Low optimism, high negative emotional expressiveness, and hostility are associated with an increased risk for type 2 diabetes among postmenopausal women, according to a study published in Menopause.

Researchers used the Women’s Health Initiative, a prospective cohort study, to examine whether personality traits are associated with the risk for type 2 diabetes among postmenopausal women. A total of 139,924 women age 50 to 79 years without diabetes at baseline were recruited and followed from enrollment to date of diabetes diagnosis, date of death, loss to follow-up, or end of clinical trial or observational study follow-up (February 2017), whichever occurred first.

Four personality traits were included in the analysis. Optimism was assessed in participants using the Life Orientation Test, a 6-item questionnaire that measures constructs such as positive expectations and hopefulness. Ambivalence over emotional expressiveness was measured with a 3-item subscale of the Ambivalent Over Emotional Expression Questionnaire; a higher score indicated greater ambivalence in expressing negative emotions. Negative emotional expressiveness (NEE) was measured with the Emotional Expressiveness Questionnaire, and hostility was assessed by the cynical subscale of the Cook and Medley Questionnaire.

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During an average of 14 years of follow-up, a total of 19,240 cases of incident diabetes were diagnosed. There was a trend toward a lower risk for diabetes with an increased level of optimism and a higher risk across increasing level of NEE and hostility. Compared with women in the lowest quartile of optimism, women in the highest quartile had 12% lower risk for diabetes (hazard ratio [HR], 0.88). Compared with women in the lowest quartile of NEE or hostility (lowest level of NEE or least hostile), women in the highest quartiles had 9% and 17% higher risk for diabetes, respectively. No association was found between ambivalence over emotional expressiveness and risk for diabetes.

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An interaction between hostility and obesity status was significant. There was a higher association between hostility and risk for diabetes among nonobese women compared with obese women. No significant interactions were found between optimism or NEE and obesity status. No interactions were found between race/ethnicity or hormone use and any of the personality traits.

“In this large, prospective study among more than 130,000 postmenopausal women, we observed that optimism was significantly associated with lower risk [for] diabetes and that NEE and hostility were significantly associated with increased risk [for] diabetes,” the authors concluded.


Luo J, Manson JE, Weitlauf JC, et al. Personality traits and diabetes incidence among postmenopausal women [published online January 21, 2019]. Menopause. doi: 10.1097/GME.0000000000001296