Characteristics of personality and depression in elderly women of the University for the Third Age

Abstracts

INTRODUÇÃO: Os aspectos de personalidade têm sido apontados como fatores que podem contribuir para o desenvolvimento de depressão na velhice. O objetivo deste estudo foi examinar a influência da personalidade no surgimento de sintomas depressivos em idosas. MÉTODO: O estudo teve um delineamento transversal, com a participação de 103 idosas, com idade entre 60 e 86 anos e escolaridade mínima de sete anos de estudo, integrantes da Universidade para a Terceira Idade (UNITI/UFRGS), e o processo de amostragem foi o de conveniência. Todas as participantes preencheram o Termo de Consentimento Livre e Esclarecido e responderam a respeito de informações sociodemográficas, fatores de personalidade (Inventário Fatorial de Personalidade - IFP) e depressão (Escala de Depressão Geriátrica - GDS). RESULTADOS: Observou-se a presença de dois grupos (clusters) com características distintas de personalidade: um mais preocupado com os outros (cluster 1) e outro mais voltado para si (cluster 2). Embora ambos os grupos não tenham preenchido os critérios para depressão, ocorreu uma diferença significativa no escore total da GDS, em que o grupo mais preocupado com os outros (cluster 1) apresentou maior intensidade de sintomatologia depressiva. CONCLUSÕES: O estudo aponta para uma associação entre dimensões de personalidade e depressão em idosas. As idosas agrupadas no cluster 1, que são mais voltadas para o outro, mais deferentes, organizadas, persistentes e interativas, apresentaram uma maior intensidade de sintomatologia depressiva em relação àquelas do cluster 2, que são mais voltadas para si próprias, menos interativas e pouco dominantes. Outros estudos são sugeridos.

Personalidade; depressão; idosas; velhice

ORIGINAL ARTICLE

Characteristics of personality and depression in elderly women of the University for the Third Age

Tatiana Quarti Irigaray^I; Rodolfo Herberto Schneider^II

^IPsychologist. MSc. and PhD student in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil. Member, Technical Team, University for the Third Age - Universidade Federal do Rio Grande do Sul (UNITI/UFRGS), Porto Alegre, RS, Brazil

^IIGeriatrician. Ph.D in Medicine, PUCRS. Associate professor, Instituto de Geriatria e Gerontologia, PUCRS. This study was performed at Instituto de Geriatria e Gerontologia, PUCRS

^{Correspondence}

ABSTRACT

INTRODUCTION: Personality aspects have been mentioned as factors that may contribute for the development of depression in old age. This study aimed at examining the influence of personality in the onset of depressive symptoms in elderly women.

METHOD: The study had a cross-sectional design and included 103 elderly women, aged between 60-86 years and with minimum schooling level of 7 years, attending the University for the Third Age (UNITI/UFRGS), using a convenience sample. All the participants signed a consent form and provided answers about sociodemographic information, personality factors (Factor Personality Inventory - FPI) and depression (Geriatric Depression Scale - GDS).

RESULTS: Presence of two groups (clusters) with distinct personality characteristics was observed: one more preoccupied with the others (cluster 1) and the other more self-concerned (cluster 2). Although both groups did not meet the criteria for depression, there was a significant difference in total GDS score, in which the group more preoccupied with the others (cluster 1) presented more depressive symptoms.

CONCLUSIONS: The study indicates an association between personality dimensions and depression in elderly women. The elderly women in cluster 1, who were more devoted to the others, more deferential, organized, persistent and interactive, presented more depressive symptoms in relation to those in cluster 2, who were more self-centered, less interactive and less dominant. Others studies are suggested.

Keywords: Personality, depression, elderly women, old age.

