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Psychological Topics, 25 (2016) 1, 129-156
Original Scientific Paper – UDC – 159.923.3.072
616-00
Jasna Hudek-Knežević, Department of Psychology, Faculty of Humanities and Social
Sciences, University of Rijeka, Sveučilišna avenija 4, 51000 Rijeka, Croatia. E-mail:
hudekj@ffri.hr
Acknowledgements:
This research was supported by the University of Rijeka grant as a part of the research
project "Personality, emotions and social processes as determinants of health outcomes
(13.04.1.2.01)".
129
Dark Triad Traits and Health Outcomes:
An Exploratory Study
Jasna Hudek-Knežević, Igor Kardum, Nermina Mehić
Department of Psychology, Faculty of Humanities and Social Sciences,
University of Rijeka, Croatia
Abstract
On the sample of 637 participants (358 women and 279 men) we explored the relationship
between Dark Triad traits (psychopathy, Machiavellianism and Narcissism) and various health
indicators including subjective (positive and negative mood and perceived physical symptoms),
protective health behaviors as well as some more objective health indicators (number of
hospitalizations, number of diseases, having specific chronic diseases, injuries and addictions).
Because of the moderate relations between Dark Triad and broad personality traits that also exert
their influence on various health-related indices, we examined the unique effects of Dark Triad traits
on health indicators above and beyond five-factor personality traits as well as sociodemographic
variables related to health (gender, age and education).
When sociodemographic variables, as well as five-factor personality traits were controlled in
hierarchical regression analyses, Dark Triad traits significantly improved the prediction of almost
all subjective health indicators, protective health behaviors, number of hospitalizations and number
of diseases. The effect sizes obtained were relatively low, and psychopathy was the most consistent
predictor.
Regarding chronic diseases, injuries and addictions, the results of hierarchical binary logistic
regressions showed that when sociodemographic variables were controlled, psychopathy was a
positive predictor of the risk of digestive diseases, tobacco use and injuries, Machiavellianism
negatively predicted the risk of injuries, while Narcissism negatively predicted the risk of skin
diseases and tobacco use. When five-factor personality traits were controlled, psychopathy was also
a positive predictor of digestive diseases, tobacco use and injuries. Machiavellianism was a positive
predictor of high blood pressure, and negative predictor of cancer, spine and back diseases and
injuries, while Narcissism was a negative predictor of skin diseases.
The results obtained are discussed in the context of possible mechanisms through which Dark
Triad traits may exert negative, but also positive effects on various health outcomes.
Keywords: Dark Triad traits, five-factor personality traits, health, chronic diseases
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
130
Introduction
The relevance of personality for health maintenance, illness onset, progression
and recovery as well as its predictive value from early childhood to the health later
in life has been well documented (Uchino, Vaughn, & Matwin, 2008). The study of
personality-health relationship nowadays provides many models, tools and concepts
necessary for understanding health. Several models explain mechanisms underlying
the connections of personality traits to health outcomes such as their influence
through the cognitive processes of perceiving and attending to the environment (e.g.
the interpretation of health risk or attending to prescribed treatment), symptoms
perception and reporting, health-related behaviors, seeking social support, exposure
to and reactivity to the environmental stimuli, especially stressful situations, etc. (e.g.
Goodwin & Friedman, 2006).
Numerous health-related personality traits have been examined in relation to
health outcomes, most frequently Type A behavior pattern (e.g. Friedman & Booth-
Kewley, 1987), hostility (e.g. Smith, 1992), optimism (e.g. Peterson & Bossio,
1991), anxiety (e.g. Shen et al., 2008), locus of control (e.g. Gale, Batty, & Deary,
2008), self-efficacy (e.g. O'Leary, 1985), hardiness (e.g. Kobasa, Maddi, & Kahn,
1982), and sense of coherence (e.g. Eriksson & Lindström, 2006).
Regarding comprehensive models of personality, Five-factor personality model
was the one most frequently explored in relation to various health indices such as
health behaviors, illnesses, disease onset, progression and recovery as well as
mortality across the lifespan. Research confirms that each of the Five-factor
personality traits, particularly conscientiousness, neuroticism, and extraversion, but
also often agreeableness and openness has an impact on various and multiple health-
related outcomes (Friedman & Kern, 2014; Goodwin & Friedman, 2006; Hampson,
Goldberg, Vogt, & Dubanoski, 2006; Smith & Gallo, 2001). For example,
conscientiousness is linked to better subjective and objective health, lower risk of
cognitive impairment (Wilson, Schneider, Arnold, Bienias, & Bennett, 2007), and
lower mortality (Friedman, 2000; Löckenhoff, Sutin, Ferrucci, & Costa, 2008),
neuroticism is related to higher disease risk and other negative outcomes such as
poorer reactions to illness, higher perception of physical symptoms, and less
successful coping (David & Suls, 1999). High extraversion is associated to better
mental health as evidenced by higher subjective well-being (Steel, Schmidt, &
Shultz, 2008), lower rates of depression (Jylha & Isometsa, 2006), higher self-rated
global health (Jerram & Coleman, 1999; Korotkov & Hannah, 2004) and higher
availability of social support (Berkman, Glass, Brissette, & Seeman, 2000), while
associations with physical health are less consistent across studies (Löckenhoff et al.,
2008). Research on agreeableness and health outcomes show that it is linked to better
mental health (Löckenhoff et al., 2008; Steel et al., 2008), but is also a positive
predictor of cardiovascular disease (e.g. Miller, Smith, Turner, Guijarro, & Hallet,
1996), while higher openness is linked to cognitive, emotional, and physical well-
Hudek-Knežević, J., Kardum, I., Mehić, N.:
Dark Triad Traits and Health Outcomes
131
being (Jerram & Coleman, 1999; Steel et al., 2008), as well as lower mortality (Iwasa
et al., 2008).
One personality domain that has aroused much scientific interest in the last two
decades, but has been relatively rarely explored in the context of health is Dark Triad.
Dark Triad personality is a constellation of three subclinical, but socially aversive
traits - psychopathy, Machiavellianism and Narcissism. Psychopathy is characterized
by impulsivity, interpersonal antagonism, sensation seeking as well as low empathy
and anxiety, Machiavellianism by manipulativeness and glib social charm, while
Narcissism by grandiosity, entitlement, superiority and dominance (Paulhus &
Williams, 2002). To some extent all three traits share a number of undesirable
features including malevolence, self-promotion, emotional coldness, hypocrisy and
aggression. It has been repeatedly found that Dark Triad traits measured by
nonclinical measures and on nonclinical populations positively correlate and,
therefore, are sometimes combined into a global Dark Triad index (e.g., Jonason, Li,
Webster, & Schmitt, 2009). Nonetheless, there is also plenty of evidence that they
are distinct constructs that are to some extent conceptually and psychometrically
related (Furnham, Richards, & Paulhus, 2013).
