性格測試也可成爲醫療手段

Are you open to new experiences? Are you a risk taker? Do you like parties?

你樂於體驗新鮮事物嗎？你願意冒險嗎？你喜歡派對嗎？

Odds are, questions like these were not part of your last doctor’s appointment. But one day they might be — a growing body of research suggests that your personality can influence your health. And some experts think changing people’s personal traits might one day help treat diseases — or keep people from getting them in the first place.
這類問題不大可能出自你剛看過的醫生之口。但有朝一日醫生也許真會這麼問——越來越多的研究表明，你的個性會影響你的健康。一些專家認爲，在未來的某一天，改變人的性格特徵或許會有助於治療疾病——或者把病痛扼殺在搖籃之中。

The research also comes at a time when many are calling for a more individualized approach to medicine. Some day, researchers hope, personality testing could be used to help your doctor design treatment specifically to you.
相關研究工作取得進展之際，許多人正在呼籲醫生以更有針對性的方法來給病人開藥。研究者們希望，個性測試有一天可以成爲你的醫生爲你專門設計治療方案的輔助手段。

For a study published in the journal Psychoneuroendocrinology, Kavita Vedhara and her co-authors gave personality tests to 121 people, and tested their blood to analyze the expression of genes related to inflammation. They found that the personality trait of extroversion was associated with increased expression of genes promoting inflammation. Meanwhile, conscientiousness, which the authors define as a trait “reflecting planfulness, caution, and harm avoidance,” was associated with decreased expression of pro-inflammatory genes. Since inflammation can be part of the body’s response to infection, higher expression of pro-inflammatory genes can mean a more active immune system; lower expression can mean a relatively less active one.
《神經心理內分泌學》(Psychoneuroendocrinology)雜誌發表了卡維塔·韋德哈拉(Kavita Vedhara)等人基於其研究寫就的一篇論文。他們對121個人進行了性格測試；還爲其做了血液檢測，以分析與炎症反應有關的基因表達。他們發現，外向型的性格特徵是與更高的促炎基因表達水平聯繫在一起的。與此同時，勤勉審慎型人格——按照作者們的義中，這種性格的主要特點在於計劃性強、謹小慎微、能夠避免受到傷害——則是和較低的促炎基因表達水平聯繫在一起的。既然炎症可以被看作人體對感染的反應，那麼促炎基因表達水平較高可能意味着免疫系統更加活躍，促炎基因表達水平較低則意味着免疫系統不那麼活躍。

It could be, the authors write, that people with weak immune systems become more introverted to protect themselves from infection (meet fewer people, get fewer germs). They might become more conscientious for the same reason. On the other hand, it’s possible that people’s personalities affect their gene expression — people who go to a lot of fun, germy parties (or who are really bad at washing their hands) might start to undergo gene-expression changes that strengthen their immune systems.
這篇論文的作者在文中寫道，爲了避免感染，免疫系統比較脆弱的人可能會變得更內向（少見人，少接觸細菌）。出於同樣的原因，他們或許也會變得更謹慎。反過來說，人們的個性也有可能在影響他們的基因表達——經常參加有趣但卻在散播細菌的派對的人（或者不會好好洗手的人）或許會在基因表達方面有所變化，而這種變化能強化他們的免疫系統。

This doesn’t mean everybody should get a personality test, Dr. Vedhara told Op-Talk. But it does suggest that in general, a treatment approach that considers the patient’s psychological profile may be more effective than one that just looks at physical symptoms.
韋德哈拉博士告訴本報Op-Talk欄目，這並不意味着每個人都該做性格測試。但由此的確可以看出，在通常情況下，把患者的心理狀況考慮在內的治療方案，可能會比只着眼於生理症狀的治療方案有效得多。

