Psychiatry & Psychotherapy Podcast - The Big Five: Openness

Episode Date: October 15, 2020

In this podcast, we discuss openness, the third of five in our podcast series looking at the domains within the Five Factor Model of personality. We look at how openness is defined, its heritability, and its effects on physical health, personal attributes, psychopathy, pharmacotherapy, and therapeutic techniques.  By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog. Link to YouTube video.

Hello and welcome to the Psychiatry and Psychotherapy Podcast. I'm here to talk about getting rid of burnout, increasing job satisfaction, and feeling like an expert in what you do. One thing that created a lot of burnout and angst for me was trying to get continued medical education right at the last minute. So why not join the CME membership and do CMEE while listening to this podcast? Go to Psychiatrypodcast.com, sign up, sign in, take the test, and the certification is email to you in seconds. All right, welcome back to the podcast. I am joined today. with three medical students, Madison O'Rourke, Kyle Logan, Matthew Hagueley. Today we are going to be doing openness. It's one of the big five personality types.

And I thought we would start with defining openness, the different domains of openness, according to the gold standard, the Neo-PI3, and talk about our own scores in it and kind of what it means. And then we'll get into some psychopathology. We're going to be talking about ecstasy, ketamine, you know, do the psychedelics increase openness? We'll talk about schizophrenia and openness, some interesting findings there, and how to think about what you might do if someone was super low or super high openness in terms of therapy, how you can think about this domain. So it's something that I think is useful. I've used it in marriage therapy. Once in a while, I have a couple where you have a very high openness and a low openness individual together and helping them navigate their marriage

with those differences and, you know, decreasing the shame maybe of having those differences, but just like how do we work together? How do we communicate? So I'm excited to have you guys on. Yeah. Excited to be here. Now, Maddie's taking the lead on this one. She did most of the digging. So maybe we'll start with the domains. And then after we talk about, each domain, we'll talk about how we scored in it and what that might mean. I think this might help this be a little bit more concrete, like what openness is. So to start with fantasy. Maddie, tell me what high and low fantasy would be in someone.

Yeah, so for fantasy, if you're high in fantasy, you have a very active imagination and fantasy life. So you would enjoy things like entertaining fantasies and having daydreams. And then along with that, one of those strengths would be it brings perspective and insight to the mundane. And then if you're low in fantasy, you try to keep your thoughts more realistic. You typically avoid flights of fancy. You don't really let your mind wander as much. You prefer to be productive with your activities instead of drifting into daydreams. And you maybe didn't enjoy make-believe games as a kid as much as others would have.

But then one of those strengths would be is that you're a more practical person. Yeah, so how did I score in fantasy? I scored high. He scored high. I scored high. One standard deviation above the mean. Maddie, you scored one standard deviation above the mean. Yeah.

Kyle, you scored average. And I did not like make-believe games as a kid. You did not, okay. And Matt, you scored high. Yes. I did enjoy make-believe games. You did? Mm-hmm.

I enjoyed them. still, I still do with my kids. Yeah, me too. Yeah. Yeah, I enjoy a good fantasy book. Like, Space Fantasy, Dune was one of my favorite novels. I was into Harry Potter. Yeah.

I wanted to get a letter. I thought I would get one. And then when I was 11 and I didn't get one, I was crushed. Aw. That's cute. Okay. Let's go to the next one, aesthetics. So, yeah.

So for aesthetics, if you're high in aesthetics, you can easily get absorbed into music. You could experience chills and excitement from reading poetry or looking at art. So like a physical response, basically, which is cool. And you could be fascinated by different kinds of music and intrigued by patterns in different things. And then so a strength that goes with that is you can find beauty and small and seemingly insignificant things. and you're more insightful. And then low for aesthetics, you're not as interested in the arts. You're not really moved by poetry.

It's not your jam. You find ballet and modern dancing boring, but a strength of that would be you're more regimented and logical, and you rely on facts. Yeah. So I have one patient who's a musician, who's two standard deviations high in this,

and she's incredibly moved by poetry, music and arts and it just totally brings her alive. And then the other partner is very low in openness, very practical or aesthetics, specifically aesthetics, so not as interested in the arts and stuff. So it's like how do you get these people to interact together? I'm very high in this. I scored about one and a half standard deviations above the mean.

How did you guys score? I was high too I was high very high Matt was very high very high yeah and it fits I really enjoy writing

I enjoy poetry music I have my little audio file headphones and the best thing in the world is to be reading a book and listening to high quality music and yeah it's a good time yeah cool yep so me and you Matt are very similar

to about you're you're really You're two standard deviations above the mean. I'm one and half. Probably because poetry has never been something that, I don't know. I think if I had a great poetry teacher, I think I could have gotten more into it. So I probably scored those a little bit more negatively. Okay. So what about the third one?

Feelings. If you're high in feelings, you experience many emotions and feelings. And your mood is influenced by sense or names of distant places. So that can like, those are connections for you. You perceive strong emotions as vital to life and rely on your gut instinct. And a strength of that is that you exhibit empathy very easily. And then for low on feelings, you rarely exhibit strong emotions, seldom notice internal feelings. Don't notice moods and feelings of different environments so much.

Like, it's not a connection for you. And then a strength of that is that you're not easily influenced by feelings. So you can be more logical or rational or... Yeah. when that's a strength, right? Not a swayed by your emotions. Yeah. So how did you guys score on this one?

I think we all scored very high except for Matt. Matt, you're scoring a little lower on this. I'm surprised. Matt's more stable. Yeah. That's interesting. Yeah, so Matt scored about half a standard deviation above the mean. Kyle, you scored, wow, two standard deviations above the mean.

I feel like it's really easy for me. to like feel what a patient's feeling. Okay. Yeah. Wow. That surprises me actually. But now I can see that. Yeah.

Cool. Yeah. So you can read people. You can feel into other people's experience very easily. Maddie also scored very high in that. Yeah. Two standard evasion. So both of you, two standard deviations of both of the mean.

I was also two standard deviations, both of me. Yeah. Yeah. When I did the other personality test, I was a feeler and I scored like 20 out of 20. feelings. Okay. Like typical for me. Yeah.

I can make decisions based on how I feel about things. Most therapists I know are higher in this. Yeah. And we'll talk about it later, but you can have some counter transference to someone who's very low in it. I think until like maybe the last five years or so, it's been harder for me to connect with someone really low in feelings and low in openness in general. And so, yeah, we could talk about it.

that. Okay. The next one is actions. So break down what is high and low and what is actions. For actions, high would be believing in variety and everything. You enjoy trying new and foreign foods and enjoy learning new hobbies. A strength of that is that you're less afraid of thinking outside of the box and you embrace new experiences. So for low, you're more set in your personal patterns. you like going to the same places on vacation. You prefer the familiar more than different things. You rely on old-fashioned methods and stick to the same roots of travel. Like if you go the same way to work every day versus like trying to pick different ways to spice it up.

A strength of that, though, is you're more content with simple aspects of life, and then you don't need thrill to achieve satisfaction. Why are you laughing? You're laughing at me, aren't you? Because we talked about this when you asked me, If I thought you were higher, low and openness, I said low. And it's because the only thing I knew about you is that you get the same, you go to Stells for lunch every day and you always get the same thing.

Yeah. It's, I think once I find what I really like, I just want the same thing. Because you prefer the familiar. Yeah. I don't know if it's that prefer the familiar. Because I do enjoy learning new hobbies. I do like trying new things, but I think on the day-to-day basis, I really like what I like. Yeah. It's just funny because this is the only place you scored low in openness is actions.