When examined in relations to the Five-factor personality traits, research shows
that all Dark Triad traits are most consistently but modestly correlated with
agreeableness. Narcissism and psychopathy correlate positively with extraversion
and openness, Machiavellianism and psychopathy negatively with
conscientiousness, while psychopathy negatively with neuroticism (Paulhus &
Williams, 2002). Although there are inconsistencies in results across various studies,
majority of them indicate that these two groups of variables are moderately
interrelated. Also, behavioral genetic studies have found a considerable overlap in
the genes influencing co-occurrence of Dark Triad and Five-factor personality traits,
and moderate phenotypic correlations based on self-report which may indicate that
these two groups of variables represent overlapping but distinct clusters of
personality (Vernon,Villani, Vickers, & Harris, 2008). Regarding HEXACO model,
all three of the Dark Triad traits correlated substantially and negatively with honesty-
humility dimension (Lee & Ashton, 2005).
Research on the relationship between Dark Triad traits and health outcomes
have been most often explored by analyzing mental than physical health indicators,
and almost always by analyzing single or two of the Dark Triad traits. A few studies
relating psychopathy and health have found that it positively predicts anxiety,
depression, reduced perception of general health (Beaver et al., 2014) and higher self-
reported reactivity to stress (Noser, Zeigler-Hill, & Besser, 2014). Also, persons
scoring high on psychopathy have been found to be at risk for many compromising
health behaviors that correlate with shorter life expectancy such as impulsive
behavior (Jones & Paulhus, 2011), sensation seeking, risk taking (Adams, Luevano,
& Jonason, 2014), substance abuse (Jonason, Li, & Teicher, 2010), risky sexual
behavior (Hudek-Knežević, Kardum, & Krapić, 2007), and an exploitative mating
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
132
style (Jonason, Luévano, & Adams, 2012; Kardum, Hudek-Knežević, Schmitt, &
Grundler, 2015). It was also found to be negatively related to problem-focused
coping and social support seeking (Aghababaei & Błachnio, 2015). The results of the
studies exploring psychopathy and some physiological indicators of health are
somewhat conflicting. While some of them found that individuals higher on
psychopathy show increased cardiovascular reactivity when exposed to negative
stimuli (Casey, Rogers, Burns, & Yiend, 2012), a meta-analysis of
psychophysiological studies of psychopathy shows that it is related neither to heart
rhythm nor cardiovascular reactivity (Lorber, 2004). Regarding physical health,
psychopathy has been found to correlate with the increased number of diagnoses,
risk of chronic diseases (e.g. diabetes, hypertension, high cholesterol), neurological
diseases (ADD/ADHD, migraines, stuttering and tinnitus) as well as to behavioral
indices of health like increased number of missed days of school or work due to
illness (e.g. Beaver et al., 2014).
Out of Dark Triad traits, Machiavellianism is the least investigated in the
context of health. Generally, it seems that the associations between Machiavellianism
and mental health indictors are weak and sometimes equivocal. For example, the
review by Fehr, Samson, and Paulhus (1992) show consistent positive associations
between Machiavellianism and anxiety, although some authors are sceptic that high
anxiety is compatible with the concept of Machiavellianism (e.g. Wrightsman,
1991). However, more recent studies either confirmed this paradoxical result (e.g.
Jakobowitz & Egan, 2006) or found no correlation between them (McNamara,
Durso, & Harris, 2007; Paulhus & Williams, 2002). Furthermore, few studies that
examined the links of Machiavellianism with mental health indices have found
positive correlations with depression (e.g. Bakir, Yilmaz, & Yavas, 1996), paranoia
(e.g. Christoffersen & Stamp, 1995), alexithymia (e.g. Wastell & Booth, 2003),
perfectionism (e.g. Sherry, Hewitt, Besser, Flett, & Klein, 2006), and low self-esteem
(e.g. Valentine & Fleischman, 2003), and negative correlations with problem-
focused coping and support seeking (Aghababaei & Błachnio, 2015). Contrary to
psychopaths, who are usually oriented towards short-term benefits, it has been found
that persons high on Machiavellianism are sometimes focused on long-term benefits
and a repetitive delay of gratifications (Jonason, Baughman, Carter, & Parker, 2015).
While some authors assume that ability of Machiavellists to inhibit behaviors might
lead to more positive effects on health (e.g. Jones & Paulhus, 2010), others suggest
that a delay of gratification may be stressful and that stressful experience may
mediate the relationship between Machiavellianism and negative health outcomes
(Jonason et al., 2015).
Research results on the associations between Narcissism and health outcomes
are inconsistent. On one hand, a number of studies have found that Narcissism is
positively related to self-esteem (e.g. Sedikides, Rudich, Gregg, Kumashiro, &
Rusbult, 2004), subjective well-being (Aghababaei & Błachnio, 2015; Egan, Chan,
& Shorter, 2014) and healthy behaviors such as exercising (e.g. Jonason et al., 2015;
Hudek-Knežević, J., Kardum, I., Mehić, N.:
Dark Triad Traits and Health Outcomes
133
Spano, 2001). Also, Narcissism was found to be related to more functional coping
strategies such as focusing on problem, planning, self-control, positive reappraisal
and social support seeking (Aghababaei & Błachnio, 2015). It should be noted,
though, that the associations of Narcissism with positive health outcomes seem to be
the result of the overlap between Narcissism and self-esteem (Ng, Cheung, & Tam,
2014; Rose, 2002; Rosenthal & Hooley, 2010; Sedikides et al., 2004). On the other
hand, Narcissism was found to exert negative effects on various health indices. For
example, it has been documented that women who regularly use suntan salons, which
is detrimental to health, have higher scores on one aspects of Narcissism called
superiority (Fiala, Kopp, & Günther, 1997). Regarding physical health, it has been
found that Narcissism was positively related to the increased cardiovascular
reactivity in stressful situations in men (Kelsey, Ornduff, McCann, & Reiff, 2001) as
well as in women (Kelsey, Ornduff, Reiff, & Arthur, 2002). Also, studies showed
the increased basal levels of cortisol (Reinhard, Konrath, Lopez, & Cameron, 2012)
and cortisol in stressful situations in men higher on Narcissism (Edelstein, Yim, &
Quas, 2010).
The explanations of the possible mechanisms through which Narcissism exerts
positive effects on health include socially oriented nature of Narcissists that may
facilitate active and passive increase of the social network (e.g. Jonason & Schmitt,
2012), thus providing a buffer from the deleterious health outcomes (e.g. Jonason et
al., 2015). The other explanation refers to the motivation of Narcissists to maintain
attractive looks, which may facilitate behaviors with positive health effects (e.g.
exercising, healthy eating), but also those behaviors that could be deleterious to
health, such as excessive sun exposure (Fiala at al., 1997). Another assumption is
that Narcissism might predict negative health outcomes through its associations to
impulsivity (Campbell, Goodie, & Foster, 2004; Jones & Paulhus, 2011), sensation
seeking (Crysel, Crosier, & Webster, 2013), risk-taking and substance abuse
(Buelow & Brunell, 2014). Furthermore, one of the main characteristics of
Narcissism, the use of defensive mechanisms for coping with ego threats, could also
be related to deleterious physiological consequences (Rutledge, 2006).
