|Year : 2017 | Volume
| Issue : 2 | Page : 76-80
A descriptive analysis of psychological traits among the health-care providers
Farah Ahmed, Tahseer Khan, Wajiha Rashid, Soubia Akhtar, Zaeem Ur Rehman Khan, Bilal Ahmed
Dow University of Health Sciences, Karachi, Pakistan
|Date of Web Publication||14-Mar-2017|
Dr. Farah Ahmed
Dow University of Health Sciences, Postal Code 75850, Karachi
Source of Support: None, Conflict of Interest: None
Objective: The objective of this study is to access various personality traits of doctors of hospital subspecialties. Introduction: One of the most common perceptions in our society is that of medicine being a very stressful profession. The demands of practicing medicine can have significant effects on general health, work satisfaction, professional, and nonprofessional life. To increase the profitability, organizations curtail the staff to reduce the costs. Hence, it can be argued that doctors are subjected to extreme amounts psychiatric duress. Methodology: A descriptive study was conducted in a tertiary care hospital. In which one hundred and twenty-one doctors were approached randomly varying from different specialties. The short form of the psychopathic personality inventory (PPI-SF) was used as a questionnaire. Results: One hundred and one (81 females and 20 males) doctors from various specialties responded and completed the PPI-SF questionnaire. The subspecialty analysis of the doctors' responses was subdivided into pediatrics, gynecology, medical specialties, surgery, anesthetics, and radiology. Surgeons and GyneObs were the highest scorers on the PPI-SF, with scores of 138 and 149, respectively. Conclusion: This study showed that doctors score higher on a scale of psychopathic personality than the general population. This study also showed that stress immunity is the overriding personality trait in doctors which may, in turn, facilitate better overall patient care. Stress immunity may better facilitate empathy in certain acute situations, which plays a vital role in being a proficient doctor and providing satisfactory patient care and counseling.
Keywords: Health-care providers, mental health, psychological traits, psychopathic personality inventory, workload
|How to cite this article:|
Ahmed F, Khan T, Rashid W, Akhtar S, Khan ZU, Ahmed B. A descriptive analysis of psychological traits among the health-care providers. CHRISMED J Health Res 2017;4:76-80
|How to cite this URL:|
Ahmed F, Khan T, Rashid W, Akhtar S, Khan ZU, Ahmed B. A descriptive analysis of psychological traits among the health-care providers. CHRISMED J Health Res [serial online] 2017 [cited 2018 Apr 26];4:76-80. Available from: http://www.cjhr.org/text.asp?2017/4/2/76/201994
| Introduction|| |
One of the most common perceptions in our society is that of medicine being a very stressful profession. The demands of practicing medicine can have significant effects on general health, work satisfaction, professional, and nonprofessional life. To increase the profitability, organizations curtail the staff to reduce the costs. However, this raises a gigantic question on compromising of their ease, psychological soundness and puts an overwhelming burden. Most of the people do not opt for this noble art just because of the shear amount of nerve required to make life and death decisions and that too under extreme pressure. Hence, it can be argued that doctors are subjected to extreme amounts psychiatric duress. Factors such as time pressure to see patients, threat of litigation, long working hours, and night shifts and divorce, are some of the leading stressors which disturb the psychological harmony of doctors. It will, therefore, not be too surprising that some of the traits associated with a psychopathic personality (e.g., preternatural calmness under pressure, or apparent indifference to human suffering when making life-or-death decisions) are perhaps selected out in those who rise to the top of our profession. Can we then assume that most of the doctors have a personality imbued with psychopathic traits which make them exceedingly well suited for this profession? You can further contemplate this might be one of the factors which separate clinicians from general population psychologically.
After a thorough search of the scientific literature worldwide it was observed that the amount of data accessing psychopathic personality traits in doctors was scarce. This study was designed as such to access various personality traits in doctors and to determine which personality trait predominates.
| Methodology|| |
A descriptive study was conducted within the tertiary care hospital. In which one hundred and twenty-one doctors were approached randomly varying from different specialties. The short form of the psychopathic personality inventory (PPI-SF) was used as a questionnaire. It was unnecessary to get an ethics approval since this was a voluntary process and no patients were involved. The data were collected in a duration of 2 months starting from January 1 and ending on February 28, 2016.
The PPI-SF was used as it is a validated short version of the full-length inventory., The PPI is used as a regular tool in the assessment of mental health. It is divided into eight subscales [Table 1]. Due to its relative efficiency, a PPI-SF was developed and has proven useful in many psychopathy studies. It has eight subscales and is valid in both forensic and nonforensic settings. Whereas the long format consists of 187 questions, the PPI-SF contains only 57. For practical settings where PPI is considered too time-consuming the PPI-SF is considered as a valid screening device. It has been validated against the longer version as a research and assessment tool for psychiatric assessment. We analyzed the data using SPSS Version 17.0 IBM Inc.
|Table 1: The eight subdivisions of the Psychopathic Personality Inventory|
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| Results|| |
A total of 101 (81 females and 20 males) doctors from various specialties responded and completed the PPI-SF questionnaire (response rate 83%). The overall mean score was 128 mean score when the PPI-SF was tested previously on 985 subjects from the general public was 119.
