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Journal ArticleDOI

A one-year prospective investigation of Type D personality and self-reported physical health

30 Jan 2019-Psychology & Health (Taylor & Francis)-Vol. 34, Iss: 7, pp 773-795

TL;DR: Although the relationships appear to be primarily driven by NA, the theory of a stress-related mechanism potentially underpinning the Type D-health relationship is supported and contributes to the literature continuing to highlight Type D personality as a risk factor for negative health outcomes.

AbstractObjective: Type D personality is characterised by negative affectivity (NA) and social inhibition (SI), and is often associated with poorer physical and psychological health. However, the underlyin...

Topics: Type D personality (70%), Negative affectivity (65%), Social inhibition (58%), Anxiety (54%)

Summary (3 min read)

Introduction

  • Type D personality is characterised by the interaction of negative affectivity (NA) and social inhibition (SI) (Denollet, 2000).
  • Existing research has established Type D as a predictor of poorer physical health, including increased somatic symptoms, general health complaints and immune related illnesses (Condén, Leppert, Ekselius, & Åslund, 2013; Stevenson & Williams, 2014; Williams & Wingate, 2012).
  • Prospective examination is required to further understand the mechanisms underpinning the now well-documented relationship.
  • It has also been criticised for not accurately representing the interactive effect of SI and NA, and typologies generated from two continuous variables in this way, have been criticised (Coyne et al., 2011).
  • In light of the current Type D literature it is hypothesised that: i) Type D personality will be linked to increased reporting of physical symptoms ii) Stress, anxiety and depression will play a mediating role in the relationships between Type D and physical symptoms iii).

Participants and Procedure

  • An online questionnaire based study was conducted with 535 healthy individuals (18-65 years).
  • Participants were recruited online via social media platforms, student participation pools and via email within the researcher’s institution.
  • Exclusion criteria stipulated that individuals with a history of psychological health issues, known chronic or immune related illnesses, and diagnosed sleep disorders should refrain from taking part (including those diagnosed in the year between baseline and follow up).
  • Informed consent was gained online via a multiple-choice selection and an option to provide an email address (to be contacted for the follow-up) was given at baseline.

Type D scale- 14

  • The CHIPS is a list of 33 common physical symptoms (e.g. ‘back pain’; ‘diarrhoea’) rated on a 5-point Likert scale ranging from (0) ‘not been bothered by the problem’ to (4) ‘extremely bothered by the problem’ (during the previous 2 weeks).
  • The total score is the sum of the responses on the 33 items (possible score range 0-132).
  • Each cluster was considered individually within the current study, with the exception of haemorrhagic symptoms, given the low internal consistency of this factor (Allen et al., 2017).

Perceived Stress Scale

  • Subjective stress was measured using the Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983).
  • The PSS is a 10-item scale (α= 0.85) that assesses how respondents have experienced and dealt with stressful situations in the past month.
  • Response choices are on a 5-point Likert scale and range from (0) “never” to (4) “very often” and a number of items are reverse scored.
  • Scores are calculated by summing the 10 item ratings, and range from 0 to 40, with higher scores indicating higher levels of perceived stress.

Hospital Anxiety and Depression Scale

  • Levels of anxiety and depression were examined using the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983).
  • The HADS comprises 14 items with answers coded between 0 and 3 (positively worded items are reversed scored).
  • 7 items measure anxiety (α= 0.83) and 7 items measure depression (α=0.82), a separate score is derived for each scale with higher scores indicating higher levels of anxiety and depression, respectively.

Social Readjustment Rating Scale

  • The Social Readjustment Rating Scale (SRRS; Holmes & Rahe, 1967) assessed the number of stressful life events experienced over the past year.
  • The scale comprises 42 items weighted by impact (e.g. 100 points for death of a spouse, 11 points for minor violations of the law).
  • The sum of the weighted items is calculated to give a total score for each participant.

Retrospective Health Questions

  • A number of retrospective health questions were included in the follow-up.
  • Example responses were categorical including scales of frequency (e.g. ‘never’ to ‘often’) and perceptions of quality (e.g. ‘very good’ to ‘very poor’).