Research by Jonason et al. (2015) is the only research dealing with the
relationships between all three Dark Triad personality traits and various measures of
mental, social and physical health. Their results are mainly in accord with previous
studies. Namely, psychopathy was related to the range of health-outcomes such as
increased depression, more risk-taking, lower life-expectancy, and a faster life-
history strategy. Machiavellianism was linked to poorer mental health and well-being
as well as to slower life-history strategy, while Narcissism to few negative as well as
some positive health outcomes such as longer life expectancy and a slow life-history
strategy.
In the present study we attempted to explore the relationship of Dark Triad traits
with various health measures including subjective health indicators (positive and
negative mood and perceived physical symptoms), protective health behaviors as
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
134
well as some more objective health indicators (number of hospitalizations, number
of diseases, specific chronic diseases, injuries and addictions). Compared to the
majority of previous studies, we included all three Dark Triad traits simultaneously
and measured them by using standard personality questionnaires whose validity has
been well documented in comparison to the briefer measures that have received less
validation. Also, wide range of health indicators have been analyzed on a relatively
large sample from middle age to elderly, who have greater risk of developing chronic
disease.
Because Dark Triad traits are modestly related to some other broad personality
traits that exert their influence on various health-related outcomes, we attempted to
explore the unique effects of Dark Triad traits on health indicators above and beyond
Five-factor personality traits. Furthermore, as it is well known, various
sociodemographic variables are also related to health (Leclerc, Rahn, & Linden,
2006), and therefore, we also examined the effects of Dark Triad personality traits
on health indices above and beyond three important sociodemographic variables -
gender, age and education. Having in mind previously mentioned research, we
hypothesized that each Dark Triad traits significantly predicts various indicators of
health. Generally, we assumed that psychopathy will be the most consistent negative
predictor of health indicators, while Machiavellianism and Narcissism will not be
only negative, but also positive predictors of health indicators. Also, we expected the
stronger effects of Dark Triad traits on the measures of subjective (mood, physical
symptoms) than objective health outcomes (number of diseases, risk of having
specific disease and number of hospitalizations).
Method
Participants and Procedure
The study was conducted on the sample of 637 participants (358 women and
279 men) from several towns in Croatia. In order to increase the probability of
various diseases in the sample, the inclusion criteria for participating in this study
was 39 years or older. Therefore, the age of participants ranged from 39 to 87 years
(M=52.66; SD=9.88). The majority of participants finished high school (54.5%),
8.3% primary school, 12.7% had higher education, 20.6% of them finished university
and 3.9% post-graduate study. Most of the participants were employed (56.5%) and
married (72.2%).
Questionnaires were administered by well-instructed psychology students in the
homes of the participants. Participation was voluntary and anonymous with no
incentives offered. They were given as much time as needed to complete the
questionnaires (approximately 45 minutes). All participants reviewed a letter of
Hudek-Knežević, J., Kardum, I., Mehić, N.:
Dark Triad Traits and Health Outcomes
135
information, were provided by informed consent and then completed the
questionnaires.
Measures
For measuring Five-factor personality traits Big Five Inventory (BFI; Benet-
Martinez & John, 1998) was used. Participants rated each of 44 items on a scale
ranging from 1 (strongly disagree) to 5 (strongly agree). Previous research showed
its appropriateness for measuring Five-factor model of personality in Croatian
language (Hudek-Knežević & Kardum, 2009; Kardum & Hudek-Knežević, 2012).
Narcissism was assessed with the 40-item Narcissistic Personality Inventory
(Raskin & Terry, 1988). For each item participants chose one of two statements they
felt applied to them more. The total number of narcissistic statements the participants
endorsed was used as an index of Narcissism. Machiavellianism was measured with
the 20-item MACH-IV (Christie & Geis, 1970). Participants indicated how much they
agreed (-3 = strongly disagree, +3 = completely agree) with each statement. The 31-
item Self-Report Psychopathy Scale-III (Paulhus, Hemphill, & Hare, 2012;
Williams, Paulhus, & Hare, 2007) was used to assess nonclinical psychopathy.
Participants rated how much they agreed (1 = strongly disagree, 5 = strongly agree)
with each statement. All three Dark Triad questionnaires were used as
unidimensional measures. Also, all of them were validated and used on Croatian
samples in previous studies (e.g. Kardum et al., 2015).
Health behaviors were measured by 23 items of the health-protective behavior
questionnaire (Harris & Gutten, 1979). Participants rated the frequency of their
behaviors (e.g. "Get enough sleep", "Avoid part of the town with a lot of pollution")
using five-point rating scale (from 1 - never to 5 - almost always). This questionnaire
was also used as unidimensional measure. The questionnaire was translated for the
purpose of this study.
Perceived physical symptoms were measured by Subjective Health Complaints
Scale (SHC, Eriksen, Ihlebaek, & Ursin, 1999) that comprises 29 items assessing
musculoskeletal symptoms (e.g. backpain, neckpain), gastro-intestinal problems
(e.g. stomach discomfort, diarrhoea), pseudoneurology symptoms (e.g. headache,
dizziness), symptoms of allergy (e.g. breathing problems, chest pain), and flu (e.g.
cold, coughing). The scale was used as unidimensional measure, and has previously
been translated and validated on Croatian language (Krapić, Sušanj, & Ćoso, 2006).
Mood was assessed by a Mood Scale (Kardum & Bezinović, 1992), an
adjective-type, 40-item scale composed of 2 higher-order mood factors (positive and
negative mood). The positive mood factor consists of 3 components reflecting
positive emotional states of happiness, acceptance and activation, while the negative
mood factor comprises specific components of negative emotional states of sadness,
anger, fear and rejection.
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
136
Diseases were assessed by a check-list constructed for the purpose of this study.
It consists of 33 items for various diseases (e.g. cancer, cardiovascular disease,
diabetes Type 2, injuries, addictions), and one for total number of hospitalizations.
From the check-list of diseases we computed the total number of diseases and
analyzed it in the first part of the study, while the analyses on the level of each disease
are presented in the second part of the study. Descriptive statistics of the continuous
variables used in this study are presented in Table1.