Yeah. Yeah. Interesting. I scored, yeah, I scored. So I scored one standard deviation below the mean. How did you score? I scored very high. I like doing different things. Like I don't like doing the same thing. Yep. I like taking different routes to work if I can find them. I like changing like things around the house and my husband's super low in openness. So that's like, I think it stresses him out a little sometimes. Right. Yeah. Why are you changing this? It was good the way it was. I'm like, but it's boring the way it was. Kyle, you scored lower than me. Yeah, I love routine. I used to eat the same thing for breakfast for years. There you go. Yeah, my husband does the same thing. I just, you know, I like trying new things also, but I feel like to really know something,

you have to do it a lot and get good at it, you know? Yeah. And, yeah. For me, it's like, once I found, like, what my, just what I liked profile-wise for coffee, this is so millennial of me. It's like, I don't like the really fruity kind. I like, you know, I like a certain amount of earthiness, you know, chocolate. Huh?

Found my coffee. Yeah, Starbucks overburnt. Don't love it. Hate it. Basically, this is like promoting Stells, this podcast. Stells, yeah. So if you want good coffee, I'll tell you what. If you sign up for my Patreon, I'll send you some coffee with, if you want.

Okay. So, and how did you score? And what did you think about that, Matt? I was average. I think it fits. I do enjoy trying new foods and everything, but definitely do the same route to work every day. I enjoy the simple things. So I could see a good mixture there. I think my girlfriend would score really high in this. Like whenever we have like a evening or an afternoon,

she wants to do a bunch of new things. I'm like, can we just do one new thing? You know what I mean? Yeah. And then. Yeah, I feel like it can be a point of contention for couples sometimes. Oh, yeah. The actions one specifically. Yeah. Yeah. Because like there's, it's like I know I'm going to be happy if I eat at a couple different restaurants. I know exactly what I want. But, you know, it's like, oh gosh, okay, if I'm paying for babysitters, pain for night out, you know, it's like, okay, do I really want to risk going to some place? Right. Exactly. So, you know, when we're on vacation, I'll risk it. I'll look at Yelp reviews. I'll kind of try to get like a feeling for like what everyone else likes. So I'm kind of swayed by that. Okay, let's go to the next one. Ideas.

So ideas, if you're high, you enjoy entertaining theories and abstract ideas. You enjoy mind-twister-type puzzles and games and a wide range of interests involving intellect. And a strength of that is that you're intellectually curious. So low for ideas you'd find philosophical arguments boring. You have little interests in matters of the universe and human condition and you don't engage as much in conversations about abstract theoretical matters. And a strength of that is that you wouldn't overcomplicate. things. Okay. Yeah. And probably the strength is, you know, if you're doing a job that's like your husband, like a diesel mechanic, like being lower in that, you know, it's just kind of like, okay, you might enjoy it more. Yeah. He definitely does. He likes the structure of it. Yeah. And you have to do it the same way every time. Yep. A policeman, you know, firemen, EMTs are lower in this kind of stuff usually. Yeah. If they're higher in it, then they, you know, may not enjoy their work that sort of the day-to-day. Yeah, they might get more bored by it because they want the more abstract part. Yeah, so what do you think? I scored, let's see, how did I score?

I scored almost, yeah, I scored one and a half standard deviations above the mean. So I was high. Matt, I would put you really high. Yeah, you are. I was very high, yes. Kyle, you're very high too. So both of you are two standard deviations of the mean. Maddie is average.

Average. Yeah, I don't like talking about like philosophical things as much. Like it stresses me out. So I think that's where my husband and I like connected because I, you know, like when I'm with him, I take a break from like all the medical school stuff and thinking about things more abstractly. And we just talk about concrete things like food and dogs and stuff like that. Cool. Yeah. Yeah, but I feel like, like I was saying before, I feel like having a higher level of education, which is shown in research, it usually correlates with higher ideas, the facet of openness, just because you have to like thinking more abstractly to go through all those levels of education.

Yeah. And I'm remembering back to when I changed light bulbs all summer, like eight hours a day, 40 hours a week, one summer I changed light bulbs. And like in my mind, I would have like fantasy. going on. I would have stories going on. I would be thinking about ideas. I'd be thinking about the future. So even when I was doing something that was very sort of repetitive, I was like somewhere else in my mind. Yeah. So if you're like, if you're in a job and you're listening to this and you're like, yeah, the job is pretty repetitive. You know, think about how you might find a job where you're able to use that skill. Because I feel like creating podcast and stuff, I'm able to use sort of my higher ideas. Because like I think in both ways it's a skill. It's a skill if you if it's low because you can do those types of jobs, but if it's high, you want to have it more. You want to be stimulated.

Yeah. Yeah. Ideally, I mean, in the in the best of all worlds, you find a job that kind of fits your personality. So, you know, if you're very gregarious and you're outgoing and you're an extrovert, right, or high and extroversion, and maybe, you know, sales. makes more sense, right? Whereas if you're very low in those things, you know, being someone who's on the phone talking to strangers all day may be like completely exhausting. Yeah.

Right? Yeah, I would be exhausted. So if you're very, very low in that, you know, a librarian or something where you're able to kind of not interact with as many people, you know, so thinking about like jobs in terms of personality profiles. Yeah, yeah, it's cool. I found a paper that we can talk about later that talks about like, using it in career advisement.

Yeah. Which is really cool. I think it makes sense. Okay. Let's go on to the last domain of values. Values. High in values means you believe laws and social policies should be flexible. You're more broad-minded and tolerant, and you believe everyone has a different version

of right and wrong. So strengths for that would be you're more flexible and willing to hear other people's perspectives. If you're low in values, it means you rely on religious authorities for decisions regarding immoral issues. You believe people need to have a concrete set of values by a young age. You prefer to stick to ingrained principles and you perceive controversial speakers as troublesome for students. I thought that one was interesting. And then you believe in a traditional set of values. So a strength for that would be you're more loyal and committed and not as easily swayed from your beliefs.

Good. Yeah. Okay. So let's see. How did I score on values? I scored. one standard deviation above the mean okay and matt how did you score in that i think i was average on that um which sort of surprises me because i think that intellectually i would like to fit into the higher side of things with ethics and different concepts of justice and you know social policies that that really appeals to me but um i guess more more things came out about my you know religious background and things like that that sort of pulled me back to the middle. Yeah. If you remember, Matt was the one who did the three-part free will series.

So you can remember him from there. And yeah, I can kind of see you middle of the road here. Because I think you do really appreciate having values that are like sort of objective. But then I think you also have a value of wanting to. to hear other people's perspectives. So I think you probably are middle of road, right? Okay. Kyle, how did you score?

I scored low. You scored low. Okay. And I think like cognitively, I'm very open to other ideas and other beliefs, but I very much think there is like right and wrong, not necessarily different version for other people. And yeah, like I said, when I do, I think I'm pretty good at entertaining other, like, kind of understanding people's situation and stuff, but it's a cognitive thing.

My gut reaction is this is right or this is wrong. Maddie? Yeah, I think it's interesting to see how people's faith plays into this one. Because for me, I have a very strong value system for myself, but I do like to constantly compare it to other people's. Like, I'm open to hearing other people's opinions, even though I feel like you should definitely have a certain one that you hold to. But yeah, so it's interesting to look at that one for me because I definitely am more flexible just with like hearing other people's perspectives and feeling like they

could have a different set of values. Like I might not necessarily agree with them, but I don't usually try to like put my own beliefs on them and tell them, no, there's one way to do things unless they like ask me my personal opinion. So it's interesting to see how it like is different for everybody. Like even though we all more or less have the same. faith background, it's interesting to see how our value personality can be different. Yeah, your values is one standard deviation above the mean as well. Yeah. Like mine.