Introduction

Personality dimensions may contribute to adaptation to the aging process, influencing health and longevity in old age.¹ Although the foundation of such association is still little known, there is evidence of the importance of personality on subjective well-being and depression onset in the elderly. The term personality does not have a single definition; it varies according to the personality theory used. According to Murray's theory,² personality refers to a series of events that comprehend the whole individual's life, reflecting both long-lasting and recurrent behavioral elements and new and single elements. To him, personality would act as the individual's organizing or governing agent.²

According to Neri,³ personality is related to how individuals usually behave, have experiences, believe and feel toward themselves, others and the world. Kaplan et al.⁴ define personality as the totality of emotional and behavioral traits that characterize the individual in everyday life situations, under normal conditions, being relatively stable and predictable. For Hilgard et al.,⁵ personality is comprised of individual behavioral characteristics that account for the individual's adequacy to the environment.

Several theories try to explain the development of personality in old age. The first studies showed that personality became more rigid with age and that it had little development in old age.^6,7 Further studies, published since the 1970's, have suggested that personality traits would be stabilized throughout adult life and old age.^8-11 Thus, personality would not become rigid, but remain as it had always been since adult life.

Some studies tend to consider that differences between cohorts are reflected in elderly individuals' personality.^12,13 People assessed in more recent cohort studies seem to be more flexible, i.e., they have less rigidity than previous cohorts.¹² These findings suggest that increased rigidity seen in previous studies could be related to the cultural influence that a generation suffered during adult life, and probably future generations of elderly individuals will be able to adapt themselves more easily to the aging process than previous generations.¹⁴

On the other hand, current personality theories understand human development as a multidimensional and multidirectional process, comprised of a joint occurrence of profits, losses and stabilities. According to this model, people have potential for changes (plasticity) and for maintenance and recovery of adaptation faced with limiting events that facilitate the process of normal development throughout life.^15-21 Thus, in old age, personality traits could be modifiable, especially because in that stage of life people are more likely to be confronted with stressing life events that require adaptation. Although many individuals can maintain their personality stable under normal life circumstances, it can be inferred that, under more complex situations, personality would change to adapt itself to life changes.¹⁷

In old age, depression is a frequent mood disorder. It has prevalence between 4.8-14.6% in the elderly who live in the community and higher prevalence among hospitalized or institutionalized elderly, reaching up to 22.0% of this population. Studies assessing clinically relevant depressive symptoms in that age group using symptom scales, but that do not meet sufficient criteria of the International Classification of Diseases, volume 10 (ICD-10) or of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV), show a prevalence in the community ranging from 6.4 to 59.3%.²² Although depression is a frequent health problem in the elderly,²³ it is still little diagnosed and treated.

According to studies,^24-27 personality can be one of the main triggering factors of depressive symptoms in old age. Low levels of dominance and high levels of neuroticism have been associated with triggering of depression in the elderly.²⁷ On the other hand, high levels of extroversion and low levels of neuroticism seem to be associated with reduced risk of mortality in old age.²⁸ Another study has demonstrated that optimistic and hopeful individuals tend to have better health status, live longer, have more positive mood and more success than pessimistic individuals, who show higher probability of developing depression and having worse health status.²⁹

This study aimed at examining the influence of personality traits on triggering of depressive symptoms in elderly women.

Method

Participants

The sample was comprised of 103 women aged 60 years or older and minimum schooling level of 7 years. The participants were recruited from the University for the Third Age (UNITI/UFRGS) using a convenience sample. All 153 UNITI participants were invited to participate in the study, but only 109 consented. Six elderly women were excluded because they were under 60 years.

The University for the Third Age (UNITI/UFRGS) is an extension project that is part of the Institute of Psychology at Universidade do Rio Grande do Sul. Its participants are community people aged 60 years or older, and its work dynamics deals with cognitive, social and community issues, leading the elderly to think and rethink their role as citizens. At UNITI, the elderly are encouraged to conquer, maintain and preserve autonomy, good quality of life and independence. They are also encouraged to acquire new information and increase their knowledge.