Table 1. Descriptive Statistics of the Continuous Variables Used in this Study
Variables
M
SD
D
Dark
Triad Traits
Psychopathy
59.80
11.18
.82
Machiavellianism
61.68
10.86
.68
Narcissism
48.54
6.48
.88
Five
-
Factor Personality Traits
Extraversion
27.12
4.51
.82
Agreeableness
33.63
4.63
.71
Conscientiousness
34.17
4.98
.80
Neuroticism
21.04
5.52
.82
Openness
33.68
6.35
.83
Health I
ndicators
Positive mood
70.94
11.14
.92
Negative mood
39.49
13.10
.94
Physical symptoms
62.26
14.36
.89
Health behaviors
73.41
12.71
.86
Number of hospitalizations
1.39
1.15
-
Number of diseases
2.35
1.98
-
Results
First, we computed the correlations between predictor variables (Table 2).
Correlations between predictor variables show that women have higher scores
on agreeableness and neuroticism, and men on all three Dark Triad traits. Younger
participants have higher education, higher scores on extraversion, openness,
psychopathy and Narcissism and lower scores on agreeableness. Participants with
higher education have higher scores on extraversion, openness and Narcissism and
lower on Machiavellianism. Correlations between Five-factor personality traits are
low to moderate indicating a relatively small overlap between them. Moderate
intercorrelations between Dark Triad traits indicate that they are distinct concepts
with some common features. Correlations of sociodemographic variables and
personality traits with indicators of health are presented in Table 3.
137
Hudek-#
Dark Triad Traits and Health Outcomes
Table 2. Correlations Between Predictor Variables
Variables Age Education E A C N O Psych. Mach. Narc.
Gender -.04 -.00 .04 -.12** -.00 -.12** -.03 .26*** .14*** .12**
Age -.16*** -.08* .19*** .04 -.01 -.10* -.19*** -.07 -.14***
Education .10* .04 .00 -.07 .29*** -.05 -.13** .18***
Extraversion .17*** .41*** -.42*** .36*** .15*** -.04 .43***
Agreeableness .35*** -.39*** .23*** -.30*** -.35*** -.15***
Conscientiousness -.41*** .27*** -.17*** -.13** .13**
Neuroticism -.29*** -.02 .14*** -.17***
Openness .06 -.09* .32***
Psychopathy .41*** .38***
Machiavellianism .25***
Note. 1 – Women, 2 – Men; E – Extraversion, A – Agreeableness, C – Conscientiousness, N – Neuroticism, O – Openness. *p**p***p1.
Table 3. Correlations of Sociodemographic Variables and Personality Traits with Health Indicators
Variables Positive
mood
Negative
mood
Physical
symptoms
Health
behaviors
Number of
hospitalizations
Number of
diseases
Gender .04 -.14** -.20** -.16** .01 -.09*
Age -.06 -.08 -.03 .34** .23** .24**
Education .07 -.02 -.17** .03 -.03 -.10**
Extraversion .50** -.39** -.21** .11** -.06 -.14**
Agreeableness .35** -.30** -.22** .24** -.02 -.04
Conscientiousness .36** -.34** -.25** .23** -.05 -.13**
Neuroticism -.52** .66** .47** -.17** .13** .23**
Openness .33** -.11** -.11** .16** .04 -.04
Psychopathy .02 .09* .10* -.24** -.03 .06
Machiavellianism -.22** .17** .10* -.14** -.07 .00
Narcissism .17** -.05 -.00 .00 -.10* -.07
Note. 1 – Women, 2 – Men; *p<.05; **p<.01.
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
138
As expected, women reported more negative mood, physical symptoms and
protective health behaviors as well as higher number of diseases. Older participants
had higher number of hospitalizations and diseases and their health behaviors were
more protective. More educated had less physical symptoms and diseases. As for
Dark Triad traits, participants higher on psychopathy and Machiavellianism reported
higher negative mood and physical symptoms and less protective health behaviors.
Additionally, Machiavellianism was negatively related to positive mood, while
Narcissism was positively related to positive mood and negatively with the number
of hospitalizations. All Five-factor personality traits were significantly related to
three more subjective health indices and health-protective behaviors in expected
direction. Participants higher on neuroticism had higher number of hospitalizations
and diseases, while those higher on extraversion and conscientiousness had lower
number of diseases.
Further, in order to explore the contributions of Dark Triad traits to above
mentioned health indices beyond and above traditional determinants of health such
as sociodemographic variables (age, gender and education) and broad personality
traits whose effects on various health outcomes have been previously confirmed, two
sets of hierarchical regression analyses were performed. In the first set of regression
analyses sociodemographic variables (Table 4), and in the second set Five-factor
personality traits (Table 5) were entered in the first step, while Dark Triad traits were
entered in the second step in both sets of regression analyses.
As could be seen from Table 4, Dark Triad traits as a group significantly
improved the prediction of all indicators of health except number of hospitalizations
beyond and above sociodemographic variables. Psychopathy significantly positively
predicted negative mood, physical symptoms and the number of diseases, and
negatively health behaviors. Machiavellianism was a significant positive predictor of
negative and negative predictor of positive mood, while Narcissism predicted these
two mood dimensions in opposite directions. Also, Narcissism positively predicted
health-protective behaviors. Except for positive and negative mood, incremental
validity of Dark Triad traits was quite low. Regarding sociodemographic variables,
female gender predicted higher negative mood, physical symptoms, health-
protective behaviors and the number of diseases, while older age predicted more
health-protective behaviors, number of hospitalizations and diseases. Lower
education predicted more physical symptoms.
139
Hudek-#
Dark Triad Traits and Health Outcomes
Table 4. Results of Hierarchical Regression Analyses with Sociodemographic Variables and
Dark Triad Traits as Predictors of Health Indicators
Predictor variables
Criterion variables
Positive
mood
Negative
mood
Physical
symptoms
Health
behaviors
Number of
hospitalizations
Number of
diseases
Step 1
Gender .04 -.14*** -.20*** -.14*** .02 -.08*
Age -.05 -.09* -.06 .35*** .23*** .23***
Education .06 -.04 -.18*** .09* .01 -.07
R .09 .17*** .27*** .38*** .23*** .26***
R2 .01 .03 .07 .15 .05 .07
Step 2
Gender .04 -.18*** -.24*** -.11** .02 -.11**
Age -.04 -.07 -.03 .33*** .23*** .25***
Education -.02 .02 -.16*** .04 .02 -.04
Psychopathy .05 .09* .12** -.17*** .07 .17***
Machiavellianism -.31*** .19*** .06 -.06 -.06 -.02
Narcissism .22*** -.13** -.02 .14*** -.08 -.08
R .33*** .28*** .30*** .42*** .25*** .30***
R2 .11 .08 .09 .18 .06 .09
2 .10*** .05*** .02** .03*** .01 .02**
*p**p***p
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
Table 5. Results of Hierarchical Regression Analyses with Five-factor Personality Traits and
Dark Triad Traits as Predictors of Health Indicators
Predictor variables
Criterion variables
Positive
mood
Negative
mood
Physical
symptoms
Health
behaviors
Number of
hospitalizations
Number of
diseases
Step 1
Extraversion .30*** -.16*** -.01 -.03 -.02 -.04
Agreeableness .15*** -.06 -.03 .15*** .03 .07
Conscientiousness .04 -.06 -.06 .15*** -.01 -.05
Neuroticism -.30*** .59*** .45*** -.03 .15*** .23***
Openness .10** .15*** .05 .09* .09* .04
R .63*** .69*** .48*** .30*** .16** .25***
R2 .40 .47 .23 .09 .02 .06
Step 2
Extraversion .29*** -.20*** -.05 .00 .01 -.05
Agreeableness .12*** .00 .01 .10* -.01 .09
Conscientiousness .06 -.04 -.05 .11* -.01 -.02
Neuroticism -.30*** .60*** .46*** -.06 .15** .25***
Openness .09* .13*** .02 .10* .11* .03
Psychopathy .08* .07 .08* -.21*** .03 .13**
Machiavellianism -.14*** .05 -.02 .01 -.07 -.04
Narcissism .02 .07* .07 .04 -.11* -.04
R .65*** .70*** .49*** .35*** .19** .27***
R2 .42 .49 .24 .12 .04 .07
2 .02*** .01*** .01* .03*** .01* .01*
*p**p***p.