And I think being a psychiatrist has probably increased my flexibility. Because just hearing people's stories over and over again, it's like you realize like, okay, people have come to their sort of places in life for, reasons and just being willing to sort of put my own preconceived notions on the backburner and just kind of like seek to understand their perspective. It's one of my values and why I love the therapeutic alliance and why I love empathy and stuff like that. So, okay, let's, um, let's keep going. Okay. So Maddie, does openness throughout life change? Yeah. So we looked into this. And Matt kind of did a deeper dive into this part, so I was going to let him take the reins for this ball jump in as well.

Matt, tell us what you found. Yeah, so found some interesting things. First off, it's interesting that across multiple countries and age ranges, people seem to have the same basic understanding of how openness changes throughout their life. The lay belief is that, you know, the young are impulsive, rebellious, undisciplined. whereas as we age, we have lower impulsivity, lower activity, and also decreased in openness. And they found that was consistent belief across cultures. As far as the actual data show is if openness changes or not, they did do some studies on teenagers, so 12 to 18 years old. And they found that there was growth in openness for both boys and girls.

and there's no consistent changes over that time frame in conscientiousness, extraversion, or agreeableness. Yeah, that was interesting to me. And I pulled out the table because I felt that was interesting. You know, you had 5% of people had, from 12 to 16, had decrease in openness, whereas 43% had increased and 51% no change. Whereas if you look at the other types of personality, you know, types like neuroticism, you get like 20% decrease, 20% increase.

So there is some movement, but it's about the same in both directions. It's interesting, yeah. Yeah. I think that has a lot to do with like some aspects of openness and cognitive function and how like the brain is developing during that time. Yeah. Okay. What about childhood adversity?

Does childhood adversity make someone less open or more open? it's associated with an increase in levels of openness, which was really interesting to me. I'm not sure if that would have been the result I expected. Yeah. I'm not surprised by that, actually. I think that I've met a lot of people who have had really rough childhoods that do have very, very strong feelings. They have this kind of like, sometimes it's, it's, it's. the openness would be like two or three standard deviations above the mean.

Wow. And I wonder about that. Yeah. So that kind of makes sense to me. Yeah. I wonder if it goes back to what you said before, how like people who have gone through a lot, like they just have a, I feel like their openness might go up just because they know that everybody's experience

might be different from theirs. You know, like they could see more about like, oh, you must have been through a lot. I could see how you would get this way. Like more flexibility knowing that people experience different things. And that would be like in the values section. Yeah, I think that's what I was thinking, yeah. Also think about like fantasy. I've had a lot of patients who deal with traumatic childhoods with a lot of fantasy.

Or they deal with some deprivation, like adult deprivation with a lot of fantasy. Yeah. So they go internal. They have like all these rich worlds that allow them to kind of escape. Yeah. Okay. Okay. Interesting.

Openness and education. What did we find? Yeah, so this was interesting. Finding in this study that openness was positively associated with entry into college. However, the part that I found was more interesting is that even though college seems to be selective for higher levels of openness, this study compared those who entered college with those who did vocational training. And they found that even though the starting points were different on openness. that over the course of the study, the changes in openness both increased were of similar

trajectory for college and vocational training. So there might be a selective factor in, you know, how in the starting points, but both do change and in the similar direction. Yeah, they both, it seems like, and it's not a huge increase in the standard deviations between the two groups. You're looking at what, like a, like I'm looking at this. this graph, you know, it's about maybe like a point three, if that standard deviation between them when they start college. And that, so that distance between them stays about the same, but they both increase a little bit with time. Interestingly, people who extraversion, not as much difference between the two groups and they kind of mirror each other as well. Conscientiousness, they have the same. They have the same

starting point. But interestingly, they both go up and the non-college goes up even higher than the college. Yeah, interesting. Which maybe is because those people are paying bills. They're living life, you know. Agreeableness, about the same. They both have some increase and neuroticism. People in college, a little bit less neurotic, but only like a 0.1 difference. So the biggest difference here is actually openness. It's about a 0.3 between the two groups. Yeah, between the groups. Okay, what about decreased openness in adulthood? What do they find? So this study was interesting.

I'm sure there are additional studies out there and some reviews I read stated that it wasn't quite as clear cut as it always seems. But in this study, it was a longitudinal study and they followed openness in participants that ranged anywhere between 30 and 90 years old. and they found that there is relative stability among a number of the subsections within openness, but values, actions, and feelings were the three subsections that showed the steepest decline as associated with age. Okay, so let's think about that. So this is interesting because if you look within the domain of openness, you now have the fish are flesh, in two slightly different directions. Okay.

So interestingly, when they did the initial study of openness, they found that openness as a group kind of flowed together. The fish were all going in the same direction. But now we're seeing as people grow older, there's certain domains of openness which are staying about the same and certain ones that are decreasing. So the ones that are decreasing are what? Let's go through one by one.

Values. Values decreasing. seen. So that means they're not as likely to, you know, think that there are different social standards and different policies. Yeah, they become less flexible. Less flexible, kind of more like said in stone, like, okay, I think this is the truth, this is reality, this is the way things are, more traditional beliefs. I mean, you see more people who are older who are attending like religious organizations and stuff like that. So, okay. And then what's the other one that? It decreases.

Actions. So people know what they want, right? They find the spot. They like to go for vacation. Right. They figure out their coffee profile. Yeah. Okay.

And what's the third one? Feelings. Feelings. And so that's decreased a little bit, huh? So, yeah, that doesn't make sense because sometimes you'll see, like, people with borderline personality disorder, they'll just kind of have, some of them, as they get older, it's like less intense, the mood swings, the emotions. Interesting.

Often throughout life you learn kind of ways of coping with it naturally, right? More support structures that sort of maybe buttress the intensity of the emotions. Do you think it could even just be like hormonal changes too? Like, I feel like when you're young, you go through. Maybe. A lot more like a roller coaster than if you're like. Decrease in, you know, like through menopause and stuff like that. Yeah, I just imagine if I stopped having periods, I probably wouldn't.

have quite as many emotional changes. Well, I don't know because some people are postmenopausal do have a lot. And then it's worse, yeah, I don't know. You know, okay, mood is influenced by sense and names of distant places. So maybe they're just less influenced. Okay. Yeah, interesting. So some of those are decreasing.

All the other ones are staying the same. It's interesting. And then moving on, there's another interesting as, you know, talking about sort of aging and changes. the concept of partner selection comes up, and this study found that when people are considering what they want in a romantic partner, the trait out of all of the big five that they want to be most similar on is openness. They find that to be most important. And granted, this could be because they want their partner to have higher of other values or lower of some of these

personality factors, but they specifically want to match well on similar levels of openness. Wow, that's interesting. It almost makes me think if you were running a dating app some way of assessing openness. Yeah, if you had everyone do the personality test. If you were just to assess openness and then create matches based off of openness and maybe some other facets, that might actually create some good matches. Yeah. We should trademark that really quick.

Yeah. Yeah. Yeah. Oh dear. Trent, cut that from the audio. Trent's my audio guy. We'll leave that in there. Yeah, interesting.

And then if people are high in openness, when they, overall, they are less likely to get married or to postpone their first marriage and then subsequently are less likely to become parents or more likely to do so later in life. Yeah. I thought that was interesting too. Yeah. Okay, what's next? Last thing we talked about over life is sort of career choices. And this seems to reflect some of the things that we talked about earlier on with higher scores on openness being related with artistic and investigative occupations, with lower scores being more correlated to realistic and conventional occupations. Yeah.