Instruments

Instruments used were as follows:

1. Collection of sociodemographic data

Collection of sociodemographic data included the following variables: age, marital status, schooling level, income, previous occupation, current occupation, health perception, physical activity and participation time at UNITI.

2. Evaluation of personality factors

Factor Personality Inventory - FPI.³⁰ It is an objective personality inventory, which assesses 15 psychological needs or reasons (assistance, dominance, order, denial, intraception, performance, exhibition, heterosexuality, caress, change, persistence, aggression, deference, autonomy and affiliation). The FPI is comprised of 155 items, which represent statements to which the individual should answer using Likert scale alternatives that progressively range from 1 (not at all characteristic) to 7 (totally characteristic). The Portuguese version of the instrument was used, approved by Conselho Federal de Psicologia [Brazilian Federal Council of Psychology], adapted and validated by Prof. Luiz Pasquali's team.³⁰

3. Intensity of depressive symptoms

Geriatric Depression Scale - GDS-15.³¹ GDS is one of the most used measurements to scan depression in the elderly. The short version of this instrument in Portuguese was used, comprised of 15 questions with answers classified in yes or no. GDS total score comprises the sum of answers given by examinees in 15 items, zero being the lowest possible score and 15 the highest. We used the version adapted by Yesavage et al.,³¹ which is considered a valid and reliable measure to be used in a Brazilian sample.

Procedures

Data collection procedures

Initially, all the elderly women signed the consent term and were then invited to provide information concerning sociodemographic data, personality factors³⁰ and depression symptoms.³¹

Sociodemographic data, FPI and GDS were obtained by self-administration. However, a research assistant (psychology student) was always available in case of doubts. The instruments were applied in groups of up to 15 participants.

The research project was properly examined and approved by the Research Ethics Committee of Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Data analysis procedures

Description of variables was performed using absolute and relative frequencies, as well as mean and standard deviation.

Associations between FPI personality factors and depression variable (GDS) were measured using Spearman's correlation coefficient.

Student's t test was used to compare depression variable (GDS) and FPI clusters.

Associations with p ≤ 0.05 values were considered significant.

SPSS for Windows, version 13.0 was used for data analysis.

Results

The sample was comprised of 103 elderly women aged between 60 and 86 years, mean age of 69.2 years (standard deviation, SD = 6.46). The most frequent group was that of widows (44.7%). In terms of schooling level, higher education was prevalent (40.8%) and the most frequent income was between 6 and 10 minimum wages (38.8%). Teacher was the most frequent previous occupation (28.1%) and retirement was the prevalent current occupation (73.8%). Predominant health perception was healthy (81.6%), most elderly women practice physical activity (74.8%) and have participated in the third age group for more than 1 year (84.4%).

The group of assessed elderly women showed, according to the FPI, median characteristics for all personality factors. The most reported dimensions were high deference (mean = 50.68; SD = 6.42) and low aggression (mean = 24.58; SD = 7.53). In the other personality factors, the group had the following results: assistance (mean = 51.59; SD = 7.04), intraception (mean = 44.69; SD = 7.78), caress (mean = 45.84; SD = 8.74), affiliation (mean = 55.06; SD = 6.64), dominance (mean = 30.31; SD = 8.64), denial (mean = 37.98; SD = 6.94), performance (mean = 47.17; SD = 7.49), exhibition (mean = 28.61; SD = 8.46), order (mean = 50.17; SD = 8.07), persistence (mean = 45.90; SD = 8.74), change (mean = 47.74; SD = 7.41) and autonomy (mean = 45.04; SD = 7.08). It should be stressed that heterosexuality was not assessed, since it was not relevant concerning the objectives of this study.

The Geriatric Depression Scale showed absence of depressive symptoms (mean = 2.65; SD = 2.42), since the assessed sample did not show sufficient scores to indicate depression, which would correspond to at least 5 points. The participants had a score ranging from 0 to 9 in GDS.