140
Hudek-Knežević, J., Kardum, I., Mehić, N.:
Dark Triad Traits and Health Outcomes
141
Table 5 shows that Dark Triad traits as a group significantly improved the
prediction of all of health indicators beyond and above Five-factor personality traits.
Psychopathy was significant positive predictor of positive mood, physical symptoms
and the number of diseases, and negatively health behaviors. Machiavellianism was
a significant negative predictor of positive mood, while Narcissism positively
predicted negative mood, and negatively the number of hospitalizations. Overall,
incremental validity of Dark Triad traits was rather low. Regarding Five-factor
personality traits, extraversion positively predicted positive mood and negatively
negative mood, agreeableness positively predicted positive mood and health-
protected behaviors, while conscientiousness positively predicted only health-
protective behaviors. Neuroticism was the strongest predictor of health indicators. It
was a positive predictor of negative mood, physical symptoms, number of
hospitalizations and diseases, and negative predictor of positive mood. Openness
positively predicted positive and negative mood, health behaviors and number of
hospitalizations. Correlations of sociodemographic variables and personality traits
with each disease are presented in Table 6.
Table 6 shows that out of socioeconomic variables older age is most frequently
related to the risk of diseases. Personality traits have relatively low correlations with
diseases. From Five-factor personality traits, neuroticism is the most frequently
related, while from Dark Triad traits it is psychopathy.
To examine the contributions of Dark Triad traits to each disease beyond and
above sociodemographic variables and Five-factor personality traits, two sets of
hierarchical binary logistic regression analyses were performed. In the first set
sociodemographic variables (Table 7), and in the second set Five-factor personality
traits (Table 8) were entered in the first step, while Dark Triad traits were entered in
the second step in both sets of analyses. In both Tables we presented the results of
only those criteria variables (diseases) for which at least one of the Dark Triad traits
was a significant predictor.
Table 7 shows that Dark Triad traits as a group significantly improved the
prediction of tobacco use and digestive diseases beyond and above
sociodemographic variables. Psychopathy was a significant positive and Narcissism
significant negative predictor of tobacco use. Psychopathy was also a significant
positive predictor of digestive diseases. Although Dark Triad traits in the second step
did not significantly improve the prediction, psychopathy significantly positively,
and Machiavellianism significantly negatively predicted injuries, while Narcissism
significantly negatively predicted skin diseases.
Regarding sociodemographic variables it should be mentioned that female
gender significantly predicted the risk of having digestive, head and neck,
musculoskeletal, endocrinological disease and anemia, while male gender predicted
the risk of injuries. Furthermore, older age predicted the risk of having higher blood
pressure, cancer, Type 2 diabetes, cardiovascular, rheumatic, eye, spine and neck as
well as musculoskeletal disease, while younger age predicted the risk of tobacco use.
Lower education predicted only the risk of having a rheumatic disease.
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
Table 6. Number and Percentage of Participants with a Specific Disease and Correlations of
Sociodemographic Variables and Personality Traits with Each Disease
Diseases N (%) Gender Age Education E A C N O Psych. Mach. Narc.
Cardiovascular 63 (9.9) -.01 .24*** -.07 -.02 -.05 -.08* .14*** -.03 -.01 .01 -.02
High Blood Press. 147 (23.1) .01 .33*** -.10* .00 .03 .02 .09* -.06 -.05 .06 -.02
Cancer 47 (7.4) -.02 .17*** -.03 -.04 .00 .00 .02 .01 -.06 -.09* -.01
Type 2 Diabetes 27 (4.2) -.01 .22*** -.04 -.00 -.01 .02 -.00 -.01 .01 .03 -.02
Respiratory 30 (4.7) -.00 .02 -.05 .01 -.10* -.06 .04 .04 .02 -.00 .03
Digestive 82 (12.9) -.07 .05 -.01 -.01 -.07 -.01 .10** .02 .10* .05 .03
Rheumatic 59 (9.3) -.07 .26*** -.17*** -.08* .07 -.02 .05 -.09* -.05 -.03 -.06
Skin 61 (9.6) -.01 -.03 .03 .03 .04 -.03 .01 .03 -.01 -.04 -.08*
Eye 41 (6.4) -.03 .09* .02 .02 -.03 -.01 .01 .06 .03 -.00 .00
Otorhinolaring. 103 (16.2) -.00 -.02 .03 -.06 -.05 -.06 .00 .00 -.01 -.05 -.05
Head and Neck 115 (18.1) -.13*** .02 -.02 -.09* .00 -.06 .15** -.04 .00 .03 -.07
Spine and Back 161 (25.3) -.03 .13*** -.09* -.10* -.04 -.02 .14*** -.11** -.00 -.07 -.10*
Musculoskeletal 36 (5.7) -.08* .10* -.06 -.07 -.06 -.06 .10* -.04 -.02 .03 .02
Endocrinological 55 (8.6) -.17*** .03 -.05 -.04 .01 -.05 .10* -.02 -.01 .03 -.01
Obesity 61 (9.6) -.04 .06 .02 -.09* -.01 -.10* .09* .03 -.01 .02 -.02
Anemia 49 (7.7) -.22*** -.06 .02 -.07 -.02 -.05 .08* .01 -.02 -.05 -.06
Tobacco Use 155 (24.3) .08* -.10* -.04 -.05 -.02 -.06 .08* .05 .17*** .07 -.01
Injuries 113 (17.7) .15*** -.01 -.01 -.02 .01 -.02 .01 -.06 .08* -.04 -.00
Note. 1 – Women, 2 – Men; E – Extraversion, A – Agreeableness, C – Conscientiousness, N – Neuroticism, O – Openness.
