|Year : 2019 | Volume
| Issue : 2 | Page : 124-136
Association between personality factors and early employment of mothers in medical undergraduates
Shubham Ratnawat, Abhijeet D Faye, Sushil Gawande, Rahul Tadke, Vivek Kirpekar, Sudhir Bhave
Department of Psychiatry, NKP Salve Institute of Medical Science and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
|Date of Submission||28-Feb-2019|
|Date of Decision||17-Apr-2019|
|Date of Acceptance||06-May-2019|
|Date of Web Publication||18-Dec-2019|
Dr. Abhijeet D Faye
Department of Psychiatry, NKP Salve Institute of Medical Science and Lata Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur - 440 019, Maharashtra
Source of Support: None, Conflict of Interest: None
Background: Personality of an individual can be influenced by a variety of factors, including parenting and mother–child interactions in childhood. Reduced time spent with mother due to early employment of mother can affect the personality development in a positive or negative way. Personality, in turn, can influence academic performance, learning, and coping in Bachelor of Medicine, Bachelor of Surgery (MBBS) students. This study aims at exploring the association of mother's employment in the initial period of life and personality traits in MBBS students. Methods: This was a cross-sectional study conducted in a tertiary care center. Consecutively selected 200 MBBS students of all the academic years were interviewed using a semi-structured pro forma and big five inventory scale. Data were statistically analyzed using mean, standard deviation, Chi-square test, and other tests. A P < 0.05 was considered statistically significant. Results: Mothers of 21% of the students worked during pregnancy, and mothers of 33% of the students started working within the first 6 months of delivery. Significantly, high score of extraversion, agreeableness, and openness was found in students whose mothers started working within the first 6 months of delivery. No significant correlation was found between early employment of mother and scores of neuroticism and conscientiousness. Neuroticism score was higher in final MBBS students, students living away from home, and those staying in nuclear families. Conclusion: Early employment in mother was associated with high extraversion, agreeableness, and openness in MBBS students.
Keywords: Bachelor of Medicine, Bachelor of Surgery students, mother's employment, personality
|How to cite this article:|
Ratnawat S, Faye AD, Gawande S, Tadke R, Kirpekar V, Bhave S. Association between personality factors and early employment of mothers in medical undergraduates. Ann Indian Psychiatry 2019;3:124-36
|How to cite this URL:|
Ratnawat S, Faye AD, Gawande S, Tadke R, Kirpekar V, Bhave S. Association between personality factors and early employment of mothers in medical undergraduates. Ann Indian Psychiatry [serial online] 2019 [cited 2020 Jan 22];3:124-36. Available from: http://www.anip.co.in/text.asp?2019/3/2/124/273371
| Introduction|| |
Personality can be described as a set of psychological characteristics that make an individual to behave in a particular pattern or in a meaningfully consistent way. Broad trait domains such as neuroticism, extraversion, agreeableness, conscientiousness, and openness also describe the overall personality type. There is a considerable literature supporting the fact that personality is significantly influenced by environmental components, and reduced or lack of time spent with mother in the early years of life can be one of the environmental components affecting the personality development. Some authors mention that maternal availability is particularly important during the first 2 years of life as, during this period, infant has limited understanding of the reasons for mother's absence and the timing of her return. Due to this, experiences of separation may be particularly salient. Parenting interactions of mother high in sensitivity and low in intrusiveness are linked to a number of positive outcomes in children, such as secure parent–child attachment, more pro-social behavior, less behavior problems, as well as more positive interactions with peers. Absence of these interactions, among other factors, can influence the personality in a negative manner. Neuroticism is a commonly studied personality domain in this respect. Neuroticism is a personality trait, characterized by the presence of anxiety, moodiness, envy, worry, and jealousy. People high in neuroticism are emotionally reactive and susceptible to stress more often compared to other personality traits. In such individuals, negative emotional responses to the challenges are frequent  and tend to persist for longer time.