Table 1 shows the correlations found between FPI factors and depression variable (GDS). Using Spearman's correlation coefficient, there were weak but significant correlations between caress and aggression (FPI) and depression variable (GDS), and a weak but significant negative correlation between persistence (FPI) and depression variable (GDS).

In Table 2 it is possible to observe a cluster analysis of FPI personality factors. Clusters were used to explore personality traits, with the aim of maximizing the differences between them in the assessed group. As can be seen, cluster 1 is formed by people who were more devoted to the other, more deferential, organized, persistent and interactive. Differently, cluster 2 is comprised of people who were more self-centered, less interactive and less dominant. Table 2 also shows the results of the comparison between depression variable (GDS) and FPI clusters. Using the Student's t test, it was possible to verify a significant difference (p ≤ 0.01) for depression variable (GDS) in clusters 1 and 2. Based on this comparison, the elderly women in cluster 1 (more devoted to the others, more deferential, organized, persistent and interactive) presented more depressive symptoms in relation to those in cluster 2 (more self-centered, less interactive and less dominant).

Clique here to enlarge

Discussion

According to the previous presentation of results, a cluster analysis was performed to explore the differences between personality aspects in the assessed group. Based on a comparison between FPI clusters and depression variable (GDS), it could be seen that the elderly grouped in cluster 2, who were more self-centered, less interactive and less dominant, had fewer depression symptoms in relation to those in cluster 1, who were more devoted to and interested in the other, more deferential, organized, persistent and interactive. Although the groups that are part of cluster 1 and cluster 2 have shown differences as to intensity of depressive symptoms, such result does not have a clinically relevant impact, since both groups had absence of depressive symptoms, which corresponds to a mean lower than 5 points in the GDS.

According to the results of the present study, cluster 1 is formed by individuals with great wishes and feelings of piety, who like to respect, admire and obey a superior, who tend to put things in order with precision, who try to end whatever they started and who like to give and receive caress from friends. Those personality traits were the most consistently variables associated with higher intensity of depressive symptoms among the elderly women in this sample. The association between personality aspects and depression in the elderly has been found by several studies.^24-27,32 One study²⁷ demonstrated that low dominance and high levels of neuroticism seem to be related to depression onset in the elderly. Thus, personality would be a triggering factor of depression in old age, more than physical health status and available social resources.²⁷

One of the hypothesis concerning that association is that, because they have personality traits that are more devoted to the others, these elderly women have unrealistic expectations regarding other people, and hope to receive more caress and emotional support than they actually do. Therefore, since they cannot find the expected affective correspondence, they develop a higher number of depressive symptoms. Neri's studies corroborate this idea, showing that subjective perception of relationship quality is essential for life satisfaction, social relationships and mental and physical health in old age.³

A second hypothesis is that personality traits of the elderly women in cluster 1 could have direct effects on their sense of self-efficacy. Thus, those personality dimensions would determine a reduction in sense of self-efficacy, which would lead to a higher expression of depressive symptoms. Neri³ therefore states that satisfaction and less depression in old age is directly proportional to sense of self-efficacy. Thus, the more structured the system of beliefs on the possibilities of controlling oneself and the environment, the higher the elderly adjustment.³

Studies have shown the influence of the role of self-efficacy beliefs on several functioning domains, such as learning, work, sport, health, social adjustment and well being.³³ Self-efficacy refers to the belief individuals have in their abilities to perform given tasks, control world events and achieve certain results, and such beliefs result in achievement and motivation.³⁴

Some authors tend to consider that a successful old age is largely dependent upon the elderly's beliefs in their abilities to manage their own lives and events in the external world.^3,33 To Neri,³ sense of self-efficacy and active lifestyle contribute to a good physical and mental performance in old age. On the other hand, loss of strength and change in focus of beliefs in self-efficacy increase vulnerability to stress and depression in the elderly, making their access to required social support difficult.³³

Another finding in this study is that the assessed elderly women had median aspects for all personality traits, high deference and low aggression being the most reported dimensions. High deference characterizes people who show respect, admiration and reverence to an individual that they consider superior, and like to compliment, admire, as well as imitate and obey them. Low aggression defines the individuals who are not characterized by anger, irritation and hate, who dislike overcoming opposition vigorously and do not wish to fight, attack, oppose, censor and ridicule others.

