Interpersonal Problems-Personality Disorder, IIP-PD-25), depression (Geriatric Depression Scale, GDS-30), social role impairment (Social Adjustment Scale-Self Report, SAS-SR), and general trust in physicians (General Trust in Physicians Scale, GTIPS). Cumulative illness burden data (Cumulative Illness Rating Scale, CIRS) were retrieved from medical records. PP and trust independently predicted outcomes. In separate models, higher neuroticism, lower agreeableness, more interpersonal problems, and lower trust predicted depression. In combined models, higher neuroticism and lower trust predicted depression, and higher neuroticism and interpersonal problems predicted impaired social functioning. Trust did not moderate the relationship between PP and depression or social functioning impairment. The present findings regarding lower levels of trust and increased self-reported depression are particularly relevant for the older adult population, as they interact with health care professionals on a regular basis. Associations between trust in physicians and self-reported depression have implications for both the assessment and treatment of depressed older adults. Public Significance Statement Trust is fundamental to relationships with health care providers and is linked to health and mental health outcomes. The present study found that after adjusting for health, personality, and financial concerns, older adult medical outpatients who had lower trust in doctors were more likely to report depression. Providers' renewed attention to fostering trusting relationships with their older patients, especially in the current health care climate, will likely better serve older adults with medical illnesses and depression.