“If you’re confronted with a chronic condition” like diabetes or heart disease, she explained, “you may well have underlying beliefs about your condition which influence how likely you are to engage with treatment, you might have an emotional response to that condition which might influence your underlying physiology and your ability to recover or to manage your disease, you may well have an orientation which makes you more or less likely to exercise” — and looking at all of those factors as well as the physical manifestations of the condition itself might help doctors treat it better.
她解釋說，“如果得了慢性病”，比如糖尿病或者心臟病，“你很可能對自己的疾病有着潛在的看法，這些看法或許會影響你對治療的投入程度；你可能因爲生病而產生情緒上的反應，這種反應或許會影響你的潛在心理、康復能力以及控制疾病的能力；你很可能具有某種傾向性，這種傾向性會影響你鍛鍊身體的意願”——把所有這些因素以及疾病本身的生理表現都納入考量，或許有助於醫生更好地治療你的病痛。

“Most areas of medical intervention work quite well,” she said, “but I think that we’re on the brink of seeing a future where we use psychological interventions and behavioral interventions to maximize their efficacy.”
“醫療干預在大多數情況下都很管用，”她說，“但我認爲，我們即將看到利用心理干預和行爲干預來實現醫療干預效用最大化的未來。”

Joshua Jackson, a psychology professor at Washington University, also sees understanding personality as a way to improve physical health. In a recent study, he and his co-authors looked at personality and longevity — or, more specifically, at how your friends’ assessments of your personality might predict how long you’ll live. They found that men whose friends thought they were conscientious and open tended to live longer than those whose friends found them less so; for women, the traits associated with longer life were agreeableness and emotional stability. And friends’ assessments of subjects’ personalities were better than their own self-reports at predicting how long they would live.
華盛頓大學(Washington University)的心理學教授約書亞·傑克遜(Joshua Jackson)也認爲，理解個性是改善身體健康狀況的一條途徑。在最近的研究中，他和合著者調查了個性和壽命之間的關係——或者更確切地說，是用你朋友對你個性的評估，來預測你的壽命。他們發現，那些被朋友評價爲謹慎、心態開放的男性，往往比沒有得到這種評價的男性壽命長；而對於女性來說，被評價爲隨和、情緒穩定的人往往有更長的壽命。在預測受試者的壽命方面，朋友對受試者的個性評估，往往比受試者的自我評估的更準確。Conscientiousness people, Dr. Jackson told Op-Talk, tend to “eat their vegetables and exercise,” as well as avoiding risky behaviors like driving without a seatbelt. “They seem to just live a nice, buttoned-up and tidy life, which helps them live longer.”
傑克遜博士對本報Op-Talk欄目說，謹慎的人往往更願意“吃蔬菜、鍛鍊身體”，避免冒險行動，比如不繫安全帶駕車等。“他們似乎過着有條理、有規律生活，這有助於他們活得更長。”

“Open individuals,” meanwhile, “are not necessarily set in their ways, they’re able to change, they’re open to new experiences.” So they may be amenable to altering their diets or making other changes that could improve their health. Openness may also be associated with a tendency to do mentally challenging activities like crosswords, Dr. Jackson noted, which may also promote good health.
同時，“心態開放的人不會自我設限，可以做出改變，樂於體驗新東西。”因此，他們可能會改變飲食習慣，或者其他習慣，來增進自身健康。心態開放的人可能喜歡填字遊戲這樣的智力挑戰性活動，傑克遜博士指出，這也可能會增進健康狀況。

He thinks the gender differences his team found may have to do with social mores in the 1930s, when the personality assessments were conducted. He and his co-authors write, “It is likely that high levels of peer-rated emotional stability and agreeableness predict mortality because they largely assess positive characteristics indicative of a supportive and easy-going wife, such as that described in the social theory of the time.” However, he told Op-Talk, some research suggests “that personality within women has a less robust relationship with health and longevity.”
他認爲，其團隊發現的性別差異，可能與上世紀30年代進行這項個性評估時的社會風氣有關。他和合著者寫到，“在女性評估中，同伴在情緒穩定、爲人隨和方面給出的高分評價，可以預測女性的壽命，這可能是因爲，當時評估的女性特性，主要顯示她們能不能成爲顧家、隨和的妻子，就像當時的社會理論所描述的那樣。”不過，他告訴Op-Talk，有些研究表明，“女性的個性與健康以及壽命之間的關係，不是太可靠。”