Psychological theories demonstrated the influence of parental employment in early childhood on subsequent development of child, in general, and the personality, in particular. Major impact can occur with the employment of mother in the first few years of life when children are much dependent on their parents, mainly for care.
In medical students, personality traits and abilities are utilized successfully to communicate with patients. More precisely, patients might evaluate doctor's communication more positively and more empathic if the communication is done with emotion recognition ability with extraversion. Extraverted medical persons can be expected to display positive emotions, and they take the lead in communications with their patients. In medical field, extraverted physicians might create a positive atmosphere besides taking the lead in diagnostic conversations, which might be interpreted by the patients as signals of expertise and hence trustworthiness. Studies also say that people with high agreeableness are known for pro-social behavior and altruism and score high on self-assessed empathy. On the other hand, in medical students with high neuroticism, stressors can have a much greater impact in the form of impaired performance, dropping out, poor development of clinical skills and acumen, decreased competency, and low self-confidence. High neuroticism can also act as a risk factor for many neurotic illnesses such as depression, anxiety disorder, phobias, panic disorder, and adjustment disorders. As medical students are at risk of developing mental distress by virtue of high academic demands, need for competency, responsibility of patient's care, and exhaustive study schedules, it is important to explore their personality profile so as to get an idea about their coping mechanisms and communication skills. This will help to make strategies for their proper functioning, promote psychological well-being, and minimize the burnout. Some studies mention that the absence of mother in childhood provided children with more opportunities to develop better self-confidence, sense of exploration, and a favorable environment for realizing their creative potential.
This study was done to assess the relationship of personality profile with early employment of mothers among the Bachelor of Medicine, Bachelor of Surgery (MBBS) students.
| Methods|| |
A single interview-based, cross-sectional study was conducted in a tertiary care hospital and research center. Considering the logistic feasibility, 200 students of MBBS stream were enrolled in the study. Medical undergraduates (MBBS stream) who were willing to give consent for participation in the study were selected consecutively. Students were approached in their classrooms after taking permission from respective teachers at the end of their 1 h lecture. Students who were not willing to participate and those suffering from medical or psychiatric illnesses hampering them to participate in the study were excluded. All the participants were given detailed information about the study, and written informed consent was obtained before administering the questionnaires. The aims of the study were to assess the personality aspects among MBBS students and to study the correlation between personality factors and employment of mother in the early years of life (of participants). Following questionnaires were administered. All the questionnaires used were in English language.
Semi-structured pro forma
Semi-structured pro forma including details about sociodemographic profile, relationship history (relationship with colleagues, teachers, and family members), childhood history (birth and developmental history, type of delivery, order of birth, working status of mother during pregnancy, and birth-related complication), history related to working status of mother, and questions related to the time when mother restarted working after the birth of the participants. All the questions in semi-structured pro forma had specific objective answers with no detailed elaboration of the answers. For example, participants were asked “How is your relationship with your colleagues? Moreover, the options were below average, average, and above average as per their subjective perception about the relationship.” The pro forma was validated from five different psychiatrists for the appropriateness of the questions and accuracy of the answers. It did not have questions specific to mother–child interaction or relationship with mother in childhood of the participant.
The Big Five Inventory (BFI)
This is a self-reported questionnaire consisting of 44 items that assess an individual on the big five factors (dimensions) of personality  that are extraversion, agreeableness, conscientiousness, neuroticism, and openness. Each item has five responses; disagree strongly, disagree a little, neither agree nor disagree, agree a little, and agree strongly which scored from 1 to 5, respectively. The reliability of the scale is 0.88, 0.79, 0.82, 0.84, and 0.81 for extraversion, agreeableness, conscientiousnes students with higher neuroticisms s, neuroticism, and openness, respectively. To score the BFI first, all negatively keyed items need to be reverse scored, i.e., subtracting the score for all reverse-scored items from 6. Next, scale scores were created by averaging the items for each big five domain (where R indicates the reverse-scored item), i.e., adding the scores of each question and dividing the sum by number of questions, respective of that particular domain. It is a good scale to measure the personality traits of individuals in research setting. It is freely available for researchers to use for noncommercial research purposes.
