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Trait Negative Affect Relates to Prior-Week Symptoms, But Not to Reports of Illness Episodes, Illness Symptoms, and Care Seeking Among Older Persons

From the Institute for Health and Department of Psychology (P.M., C.R., H.L.), Rutgers University, New Brunswick, NJ; and Department of Psychiatry (M.S.) and Department of Medicine (E.A.L.), Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ.

Address reprint requests to: Howard Leventhal, Institute for Health, Rutgers University, 30 College Avenue, New Brunswick, NJ 08901-1293. Email: howardl{at}rci.rutgers.edu

OBJECTIVE: Use the commonsense model of self-regulation to generate and test hypotheses about the relationships of trait negative affect (NA) and self-assessed health (SAH) to reports of current symptoms (acute and chronic), episodes of illness, and use of health care during illness in a sample of elderly, community-dwelling respondents. Trait NA and SAH were compared with the properties of the illness episodes in models predicting the use of medical care.

METHODS: Data were obtained from two successive annual interviews (N = 790 and 719, respectively) conducted with elderly respondents (mean age = 73 years).

RESULTS: Both NA and SAH correlated (positively and negatively, respectively) with reports of prior-week acute and chronic symptoms at each of the two interviews. Trait NA and SAH also predicted changes in prior-week symptoms 1 year later. Neither trait NA nor SAH was related to reports of acute illness episodes, but each showed a very small relationship to reports of chronic illness episodes. Neither trait NA nor SAH predicted the average number of symptoms reported during acute or chronic episodes. The use of medical care during acute and chronic illness episodes was related to the properties of the episode: reported duration, novelty, and severity. Neither NA nor SAH predicted use of care for acute episodes; SAH was related to use of care for chronic episodes. Worry about the illness episode, but not trait NA, was related to care seeking for participants interviewed during a chronic episode.

CONCLUSIONS: Trait NA does not bias elderly adults’ reports of symptoms, illness episodes, symptom reports for episodes, or the use of health care. Both NA and SAH reflect independent sources of common sense and self-knowledge, and each contributes valid information about the elderly individuals’ perceptions of their somatic states.

Key Words: trait negative affect, • self-assessed health, • symptoms, • care seeking, • self-reports.

Abbreviations: CI = confidence interval;; NA = negative affect;; OR = odds ratio;; SAH = self-assessed health.

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