Dr. Jackson sees a role for personality research beyond predicting when you’re going to die. Understanding someone’s personality could help doctors determine which patients are going to have trouble following a new medication or exercise regimen (conscientious people, he said, are especially good at doing what their doctors tell them to do).
傑克遜博士認爲，人格研究的作用不僅侷限在壽命預測上。瞭解一個人的個性，可以幫助醫生預知哪些病人難以堅持服用新藥物或遵循新療法（他說，謹慎的人在遵守醫囑方面做得特別好）。

He’s also involved in research into how changes in personality might affect health. “We know that personality changes across the life span” — people tend to become more conscientious and less neurotic over time — “but some people change more than others.” And since personality traits are associated with health, altering those traits might make someone healthier or sicker.
他還參與研究了個性變化可能會如何影響健康狀況。“我們知道，在整個生命週期裏，人的性格都在改變”——隨着時間的推移，人們往往會變得更加謹慎，不那麼神經質——但有些人變化大，有些人變化小”。既然人格特質與健康有關，那麼改變這些特質就可能會讓人變得更健康或更多病。

Brent Roberts, a psychology professor at the University of Illinois at Urbana-Champaign (Dr. Jackson was once his student), has found that changes in personality can be linked to changes in health. “That sets up an interesting possibility,” he told Op-Talk: If personality can be altered, “then it could be a target of intervention.” People can become less neurotic with medication or therapy, he said, and “if that’s the case, then you have an interesting question about whether interventions like that could be used to help people be healthier at an earlier age because you could change their personality.”
布倫特·羅伯茨(Brent Roberts)是伊利諾伊大學厄巴納-香檳分校(University of Illinois at Urbana-Champaign)的心理學教授（傑克遜博士曾經是他的學生），他發現，人格改變可以引起健康狀況的變化。“這開啓了一個有趣的可能性，”他對Op-Talk說，如果性格是可以改變的，“那它就可能成爲干預目標”。通過服用藥物，或者採用一些療法，人們可以變得不那麼神經質，他說，“如果事實如此，那麼你就會面對一個有趣的問題：你有了改變人們個性的能力，那麼這樣的干預是否可以在他們年輕的時候就用來改善其健康狀況呢?”

The psychiatry professor Benjamin Chapman says personality was long thought to be unchangeable: “the term was, personality was set like plaster.” But now, he told Op-Talk, some believe people can change their personalities if they want to: “You might be able to change at least some aspect of conscientiousness in your 40s, for instance, and not get heart disease in your 60s.”
精神病學教授本傑明·查普曼(Benjamin Chapman)表示，長期以來，人們一直認爲性格是無法改變的：“也就是說，人的性格都是定了型的。”不過現在，他對Op-Talk欄目說，一些人認爲，如果有意願的話，人可以改變自己的性格：“例如，你至少能在40多歲的時候在某些方面改善自己的謹慎程度，然後，在60多歲的時候就不會得心臟病了。”

Therapy is one way to change personality, he added, but its scale is necessarily limited. “Psychotherapy for hundreds of thousands of people is not cost-effective,” he said, and the question is “whether this sort of thing can be accomplished with something that’s less labor-intense and reaches more people.” Some programs in schools, such as those that teach responsibility and goal setting, “probably have a de facto effect on the shaping of personality and traits like conscientiousness,” he noted. “The tricky thing is, how would you do that later in life?”
他還表示，改變性格的一種方法是通過治療，但它的覆蓋範圍必定有限。“讓幾十萬人去做心理治療可不划算，”他說。問題是，“能不能通過不那麼勞民傷財的辦法來達到這個目的，並且惠及更多人。”中小學的某些項目，比如培養責任感和目標設定的課程，“很可能在塑造性格以及培養謹慎等個性特徵方面擁有實實在在的效果，”他指出。“棘手的地方在於，在此後的人生階段，該怎樣開展這種項目？”