Treatment of data

  • At baseline, all 535 participants completed the DS14, CHIPS and HADS; however, 11 participants did not complete the PSS.
  • The remainder of the participants’ data was included in analyses.
  • Mediation analyses using the PROCESS macro for SPSS (Hayes & Preacher, 2013) were then used to examine if perceived stress, anxiety, depression, or stressful life events mediated the relationship between Type D and physical symptoms at follow up.
  • The indirect effect shows the indirect relationship between Type D personality and CHIPS scores via each mediator (i.e. path a*b).

Temporal stability

  • Pearson’s correlations analyses demonstrated strong correlations between baseline and follow-up scores; (SI; r= .857**, NA; r=.837**, Type D; r=.828**) indicating the DS14 exhibited excellent test-retest reliability, and stability over the year period.
  • For the purpose of the current study Type D scores and categorisation determined at baseline were used for the remaining analyses.
  • Test-retest correlations of SI, NA, Type D, anxiety, depression, perceived stress and total physical symptoms between baseline and follow up can be observed in table 2. TABLE 2 HERE.

Anxiety, depression and stress

  • As shown in Table 3, Type D participants reported significantly greater levels of anxiety, depression, and perceived stress at baseline (N=535) compared with non-Type D participants.
  • These findings were supported by Pearson’s correlational analyses, which indicated significant positive correlations between SI, NA, and total Type D (NA × SI) scores with anxiety, depression, and perceived stress at baseline.

Physical symptoms

  • Type D participants reported significantly more physical symptoms than non-Type D participants at baseline across all symptom clusters.
  • Pearson’s correlational analyses indicated significant positive correlations between SI scores (at baseline) and physical symptoms, with the exception of gastrointestinal symptoms.

Mediating pathways

  • All symptom clusters at baseline significantly predicted the respective cluster at follow up (all p values ≤ .001).
  • As shown in table 4, Type D personality was found to be a significant predictor of metabolic, cold/flu, and gastrointestinal symptoms (path c) one year later when baseline scores were controlled (total effect).
  • The indirect effect (a*b) of Type D on metabolic symptoms (whereby the bootstrapped confidence interval for the indirect effect did not include 0) via both anxiety (BaC CI [.0017, .0070]) and stressful life events (BaC CI [.0001, .0020]) was significant.
  • The direct effect (path c’) became nonsignificant when considered through the anxiety pathway (p=.130) indicating full mediation, and remained significant through the stressful life events pathway (p=.015) indicating partial mediation.
  • No mediating effects of, depression, anxiety and perceived stress were observed.

Perceived general health

  • Ds were more likely to rate their current general health as ‘fair’, their health over the past year as ‘not very good’, and be dissatisfied’ with their current health status.
  • Ds were also less likely to provide ratings of ‘very good’ for these questions.
  • There were no differences in how participants compared their current health status to one year earlier (X² (4) =7.299, p=.099).

Frequency of illnesses

  • Ds were more likely to have felt unwell or run-down ‘frequently’ and were less likely to have ‘never’ suffered a non-serious illness or taken time off work.
  • Type D category did not relate to the frequency of participants suffering an illness requiring prescription medication; X² (4) =2.749, p=.65.

Healthcare utilisation

  • Type D was significantly associated with seeking medical information (without visiting a medical professional) (X² (4) =15.444, p=.003).
  • Type D individuals were more likely to have ‘never’, or ‘once or twice’ sought medical information.
  • (See Table S2 for responses to each retrospective health question for Type D and non-Type Ds).

Discussion

  • The current study is the largest to date to i) consider the relationship between Type D and physical symptoms in the general population, and ii) investigate differences in aspects of retrospective health and healthcare utilization in relation to Type D status.
  • This also indicates that the relationships between Type D and physical symptoms exist across both the dichotomous and dimensional conceptualisations of Type D. However, in the regression models controlling for SI and NA, Type D was only found to be predictive of total symptoms, sympathetic/cardiac, muscular, metabolic, vasovagal, and headache symptoms.
  • This should also be considered when interpreting these findings, particularly with respect to the predictive utility of the Type D construct.
  • Further, as stress is associated with various health outcomes, it is likely this theory could explain the observed associations with other symptom clusters.
  • In summary, the current study has provided evidence that Type D personality may predict particular symptoms which are often associated with heightened stress.