*p**p***p1.
142
143
Hudek-#
Dark Triad Traits and Health Outcomes
Table 7. Results of Hierarchical Binary Regression Analyses with Sociodemographic Variables and
Dark Triad Traits as Predictors of Diseases
Predictors Tobacco use Injuries Digestive diseases Skin diseases
OR 95% CI p OR 95% CI p OR 95% CI p OR 95% CI p
Gender
Age
Education
1.44
.97
.88
1.00 - 2.08
.95 - .99
.73 - 1.06
.049
.010
.174
2.24
1.00
.97
1.48 - 3.39
.98 - 1.02
.79 - 1.19
< .001
.894
.772
.68
1.01
1.00
.42 - 1.10
1.00 - 1.04
.79 - 1.25
.111
.274
970
.94
.99
1.07
.55 - 1.61
.96 - 1.02
.83 - 1.38
.829
.443
.598
Step 1 2=12.34; df=3; p=.006 2=14.97; df=3; p=.002 2=3.99; df=3; p=.263 2=1.07; df=3; p=.784
Gender
Age
Education
Psychopathy
Machiavellianism
Narcissism
1.24
.98
.94
1.04
1.00
.96
.85 - 1.82
.96 - 1.00
.77 - 1.14
1.02 - 1.06
.98 - 1.02
.93 - 1.00
.271
.043
.535
< .001
.864
.031
2.16
1.00
.97
1.02
.98
.99
1.41 - 3.33
.98 - 1.02
.78 - 1.20
1.00- 1.04
.96 - 1.00
.95 - 1.02
< .001
.983
.765
.047
.039
.504
.54
1.02
1.03
1.03
1.00
1.00
.33 - .90
1.00 - 1.04
.82 - 1.31
1.01 - 1.06
98 - 1.03
.96 - 1.04
.019
.087
.791
.006
.800
.877
.98
.99
1.13
1.01
.99
.94
.56 - 1.71
.96 - 1.02
.86 - 1.47
.98 - 1.04
.96 - 1.02
.89 - 1.00
.951
.347
.372
.567
.546
.038
Step 2
Model
2=15.98; df=3; p=.001
2=28.32; df=6; p<.001
2=6.50; df=3; p=.089
2=21.47; df=6; p=.002
2=10.20; df=3; p=.017
2=14.18; df=6; p=.028
2=5.81; df=3; p=.121
2=6.88; df=6; p=.332
Note. OR - Odds Ratio; CI - 2 - Chi-square.
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
Table 8. Results of Hierarchical Binary Regression Analyses with Five-Factor Personality Traits and
Dark Triad Traits as Predictors of Diseases
Predictors High blood pressure Cancer Digestive diseases Skin diseases
OR 95% CI p OR 95% CI p OR 95% CI p OR 95% CI p
Extraversion
Agreeableness
Conscientiousness
Neuroticism
Openness
1.23
1.44
1.21
1.60
.78
.83 - 1.82
.96 - 2.16
.81 - 1.80
1.16 - 2.21
.57 - 1.08
.296
.082
.349
.004
.137
.70
1.02
1.18
1.12
1.19
.38 - 1.32
.53 - 1.97
.62 - 2.24
.67 - 1.87
.71 - 2.00
.270
.947
.618
.671
.510
1.12
.76
1.22
1.68
1.25
.69 - 1.82
.46 - 1.25
.73 - 2.03
1.12- 2.50
.83 - 1.87
.646
.273
.446
.011
.279
1.10
1.46
.71
1.16
1.22
.63 - 1.92
.81 - 2.62
.41 - 1.23
.74 - 1.82
.87 - 1.94
.732
.206
.228
.524
.388
Step 1 2=12.11; df=5; p=.033 2=1.90; df=5; p=.863 2=10.28; df=5; p=.068 2=3.50; df=5;p=.623
Extraversion
Agreeableness
Conscientiousness
Neuroticism
Openness
Psychopathy
Machiavellianism
Narcissism
1.27
1.54
1.16
1.57
.80
.99
1.02
1.00
.83 - 1.93
.99 - 2.42
.77 - 1.74
1.14 - 2.18
.57 - 1.12
.97 - 1.01
1.00 - 1.04
.97 - 1.04
.269
.056
.484
.007
.187
.241
.040
.900
.68
.80
1.10
1.11
1.13
.98
.97
1.02
.35 - 1.33
.39 - 1.62
.57 - 2.15
.66 - 1.87
.66 - 1.93
.95 - 1.02
.94 - 1.00
.97 - 1.08
.264
.531
.773
.691
.655
.388
.046
.429
1.02
.88
1.35
1.77
1.23
1.03
1.00
.99
.60 - 1.74
.51 - 1.53
.81 - 2.27
1.18- 2.66
.81 - 1.87
1.00- 1.05
.97 - 1.02
.95 - 1.04
.935
.647
.249
.006
.339
.025
.811
.775
1.38
1.22
.33
1.14
1.42
1.01
1.00
.93
.75 - 2.52
.63 - 2.34
.42 - 1.30
.72 - 1.81
.87 - 2.33
.98 - 1.04
.97 - 1.02
.88 - .99
.300
.554
.294
.581
.163
.612
.756
.030
Step 2
Model
2=4.68; df=3; p=.200
2=16.78; df=8; p=.032
2=6.74; df=3; p=.080
2=8.64; df=8; p=.373
2=5.35; df=3; p=.148
2=15.53; df=8; p=.048
2=5.86; df=3; p=.119
2=9.36; df=8; p=.313
Note. OR - Odds Ratio; CI - 2 - Chi-square.
144
145
Hudek-#
Dark Triad Traits and Health Outcomes
Table 8. – Continued
Predictors Spine and back diseases Tobacco use Injuries
OR 95% CI p OR 95% CI p OR 95% CI p
Extraversion
Agreeableness
Conscientiousness
Neuroticism
Openness
.83
1.05
1.37
1.57
.74
.57 - 1.22
.71 - 1.55
.93 - 2.04
1.15 - 2.16
.54 - 1.02
.341
.815
.114
.005
.064
.87
1.05
.81
1.27
1.42
.59 - 1.28
.70 - 1.56
.55 - 1.20
.93 - 1.74
1.03 - 1.95
.481
.821
.291
.134
.032
1.03
1.14
.93
.98
.76
.67 - 1.59
.73 - 1.78
.60 - 1.42
.68 - 1.40
.53 - 1.08
.881
.567
.727
.888
.124
Step 1 2=19.02; df=5; p=.002 2=9.38; df=5; p=.095 2=2.84; df=5; p=.725
Extraversion
Agreeableness
Conscientiousness
Neuroticism
Openness
Psychopathy
Machiavellianism
Narcissism
.85
.92
1.48
1.63
.75
1.02
.98
0.98
.56 - 1.28
.59 - 1.42
.99 - 2.23
1.18 - 2.25
.54 - 1.04
1.00 - 1.04
.96 - 1.00
.94 - 1.01
.435
.702
.059
.003
.090
.072
.016
.211
.82
1.34
1.97
1.38
1.46
1.05
1.00
.97
.54 - 1.26
1.86 - 2.22
.65 - 1.44
1.00 - 1.91
1.04 - 2.05
1.03 - 1.07
0.98 - 1.02
0.93 - 1.00
.360
.198
.879
.052
.029
<.001
.702
.078
.89
1.24
1.05
1.04
.71
1.03
.98
1.00
.56 - 1.43
.76 - 2.04
.68 - 1.63
.72 - 1.49
.49 - 1.02
1.01- 1.06
.96 - 1.00
.96 - 1.04
.631
.383
.824
.836
.065
.003
.040
.838
Step 2
Model
2=9.14; df=3; p=.027
2=28.16; df=8; p<.001
2=24.10; df=3; p<.001
2=33.47; df=8; p<.001
2=10.40; df=3; p=.015
2=13.24; df=8; p=.104
Note. OR - Odds Ratio; CI - 2 - Chi-square.