That's good. Yeah, so this was the study I was talking about where it talked about career counseling, too. And basically they said that there's instances where they could still be making the right decision, but as a counselor, you would want to guide them and figure out, are you making a good decision if the career choice you have doesn't align with your level of openness? Like, are you going to be satisfied? Because usually you're more satisfied if you choose one that kind of fits better. Yeah. One thing that I think I just want to put out there is to not put your own sort of openness onto other people, right? So we can think that people, our natural inclination is to think that people think pretty similar to the way that we think. Yeah. Yeah. And so, you know, when I go to order my steles, I check in with Maddie and see if she changed her mind and she usually has for what she wants for the day.

Oh, good. But that's why this is so cool for like therapy because it reminds you that they might not think the same way as you. Yeah. Yep. It's a great. It's a cool. It's a good construct to think in because then you can think about like, oh, okay, where does this person fall in line with these different domains? And then how does that relate to maybe what they might be interested in doing?

Or like you said with couples therapy, like it can help couples see how each other are different and relate better. Yeah. Okay. let's get into genetics. Yeah, so the genetics one was interesting. It's not like as concrete as some of the other personality traits. It's like they haven't done a ton of research on it. But basically one of the things that they found was that it's the only one of all the big five personalities

that wasn't associated with either sex. It was like it didn't really make a difference. And then they did find that there was some heritability with it. They found a 21% of variance between individuals explained by genotype common variants. But it's like they're still, they still need to do a lot of research with it, basically. It's like the tip of the iceberg, I think. Yeah.

Openness was one of the last personality types to be decided on. So there hasn't been as much research on it compared to other ones like neuroticism especially. Yeah, 21% variance is not very high. Yeah. for genetics. Okay, what about oxytocin pathway genes?

What did you find there? Yeah, so they looked at the oxytocin pathway gene. They found that people who had reduced methylation of the gene tended to score higher on openness to experience.

And interestingly, interestingly, they found that no other personality trait had that association with that specific gene. Right. So the people who had this gene, had oxytocin, you know, that was this gene that's unpacked, basically.

So methylation means you're packing up the gene so that you're not going to be using that epigenetically. And so if you have demethylation, then you have that, you're expressing that. So people who are expressing that tended to be higher in openness. Yeah. Which kind of makes me think oxytocin is kind of bonding. So are you like connecting to things like music, literature? your oxytocin is going, you're just connecting to everything. Okay, in terms of monosagotic and dysegotic twins,

looking back at a study that they did in 1993, they found that those that were reared apart, openness was correlated for monozygotic twins, 0.43, and for diZegotic, 0.23, whereas when they were reared together, it jumped up to 0.51 for monozygotic and 0.14 for dyesaecotic. So environment looks like it has some impact, but it looks like even when they're reared apart, there's some impact genetically.

But once again, this is maybe 40% at the max. This study came out. It said 40% at the max was like for the variance. accounting for the genetics. Yeah, it's definitely not as strong of a correlation as some of the other personality traits. Well, this study actually showed that it was lower for agreeableness and conscientiousness. But like neuroticism was what I was thinking of specifically, or they've shown many times that it's like linked. Okay, yeah, I agree with that.

Okay, so neuroticism probably the highest. Yeah. They didn't look at neuroticism in this study. In this study, they didn't look at it. this one we're looking out. Yeah, so it's harder to compare. Okay. Let's go on to physical health.

Kyle, time of you found. Well, there was this big study, big meta-analysis of nine cohorts, over 78,000 people. They were looking at BMI, like, you know, development of obesity and personality traits. There was like a slight decrease in obesity and people in higher in openness, but this went away. once you corrected for education. There's really not much connection between openness to experience and the risk of obesity. This study did find that open people,

like people who scored high in openness, tended to eat like a very diet and a healthier diet, you could argue, but it didn't relate, like it didn't transfer into like a decreased risk for obesity. Basically only conscientiousness was associated with a decreased risk. This next study, this was a cool study. It's on patients who had nearly a thousand patients who underwent coronary catheterization. They were looking at kind of risk of death.

And openness as a domain did not have any correlation, but diving into the different facets. Openness to feelings and openness to actions were associated with a 24% and a 23% reduction in cardiac death, respectively, and a 17 and 14% reduction in all-cause mortality risk, respectively. Wow, let's think about that. So openness to feelings, 24% reduction in cardiac death risk, and 17% all-cause mortality reduction, openness to feelings. So those people are in touch with their feelings, they know what they're feeling.

Do you think they're able to regulate their own emotion? stress better? I think they're more aware of their feelings. One thought is that a lot of the people have feelings that don't know that they have feelings, so they have a lot of psychological defenses against the feelings. Whereas in therapy, you learn how to, like, identify your feelings and be able to put words to them. So maybe it's the people who, like, have that ability rather than just, like,

stuff them down, dissociate away from them. And then they come out physically. They come out physically, right? With like higher blood pressure and. Yep, yep. And then the other aspect that reduced mortality was open to actions. So, you know, this is something I scored average in. So I have a higher risk of death because of, oh gosh, maybe I shouldn't get the same food every day.

As long as it's healthy, it doesn't matter, right? As long as it's a turkey sandwich. Yeah. That's pretty good. There's also aesthetics was protective against cardiac death with a 15% reduction risk, so Matt's going to be okay. I'll live forever. Actions.

So it's like there's something about variety, trying new things. Yeah. And join learning new things, right? Yeah. Okay. Maybe you like to go outside more and do more physical things. Yeah, maybe. Well, he's...

I don't know. There wasn't that much of an association with, physical activity, right? Not really. Yeah, it's interesting, so I wonder what the... Well, yeah, maybe they're just willing to kind of put themselves out there more. Yeah. Build relationships, maybe through that.

And when you get older, maybe a little bit higher ability to try new things, get some new friends or something. Because I know being lonely is a high risk for mortality. Yeah. So being kind of isolated alone is one of the highest risks. Okay. So I looked at another study looking at BMI and yeah, no connection at all between openness to experience and risk of BMI. Conscientiousness seems to be like the most important personality trait when it comes to BMI.

It would be conscious, more, higher conscientiousness is like lower BMI? Yeah. High conscientiousness. You know, it's like someone who's high conscientious will execute. a plan better, right? Yeah. Yeah. So they'll diet better or they'll keep with an exercise program better.

Yeah. Okay. So this next study, looking at a little over 10,000 Australian adults, they did find that people who are conscientious, no, you know, no surprise, and scored higher in openness, had, like, predicted subsequent increases in physical. activity. It wasn't a huge effect size. 0.14. So not huge. That's not much. Honestly, that probably doesn't do much for them. Yeah.

It's like if you study enough people, you're going to get, you'll find something. Yeah. Yeah. Because that's a good study size. Okay. So the next stuff, this had a clear connection. Out of all the physical health topics, this had the biggest connection. And it was predicting marijuana use.

Okay. So the study of 300 college students found greater openness to experience and impulsivity were associated with greater marijuana use within the last year, with an odds ratio of 1.13 and 1.05, respectively. Wait, what's the, what's the, what's the, the 1.13. Is that the openness? Greater openness? Yeah, the openness. And impulsivity, 1.05.

Yeah. So impulsivity, interesting, wasn't as highly linked. I was surprised by that. Okay. And openness to experience was also associated with recent marijuana use, like within the last month of 1.08. It almost makes me wonder which comes before, which one comes first, right? Good question.

Because in later studies, we find some of these more psychedelics, like, increase openness. Yeah, it was just an association, right, that they found it wasn't like. Yep. So it's not like a, it's not like a predictive thing. So I like this next study because it looks at chronic cannabis users and people who have never used cannabis before. Oh, cool. And looks at openness to experience between the group. And there's a huge effect.