The time may be ripe for a focus on the personal. “The personalized medicine movement,” said Dr. Chapman, seeks “to get a very individualized prediction of, will you get this disease, will this treatment work for you, how long will you live?” Such predictions are usually made based on demographic information and risk factors like smoking, he said (some, like the chief executive of England’s National Health Service, have called for a personalized-medicine approach focusing on genetic information). But Dr. Chapman believes personality may be a useful element in such predictions: “What we’ve suggested is that certain aspects of personality pick up on a very unspecified and general but highly relevant set of factors related to future health, and you might be able to augment those predictive models with personality-type measures.”
關注個體的時機可能已經成熟。查普曼稱，“個性化醫療運動”旨在“針對以下問題進行非常個體化的預測：你是否會患某種疾病？這種治療方法對你是否管用？你還能活多久？”目前，這些問題的預測通常是根據人口統計信息及吸菸等風險因素做出的，他說（有些人已經呼籲採取關注基因信息的個性化醫療手段，包括英國國家醫療服務體系[National Health Service]的首席執行官）。不過查普曼認爲，在此類預測中，個性或許是一個有用的元素：“我們的意思是，個性的某些方面強化了一系列不明確且籠統、但卻非常重要的與未來健康有關的因素，而把性格納入考慮的話，也許可以提升這些預測模型的效果。”

“Especially with the Affordable Care Act,” he added, “there’s been a big shift in medicine toward patient satisfaction and patient-centered care.” And collecting some information on patients’ personalities might be one way of fostering better relationships between patients and doctors: “the question would be, can the doctor use that information to better understand the patient, better understand how to approach them, how to interpret their behavior?” As Dr. Chapman, Dr. Roberts, and Paul Duberstein write in a 2011 review article in the Journal of Aging Research:
“尤其隨着《合理醫療費用法案》(Affordable Care Act)的出臺，”他還說，“在醫療領域出現了向重視病人滿意度，以及提供以病人爲中心的醫療服務的重大轉變。”此外，蒐集某些關於患者個性特徵的信息可以幫助建立更好的醫患關係：“問題是，醫生能否通過這些信息更好地理解病人，更好地懂得如何接觸他們、如何解讀他們的行爲？”查普曼、羅伯茨和保羅·杜伯斯坦(Paul Duberstein)在2011年刊登在《衰老研究雜誌》(Journal of Aging Research)上的一篇綜述文章中寫道：

“Personality assessment could improve the provision of patient-centered care because the physicians better understand how to approach and interact with different kinds of patients. The mere presence of these assessment tools in primary care waiting rooms would convey to patients that the provision of high quality health care is not solely about ordering diagnostic tests, arriving at the correct diagnosis, and prescribing appropriate treatments. It is also about expressing concern and empathy and understanding the patient’s perspective.”
“個性評估或可改善以患者爲中心的醫療服務，因爲醫生可以更好地瞭解如何與不同類型的病人接觸和互動。單是在基本醫療候診室設置這樣的評估工具，就會向患者傳遞這樣的信息：高質量的醫療服務不光是預定診斷檢查、得到正確的診斷結果，以及醫生開出適當的治療方案。它也包括表達關心和同情，以及理解患者的想法。”

At The New York Times’s Well Blog, Dr. Sandeep Jauhar writes, “quality improvement in medicine is too often a blunt instrument. We try to take what works in certain situations and apply it to all situations. Our methods yield results for populations, not individual patients.” And, he adds, “a shift to more personalized medicine will be needed to continue to make the kind of progress to which patients and doctors have become accustomed.”
桑迪普·喬哈爾(Sandeep Jauhar)博士在《紐約時報》的健康博客(Well Blog)中寫道，“醫療質量的提高方法常常十分笨拙。我們總是設法把在特定情形下有效的方式，應用於所有情況。我們的方法對某些類型的人有效，而不是具體的某些個體。”此外，他接着說，“要繼續實現患者和醫生已經習慣的那種進展，必須向更加個性化的醫療方式進行轉變。”

Personality research could become part of such a shift. As Dr. Vedhara puts it, “the individual who has the disease is almost as important as the underlying disease itself. So if medicine treated not only the pathology but the person with the pathology, it would probably get more bang for its buck.”
性格研究可以成爲這種轉變的一部分。正如韋德哈拉博士所說，“患病的個體幾乎與疾病本身同樣重要。因此，如果醫務服務治療的不光是病症，還包括患有這種病症的那個人，可能會產生更好的效果。”