Each interview took around 20 min. The participants carried the pro forma home to get the details from parents about working status and time when mother started working postdelivery along with the birth and developmental history. The pro forma was collected back from the participants the next day. The confidentiality was assured. Two hundred and twenty-five students were approached, but 19 students did not return the pro forma back whereas six students refused to participate. Thus, only 200 students could be included in the study.
The collected data were pooled, and statistical analysis was done depending on the type and distribution of the sample. Data were entered in MS-Excel and analyzed on social statistics (www.socscistatistics.com). Categorical variables were summarized as counts and proportions, while numerical variables were summarized as mean and standard deviation. The prevalence was reported as proportion with its 95% confidence interval. Sociodemographic details and scores of BFI scale were compared with various factors using Chi-square test. A P < 0.05 was considered statistically significant.
| Results|| |
[Table 1] demonstrates the demographic profile of the study participants.
[Table 2] shows birth and childhood details of the participants. 78.5% had a history of normal delivery in their mothers and 21.5% had undergone cesarean section. Fifty percent of the participants were first in the order of birth among siblings and 30.5% were second in birth order. 21% of the participants had their mothers working during pregnancy. 34% (68) had their mothers working after delivery (post-partum). Out of this group, 18.5% (37) started working within 6 months of delivery, 12.5% (25) in 6–12 months, and 3% (6) after 12 months of delivery.
[Table 3] compares various demographic and childhood factors with neuroticism score above and below the mean. For 200 students assessed, the mean neuroticism score was found to be 23.98. In this study, 70 males and 34 females scored below 23.98, and 57 males and 39 females scored above 23.98. Similarly, in contingency table for the study year, 38 first-, 9 second-, 22 third-, and 35 final-year students scored below 23.98 while 32 first-, 20 third-, and 44 final-year students scored above 23.98. High neuroticism score in the final-year students compared to others was statistically significant (with P = 0.015). Those who confessed about strained relationship with family members had high score on neuroticism which was statistically significantly (P = 0.01). 43.5% of the participants (87 out of 200) said that they usually need longer time to recover from stress compared to others, of which 27.5% (55 out of 200) had higher neuroticism score which was statistically significant (P = 0.001). No significant difference in neuroticism score was found between the groups with working and nonworking status of mothers. With respect to details about working status of mother after delivery, it was found that 17.5% (37 out of 200) of the participants had a history of their mothers starting work (occupational) within 6 months of delivery. Of this group, 57% (21 out of 37) had higher score on neuroticism subscale, but it was not significant statistically.
On comparing residence, type of family, choice of profession, order of birth, and working status of mother during pregnancy, no statistically significant correlation was found with the score of neuroticism.
[Table 4] presents the relationship between various demographic and childhood factors with extraversion score above and below the mean of 25.03. It was found that 73 males and 35 females scored less than the mean and 54 males and 38 females scored above the mean. On comparing MBBS year-wise distribution of extraversion score, it was found that significantly, higher number of final-year students had lower score on extraversion subscale (P < 0.01). Among the participants who were staying with their parents (44 of 200), 63.64% (28) had higher score on extraversion subscale and the finding was statistically significant (P < 0.01). 24.5% (49 out of 200) of the participants said that they could sleep for <40 h per week, of which 75% (33) had lower score on extraversion subscale and the finding was statistically significant (P = 0.03). Among those who confessed that they are facing stressful (life) situation in their lives, 64.13% (59 out of 92) had lower score on extraversion which was significant statistically (P < 0.01). On assessment of working status of mother after delivery, it was found that high score was found on extraversion in those students whose mothers started working within 6 months of delivery (P = 0.03).
No significant correlation was found between gender, type of family, choice of profession, relationship with others, order of birth, and working status of mother during pregnancy.