The explanation for this finding could lie in the fact that the elderly women in this sample are part of a cohort that was essentially educated to play the roles of wife, mother and housewife. This result is in agreement with the data from a research on the history of Brazilian women,³⁵ which demonstrated that in the family-model of the 1950's, men had authority and power over women and were responsible for supporting their wives and children. Marriage presupposed a hierarchy in which the husband was the boss, power holder over wife and children. The ideal woman was defined based on the traditional feminine roles of housewife, mother and wife. Maternal instinct, purity, resignation and sweetness were part of women's essence, with no possibilities of contestation. Vocation to maternity and domestic life were trademarks of femininity, whereas participation in the job market, strength and adventure spirit defined masculinity. Girls were raised to be good mothers and exemplary housewives.³⁵ Similarly, another study³⁶ supports the idea that education does not prepare people to old age, producing individuals with low resources for late development. People reach old age with a fragile set of dispositions, due to an excessive emphasis on social identifications, with work and procreation, which eventually reduce human potential for development.³⁶

In the present study, the elderly women had absence of depression. One possible explanation for this finding may be the fact that our sample was comprised of elderly women who participated in a group in which they are encouraged to maintain cognitive and social activities, which might result in a higher felling of well being and act as a possible protective factor against depression in old age. Such evidence is in accordance with the theory of activity, which states that the more active the elderly people are, the better they grow old.¹⁴ According to this theory, adult roles are important sources of satisfaction, the greater the loss of roles due to retirement, widowhood, children leaving home, diseases, the less satisfied the individual will be. People who are growing old well maintain the highest amount of activities as they can and find substitutes for lost roles.³⁷ Another hypothesis to explain the result of absence of depression is that when the elderly women search UNITI, they already join the group with few depressive symptoms or absence of them, which would lead them to a large motivation to engage in new activities. Or also that the absence of depressive symptoms would be more influenced by participation time in the group than by the mood state with which the elderly women join UNITI.

Among the possible limitations of this study, it is worth stressing that it was conducted using a sample comprised only by elderly women, coming from the same context, as well as the fact that a convenience sample was used, which may not reflect the reality of elderly people in the community.

Conclusions

Personality traits can both contribute to health maintenance and subjective well being in old age and influence triggering of depressive symptoms in the elderly. Based on the results obtained in this study, the elderly who were more self-centered, less interactive and less dominant had fewer depression symptoms in relation to those who were more devoted to and interested in the other, more deferential, organized, persistent and interactive.

We also observed that the assessed elderly women had median aspects for all personality traits, high deference and low aggression being the most reported dimensions. In general, personality of the elderly women in this sample was characterized by respect, admiration and reverence to an individual considered superior, whom they compliment, honor, imitate and obey. On the other hand, aggression did not prove to be a marked characteristic of this group of elderly, since they were not characterized by anger, irritation or hate, neither by the desire of overcoming opposition vigorously.

The participants of this study did not have presence of depression as characteristic. Search for UNITI probably occurs by people who are not depressed or maybe the group plays a major role in conquering and maintaining a successful aging process, as well as in the triggering of depressive symptoms.

Others studies are suggested to confirm or raise other hypotheses about which personality variables could be related to depression in the elderly. In addition, there is a lack of studies in the literature on the association between personality traits and depression in the elderly.

References

Received February 2, 2007

Accepted March 20, 2007

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Publication Dates

• Publication in this collection
  13 Dec 2007
• Date of issue
  Aug 2007

History

• Accepted
  20 Mar 2007
• Received
  02 Feb 2007