Personality and alcohol consumption: Pooled analysis of 72,949 adults from eight cohort studies
Introduction
Heavy alcohol consumption is a major public health problem (World Health Organization, 2014), increasing the risk of cardiovascular diseases, liver disease, certain cancers, mental health problems, and premature mortality (Rehm et al., 2009, Jemal et al., 2011). Understanding the determinants of harmful levels of alcohol intake is important if progress is to be made in modifying this behavior. While socioeconomic status and mental health are established predictors, the role of other psychosocial factors has been much less well explored. The extent to which alcohol consumption is determined by personality has long been debated (Cloninger et al., 1988, Tarter, 1988).
The Five-Factor Model, which consists of five higher-order personality traits (extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience), is recognized as the most comprehensive conceptualization of personality structure (John et al., 2008). Extraversion refers to sociability, social confidence, and sensitivity to positive emotions; neuroticism comprises low emotional stability, anxiety proneness, and sensitivity to negative emotions; agreeableness reflects features such as cooperativeness, kindness, and trust towards other people; conscientiousness is characterized by high self-control, flexibility, and adherence to social norms; and openness to experience is denoted by curiosity, broadmindedness, and creativity. In a meta-analysis that examined the cross-sectional association between the Big Five personality traits and alcohol consumption in a total sample of 20 studies (7886 participants), alcohol consumption was higher in individuals with low conscientiousness, low agreeableness, and high neuroticism (Malouff et al., 2007). Another meta-analysis of cross-sectional studies reported that individuals with alcohol-related substance disorder had higher levels of neuroticism and lower levels of conscientiousness compared to controls (Kotov et al., 2010). In addition, a meta-analysis investigating the associations between conscientiousness and health behaviors in a total sample of 32,137 participants from 65 studies found low conscientiousness to be associated with excessive alcohol use (Bogg and Roberts, 2004).
However, the interpretation of cross-sectional findings is not straightforward because observed associations may reflect both the effect of personality on alcohol use and the consequences of heavy alcohol consumption to personality. To date, we are aware of only two studies that have examined associations between personality and alcohol use longitudinally. In the Midlife in the United States study, higher neuroticism, higher extraversion, and lower agreeableness were associated with future alcohol problems (Turiano et al., 2012). In addition, in the Minnesota Twin Family Study, negative emotionality (i.e., high neuroticism) was associated with increased risky alcohol use (Hicks et al., 2012). Thus, longitudinal evidence is currently limited to these two studies from United States, and the extent to which these associations are generalizable remains unclear. Furthermore, there has been a lot of heterogeneity in the assessment of alcohol use in the published studies and also with the meta-analysis of published studies. For example, less than half of the 20 studies in the meta-analysis by Malouff et al. (2007) utilized a direct assessment of alcohol consumption, with the remainder using proxies such as alcohol-related problems.
To address these limitations and to clarify whether the five major personality traits are, in fact, important determinants of alcohol consumption, we pooled data from eight prospective cohort studies for an individual participant meta-analysis. To the best of our knowledge, the current study is the largest meta-analysis of multiple personality traits and alcohol consumption.
Section snippets
Population
We searched two data repositories, the Inter-University Consortium for Political and Social Research (ICPSR; http://www.icpsr.umich.edu/icpsrweb/ICPSR/) and the Economic and Social Data Service (http://ukdataservice.ac.uk/), to identify potential large-scale cohort studies on personality and alcohol consumption. In order to be included, the studies needed to be open access, have information on participant's alcohol consumption, have a large sample size (N > 1000), and have personality measured
Characteristics (Table 1)
The total analytical sample in the current study comprised 72,949 participants (age range 15–104, mean age 49.7 years, 54% women). A total of 46,160 participants were included in the longitudinal analysis where the mean follow-up time was 5.5 years. Across studies, between 13% and 76% of the participants reported never using alcohol at the study baseline. The proportion of heavy alcohol consumption ranged between 1% and 7% at baseline, and 1% and 6% at follow-up.
Cross-sectional and longitudinal associations between personality and alcohol use (Fig. 1)
Compared to moderate
Discussion
The main finding of this individual-participant meta-analysis of over 70,000 participants from eight cohort studies was that higher extraversion and lower conscientiousness were associated with increased risk of transitioning from moderate to heavy alcohol consumption over time, whereas higher neuroticism and lower agreeableness were associated with heavy alcohol consumption only in cross-sectional analysis. Alcohol abstinence was associated with lower extraversion, higher neuroticism, higher
Role of the funding source
Nothing declared.
Contributors
C.H. analyzed the data and wrote a first draft of the manuscript. All authors contributed to the design of the study, interpretation of the data, and editing the manuscript.
Conflict of interest
No conflict declared.
Acknowledgements
M.E. is supported by the Academy of Finland (265977). G.D.B. is a member of the Alzheimer Scotland Dementia Research Centre funded by Alzheimer Scotland, and the University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative (G0700704/84698). Funding from the BBSRC, EPSRC, ESRC, and MRC is gratefully acknowledged. M.V. is supported by the Academy of Finland (258598, 265174). M.K. is supported by the UK Medical
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