[Table 5] describes relation of various demographic and childhood factors with agreeableness score above and below the mean of 33.86. Among male students, 63 had score <33.86. Among female participants, 28 had score <33.86 whereas 45 students had score more than 33.86. 65.3% (64 out of 98) of those with good relation (above average) with their teachers had significantly high score on agreeableness (P < 0.01). Fifty-five percent of the first-born participants had significantly low score on agreeableness (P < 0.05). In those whose mothers started working within 6 months of delivery, 73% (27 out of 37) had higher score on agreeableness and the finding was statistically significant (P = 0.02). No significant correlation was found between agreeableness score and factors such as residence, choice of profession, family type, exposure to stressful life situation, and working status of mother during pregnancy. Agreeableness score was significantly higher in participants whose mothers started working within 6 months of delivery (P < 0.05).
[Table 6] shows that 50 out of 79 final-year students (63%) had conscientiousness score significantly above the mean as compared to those in first-, second-, and third-year students. First-year students had significantly low score on conscientiousness compared to others. Sixty-two percent of the students from nuclear families had higher score on conscientiousness compared to those in joint families (P < 0.05). Participants who were first born had significantly low score on conscientiousness compared to second- or later-born participants (P < 0.05). No significant correlation was found between conscientiousness and working status of mother during pregnancy or after the delivery.
No significant correlation was found between openness and demographic or other factors though first-born participants scored significantly lower on openness whereas second and later born scored significantly higher on openness (P < 0.05). Working status of mother during the pregnancy did not have significant relation with the openness score; however, among those whose mothers started working within 6 months of delivery, the openness score was significantly higher (P = 0.03) [Table 7].
| Discussion|| |
Medical studies are considered to be highly demanding as well as exhaustive, and certain personality traits may affect the overall performance during the MBBS years. Studies have described how personality predicts academic performance. Recent meta-analyses of educational research based on five-factor model , have shown a consistent association between personality and academic performance. Conscientiousness, openness, agreeableness, and extraversion have positive correlation with the academic performance. It is therefore useful to study the personality factors in MBBS students along with the assessment of factors influencing it.
To assess the neuroticism on BFI scale, the mean score of neuroticism domain was calculated which was 23.98 and participants above this value were considered to have neurotic traits. In this study, 48% of the participants had neuroticism score more than a mean with no significant gender differences. It was also found that the neuroticism personality score was significantly high in final-year MBBS students compared to third year or below. For MBBS students, facing examination, especially final year examination is a significant stressor. Studies have shown that examinations along with new life situations causing fear reduce the effective functioning and may cause mental health-related problems., Each student experiences stress on an individual basis, but each student's physical or mental health is threatened during such stressful situations. Neuroticism score was higher in those participants living away from their parents (hostilities) compared to those living with parents. Family support usually plays a vital role while dealing with life problems. Family as a unit helps in coping with any stressful situation. This study showed that participants living in nuclear families had higher score on neuroticism. This can be explained by the fact that in a joint family, some or the other family member is always available for sharing and supporting in any stressful situation which, in turn, may help in better coping with the stress. This study also showed that participants with good relationship with their family members had scored significantly high on neuroticism score compared to those with average or below average relationship. Although this finding is contradictory to that of most of the studies, this can be explained as every individual tries to maintain their relation in a good and stable state which may sometimes act like stress leading to more neurotic traits.
In this study, students with higher neuroticism score (more than a mean) took longer time to come out of any stressful event, compared to those having less score. Some studies have shown that participants with high neuroticism score responded to a standard “negative mood induction task” with more negative affect than participants having lower score on neuroticism. This explains that the presence of neurotic traits can lead to emotion-based coping and difficulties in coming out of any stressful situation. Another 30-day daily diary study of patients with rheumatoid arthritis found that persons with higher neuroticism score experienced greater negative affect on days when negative events occurred in their lives than persons having lower neuroticism scores.
