Abstract. The current study examined the degree to which applicants applying for medical internships distort their responses to personality tests and assessed whether this response distortion led to reduced predictive validity. The applicant sample (n = 530) completed the NEO Personality Inventory whilst applying for one of 60 positions as first-year post-graduate medical interns. Predictive validity was assessed using university grades, averaged over the entire medical degree. Applicant responses for the Big Five (i.e., neuroticism, extraversion, openness, conscientiousness, and agreeableness) and 30 facets of personality were compared to a range of normative samples where personality was measured in standard research settings including medical students, role model physicians, current interns, and standard young-adult test norms. Applicants had substantially higher scores on conscientiousness, openness, agreeableness, and extraversion and lower scores on neuroticism with an average absolute standardized difference of 1.03, when averaged over the normative samples. While current interns, medical students, and especially role model physicians do show a more socially desirable personality profile than standard test norms, applicants provided responses that were substantially more socially desirable. Of the Big Five, conscientiousness was the strongest predictor of academic performance in both applicants (r = .11) and medical students (r = .21). Findings suggest that applicants engage in substantial response distortion, and that the predictive validity of personality is modest and may be reduced in an applicant setting.

Objective: Psychological distress and alcohol consumption are associated but few studies have focused on the association with problematic drinking in semiurban and rural settings. In this study, we assessed the role of psychological distress on various measures of problematic drinking in urban, semi-urban and rural settings. Design: Retrospective descriptive study Setting Setting: National Drug Strategy Household Survey population health survey data Participants: 151,341 Australian residents Main outcome measures: Problematic alcohol consumption categorised as either heavy-episodic drinking (defined as drinking 5 or more standard drinks at least once in the last 12 months) or long-term risky drinking (defined as drinking more than 730 standard drinks in the past 12 months) was the outcome variables.Psychological distress was identified from the K10 questionnaire. Participants were grouped into area of residence: urban, semi-urban and rural. Sex differences were also explored. Results:Poor-to-severe psychological distress was associated with higher odds of both long-term and heavy-episodic drinking. Being male alone increased the risk of both long-term and heavy-episodic drinking in all areas. When stratified by sex, being female and severe levels of psychological distress increased the risk of both long-term risky and heavy-episodic drinking. These risks were greater in non-urban environments. Conclusions:Poor mental health outcomes may exacerbate problematic drinking amongst females, especially those living in non-urban environments. Public health campaigns could both target these at-risk groups of females in non-urban settings and also account for the interplay between problematic drinking and mental health.

Current alcohol public health policy in Australia is not uniform but is generally focused on restricting access and early prevention of problematic alcohol use. Semi-urban and rural populations are at greater risk of disease and other poor health outcomes due to a variety of factors. Little is known about problematic drinking patterns over time in semi-urban and rural populations. This study aims to assess patterns of problematic drinking defined as both long-term risky and heavy episodic drinking over time by age, sex, and mental health status among urban, semi-urban and rural populations). Four waves (2004 to 2016) of the Australian NDSHS (National Drug Strategy Household Survey) were analyzed to assess problematic drinking of participants over 18 years of age. We used regression models and predictive margins to identify trends in problematic drinking over time based on age, sex, and mental health status. Our results show young adults across all regions, males, and mentally well individuals in urban areas have reductions in the risk of problematic drinking over time. Middle-aged adults across all regions, females, and those with varying mental health presentations in rural areas have some increases in risk of problematic drinking over time. The general conclusion is that targeted alcohol-related public health policy may need to change and focus on females, middle-aged individuals, and those living in rural areas. Programs to support problematic drinking in people with mental health disorders may also need to be a priority.