In this study large number of pregnant women in urban area of Jakarta had food cravings (63.8%). A food craving is a strong desire to consume certain foods that is very difficult to resist and specifically different from mere hunger. If the craved food is not available, a feeling of anxious will be aroused and after it is available, there is a change in speed of consumption.22,24
The phenomenon of fruit craving is common, especially to pregnant women. It is generally known that they sometimes crave sweet food, fruit, or calorie-dense foods, as well as strange combinations such as pickles and ice cream. Even pica may also occur. Although this phenomenon is widely known, it is still not properly understood.5
The concept of personality traits refers to traits consistent over time and traits influencing behavior.25 Personality is one of the psychological variables that can affect psychopathological development.26 Personality traits have been corelated with several issues such as healthy behaviour, happiness, academic and job performance, and antisocial and criminal conduct. There are several models to describe human differences in personality traits based on different perspectives. One of the most widely accepted structural personality models is the Big Five Factor which categorizes individuals in five dimensions.27
The five-dimension personality traits are openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Each personality trait has its characteristic. People with openness to experience trait are usually curious, imaginative, and like to have new experience. Those who have conscientiousness trait have good planning, high levels of thoughtfulness, good impulse control, and goal-directed behaviour. Extraversion trait is reflected by sociability, talkativeness, activity, excitability, and positive emotionality. People with agreeableness trait have empathy, altruism, kindness, and affection behaviours. Neuroticism trait is represented with negative emotions, such as anxiety, fear, sadness, and low self-esteem.28 Every traits has its pole, for example people with high neuroticism have a lot of stress experience, while those with low neuroticism on the contrary, are emotionally stable. Whereas people with high extraversion trait like to be the centre of attention, it is difficult for those with low extraversion trait to have social interaction.
Gaining body weight and having appetite may be determined by various factors such as health status, age, gender, genetics and socioeconomic status. These will form a dietary pattern, and it can represent the regulation of emotions, as well as the inability to resist food cravings or binge eating. Evidences suggests that the manifestations of weight gain are also consistent with individual personality traits.13
Many factors influence the personality traits in populations. Gender, culture, geography, social status, and many others can form people personality traits. We observed that the number of subjects with high conscientious trait was the highest in our samples. It was different with other study in this country, which collected samples from college students.29 In addition, the difference was also observed in a study in Great Britain.30 High conscientious trait is associated with orderliness behaviour.
It is suggested that food cravings do not influence the total dietary intake during pregnancy, nor are they associated with more gestational weight gain, risk of maternal glycaemia or offspring outcome biometri.31 However, others found that the first trimester craving is associated with dietary intake and the type of cravings may modulate the risk of gestational diabetes melitus.32 The personality traits affect dietary intake and weight gain because these individual characteristics are related to patterns of thinking, feeling, and behaviour.
Many studies have reported on food cravings but only this study has linked cravings with personality traits in pregnancy. From all five types of personality trait, only neuroticism had a significant statistic difference in food cravings. Therefor women with high neuroticism trait should receive special attention when getting pregnant. High neuroticism trait is represented by irritable behaviour which is having a lot of stress, easy to be angry, anxious, and always trying to exact revenge. Individuals with high neuroticism trait are easily threatened, have difficulties to deal with problems, and often experience negative emotions such as fear, shame, and anger. In correlation with the incidence of mental and physical health problems, a meta-analysis study conducted by Malouff et al33 found a strong correlation of high neuroticism with it, in comparison with other personality traits. Therefore, it seems that this personality trait more easily gets food cravings since food cravings usually reflect an unusual habit that cannot be controlled. On the contrary, low neuroticism personal trait has a characteristic of stable emotion, having ability to manage stress, happiness, and optimistic. From a previous study, it was found that high neuroticism trait had impulsive tendency to food addiction.15 In addition, this personality trait was also associated with obesity, binge eating, alcohol consumption, smoking, and substance abuse.14,16−19
Individuals with the neuroticism personality trait are said to be easier to give in to temptation to eat and have difficulty in following the discipline of healthy living habits such as doing exercise or physical activity. In addition, they also have difficulty in following a strict schedule at meal times, so it will be difficult to reduce extra calorie intake outside of mealtimes.14 Another study also found that high neuroticism trait has higher triglyceride level and higher inflammation.34,35
In previous studies, the personality opposite to neuroticism is the conscientiousness personality trait, and people with this trait are rarely obese. This personality trait is known to have a regular, disciplined, and healthy lifestyle such as doing regular exercise, eating healthy foods, and avoiding alcohol. This is also reflected in other studies which show that people with conscientiousness personalities have lower levels of fat. They will have more organized and scheduled time to eat and healthy choice of food. They also able to resist cravings such as drinking alcohol and binge eating.13,14,20,21
The weakness of this study is the subjective questionnaire relies on the patient's memory so that recall bias may be occurred. Personality traits assessment instrument is based on self-assessment that is done in a short time and not giving enough time to observe the subject. However, the implication of this study that if we detect personality traits of women before pregnant, we should give an appropriate antenatal care for the food cravings’ women, especially with high neuroticism trait, to prevent adverse pregnancy outcome as reported above. Further research is suggested to evaluate the association of personality traits, food craving, and pregnancy outcome.