No significant correlation was found between working status of mother during the pregnancy or postpartum and neuroticism. This finding is in contradiction to prior research that has found significant relationship of mother's employment to child's development., There are many studies which suggest the negative effects of mother's employment on child. Hill et al. found that working of mother in the 1st year of life can have a negative effect on the child's later development. At the same time, few researchers  also concluded that maternal employment does not have any effect on outcome of child such as academic achievement, delinquency, or substance abuse. Thus, both positive impact  and negative correlation have been mentioned in the literature.
Extraversion is considered as a stable personality dimension characterized by the tendency to experience positive affect. It includes the tendencies toward being sociable, talkative, assertive, energetic, and warm. Individuals high in extraversion generally prefer excitement, stimulation, and social interaction. It is usually assumed that extraversion is associated with positive stress outcomes.
In this study, there was no relation between gender and extraversion. Studies show that gender differences are usually small on extraversion (with females scoring higher). Women usually score higher on traits such as warmth, gregariousness, and positive emotions, whereas men generally score higher on assertiveness and excitement-seeking. One study also showed that both men and women had significant negative correlations between the emotional scale and extroversion.
Extraversion score was low in students sleeping less (<40 h/week). Literature shows the link of poor sleep quality to low extraversion although the mechanism is unknown. Students who had faced a stressful situation in life were found to have low score on extraversion. It has been reported that extraverts experience more positive stressful life events, selectively attend to positive aspects of stressors, and engage in more social support and help-seeking behavior when they encounter stressors. Few other studies have shown a positive correlation between extraversion and positive affect, experiences of positive life events, well-being and positive mental health, and happiness and resiliency. No correlation was found between extraversion and time required to come out of stress in the present study.
In this study, significant relation of extraversion and working status of mothers postdelivery (within 6 months) was found. This was contradictory to various studies in literature which described that there is very little influence of family structure on the personality development of the students. Absence or reduced interaction of parents with their children have no major effect on the personality development of the children; thus, the amount of time spent by mother with their children does not have influence on personality development of students. Literature also mentions that employment may affect mother's emotional state about providing loving care to the child. Sometimes, it may induce guilt in mother for not giving quality time to her child which, in turn, influences the mother–child relationship. The different situational demands as well as the emotional state of the working mother affects overall child-rearing practices. Working mothers cannot provide adequate supervision, and this may result in emotional and even cognitive deprivation of the child  which may result in lower level of extraversion.
Agreeableness involves trust, altruism, and tender-mindedness. It is a personality trait manifesting in behavioral characteristics that are perceived as kind, sympathetic, cooperative warm, and considerate. These characteristics are important for medical students to have a better doctor–patient relationship and to be empathetic with patients. Individuals with high agreeableness generally have an optimistic view about human emotions and behavior, and such person gets along well with others. In this study, more number of female students had higher score on agreeableness compared to males (though statistically not significant). This is consistent with the findings of other studies done on college students showing higher agreeableness in women than men. Similar finding is noted in other studies of high score on agreeableness and related measures, such as tender-mindedness, in females.
Although we did not find any relation between facing stressful situation in life and agreeableness, many studies have linked low agreeableness with difficulty in dealing with stressful situations. Some other studies suggested that ineffective coping strategies are associated with low conscientiousness, low agreeableness, and high negative affectivity.
Students who scored low on agreeableness had poor relationship with their teachers compared to those with high agreeableness. This is self-explanatory as agreeableness is characterized by co-operating and trusting others, warmth, empathy, communicating with others, and tender-mindedness that help in establishing and maintaining any relation in a good and positive manner. Studies have mentioned that, compared to those who are more disagreeable, agreeable individuals tend to be more involved in helping behavior, such as cooperating with others, being respectful and polite to others, and supportive. These traits can be important for good relations with teachers.