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
146
As could be seen form Table 8 Dark Triad traits as a group significantly
improved the prediction of the risk of spine and back diseases, tobacco use and
injuries. Machiavellianism was a significant negative predictor of spine and back
diseases and injuries, while psychopathy positively predicted tobacco use and
injuries. In the second step, Dark Triad traits as a group did not significantly improve
the prediction, but psychopathy significantly positively predicted digestive diseases,
Machiavellianism positively predicted high blood pressure and negatively cancer,
while Narcissism negatively predicted skin diseases.
Concerning Five-factor personality traits, our results show that neuroticism
positively predicted the risk of having high blood pressure, cardiovascular, digestive,
endocrinological, head and neck as well as spine and back diseases. Agreeableness
was a negative predictor of the risk of respiratory and positive predictor of rheumatic
diseases, while openness was a positive predictor of tobacco use.
Discussion
When interpreting the results, we will stress only those effects of Dark Triad
traits on health indices that are consistent across both sets of hierarchical regression
analyses, one controlling for sociodemographic variables and the other for Five-
factor personality traits. There are several reasons for this, although we are aware
that sociodemographic variables and Five-factor personality traits may have diverse
effects on health indices and are differentially related to Dark Triad traits that may
result in their different effects on health outcomes when these two groups of
predictors are controlled for. One of the reasons lies in the exploratory nature of the
present study and its cross-sectional design which decreases its explanatory power,
and thus it seemed appropriate to focus only on most prominent results. Second
reason lies in the attempt to decrease Type 1 error, frequent in studies with relatively
large sample of participants, which may result in low, yet statistically significant
coefficients. Exclusive reliance on self-report measures may also increase Type 1
error, because common method bias inflates relationships between variables
measured only by self-reports. Furthermore, robust effects of Dark Triad traits may
be better indicators of potential mechanisms through which they exert their effects
on health, which should be the topic of future, more detailed research.
Regarding more subjective health measures, the results show that psychopathy
consistently positively predicted physical symptoms and the number of diseases, and
negatively health-protective behaviors above and beyond socioeconomic variables
(Table 4) and Five-factor personality traits (Table 5), thus confirming the hypothesis
about psychopathy as a negative predictor of health indicators. On the other hand,
Machiavellianism negatively predicted positive mood, while Narcissism proved to
be the least consistent predictor of health indices, not predicting any of the health-
Hudek-Knežević, J., Kardum, I., Mehić, N.:
Dark Triad Traits and Health Outcomes
147
related criteria across both groups of variables that were controlled for in the first
step.
Concerning the effects of Dark Triad traits on diseases, the results of
hierarchical binary regression analyses in which socioeconomic variables (Table 7)
and Five-factor personality traits (Table 8) were controlled for, show that
psychopathy consistently increased the risk of digestive diseases, tobacco use and
injuries. Machiavellianism consistently decreased only the risk of injuries, while
Narcissism decreased only the risk of having skin diseases.
As expected, psychopathy proved to be the most consistent negative predictor
out of the three Dark Triad traits. When compared to Machiavellianism and
especially Narcissism, the effects of psychopathy on specific health indices were
very similar notwithstanding which group of predictors were controlled for in the
first step.
The results also support our assumption that Machiavellianism would not be
only negative, but also positive predictor of health indicators. Additionally,
Machiavellianism showed some inconsistent effects when predicting the risk of
having various diseases depending on the group of variables controlled in the first
step, while Narcissism turned out to be the only negative predictor of the risk of skin
disease, but was also inconsistent in predicting more subjective health measures.
Generally, the results support our hypothesis that each Dark Triad traits will
predict various indicators of health, which once again confirm that they are different
constructs that should be measured separately. Dark Triad traits predicted subjective
and objective health indices with almost even consistency, but usually low effect
sizes were obtained.
Regarding psychopathy, contemporary evolutionary conceptualizations
consider this trait as an adaptation designed by natural selection that is maintained in
population by frequency-dependent selection (Quinsey, Harris, Rice, & Cormier,
1998). The number of individuals high on psychopathy is relatively small but stable
because this characteristic is advantageous as long as it is relatively rare in
population. For example, Barr and Quinsey (2004) suggested that psychopathy could
be regarded as a strategy that includes short-term mating efforts, aggressive and risky
way of acquiring social domination and frequent violation of social exchange norms.
In the context of life-history theory psychopathy may be considered as a part of fast
life-history strategy characterized by life-history and behavioral characteristics such
as shorter life expectancy, precocious reproduction, high growth rate, lower level of
parental care and sociability as well as higher aggressiveness and activity. This life-
history strategy is also characterized by various physiological processes like low
HPA axis reactivity, high sympathetic and low parasympathetic reactivity, high
metabolism, high sensitivity to oxidative stress and low immune response (Reale et
al., 2010). Obviously, individuals with these behavioral and physiological
characteristics may have greater risk of various negative long-term health outcomes.
More specifically, these behavioral tendencies can result in riskier health behaviors
PSYCHOLOGICAL TOPICS, 25 (2016) 1, 129-156
148
which can lead to the greater number of injuries and, together with physiological
predispositions mentioned, to the greater number of chronic diseases. Accordingly,
there are diverse potential mechanisms through which psychopathy exerts its effects
on health, among them unhealthy behaviors, low level of social support and
maladaptive coping. When considered in the context of fast life-history strategy, the
effects of psychopathy on health outcomes could be also understood within the
Constitutional predisposition model (Wiebe & Fortenberry, 2006) in which
psychopathy and negative physiological predispositions are common manifestations
of the same constitutional factors. Consequently, early prevention as well as
interventions aimed at promoting healthy habits may be especially important for
persons high on psychopathy.
