性格测试可能成为医疗手段.

　　你乐于体验新鲜事物吗?你愿意冒险吗?你喜欢派对吗?这类问题不大可能出自你刚看过的医生之口。但有朝一日医生也许真会这么问——越来越多的研究表明，你的个性会影响你的健康。一些专家认为，在未来的某一天，改变人的性格特征或许会有助于治疗疾病——或者把病痛扼杀在摇篮之中。请看下面的双语文章以了解详细内容。

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

　　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.

　　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.

　　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 dine as a trait “rlecting 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.

　　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.

　　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 fective than one that just looks at physical symptoms.

　　“If you’re confronted with a chronic condition” like diabetes or heart disease, she explained, “you may well have underlying belis 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.

　　“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 ficacy.”

　　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.

　　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.”

　　“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.

　　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.”

　　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).

　　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.

　　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.”

　　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.”

　　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-fective,” 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 fect on the shaping of personality and traits like conscientiousness,” he noted. “The tricky thing is, how would you do that later in life?”

　　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 chi 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 usul 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.”

　　“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:

　　“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.”

　　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.”

　　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.”

　　你乐于体验新鲜事物吗?你愿意冒险吗?你喜欢派对吗?

　　这类问题不大可能出自你刚看过的医生之口。但有朝一日医生也许真会这么问——越来越多的研究表明，你的个性会影响你的健康。一些专家认为，在未来的某一天，改变人的性格特征或许会有助于治疗疾病——或者把病痛扼杀在摇篮之中。

　　相关研究工作取得进展之际，许多人正在呼吁医生以更有针对性的方法来给病人开药。研究者们希望，个性测试有一天可以成为你的医生为你专门设计治疗方案的辅助手段。

　　《神经心理内分泌学》(Psychoneuroendocrinology)杂志发表了卡维塔·韦德哈拉(Kavita Vedhara)等人基于其研究写就的一篇论文。他们对121个人进行了性格测试;还为其做了血液检测，以分析与炎症反应有关的基因表达。他们发现，外向型的性格特征是与更高的促炎基因表达水平联系在一起的。与此同时，勤勉审慎型人格——按照作者们的义中，这种性格的主要特点在于计划性强、谨小慎微、能够避免受到伤害——则是和较低的促炎基因表达水平联系在一起的。既然炎症可以被看作人体对感染的反应，那么促炎基因表达水平较高可能意味着免疫系统更加活跃，促炎基因表达水平较低则意味着免疫系统不那么活跃。

　　这篇论文的作者在文中写道，为了避免感染，免疫系统比较脆弱的人可能会变得更内向(少见人，少接触细菌)。出于同样的原因，他们或许也会变得更谨慎。反过来说，人们的个性也有可能在影响他们的基因表达——经常参加有趣但却在散播细菌的派对的人(或者不会好好洗手的人)或许会在基因表达方面有所变化，而这种变化能强化他们的免疫系统。

　　韦德哈拉博士告诉本报Op-Talk栏目，这并不意味着每个人都该做性格测试。但由此的确可以看出，在通常情况下，把患者的心理状况考虑在内的治疗方案，可能会比只着眼于生理症状的治疗方案有效得多。

　　她解释说，“如果得了慢性病”，比如糖尿病或者心脏病，“你很可能对自己的疾病有着潜在的看法，这些看法或许会影响你对治疗的投入程度;你可能因为生病而产生情绪上的反应，这种反应或许会影响你的潜在心理、康复能力以及控制疾病的能力;你很可能具有某种倾向性，这种倾向性会影响你锻炼身体的意愿”——把所有这些因素以及疾病本身的生理表现都纳入考量，或许有助于医生更好地治疗你的病痛。

　　“医疗干预在大多数情况下都很管用，”她说，“但我认为，我们即将看到利用心理干预和行为干预来实现医疗干预效用最大化的未来。”

　　华盛顿大学(Washington University)的心理学教授约书亚·杰克逊(Joshua Jackson)也认为，理解个性是改善身体健康状况的一条途径。在最近的研究中，他和合著者调查了个性和寿命之间的关系——或者更确切地说，是用你朋友对你个性的评估，来预测你的寿命。他们发现，那些被朋友评价为谨慎、心态开放的男性，往往比没有得到这种评价的男性寿命长;而对于女性来说，被评价为随和、情绪稳定的人往往有更长的寿命。在预测受试者的寿命方面，朋友对受试者的个性评估，往往比受试者的自我评估的更准确。

　　杰克逊博士对本报Op-Talk栏目说，谨慎的人往往更愿意“吃蔬菜、锻炼身体”，避免冒险行动，比如不系安全带驾车等。“他们似乎过着有条理、有规律生活，这有助于他们活得更长。”

　　同时，“心态开放的人不会自我设限，可以做出改变，乐于体验新东西。”因此，他们可能会改变饮食习惯，或者其他习惯，来增进自身健康。心态开放的人可能喜欢填字游戏这样的智力挑战性活动，杰克逊博士指出，这也可能会增进健康状况。