Well, comparatively. Of 0.67. For what in particular? So people who, like, used? Yeah, the chronic cannabis using group was much higher in openness to experience than the never used cannabis group. Wow. Yeah.

Yeah, that is a big jump. I'm looking at the other personality types. Yeah. And it doesn't seem like there's much of a link. Yeah. Between the two. Maybe, oh, cannabis, lower conscientiousness. Yeah.

Quite a bit, actually. Okay. Quite a bit. And also lower on agreeableness for the chronic years. A little bit lower on agreeableness. Yeah. Interesting. I wonder if that's why they always, like, get upset when I recommend that they stop marijuana.

They're not agreeable. I'm just joking. It's hard as a psychiatrist when I see that someone is being negative. influenced by marijuana, and they're also, they have a very strong attachment to marijuana, which is why I did a couple episodes on marijuana in the past, showing that it increases risk of psychosis, depression, anxiety. Yeah, I listened to that one. I was surprised that I didn't really think there would be like long-term consequences,

and I forget the amount of IQ points that drops off for like chronic use. Chronic heavy use over 20 years, it's like half a standard deviation. Wow. That's significant. Almost half a standard vision, yeah. Okay. Let's keep going. Traits.

What about traits? Are conservatives lower in openness? Yeah, this one was interesting. Because basically, I think the thought, if you don't look into it too much, is that people think that if you're less open, you're more conservative. Because it like makes sense. You're not as flexible in your values. You have a more strict. It's mostly connected to values, I think, more than other traits of openness specifically.

So that's why this study wanted to look at that. Yeah, it's an interesting study because they're doing some complex statistical modeling, which honestly it's like what's tying my brain into a knot. Oh, man. So what were their conclusions? Yeah, basically they said that they're not so sure that personality, like openness causes conservatism versus being more liberal, but they did find that your openness develops in parallel with your conservatism. So like if you're more conservative,

if that changes over time, like if you become more conservative, you'll also, your openness will change. Yeah. So it's like which one comes first? Yeah. That's what they were asking. Do you choose to become conservative and then because you're less open because you're less open or do you become less open as you become more conservative and they see that they kind of like go they float together a little bit yeah they did they did say at the end um it seems like openness to experience decreases conservative conservatism more than conservatism decreases openness to experience yeah openness to experience Which is like what people think. Right.

Yeah. Like if you're more open, you'll probably be less conservative. Yeah. I think it has a lot to do with like as you develop a group identity. Yeah. You often will adopt all of the different aspects of the group identity. I think that's where. And then so there's kind of like group think that occurs more and more.

In this culture, we see that. I would say to like a higher degree than usual ever than I've ever seen it. Yeah. So it's like the set beliefs of an identity sort of move you and move you further, further away until you almost think that the other group is completely evil, which is dangerous. Okay. Americans who are hearing this, it's dangerous to believe that. All right.

You know, I was not impressed by some of the effect sizes. to tell you the truth in this study. It's not like they're huge, huge differences. That was one thing that jumped out to me. So, you know, how clinically relevant is this? Maybe a little bit, right? Maybe a little bit. Like, I think when we get to the extremes,

like two and three standard evitations, one way or the other, is where you'll meet someone who's, like, very, very fixed in their beliefs. And it's like, okay, what is your, what is the countertransference that may occur when you meet someone who's of your opposite political ideology? Yeah, as a therapist. Maybe you can have a little bit decreased countertransference by thinking it might be related to some of the degree their openness, right?

And so can you see them for who they are, you know? interestingly if you think about jobs that tend to run more conservative they tend to be more like blue collar jobs all the policemen firefighters those tend to be more conservative decent mechanics right whereas you think about like people who are super high openness maybe like your college professor tend to be more liberal i think it's like something like 95 percent of college professors are liberal or something like that Okay. Yeah.

How about love and work? Yeah, this study was interesting. They just had the question of like, how does openness play into how a person loves and how they work? So it was, it was a cool study. They, like Kyle was saying, they basically had to look at facets to see how it played into it. And they saw that their intellectual interests were predictive of positive educational outcomes, while their aesthetic interests, unconventionally predicted, winding an autonomous career path. So if you were more high on aesthetics, you were more likely to have a less straightforward career path,

like you would try different things before finding what you liked to do. But if you were higher on the intellectual side, you're more likely to have a higher level of education, basically. And then, so like they were saying, they found that openness plays a difference, but it wasn't like openness overall. You had to go into the facets of openness. And then they also said that it changes into adulthood, and that seemed to be a bigger factor, like how it changed more than just what level you are at at any point in time.

Okay. Yeah. Oh, so then one of the things I forgot to mention that they said, as far as love was concerned, where did it go? If you're higher in openness, you're more likely, which another study said, you're more likely to delay romantic commitment. And you're more likely to, you put less of an emphasis on extrinsic rewards like salary. So if you're higher in openness, you might like try different careers or careers that maybe don't make as much money. And then you're also, you might not like get married as soon as other people, which that other study said too.

Yeah. Yeah. It's very like complicated. It's not like super straightforward. Like it like since openness changes so much over your lifetime, you can't just like look at someone at one point in time and say this is how your life is going to go. You have to look at how it changes. Yeah.

And once again, partners tend to have similar openness scores. Yeah. One study showed that people generally desire partners high in openness. Yeah. That's interesting. Yeah. It's like, that's like, I want someone who wants to try new things and explore. I feel like everyone says that.

That's what they always say like on the Bachelor and Bachelorette. I want someone who's going to explore the world with me. Yeah. Not go to the same place. Yeah. Imagine me on like a date. Yeah, this is the only coffee that I like. It's like day 10.

It's like, so you get the same sandwich. Oh, man. It's like over time, you just know what you love, you know? Yeah. Like avocados. I like hoss avocados. Yeah, me too. Other kinds, not as much.

I really like hoss. It's fattier. It's better. It's a millennial thing to say. Okay. It's the avocado toast. I call it content for me. Yeah.

I prefer like 23% fat. So it's like picked right at the end of the food. the season, that's like the best. That's the wonderful thing about coffee. You can have this conversation with coffee and you're not crazy. Because you can talk, I want this origin, this elevation. But if it's avocados. I like my dark chocolate, like Guatemalan because it's a little bit more earthy than

the Dominican Republic. Okay. All right, let's keep going. So for this next study, they looked into life events and abuse, and they found that openness was significantly positively correlated with abuse, like a history of abuse. And they also found that childhood abuse, openness to experience an extroversion together were significantly positively correlated with negative life events, which was interesting. Hmm. Okay. Academic performance. What do you find there? For academic performance, so this was like a meta-analysis, they found that only two of the six openness facets were positively related to academic performance. It was ideas and values, which I think makes sense that those two would be, and the other ones weren't positively related.

Yeah. Ideas and values. Yeah. Yeah, that one made sense to me. It wasn't. This next section, I think, is really, really fun. This is the good stuff. This is the good stuff.

Okay, guys, if you've listened so far, congratulations. You made it. You made it. Psychopathology. Let's talk about psychosis. Bicosis. So interesting. So interesting.

So with psychosis, they looked at like two sort of brain areas. Yeah, this one was more complicated. That's why I looked at. Yeah. Okay, tell me what you found it, and then I'll tell you what I think. Basically, they found a link between psychosis and openness, which was interesting to me. Higher levels of openness were associated with psychosis. Yeah, so there's two different sort of networks that they looked at.

They looked at the default network, which is, like anything that requires the simulation of experience rather than attention to current sensory input, that's like the default network. So simulation of experience. And they found that increased connectivity and activity of the default network has been observed in patients with schizophrenia and in people at high risk for psychosis and during tasks. So this seems to be elevated in people with schizophrenia or at risk for psychosis. And what they found, importantly, the relation of schizophrenia to this default network connectivity appears to be specifically linked to positive symptoms of psychosis.

