relationships between education, personality, change in personality traits, and the use of mental

135 Pages·2013·1.12 MB·English

RELATIONSHIPS BETWEEN EDUCATION, PERSONALITY, CHANGE IN
PERSONALITY TRAITS, AND THE USE OF MENTAL HEALTH SERVICES
AMONG MIDDLE-AGED WOMEN OVER A 10-YEAR TIME SPAN

by

Amy Courtenay Berwick

A dissertation submitted to the faculty of
The University of North Carolina at Charlotte
in partial fulfillment of the requirements
for the degree of Doctor of Philosophy in
Counseling

Charlotte

2013

Approved by:

____________________________________
Dr. Phyllis Post

____________________________________
Dr. Lyndon Abrams

____________________________________
Dr. Claudia Flowers

____________________________________
Dr. Kok-mun Ng

____________________________________
Dr. Suzanne Lamorey
ii

© 2013
Amy Courtenay Berwick
ALL RIGHTS RESERVED
iii

ABSTRACT

AMY C. BERWICK. Relationship between education, personality traits, change in
personality traits, and the use of mental health services among middle-aged women over
a 10-year time span. (Under the direction of DR. PHYLLIS POST)

The purpose of this study was to examine the relationship between various levels
of education, personality traits (neuroticism, extraversion, conscientiousness,
agreeableness, and openness to experience), personality trait changes over time, and use
of mental health services among middle-aged women. The subjects were 1110 women
from 40 to 60 years of age responding to the 2005 National Survey of Midlife
Development in the United States (MIDUS). The study used logistic regression first to
investigate the predictive value of varying levels of education and personality traits on
use of services during the past 12 months. A second logistic regression was used to
investigate personality trait changes (between 1995 and 2005) on use of services during
the past 12 months. Change scores were calculated using the reliable change index (RCI).
In the first logistic regression, neuroticism (OR = 1.82, p <.001) and openness to
experience (OR = 1.51, p < .05) were associated with significantly increased likelihood of
mental health service utilization among middle-aged women. Conscientiousness (OR=
0.65, p < .05), in contrast, was associated with decreased likelihood of use of mental
health services. Education and use of mental health services were not significant in the
logistic regression. The second regression using the RCI scores was not significant, most
likely due to the lack of reliable change for any of the personality traits. The significant
association between neuroticism and conscientiousness and the use of mental health
services among middle-aged women replicated findings from the 1995 MIDUS survey.
iv

However, this is the first study to find significance with openness to experience and use
of mental health services among middle-aged women. Implications and future research
are discussed.
v

ACKNOWLEDGEMENTS

My special thanks go to my dissertation chair, Dr. Phyllis Post. Her assistance in
organizing my thoughts and her guidance in developing my dissertation, were invaluable.
The extraordinary amount of time she provided was amazing. My gratitude extends to my
committee members, Dr. Lyndon Abrams, who always had time to listen; Dr. Kok-mun
Ng, who pushed to make me be the best I could be; Dr. Claudia Flowers, without whom
statistics would still be a mystery; and Dr. Suzanne Lamorey for joining from the outside
to provide insight and expertise. Finally, I would like to express my sincerest
appreciation to my entire committee for their extraordinary effort in the final push to get
this project completed in time for a May graduation.
None of this would have been possible without the support of my family and
friends. To my son, Stirling, who inspires me with his love of life, to my father, Robert,
who encourages me to set my goals high, and to my sister, Meredith, my best friend, we
did it! I want to thank my incredible cohort for their encouragement and commiseration
as we navigated this journey together. The bonds that we forged have made this process
one of the most meaningful and rewarding experiences of my life. Finally, to Shenika
Jones, from start to finish you have been with me, I cannot imagine this program without
you.
vi

TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION .......................................................................................1
Overview ..........................................................................................................................1
Midlife..............................................................................................................................2
Mental Health and Underutilization of Services ..............................................................5
Education .........................................................................................................................7
Personality........................................................................................................................8
Purpose of the Study ......................................................................................................10
Significance of the Study ...............................................................................................10
Research .........................................................................................................................11
Questions ...........................................................................................................12
Design ................................................................................................................12
Delimitations .....................................................................................................13
Assumptions ......................................................................................................13
Limitations .........................................................................................................13
Validity ..........................................................................................................................14
Threats to Internal Validity ...............................................................................14
Threats to External Validity ..............................................................................15
Operational Definitions ..................................................................................................15
Midlife in the United States Study (MIDUS) ....................................................15
Middle-Aged Women ........................................................................................16
Education ...........................................................................................................16
Mental Health Service Utilization .....................................................................16
vii

Personality Traits ...............................................................................................16
Summary ........................................................................................................................18
Organization of the Study ..............................................................................................18
CHAPTER 2: REVIEW OF THE LITERATURE ............................................................19
Introduction ....................................................................................................................19
Mental Health Services ..................................................................................................20
Empirical Research ............................................................................................21
Summary ...........................................................................................................24
Midlife............................................................................................................................25
Midlife Theories ................................................................................................26
Cohort Theory ..........................................................................................29
Role Enhancement Theory .......................................................................30
Midlife Mental Health .......................................................................................31
Summary ...........................................................................................................33
Education and Mental Health Services ..........................................................................34
Empirical Research ............................................................................................35
Summary ...........................................................................................................36
Personality......................................................................................................................37
Personality Theory .........................................................................................................38
Trait Theory .......................................................................................................40
Empirical Research ............................................................................................41
Personality and Gender ............................................................................42
Personality and Aging ..............................................................................43
viii

Personality and Mental Health .................................................................44
Stability. ...................................................................................................47
Summary ...........................................................................................................50
Personality Traits ...........................................................................................................50
Neuroticism .......................................................................................................51
Stability ....................................................................................................51
Use of Services .........................................................................................53
Summary ..................................................................................................54
Extraversion .......................................................................................................55
Stability ....................................................................................................55
Use of Services .........................................................................................56
Summary ..................................................................................................57
Conscientiousness .............................................................................................58
Stability ....................................................................................................58
Use of Services .........................................................................................59
Summary ..................................................................................................59
Agreeableness ....................................................................................................59
Stability ....................................................................................................60
Use of Services .........................................................................................60
Summary ..................................................................................................60
Openness to Experience ....................................................................................61
ix

Stability ....................................................................................................61
Use of services ..........................................................................................61
Summary ..................................................................................................62
Conclusion .....................................................................................................................63
CHAPTER 3: METHODOLOGY .....................................................................................65
Participants .....................................................................................................................65
Procedures ......................................................................................................................66
Instrumentation ..............................................................................................................66
Research Design.............................................................................................................70
Research Questions ........................................................................................................70
Data Analysis .................................................................................................................71
Summary ........................................................................................................................72
CHAPTER 4: RESULTS ...................................................................................................73
Description of Participants .............................................................................................73
Results of Research Question 1 .....................................................................................76
Results of Research Question 2 .....................................................................................78
Personality Trait Change Scores .......................................................................78
Logistic Regression ...........................................................................................79
Summary ........................................................................................................................80
CHAPTER 5: DISCUSSION .............................................................................................81
Overview ........................................................................................................................81
Discussion of the Results ...............................................................................................82
Demographics ....................................................................................................82
x

Results of Research Question 1 .........................................................................83
Results of Research Question 2 .........................................................................87
Contribution of the Study...............................................................................................88
Implications of the Findings ..........................................................................................89
Limitations of the Study.................................................................................................90
Future Research .............................................................................................................92
Concluding Remarks ......................................................................................................93
REFERENCES ..................................................................................................................95
APPENDIX A: IRB EXEMPTION .................................................................................111
APPENDIX B: TERMS OF USE ....................................................................................112
APPENDIX C: MIDUS CODE BOOK ...........................................................................115
APPENDIX D: MIDUS SURVEY ..................................................................................121