　　他认为，其团队发现的性别差异，可能与上世纪30年代进行这项个性评估时的社会风气有关。他和合著者写到，“在女性评估中，同伴在情绪稳定、为人随和方面给出的高分评价，可以预测女性的寿命，这可能是因为，当时评估的女性特性，主要显示她们能不能成为顾家、随和的妻子，就像当时的社会理论所描述的那样。”不过，他告诉Op-Talk，有些研究表明，“女性的个性与健康以及寿命之间的关系，不是太可靠。”

　　杰克逊博士认为，人格研究的作用不仅局限在寿命预测上。了解一个人的个性，可以帮助医生预知哪些病人难以坚持服用新药物或遵循新疗法(他说，谨慎的人在遵守医嘱方面做得特别好)。

　　他还参与研究了个性变化可能会如何影响健康状况。“我们知道，在整个生命周期里，人的性格都在改变”——随着时间的推移，人们往往会变得更加谨慎，不那么神经质——但有些人变化大，有些人变化小”。既然人格特质与健康有关，那么改变这些特质就可能会让人变得更健康或更多病。

　　布伦特·罗伯茨(Brent Roberts)是伊利诺伊大学厄巴纳-香槟分校(University of Illinois at Urbana-Champaign)的心理学教授(杰克逊博士曾经是他的学生)，他发现，人格改变可以引起健康状况的变化。“这开启了一个有趣的可能性，”他对Op-Talk说，如果性格是可以改变的，“那它就可能成为干预目标”。通过服用药物，或者采用一些疗法，人们可以变得不那么神经质，他说，“如果事实如此，那么你就会面对一个有趣的问题：你有了改变人们个性的能力，那么这样的干预是否可以在他们年轻的时候就用来改善其健康状况呢?”

　　精神病学教授本杰明·查普曼(Benjamin Chapman)表示，长期以来，人们一直认为性格是无法改变的：“也就是说，人的性格都是定了型的。”不过现在，他对Op-Talk栏目说，一些人认为，如果有意愿的话，人可以改变自己的性格：“例如，你至少能在40多岁的时候在某些方面改善自己的谨慎程度，然后，在60多岁的时候就不会得心脏病了。”

　　他还表示，改变性格的一种方法是通过治疗，但它的覆盖范围必定有限。“让几十万人去做心理治疗可不划算，”他说。问题是，“能不能通过不那么劳民伤财的办法来达到这个目的，并且惠及更多人。”中小学的某些项目，比如培养责任感和目标设定的课程，“很可能在塑造性格以及培养谨慎等个性特征方面拥有实实在在的效果，”他指出。“棘手的地方在于，在此后的人生阶段，该怎样开展这种项目?”

　　关注个体的时机可能已经成熟。查普曼称，“个性化医疗运动”旨在“针对以下问题进行非常个体化的预测：你是否会患某种疾病?这种治疗方法对你是否管用?你还能活多久?”目前，这些问题的预测通常是根据人口统计信息及吸烟等风险因素做出的，他说(有些人已经呼吁采取关注基因信息的个性化医疗手段，包括英国国家医疗服务体系[National Health Service]的首席执行官)。不过查普曼认为，在此类预测中，个性或许是一个有用的元素：“我们的意思是，个性的某些方面强化了一系列不明确且笼统、但却非常重要的与未来健康有关的因素，而把性格纳入考虑的话，也许可以提升这些预测模型的效果。”

　　“尤其随着《合理医疗费用法案》(Affordable Care Act)的出台，”他还说，“在医疗领域出现了向重视病人满意度，以及提供以病人为中心的医疗服务的重大转变。”此外，搜集某些关于患者个性特征的信息可以帮助建立更好的医患关系：“问题是，医生能否通过这些信息更好地理解病人，更好地懂得如何接触他们、如何解读他们的行为?”查普曼、罗伯茨和保罗·杜伯斯坦(Paul Duberstein)在2011年刊登在《衰老研究杂志》(Journal of Aging Research)上的一篇综述文章中写道：

　　“个性评估或可改善以患者为中心的医疗服务，因为医生可以更好地了解如何与不同类型的病人接触和互动。单是在基本医疗候诊室设置这样的评估工具，就会向患者传递这样的信息：高质量的医疗服务不光是预定诊断检查、得到正确的诊断结果，以及医生开出适当的治疗方案。它也包括表达关心和同情，以及理解患者的想法。”

　　桑迪普·乔哈尔(Sandeep Jauhar)博士在《纽约时报》的健康博客(Well Blog)中写道，“医疗质量的提高方法常常十分笨拙。我们总是设法把在特定情形下有效的方式，应用于所有情况。我们的方法对某些类型的人有效，而不是具体的某些个体。”此外，他接着说，“要继续实现患者和医生已经习惯的那种进展，必须向更加个性化的医疗方式进行转变。”

　　性格研究可以成为这种转变的一部分。正如韦德哈拉博士所说，“患病的个体几乎与疾病本身同样重要。因此，如果医务服务治疗的不光是病症，还包括患有这种病症的那个人，可能会产生更好的效果。”