And they found that relatives of those with schizophrenia also show increased connectivity of the default network. That's interesting to me. So there's like that sort of genetic link there. And greater connectivity of the default network is seen among individuals who report more frequent mind wandering and higher levels of creativity, which are both correlated with positive symptoms of schizotippy. So, you know, additionally, the default network connectivity has been found to be positive related to individuals, individual differences in openness. So people who are higher in openness have this higher level of the activity of the default network. And if you're wanting some numbers, so default network coherence positively predicted open. with a beta of 0.21 and positively correlated with different psychotic type of things, 0.25. Okay, the second sort of brain network that they looked at was called the frontal parietal

control network, which is primarily nodes in the dorsal lateral prefrontal cortex, lateral parietal cortex, and dorsal interior singular cortex. And it appears responsible for voluntary control of attention and has been shown to exhibit reduced functional connectivity in those with psychosis. So there's this link, right, between psychosis and a disturbed function of the dorsalateral prefrontal cortex. So what they found is a negative effect size

between different psychotic stuff and the frontal parietal control network. It was 0.32, negative 0.32. And they found a similar negative value in openness. Yeah. So of 0.25. Yeah, so both psychoticism and openness related to the different areas the same way. Yeah. which kind of makes me think like, okay, so, you know, you have like some advantage of being more open, creativity, you know, ability to think abstractly, right?

So in certain environments, that's going to be very good. Push that to the extreme, you know, fantasy becomes hallucinations, right? So it's kind of like, you know, there's always positives and negatives to different traits. Yeah, they definitely need to do more studies with this, but it's like the question of, is there, does high openness link to schizophrenia and things like that? What do you think about? Because I've always heard when people are describing schizophrenia, they say, okay, well, think about someone who breaks, like in college, like early college. And that's always been described to me as like based on their age. But I wonder if we think about this thing with openness, if that's based on the fact that they're in college as well, because they're already selecting for higher openness. since they're in college, they are having more education. And I wonder if this link we've been talking about. You know, with schizophrenia, it tends to actually be linked to lower IQ.

So it's more rare to have a high functioning schizophrenic. I think it's just that much more devastating when it happens to like the individual, right? Because it's often the individual who sees what their potential could have been. and then they develop the schizophrenia. There's a lot of links between like cognitive decline and schizophrenia. Yeah. And different things like the, there's a lot of prefrontal cortex not functioning as well, right?

Like that planning area. Yeah. Stuff like that. So, you know, I do have patients who are very high functioning who have schizophrenia, who are on medications who are doing well, who are able to, you know, do graduate school and stuff like that. that like they're functioning really well but their pre morbid function coming into it was very high you know so you know it's interesting to me like we saw that study that um people who used marijuana had increased

openness and like if you use marijuana sometimes you can develop symptoms of schizophrenia earlier yeah no it increases your risk of developing psychotic illness period maybe there's a link with openness Maybe. Yeah. That would be really interesting to look at. Yeah. For some person out there who needs a doctoral dissertation, right? Okay. All right. Dementia. What did you find with dementia? Yeah. For dementia, they were looking at the overlap between openness and cognitive functioning. And they found that openness is a better predictor of activity diversity than of time spent engaged in activities.

or time spent in cognitively challenging activities. And then they saw that activity diversity explained significant variance in the relationship between openness and cognitive ability. So basically, they saw that participating in a more diverse array of activities was most beneficial for those with less formal education. So they were looking at like, can you help someone decrease their risk for dementia? and they found that since you can't change their education level per se for people with a lower education level participating in a more diverse array of activities could be beneficial for decreasing your risk of dementia and it related to openness. Okay.

So I need to diversify my activities basically, that's what you're saying. Yeah. Yeah, that's what the study said. Like it can it could be a help for people. Yeah. That's good. Yeah. What about depression in medical students?

What do they find? Yeah, this one was interesting. They found that depression was seen to be associated with openness and agreeableness, and they found that the medical students who were more open were less likely to develop depression. Hmm. Yeah. So it's associated with openness. Point two for one.

but then it's also students who are less adjusting more open and more agreeable are also less likely to develop depression. Okay. Yeah, so like one of the things with the study was they wanted to like look at medical students coming in and use the personality inventory to like help guide like what kind of support they might need, what their risk factors were for depression. So if they were less open, they might have higher risk for depression. So they might need to be given more support. So like future research, like can we use personality traits to guide? Yeah. Like risk management, more or less.

These associations are very small. Yeah. Right? So that would be like that would, I don't think I would run this study in the future. It's probably not how I would screen people for risks, honestly. Neuroticism, maybe. Yeah, yeah. Neuroticism would be a good one.

It's the most linked to depression. Okay, what about anxiety in college? Yeah, for anxiety in college, they looked at the stressful situation of entering professional curriculum and found that it was marked by a combination of decreased openness to experience and increased extroversion in the great majority. of normal students and those with anxiety. So they also found that people who had decreased extroversion and openness, both of those

together, they're more likely to spend their time alone. So they kind of thought that having a good balance of extroversion and openness to experience was essential for psychological resilience. So like because you're less likely to kind of keep to yourself and have less like positive coping skills. Okay. Yeah, they say that there's like this elixothymia, like an inability to know your own emotions, your own experience, you know, that's like that very low feelings. Yeah. Right. And I've met some people who are are elixothymic, but they have emotions, right? So you see it on their face, you see it on their micro expressions. They're flashing the emotions. They just have no

clue what they're feeling. And so I help those people by, you know, getting in touch with what they're feeling in their body, get them talking about something that makes them angry, get them to feel it in their body. That helps them, you know, like, what do you feel in your chest? Do you feel tight in your chest? Yes, I do actually. What does that mean? That might mean that you are frustrated. Oh, that's helpful. Okay. Yeah, that's basically what they were saying, like in order to have some resilience, you need to be more aware of your feeling so people with low openness seem to be a little bit less aware. So they were a higher risk for developing symptoms. Okay, what else?

Yeah. So maybe let's go on to ASD, ASD, autism spectrum disorder? Yeah. They basically found a negative correlation between the severity of autism. and openness to experience, which I just thought was interesting. So they're more, they're less, if they're more severe autistic. They're less open. They're less open.

Yeah. I mean, it makes sense because they're very regimented, right? They're very, they like the routines. They get very upset when their routines are broken. Very upset. Okay. Yeah, that one makes sense. I thought that was interesting.

How about schizophrenia? and borderline personality disorder. Yeah, for those, they found high genetic correlations between extroversion and ADHD and between openness and schizophrenia and bipolar disorder. So they found genetic correlations between openness and schizophrenia and bipolar disorder. So higher openness with schizophrenia or lower opens?

Yeah, higher. And bipolar, higher or lower? I think it was also higher. Okay. Yeah. Interesting, they found ADHD. was linked to extroversion. Yeah.

But it makes sense. They're more gregarious. Yeah. It's like if I'm sitting in front of a person who thinks they're ADHD but they look depressed and they're very low energy individual, I tend to think this person is more depressed. Yeah. Okay. What about migraines and depression?

Yeah, this one was really interesting. So they found that openness to experience was significantly lower in the co-occurrence of migraines and depression. So people who had migraines and depression at the same time had lower openness. So then it suggested that increased openness might decrease the risk of the co-occurrence of depression and migraines. And so they were thinking it would provide valuable insight for newer prevention and intervention approaches in the treatment of these conditions. So basically thinking like if you can change their level of openness, maybe you can change their risk. for depression and migraines. Huh.