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1
A one-year prospective investigation of Type D personality and self-reported physical health
Authors: Sarah F. Allen PhD
a
, Mark A. Wetherell PhD
b
, & Michael A. Smith PhD
bc
a
Department of Health Sciences, Faculty of Science, University of York, UK. sarah.allen@york.ac.uk
b
Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, UK
c
Faculty of Health and Medical Sciences, University of Western Australia, Australia
Running Head: Type D and Physical Health
Key words: Type D; health; physical symptoms; stress; anxiety.
Words: 6900
References: 79
Number of tables: 4
Number of figures: 1
Number of appendices: 1
Supplementary tables: 2
COI: No conflicts of interest.
Funding: The project was undertaken as part of a Northumbria University funded PhD studentship.
*Corresponding author: Dr Sarah F. Allen. Department of Health Sciences, Faculty of Science, University
of York, UK. sarah.allen@york.ac.uk. +44(0)1904321949

2
Abstract
Objective: Type D personality is characterised by negative affectivity and social inhibition, and is
often associated with poorer physical and psychological health. However, the underlying mechanisms
are unclear and the literature lacks longitudinal assessment. We aimed to prospectively examine the
relationships between Type D and physical symptoms, in addition to retrospective health.
Design: An online questionnaire-based study (N=535) with a one-year follow-up (N=160) was
conducted with healthy individuals (18-65years). Type D was assessed as a categorical and dimensional
construct.
Main Outcome Measures: Participants completed Type D scale-14, Hospital Anxiety and
Depression Scale, Cohen-Hoberman Inventory of Physical Symptoms and Perceived Stress Scale at both
phases. Retrospective health questions and Social Readjustment Rating Scale were completed at follow-
up.
Results: Type D was related to cardiac/sympathetic, metabolic, vasovagal, muscular, and
headache symptoms at baseline. At follow-up stressful events and anxiety mediated the relationships
between Type D and particular symptoms. Type Ds were more likely to report poorer health, and
increased minor illnesses, work absences, and medical-information-seeking.
Conclusions: Type D is associated with stress-related symptoms. Although the relationships are
primarily driven by NA, this supports the theory of a stress-related mechanism. These findings
contribute to the literature highlighting Type D as a risk factor for poor health.

3
Introduction
Type D personality is characterised by the interaction of negative affectivity (NA) and social
inhibition (SI) (Denollet, 2000). Type D individuals have the tendency to experience negative emotions
including dysphoria, anger, anxiety, hostility, and general distress across situations and time, whilst also
inhibiting the expression of these emotions in social situations due to fear of rejection or disapproval
(Denollet, 1998b; Mols & Denollet, 2010a).
Since its initial proposal the prognostic validity of the Type D construct has been demonstrated in
cardiac patient populations. However, there is accumulating evidence that Type D may be an important
risk factor for poor health in other illness groups (Mols & Denollet, 2010a), as well as in otherwise
‘healthy’ individuals (Smith et al., 2018; Williams & Wingate, 2012), that is, individuals who are free
from any chronic conditions. Existing research has established Type D as a predictor of poorer physical
health, including increased somatic symptoms, general health complaints and immune related illnesses
(Condén, Leppert, Ekselius, & Åslund, 2013; Stevenson & Williams, 2014; Williams & Wingate, 2012).
Early estimates suggest that Type D personality was prevalent in 20% of the general population
(Denollet, 2005). However, recent studies have estimated prevalence of up to 42.8% (Booth & Williams,
2015), which further exemplifies the importance of researching the health effects of Type D in ‘healthy
populations
Type D has also been associated with increases in anxiety, depression, somatisation (Michal,
Wiltink, Grande, Beutel, & Brähler, 2011), maladaptive stress reactivity (Habra, Linden, Anderson, &
Weinberg, 2003; Howard & Hughes, 2013; Kelly-Hughes, Wetherell, & Smith, 2014; O’Leary, Howard,
Hughes, & James, 2013), dysfunctional coping strategies, lower social support (Williams & Wingate,
2012), and adverse health behaviours (Booth & Williams, 2015) in the general population. Accordingly,
these are all factors which may potentially mediate the relationship between Type D and physical health
(Howard, Hughes, & James, 2011; Williams & Wingate, 2012). The relationship between Type D and
health in the general population is beginning to receive more attention, and in a recent study, has been
found to be mediated by anxiety and perceived stress (Smith et al., 2018). However, prospective