The subspecialty analysis of the doctors' responses was subdivided into pediatrics, gynecology, medical specialties, surgery, anesthetics, and radiology. The results are summarized in [Table 2]. [Table 3] shows the frequency of the highest-scoring personality traits among the 101 participants. [Table 4] indicates the leading personality traits by specialty.
|Table 2: The mean Psychopathic Personality Inventory – Short Form scores (out of a maximum of 224) for each of the hospital subspecialties|
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|Table 3: The frequency of the highest-scoring personality traits from the Psychopathic Personality Inventory – Short Form among the 101 participants|
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| Discussion|| |
This study clearly demonstrates that stress immunity is the overriding personality trait in doctors followed by cold-heartedness. The mean PPI-SF score of 101 doctors accessed was higher than the mean for the general population (119). It has been shown previously that high achievers in various professions (including elite soldiers and company chief executives) are over-represented among high psychopathic scorers.
Among the hospital subspecialties, the personality traits associated with gynecologists were Stress immunity, nonplayfulness, fearlessness, and being carefree. Surgeons, mostly have the traits of being fearless and immune to stress. Pediatricians have the personality traits of being Stress immune, nonplayful, fearless, and carefree. Anesthesiologists were mostly found to have a stress-immune and cold-hearted personality. Radiologist, have the dominant personality traits of being socially potent and cold-hearted. Whereas doctors practicing medical specialties have the personality traits of being immune to stress, care-free, and nonplayful. Stress immunity was found to be the common personality trait among all the specialties except radiology in which cold-heartedness and was the predominant trait.
Among the hospital subspecialists, surgeons and GyneObs were the highest scorers on the PPI-SF, with scores of 138 and 149, respectively. There is evidence in the literature that surgeons have the highest levels of stress. Whether these traits were acquired during their training period or manifested as a defense mechanism or were acquired during their practice is debatable.
In various studies performed previously, doctors have been found to have increased psychiatric tendencies compared with the general population. An Australian study using the General Health Questionnaire showed that doctors had a psychiatric morbidity in 28% of cases  versus 19.5% in the general population. Our study clearly indicates that stress immunity is the foremost personality trait among doctors, with higher PPI-SF scores found in surgeons and pediatricians.
This, however, is not the first study to accesses the psychotic personality traits in doctors. A British study using the PPI-SF questionnaire compared the various personality traits among senior doctors across six hospitals and to find out which traits predominate. This study showed that consultants at teaching hospitals score higher on a scale of psychopathic personality than district general hospital (DGH) consultants, who in turn score higher than the general population. Our study, conducted in civil hospital Karachi, also show a similar result with doctors scoring higher on a scale of psychotic personality than the general population. Hence, it would be safe to say that doctors due to their day-to-day practice in a stress full environment develop a demeanor which incorporates some psychotic traits to better deal with the stressors which hinder them from performing their duties avidly. Factors significantly associated with psychiatric morbidity in doctors were: having a current medico-legal matter, not taking a holiday in the previous year, working long hours, type of specialty, and having personality traits of neuroticism, introversion, and the stress of making life and death decisions to name a few.
This study emphasizes on the role of stress immunity as an over-riding trait in doctors. Doctors, with a high level of stress immunity work more efficiently in difficult and challenging situations where decisions of grave importance need to be made. This may improve decision making and may preserve empathy in difficult situations. This may also benefit doctors applying in subspecialty training.
Empathy can be defined as the ability to understand and share another person's feelings, thoughts and experiences of either their past of present without having the experience fully conveyed in an objective manner. Empathy is commonly regarded as the key attribute for doctors. There is a conviction that empathy must be taught to medical students. For doctors, it is always better to empathetic rather than being sympathetic. This not only makes them more genuine caregivers but the patients are also much more satisfied with the counseling of their doctor when their doctors are being empathetic. There might be certain situations where stress immunity may better facilitate empathy in medical professionals. There may be other such areas of medical practice that require the doctors' ability to distance themselves from the subjective world of the patient.
Measures taken to understand the personality traits in doctors might be advantageous in their training and subspecialty selection. This may translate to better patient care and the patient being grateful and much more satisfied. Patient satisfaction is a multi-dimensional healthcare construct affected by many variables. The factors with the clearest relationship to patient satisfaction include the accessibility of medical care, the organizational structure of clinics, treatment length, perceived competence of physicians, clarity and retention of physicians' communication to patients, physicians' affiliative behavior, physicians' control, and patients' expectations. Understanding which personality traits are essential for a more proficient doctor–patient relationship and further working on instilling them within our medical professionals might provide a much more satisfactory health-care experience in the future.
The PPI-SF is a tool which only gives an actual diagnosis of psychopathic personality when an individual has high scores across all the subdivisions. The concept of psychopathy is obviously considerably more complex than a linear scale of increasing psychopathic tendency with increasing numerical score. This should be kept in mind when interpreting the results of this study.