Yeah. Well, I think about, in general, psychosomatic type of things, you know, where you're stuffing your emotions in your body, you know, you might have more body pains. And then if you're able to kind of like process the emotions as they happen, be congruent with your inner experience, congruent meaning your inner experience matches your outer experience. Because yeah, if you look at the, I put the, the graphs on the next page. It's pretty different.

Wow. So as you, yeah, explain this graph to me or put it into words that would make sense to someone listening to a podcast. Basically, they compare openness to like having migraines and not having migraines. And then so they compared it also to having depression. So there's three different things going on in this thing. And people who had depression and migraines had a lot lower openness than people who had migraines without depression. And then so like if you have a migraine, if you also have depression, your openness is going to be lower. If you have migraines but you don't have depression, you have higher openness.

And then if you don't have migraines but you have depression, they had higher openness. And then, yeah, it's crazy. I know. Oh, okay. Go on the website. Look at this thing yourself. Yeah. If this is interesting to you.

It's in the resource library. Okay. Yeah. They basically wanted to see, like, can you help treat people with migraines and depression by looking at their openness? Yeah. So concluding remarks on this study? What did they conclude that you could or couldn't help them by looking at their openness?

Yeah, they were thinking that like maybe you can, maybe you can. Like if they have depression and migraines, can you work on changing their levels of openness as part of treatment, like doing therapy, basically? Okay. All right. Treatment resistant depression and low openness. Yeah, this one was cool too. For people with treatment resistant depression, they had lower openness. lower levels of openness.

Yeah. It was harder to treat them. Yeah. Basically, they were thinking as like doing the, looking at openness to see, like, kind of like gauging how you should treat patients with depression. So like if they have low openness, they're more likely to be treatment resistant. Yeah, they concluded this newly identified trait should be included as a risk factor in treatment-resistant. It's really interesting.

Yeah. Okay, so tell me about this ketamine study. What do they find? Yeah, this was really interesting. So they found that someone with high openness, it significantly predicted a sustained treatment outcome when they were treating patients with treatment resistant depression with long-term ketamine therapy.

So if you have a patient with treatment-resistant depression, if they have high openness, they're more likely to have a sustained treatment outcome if you try ketamine therapy with them. Yeah, and this is substantial. It's almost like a two times more likely. Yeah. I've never seen any studies like this.

So I think this is really kind of going along with that prior research, that low openness was a significant mediator of treatment-resistant depression. And so, you know, someone who's very depressed, who also has very low openness, they're going to be harder to treat with anything. Ketamine, no ketamine. Like one study found that low openness predicted a negative outcome

in the use of lithium augmentation therapy. Interestingly, in another study, openness did not predict a response to fluoxetine in depressed outpatients. So, you know, it's kind of like a mixed result. So maybe if they're low openness, Fluoxetine might be a better option. Yeah, maybe.

Yeah. Also in deep brain stimulation, openness scores were lower in general, but did not predict antidepressant response. Yeah. So I doubt that any ketamine clinics that are run by non-psychiatrists are going to check for openness. Yeah. They're just, man, they're money mills to some degree in some of these places. If you are looking for ketamine treatment, do not go to a non-psychiatrist to get your ketamine because they do not know how, you know, they don't treat thousands and thousands of patients with depression.

So they're not used to the nuances of depression and what might work or what might not work or what might be the best option. Okay. So let's talk about MDMA and openness. What do they find? In general. Yeah, in general, they found that there was a relationship between openness and reduced PTSD symptoms with MDMA treatment. So they had a treatment. They had eight people taking a placebo doing this MDMA therapy.

They had 12 people on MDMA. So this is, you know, real MDMA ecstasy. This is not street ecstasy, which is often laced with all sorts of things like methamphetamines or fentanyl. rarely probably but it you know could be laced with things so then they did this this therapy there was a decrease in the the caps score interesting

the placebo had quite a substantial decrease too yeah and they showed that there was a decrease in neuroticism and an increase in openness mm-hmm

the increase in openness only occurred in the people taking the MDMA. And it wasn't huge. It's like a third of a standard deviation, basically is what I see. So they did a T score. Openness started at 56.4, went to 59.7.

So three points, three points, which is a third of a standard deviation. Neuroticism decreased from 69 to 59. And that's a one standard deviation shift. Interesting. So remember our openness, like some of us are like two standard deviations above the mean. One standard deviation above the mean. So it's like it would shift, but it would shift very little.

So it's not like all of a sudden their openness is like, three standard deviations different. And they listen to poetry and it's like, oh my gosh, I'm connecting with this, right? So. And then any other studies? How about this one on psychedelics? What did you find? Yeah, they found that openness to experience differed between three groups.

So they were looking at three groups. People who used psychedelics recreationally, people who preferred MDMA, and then people who didn't use either of them, the control group. And they found that openness to experience was higher specifically in the psychedelic group compared to both the MDMA and control. And so were they, they were testing people who had, who had used the substance. Who had used it in the past.

And they were looking at their levels of openness, yeah, to see if like use of either psychedelics or MDMA would possibly change your level of openness. Yeah, so they found a positive association between openness and the lifetime number of psychedelic exposures. Yeah. Okay. breakdown what specifically happened in the different domains of openness um yeah they found that

specifically values actions and ideas showed a positive association with lifetime psychedelic use which is really interesting there's an increase in values whereas openness to feelings and fantasies were not associated yeah which i thought was interesting because i would have thought maybe fantasy would have changed yeah but it didn't Okay, and what did we find about this therapy increased openness in older adults? Yeah, so I thought, like, looking at therapy would be really interesting with openness to see, like, how you could use it. So when they, the study that looked at openness and older adults, they found that you could, doing some training could maybe change and increase, actually, their levels of openness.

So when they compared the group that they were doing training with to the control, their openness after training increased significantly compared to the control. They were doing inductive reasoning training. Yeah. Oh, that's interesting. So that was the therapy that they gave? Yeah. So, like, the very basic question for this one was, like,

they were looking at dementia, like, if you could, if changing their openness could change their risk of dementia. in the future. Yeah. So they found that if you did this inductive reasoning training, it increased their openness. And so they were hoping that maybe that could help with their future risk of dementia. Did they find that it changed the future risk of dementia? I don't think they could make that conclusion just based off of this study.

Okay. Like it was like one of the first steps to see if changing personality traits could do that. that. How did openness predict therapy? There's another study, Samuel, 2018. They looked at 54 therapist client diads within a doctor training program. Yeah. So for this one, they basically wanted to see, like, if you look at your level of openness, will it predict how you respond to therapy? They used different types of therapy depending on the patient, CBT motivational interviewing some third wave therapy techniques as well. And then they looked at the therapist rated their conscientiousness and how they would respond,

their initial engagement to therapy. And then so they had like therapists and clients rate themselves in different areas for the study. And then they found that therapist rated conscientiousness was most predictive of the initial engagement, but client-related openness after the fourth session was most strongly predicted, predictive of symptom reduction over the course of therapy. Interesting. So the client rating how open they were strongly predicted their reduction of symptoms. Like so higher openness, more reduction of symptoms.

Yeah, conscientious first makes the biggest impact because they're going to therapy, they're following through with recommendations. but then openness, you know, like how in tune to their emotions, it's a lot of work to get someone to increase their feelings, their ability to connect with their emotions. That could take a lot more time, right? If someone has a lexathymia, that could take a lot more time to get there. And so you're able to potentially do the work earlier on

if you have that emotional awareness. In my episode with Ginger on congruence, we talk about how we help people gain that emotional awareness. There's three domains that people can be congruent in writing, in art, or in talking. And so we'll have people who are not congruent in anything but art. So we have them do art. The art's very congruent. And then we have them describe the art. We have them write about the art.

so then we pull the congruence into the other two domains. Yeah, but interesting that they found that people who are, people who tend to be low in feelings are sometimes harder to do work with. So I think there's ways of getting around that and I like training people in that. Yeah. Getting them congruent. If they're congruent in art, they may be a lexathymia in regards to, you know, talking about or writing about what's going on internally.