4
examination is required to further understand the mechanisms underpinning the now well-documented
relationship.
Type D personality is traditionally assessed categorically, with individuals scoring above a
particular threshold on both SI and NA being classified as Type D (Denollet, 2005). Although this
approach is useful, it has also been criticised for not accurately representing the interactive effect of SI
and NA, and typologies generated from two continuous variables in this way, have been criticised
(Coyne et al., 2011). Consequently, Ferguson et al., (2009) has recommended that Type D may be better
conceptualised as a dimensional variable. Therefore, in line with previous studies (e.g. Stevenson &
Williams, 2014), Type D will be considered as both a categorical and a continuous variable within the
current study.
Given previous findings linking Type D to a range of health outcomes including; poor prognosis in
heart disease patients (Kupper & Denollet, 2007); cancer survivors (Mols, Denollet, Kaptein, Reemst, &
Thong, 2012) and other clinical populations (Mols & Denollet, 2010a) as well as increased physical
symptoms (Smith et al., 2018; Williams & Wingate, 2012), it appears necessary to assess the extent to
which Type D personality may predict physical health over time. Moreover, there is a notable lack of
longitudinal evidence to support the predictive value of Type D personality on health in the general
population. This makes it difficult to reliably infer cause and effect, and limits the capacity to investigate
potential mediating mechanisms (Maxwell & Cole, 2007). Therefore, a longitudinal assessment of the
associations between Type D personality and physical symptoms, in addition to aspects of general
health status and healthcare utilization, is warranted.
In light of the accumulating evidence with respect to the role of stress and distress in the Type D-
health relationship (e.g. Smith et al., 2018) this study will examine the potential mediating effects of
stress, anxiety and depression. The current study aims to contribute to our understanding of the
pathways underpinning the relationship between Type D personality and the manifestation of physical
symptoms. In light of the current Type D literature it is hypothesised that:
i) Type D personality will be linked to increased reporting of physical symptoms

Citations
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01 Jan 2010
Abstract: Objective. This study investigated whether approach coping, avoidance coping, or perceptions of available social support mediated the relationship between Type D personality and perceived stress. Furthermore, this research also examined whether Type D moderated the relationship between perceived stress and symptoms of burnout. Methods. In this cross-sectional study, 334 (male N = 180; female N = 154) firstyear undergraduate students completed the Type D Scale-14 (DS14), the Brief Approach/Avoidance Coping Questionnaire, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and the Oldenburg Burnout Inventory. Design. Cross-sectional. Results. Multiple mediation analysis revealed that only resignation and withdrawal coping, but not social support partially mediated the relationship between Type D and perceived stress. A small moderation effect was found for the disengagement subscale of the burnout inventory, with Type D individuals experiencing higher levels of disengagement at low and average stress levels. The correlations between variables provided support for most of the prediction from the literature with regard to Type D. Conclusion. Of the participants in the present study, 24.9% were classified as Type D. These individuals tend to use more passive and maladaptive avoidance coping strategies such as resignation and withdrawal. This is associated with higher levels of perceived stress and linked to increased levels of burnout symptoms. © 2010 The British Psychological Society.

134 citations


Journal ArticleDOI
TL;DR: The results support recent findings in the Type D literature that have identified null effects of Type D when controlling for negative affectivity.
Abstract: Background and Objective: Type D personality has been associated with increased perceptions of stress. As Type D individuals have been noted to report lower social support and greater perceptions o...

6 citations


Cites background or result from "A one-year prospective investigatio..."

  • ...…prior studies that have examined the association between Type D personality and perceptions of stress have not examined if results were confirmed whilst controlling for the individual Type D subcomponents (Allen et al., 2019; Polman et al., 2010; Smith et al., 2018; Williams & Wingate, 2012)....