Other means for the assessment for psychopathy or mental health include the General Health Questionnaire,, State-Trait Anxiety Inventory, the Eysenck Personality Scales,, and the revised NEO Personality Inventory., However, PPI-SF was our primary choice because of the validated shorter number of questions and the personality traits being accessed so that the questionnaires could be completed in a timely and convenient fashion.
Questionnaires are prone to some selection bias; doctors who were curious or who had greater degrees of experience of the day-to-day stresses of the job may have been more emphatic to determine their results. The response rate of 83% in our population was found out to be more than the physician response rates of 14%–71% published in the literature.,
| Conclusion|| |
This study showed that doctors score higher on a scale of psychopathic personality than the general population. This study also showed that stress immunity is the overriding personality trait in doctors which may, in turn, facilitate better overall patient care. Stress immunity may better facilitate empathy in certain acute situations, which plays a vital role in being a proficient doctor and providing satisfactory patient care and counseling.
It is still not known if there are any particular personality traits which are beneficial in patient-centered care when working in a team setting and further studies are required to evaluate the personality traits and the variation in personality scores in this particular area.
It is also recommended that we evaluate the personality traits and the variation in personality scores among teaching hospital consultants versus DGH consultants and correlate the career advantages conferred by the personality traits among the two in various setups to make the data more authentic.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Firth-Cozens J, Payne R. Stress in Health Professionals. Chichester, UK: John Wiley and Sons; 1987.
Schattner PL, Coman GJ. The stress of metropolitan general practice. Med J Aust 1998;169:133-7.
Hayasaka Y, Nakamura K, Yamamoto M, Sasaki S. Work environment and mental health status assessed by the general health questionnaire in female Japanese doctors. Ind Health 2007;45:781-6.
Pegrum J, Pearce O. A stressful job: Are surgeons psychopaths? RCS Bull 2015;97:331-4.
Tonnaer F, Cima M, Sijtsma K, Uzieblo K, Lilienfeld SO. Screening for psychopathy: Validation of the psychopathic personality inventory-short form with reference scores. J Psychopathol Behav Assess 2012;35:153-61.
Kastner RM, Sellbom M, Lilienfeld SO. A comparison of the psychometric properties of the psychopathic personality inventory full-length and short-form versions. Psychol Assess 2012;24:261-7.
Lilienfeld SO, Widows MR, Psychological Assessment Resources I. PPI-R: Psychopathic Personality Inventory-revised: Professional Manual. Psychological Assessment Resources; 2005.
Dutton K. The Wisdom of Psychopaths: Lessons in Life from Saints, Spies and Serial Killers. London: William Heinemann; 2012.
Nash LM, Daly MG, Kelly PJ, van Ekert EH, Walter G, Walton M, et al.
Factors associated with psychiatric morbidity and hazardous alcohol use in Australian doctors. Med J Aust 2010;193:161-6.
Nash L, Daly M, Johnson M, Walter G, Walton M, Willcock S, et al.
Psychological morbidity in Australian doctors who have and have not experienced a medico-legal matter: Cross-sectional survey. Aust N
Z J Psychiatry 2007;41:917-25.
Taylor AW, Wilson DH, Dal Grande E, Ben-Tovim D, Elzinga RH, Goldney RD, et al.
Mental health status of the South Australian population. Aust N
Z J Public Health 2000;24:29-34.
Cowley C. Polemic: Five proposals for a medical school admission policy. J Med Ethics 2006;32:491-4.
Smajdor A, Stöckl A, Salter C. The limits of empathy: Problems in medical education and practice. J Med Ethics 2011;37:380-3.
Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur 2009;22:366-81.
Lochman JE. Factors related to patients' satisfaction with their medical care. J Community Health 1983;9:91-109.
Goldberg D. Use of the general health questionnaire in clinical work. Br Med J (Clin Res Ed) 1986;293:1188-9.
Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979;9:139-45.
Fountoulakis KN, Papadopoulou M, Kleanthous S, Papadopoulou A, Bizeli V, Nimatoudis I, et al.
Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: Preliminary data. Ann Gen Psychiatry 2006;5:2.
Eysenck HJ, Furnham A. Personality and the Barron-Welsh Art Scale. Percept Mot Skills 1993;76(3 Pt 1):837-8.
Eysenck HJ, Eysenck SB. Manual for the Eysenck Personality Questionnaire: (EPQ-R Adult). Educational Industrial Testing Service; 1994.
Costa P. Revised Neo Personality Inventory (Neo Pi-R) and Neo Five-factor Inventory (Neo-Ffi): Professional Manual. Psychological Assessment Resources; 1994.
Fountoulakis KN, Siamouli M, Moysidou S, Pantoula E, Moutou K, Panagiotidis P, et al.
Standardization of the NEO-PI-3 in the Greek general population. Ann Gen Psychiatry 2014;13:36.
Kellerman SE, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med 2001;20:61-7.
Delnevo CD, Abatemarco DJ, Steinberg MB. Physician response rates to a mail survey by specialty and timing of incentive. Am J Prev Med 2004;26:234-6.
[Table 1], [Table 2], [Table 3], [Table 4]