Participants with birth order of second and later had significantly higher agreeableness score as compared to the first order of birth. Birth-order effects on personality traits were examined in many studies. One study supported the hypotheses that later-born children have high score in openness and agreeableness, with rating being done by peers. Students whose mothers started working within 6 months after delivery had significantly more agreeableness. Exact reason for this could not be traced, but there is a possibility that early separation from mothers may result in development of traits such as cooperating with others, being kind, and considerate for fulfilling the needs for emotional and other supports.
Conscientiousness describes traits related to self-discipline, organization, and control of impulses. It appears to reflect the ability to exert self-control to follow the rules or maintain goal pursuit.
Conscientiousness score was higher in males as compared to females in this study. Literature shows that women score higher on some facets of conscientiousness, such as order, self-discipline, and dutifulness. However, these differences are not consistent across the cultures and at the big five trait level; no significant gender difference is found in conscientiousness. Second-, third, and final-year MBBS students had significantly higher conscientiousness score than the first-year students. This can be explained as students progressively become more and more self-disciplined, organized, especially with regard to their studies, and develop a sense of self-responsibility during medical studies. Conscientiousness score was significantly higher in students whose order of birth was more than two compared to those with first and second order of birth. This finding was contradictory to the predictions drawn from Sulloway's model that is firstborns are more achieving and conscientious than later born.,
Openness reflects intellectual curiosity, creativity, imagination, and appreciation of esthetic experiences. These characteristics can be significant, especially for clinical learning of MBBS students when they are required to apply theoretical knowledge for practical purpose. No significant gender difference is found on openness. Some authors explained this due to the divergent content of the trait though women generally score higher than men on esthetics and feelings  and men on the ideas facet. Some studies found that medical students are high in extraversion and openness, reflecting personal growth, leadership, and problem-solving and are influencing.
Students whose mothers started working within 6 months of delivery had scored more on openness compared to others. The exact reason for this finding could not be commented upon, but some studies describe no effects on overall personality of the individual with respect to time spent with the child by mother in the initial period of life or whether the mother is employed or not.
Limitations of the study are mentioned before the conclusion as we have drawn the conclusion keeping in mind certain important limiting factors. The sample size of this study was small and studies with larger sample size may be necessary to analyze exact cause-and-effect relationship between personality trait and employment in mother during initial life years. Absolute relationship between personality traits and early employment of mother cannot be commented upon, as other factors (mother–child relationship, environmental factors, life experiences, exposure to stressors, parental personality, and genetic factors) that can influence the development of specific traits in students were not studied. The study was carried out in only one center with a nonrandom selection of sample, and it is difficult to determine the true point prevalence of any personality trait. As this was a cross-sectional single-interview study, the answers given to the questionnaire might have been affected by the state of mind at the time of interview as no follow-up assessment was done. Memory bias can also be present as some details on pro forma needed remembering the past and childhood history.
| Conclusion|| |
This study found that MBBS students with a history of their mothers starting work (occupational) within the first 6 months of delivery (postpartum) scored significantly higher on extraversion, agreeableness, and openness traits. In other words, relational/emotional stability and flexibility in thoughts/plasticity were higher in students whose mothers started working early. No significant relation was found between working status of mother postpartum and personality traits of neuroticism and conscientiousness.
This study is among the important studies demonstrating the relationship between working status of mother in the early years of life and personality profile in MBBS students. Working mothers who are mostly multitasking are good role model for children and can be an important factor for personality development. This study can also help to plan strategies for the students with a history of early separation from their mothers, though large-scale studies are needed to validate this relationship.
We wish to thank all the MBBS students who participated and agreed for the publication of data.
This study was approved by Institutional Ethics Committee with reference number IEC/NKPSIMS/14/2017 obtained on 12th January 2017.
Declaration of Patient Consent
Patient consent statement was taken from each patient as per institutional ethics committee approval along with consent taken for participation in the study and publication of the scientific results / clinical information /image without revealing their identity, name or initials. The patient is aware that though confidentiality would be maintained anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]