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  • ...Apart from one prior study (Allen et al., 2019), previous research has primarily examined the association between Type D personality and perceptions of stress, omitting the quantity of stressful life events experienced (Polman et al., 2010; Smith et al., 2018; Williams & Wingate, 2012)....

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  • ...More recently, Type D personality has been associated with a myriad of inauspicious physical and mental health states in both the general population (Allen et al., 2019; De Fruyt & Denollet, 2002; Jellesma, 2008; Kupper & Denollet, 2014; Smith et al., 2018; Stevenson & Williams, 2014; Van Den Broek…...

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  • ...…relationship between Type D personality and adverse health may be facilitated via increased perceptions of stress, with several studies identifying that Type D individuals report greater perception of stress (Allen et al., 2019; Polman et al., 2010; Smith et al., 2018; Williams & Wingate, 2012)....

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01 Jan 2012
Abstract: Discusses a number of articles in relation to the association of type D personality and cardiovascular health.

6 citations


Journal ArticleDOI
Abstract: People with acne vulgaris report a lower level of satisfaction with life and are more frequently classified as having Type D personalities than those without acne. This research examined, for the first time, the moderating and mediating role of personality type in the relationship between acne severity and satisfaction with life. Among 300 female nursing and cosmetology students ranging in age from 19 to 24 years (M = 21.28, SD = 1.39), 150 individuals (50%) presented with symptoms of acne vulgaris (AV group), while the other 150 (50%) were categorized as controls without acne vulgaris (WAV sample). A cross-sectional study was conducted using three self-report questionnaires: The Satisfaction with Life Scale (SWLS), the Framingham Type A Scale (FTAS), and the Type D Scale (DS14). Acne vulgaris was clinically diagnosed using the Hellgren-Vincent Scale (HVS). The AV group scored significantly higher on the FTAS and DS14 and lower on the SWLS than the WAV sample. Life satisfaction correlated negatively with both the negative affectivity (NA) and social inhibition (SI) subscales of the DS14. The moderating role of the Type A behavioral pattern (TABP) and the mediating role of both NA and SI subscales of the DS14 were observed in the relationship between acne severity and satisfaction with life. The type of personality may explain the mechanism of the relationship between acne disease and subjective well-being. Therefore, psychological interventions and strategies focused on managing stress and mood may effectively improve satisfaction with life in people with acne.

5 citations


Cites background or result from "A one-year prospective investigatio..."

  • ...People with a Type D personality are more likely to report cardiac–sympathetic, metabolic, vasovagal, muscular, and headache symptoms, poorer health, increased minor illnesses, work absences, and medical information seeking than people without a Type D personality [64]....

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  • ...TABP and Type D personality were considered in this study as categorical and continuous variables, consistent with previous research [64,73]....

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Journal ArticleDOI
TL;DR: The predictive utility of Type D personality on cardiovascular reactivity above and beyond the individual effects of NA and SI is limited, and may vary depending on the cardiovascular parameter of focus.
Abstract: Type D personality has been consistently associated with adverse cardiovascular health with atypical cardiovascular reactions to psychological stress one potential underlying mechanism. As Type D individuals have been noted to report lower social support and greater perceptions of negativity in social interactions, this study examined if the association between Type D personality and cardiovascular reactivity was mediated by these social relationships. A sample of 195 undergraduate students (138 female) participated in this observational study, where they completed measures assessing Type D personality (DS14), social support, and perceptions of negative social relationships (National Institute of Health social relationship scales), before undergoing a traditional cardiovascular reactivity protocol. Systolic and diastolic blood pressure (SBP; DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) were monitored throughout. ANCOVAs and regressions indicated that Type D personality was associated with lower cardiovascular reactivity to a mental arithmetic stressor. Furthermore, mediation analyses (process macro) indicated that the relationship between Type D personality and cardiovascular reactivity was mediated via increased perceptions of negative social relationships, as well as lower levels of social support. Apart from a significant association between Type D personality and increased HR reactivity, all results failed to withstand adjustment for the individual effects of negative affect (NA) and social inhibition (SI) in controlled analyses. Overall, these findings suggest that the predictive utility of Type D personality on cardiovascular reactivity above and beyond the individual effects of NA and SI is limited, and may vary depending on the cardiovascular parameter of focus.