But their art is not. Alexothymic. Yeah. So I feel like that's one of the important things about this. Like when we're looking at therapy, if you do the personality traits, you can see like how do I work with this patient best? Like, especially when

we're looking at openness. Like if they have high openness, you're maybe going to try different things than if they have low openness. Yeah. And then also thinking about the domains. Like if someone's high in everything but feelings, maybe they've just learned how to cut those feelings off, you know, a little bit of intellectualization, right?

Or rationalization, especially if they're like us, like, you know, professionals. That's very normal to have those sort of characteristics. Yeah. Okay. Yeah, what about this therapeutic alliance study? So they said we asked 38 clinicians to assess the importance of each domain and the facet of the five-factor model in regards to the therapeutic alliance. And results indicate that high openness,

high agreeableness, high conscientiousness, are perceived as favorable to therapeutic alliance. Yeah. I would agree. I would agree for most clinicians, you know. And, you know, someone who's high openness, they may not like CBT. They may like more of the psychodynamic approach,

the open-ended approach. Yeah. Looking at their dreams, looking at their associations, to like fantasies and stuff like that. Yeah, interestingly, they also asked them like the facets that they thought were, that would positively affect the therapeutic alliance. And for openness, they found that feelings, ideas, values, and fantasy positively affected

the therapeutic alliance. Yep, that makes sense. Okay, and then there's one other study that we looked at, Butcher 2019, looked at openness and therapy outcomes. And they found that higher openness relates to a lot of different parts of increased therapy outcomes. Yeah, therapy outcomes. Yeah. And neuroticism makes therapy outcomes harder because people are probably more sick.

And, you know, neuroticism and depression are so linked. Yeah. So there's more severity. And extroversion helped outcomes a little. little bit, agreeableness, and conscientious. So when those were high, that helped outcomes. Yeah. So finally, we're looking at, let's see, we're looking at how openness might relate to how

therapists would perceive them. So someone who's low openness may seem resistant to therapy and closed off. and it may be important to not mistake this aspect of the personality and judge them too early, right? Yeah. But to rather try to work with them and to see the openness as like part of the personality and part of maybe something you can work within. So someone who's low openness might be better with more of CBT or behavioral approach early on. right someone high openness might be more the psychodynamic working with the dreams working with ideas their feelings yeah i thought this one was important because one of the things the author

said was that um like you said trying not to mistake low openness for like not responding to therapy like especially if you as a therapist have high openness like looking at their openness can help you realize that it it's more a personality trait than like how invested in responsive they are to therapy. And then conversely, like if they have super high openness, you might think they're doing better than they actually are just because they might be just really good at thinking about their feelings and thinking about them in more metaphorical ways. Yeah. So it just might make your, it'll make your therapy better, like if you pay attention to their openness and how it relates to their feelings in response to therapy.

Yeah, they said the patient's level of openness will likely gauge, how imaginative the therapist can be in regard to intervention. Patients high on this dimension can be challenged and confronted with new and unusual ways of thinking. For patients low on this dimension, novelty is frightening. For these patients, it is recommended that the clinician tests the limits to see what is tolerable. Perhaps psychoeducation or behavioral therapy can be used with success. This is Anderson, 1998. So, lastly, career.

planning. I know we've talked about this a little bit. Is there anything you would like to add? For this one, it is like a lot of what we said before. Basically like when you're doing career planning with patients looking at openness to figure out what kind of career path they should be choosing, like what they'll find the most fulfillment from. Yeah. I, you know, I think this is a helpful discussion. I think now let's just kind of like say what maybe our main takeaways are if you've had any about yourself or about kind of like openness in general about what all this means. Matt, you want to start? Sure.

I think taking the test was helpful for myself to better understand and sort of confirm what things are meaningful to me. I think the idea that I scored highly on the aesthetics section is really interesting for me as a pretty strong introvert. I can think back on social interaction. and the times that I'm not tired and I'm getting more out of it is when we're discussing philosophical ideas, when we're thinking about bigger picture concepts, and that's something that in reflection has been really helpful for me. I think that this does have a pretty significant impact on a variety of areas in your life,

and it's also probably affected the way that I will approach people that are older or younger than me, knowing that there are differences in openness throughout life. And I think that's probably what's going to be the most helpful for me. Yeah. Maddie? I liked the idea of looking at your personality traits and linking them to how you would interact with patients in therapy. One of the things I thought was cool is when you take the personality test at the end, they give you like how should you take this when you relate to a patient.

So for mine, for openness, it said, this patient is open to experience, probably including the novel experience of psychotherapy. She tends to be introspective and psychologically minded and will probably be willing to try a variety of psychotherapeutic techniques. Free association, dream interpretation, and imaging techniques are likely to be congenial. Focusing on concrete solutions to problems may be more difficult for extremely open individuals. So I like that they, on this test even give you some examples of how you can use this. with patients to make your therapy more effective. So I thought it was really important, like, especially in the feelings aspect of openness to realize that if patients have low openness, they just might not be as in tune with their feelings.

And, like, it doesn't necessarily mean that they're not responding to therapy that they don't want to change. It just might be harder for them to go through the therapy process than someone with high openness. Yep. That's good. Kyle, anything? Yeah, I like learning about this stuff because it's,

I think it helps me have a better appreciation for people that are different from me, both in like a clinical sense and for relationships I have with family and friends. Yeah. You know, I think the key for me is to kind of understand how people may be different and then to think about like catering the treatment to them in the midst of their differences. you know so if someone's super low fantasy you know it might not make sense to ask them about their fantasies or like you know about their dreams and stuff like that um if someone's you know low and feelings to think through like okay is it are all the other domains low or is this uniquely a low domain and if

it's uniquely a low domain then like maybe it's just like there's psychological defenses around it and and it's there, you know, like, but you can't, you don't have access to it for some reason, right? So then it's kind of like, how do it help them be congruent into their feelings? If they're high in feelings, it might be helpful to look at, you know, how do we help them cope with the strong feelings that they're having or interpret them more accurately or not jump to conclusions or mind read too extensively because, you know, often people that can then create. create narratives that don't really exist in others people and kind of so looking at reality right and the extreme of high and openness might be like you know it's linked to psychosis that was interesting to me yeah um i also found it really interesting to think about treatment resistant depression if they're low in openness that might even be another sort of like hit to their

their difficulty in the treatment yeah and so to think through like you know things like the ketamine might not work as well in people that are very low openness. So, you know, just being more patient with the process with someone who's low openness as like, okay, this may be a more difficult treatment. And if someone's really low openness, because I'm very high to think of like the countertransference that might develop there. And then how can I think about that? Just even starting to recognize like, oh, I'm reacting to this person.

not because they're different political ideology to me, but because they're probably low openness and there's that gap there in difference. So, yeah, those are some of my thoughts. It was really fun to look at your scores. It kind of helps bring it more concrete to me. And, you know, if you're professional, you can actually get a license to give this test.

Now, I don't make any money from the people who would do that. You can ask me by email if you want more information on that. or if you're professional and you're listening to this and you want to get tested yourself, you know, you can always engage me as your coach to walk you through what it might mean to have your score. And I would enjoy that. So I'll leave it there for today. And we will put this up on the website, psychiatrypodcast.com. If you want to support the podcast, please sign up for the CME.

It really does help. And we'll leave it there.