Machiavellianism generally exerted weaker effects on health indices compared
to psychopathy, the most consistent being decreased positive mood and decreased
risk of injuries. Negative consequences of Machiavellianism on positive mood are
probably the result of inadequate social relationships. Previous studies show that
Machiavellianism is associated with many variables indicating to the superficial
relationships with others. For example, it is characterized by distancing from other
people (Jonason, Wee, Li, & Jackson, 2014), refraining to help others and low
empathy (Jonason & Krause, 2013; Jonason, Lyons, Bethell, & Ross, 2013). Also,
they have serious disadvantage in forming cooperative alliances that depend on trust
(Jones & Paulhus, 2009), and therefore, they are less favored as friends, confidants,
and business partners (Wilson, Near, & Miller 1998). Additional analyses of our
results concerning moods show that out of all components of positive mood,
Machiavellianism had the highest negative correlation with acceptance (r=-.25;
p<.001), and out of the components of negative mood, it had the highest correlation
with anger (r=.20; p<.001), which indicate to the connections of Machiavellianism
with interpersonal aspects of mood. Furthermore, as compared to psychopathy,
Machiavellianism is related to less impulsive and less aggressive way of life (Jones
& Paulhus, 2010). For example, out of the Dark Triad traits Machiavellianism have
the lowest correlations with various risky sexual behaviors such as mate poaching
(e.g. Kardum et al., 2015). As pointed out by Jonason et al. (2015), it seems that
Machiavellianism is characterized by delayed approach to life rather than risk-taking
or fast life-history strategy. Our results that consistently show its relation to the
decreased risk of injuries are in accord with this interpretation of Machiavellianism.
The results of the present study confirmed our hypothesis that Narcissism exerts
positive as well as negative effects on various health outcomes. However, its effects
on subjective health measures were inconsistent, while it consistently predicted only
decreased risk of skin diseases. This corresponds with one explanation of the
relationship between Narcissism and health based on the motivation of Narcissists to
take care of their bodies and physical appearance. While this explanation may imply
health-protective behaviors as a mechanism through which Narcissism influences
health, our result showed that it is in zero correlation with scores on health-protective
behavior questionnaire. It seems that the primary motivation of Narcissists is not
Hudek-Knežević, J., Kardum, I., Mehić, N.:
Dark Triad Traits and Health Outcomes
149
maintaining health, but physical attractiveness which could be attained by either
health-protective (e.g. healthy diet, exercising) or harmful health behaviors (e.g.
excessive sun exposure, excessively low caloric intake).
Although not a central problem of this study, our results show that out of
sociodemographic variables, female gender and older age were more strongly related
to negative health indicators, while out of Five-factor traits, it was neuroticism. These
results were not unexpected and are in accordance with numerous previous results
(Goodwin & Friedman, 2006; Pol & Thomas, 2013).
The major limitation of this exploratory study lies in its cross-sectional design
that does not permit the conclusions about causal relationship between variables.
Thus, although the results obtained may indicate the effects of Dark Triad traits on
some health outcomes, they may also imply the reverse relationship (i.e. health
outcomes may influence the manifestation of personality traits). For example, higher
Narcissism may be related to the decreased risk of skin disease because person high
on this trait may be preoccupied with their physical appearance. However, skin
disease itself may lead to the decreased manifestation of behavior tendencies
described in Narcissistic Personality Inventory (e.g. "I like to show off my body").
Additionally, all variables were measured by self-report instruments which increased
the common method variance. Furthermore, a cross-sectional nature of the design of
this study does not allow for the examination of the specific mechanisms through
which these traits exert their effects on health outcomes. Nonetheless, the results
obtained show some indications that their effect may be mediated through health
behaviors. Some other mechanisms such as social support, exposure and reactivity
to stress, cognitive appraisal and coping can also be potentially operative.
It should be noted that Dark Triad traits may also be related to some other
diseases that were not examined here. For example, some diseases that occurred with
relatively low frequency rate in this study (e.g. liver diseases, multiple sclerosis,
venereal diseases) were not included into analyses because of too few outcome
events per predictor variable (Peduzzi, Concato, Kemper, Holford, & Feinstein,
1996). Future studies should also analyze processes associated with health
maintenance, illness onset and recovery as e.g. illness perception, progression, speed
of recovery etc.
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Rasgos de la tríada oscura y efectos sobre la salud:
Un estudio exploratorio
Resumen
En la muestra de 637 participantes (358 mujeres y 279 hombres) hemos investigado la relación
entre los rasgos de la tríada oscura (psicopatía, maquiavelismo y narcisismo) y varios indicadores
de saludos, incluidos los indicadores de salud subjetivos (estado de ánimo positivo y negativo y
síntomas físicos notados), comportamiento de protección de la salud y algunos indicadores de salud
objetivos (número de hospitalizaciones, número de enfermedades, enfermedades crónicas
específicas, lesiones y adicciones). Por la relación moderada entre la tríada oscura y el modelo de
los cinco grandes que también ejercen su influencia en diferentes índices relacionados con la salud,
hemos investigado los efectos únicos de los rasgos de la tríada oscura sobre los indicadores de salud
mucho más allá del modelo de los cinco grandes, tanto como las variables sociodemográficas
relacionadas con la salud (sexo, edad y educación).
Cuando las variables sociodemográficas y el modelo de los cinco grandes se controlaron en el
análisis regresivo jerárquico, los rasgos de la tríada oscura mejoraron significativamente la
predicción de casi todos los indicadores de salud subjetivos, comportamientos de protección de la
salud, número de hospitalizaciones y número de enfermedades. Los resultados obtenidos eran
relativamente bajos y el predictor más consistente era psicopatía.
En cuanto a las enfermedades crónicas, lesiones y adicciones, los resultados del análisis
regresivo jerárquico demostraron que en caso de controlar las variables sociodemográficas,
psicopatía era el predictor positivo del riesgo de tener enfermedades digestivas, uso de tabaco y
lesiones, maquiavelismo predecía negativamente el riesgo de las lesiones, mientras que narcisismo
predecía negativamente el riesgo de las enfermedades de la piel y el uso de tabaco. Cuando se
controló el modelo de los cinco grandes, psicopatía era también el predictor positivo de las
enfermedades digestivas, uso de tabaco y lesiones. Maquiavelismo era el predictor positivo de la
presión arterial alta y el predictor negativo del cáncer, enfermedades de la espina y la espalda y
lesiones, mientras que narcisismo era el predictor negativo de las enfermedades de la piel.
Los resultados obtenidos se han discutido en el contexto de posibles mecanismos a través de
los cuales los rasgos de la tríada oscura podrían ejercer efectos negativos, pero también positivos,
sobre la salud.
Palabras claves: rasgos de la tríada oscura, modelo de los cinco grandes, salud, enfermedades
crónicas
Received: March 10, 2016