4 citations


References
More filters

Journal ArticleDOI
TL;DR: It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
Abstract: A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.

31,600 citations


"A one-year prospective investigatio..." refers methods in this paper

  • ...Levels of anxiety and depression were examined using the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983)....

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Journal ArticleDOI
TL;DR: The Perceived Stress Scale showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance and was a better predictor of the outcome in question than were life- event scores.
Abstract: This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.

19,179 citations


Journal ArticleDOI
TL;DR: This report defines a method which achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease and provides a quantitative basis for new epidemiological studies of diseases.
Abstract: IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD

10,181 citations


"A one-year prospective investigatio..." refers methods in this paper

  • ...The Social Readjustment Rating Scale (SRRS; Holmes & Rahe, 1967) assessed the number of stressful life events experienced over the past year....

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Book
01 Jul 2004
Abstract: Preface.Acknowledgments.PART I: INTRODUCTION TO LONGITUDINAL AND CLUSTERED DATA.1. Longitudinal and Clustered Data.2. Longitudinal Data: Basic Concepts.PART II: LINEAR MODELS FOR LONGITUDINAL CONTINUOUS DATA.3. Overview of Linear Models for Longitudinal Data.4. Estimation and Statistical Inference.5. Modelling the Mean: Analyzing Response Profiles.6. Modelling the Mean: Parametric Curves.7. Modelling the Covariance.8. Linear Mixed Effects Models.9. Residual Analyses and Diagnostics.PART III: GENERALIZED LINEAR MODELS FOR LONGITUDINAL DATA.10. Review of Generalized Linear Models.11. Marginal Models: Generalized Estimating Equations (GEE).12. Generalized Linear Mixed Effects Models.13. Contrasting Marginal and Mixed Effects Models.PART IV: ADVANCED TOPICS FOR LONGITUDINAL AND CLUSTERED DATA.14. Missing Data and Dropout.15. Some Aspects of the Design of Longitudinal Studies.16. Repeated Measures and Related Designs.17. Multilevel Models.Appendix A: Gentle Introduction to Vectors and Matrices.Appendix B: Properties of Expectations and Variances.Appendix C: Critical Points for a 50:50 Mixture of Chi-Squared Distributions.References.Index.

3,555 citations


Journal ArticleDOI
TL;DR: Results demonstrate the importance of including different types of health measures in health psychology research, and indicate that self-report health measures reflect a pervasive mood disposition of negative affectivity (NA), which will act as a general nuisance factor in health research.
Abstract: Most current models in health psychology assume that stress adversely affects physical health. We re-examined this assumption by reviewing extensive data from the literature and from six samples of our own, in which we collected measures of personality, health and fitness, stress, and current emotional functioning. Results indicate that self-report health measures reflect a pervasive mood disposition of negative affectivity (NA); self-report stress scales also contain a substantial NA component. However, although NA is correlated with health compliant scales, it is not strongly or consistently related to actual, long-term health status, and thus will act as a general nuisance factor in health research. Because self-report measures of stress and health both contain a significant NA component, correlations between such measures likely overestimate the true association between stress and health. Results demonstrate the importance of including different types of health measures in health psychology research.

3,029 citations


"A one-year prospective investigatio..." refers background or methods or result in this paper

  • ...…technique for assessing perceived health and physical symptoms (Cella et al., 2010) Furthermore, with regards to the symptom perception hypothesis (Watson & Pennebaker,1989), it must also be considered that distress can influence perceptions of health (Farmer & Ferraro, 1997; Tessler & Mechanic,…...

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  • ...This does not reflect the general finding that females tend to report higher levels of negative affect (e.g. Watson & Pennebaker, 1989), and is also somewhat dissimilar to a sample of the general population from Germany in which a marginally higher percentage of females (31.6% compared to 30.6% of…...

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  • ...These findings are not entirely surprising, given the large body of literature linking NA (and neuroticism) to both distress and negative health outcomes (e.g. Watson & Pennebaker, 1989, Cohen et al., 1995)....

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