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Depressive Symptomatology, Rather than Neuroticism, Predicts Inflated Physical Symptom Reports in Community-Residing Women

From the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) (M.B.H., R.M.); Veterans Affairs Medical Center; College of Nursing (R.M.); and the Department of Psychology (M.B.H., J.S.), The University of Iowa, Iowa City, Iowa.

Address correspondence and reprint requests to Jerry Suls, Department of Psychology, University of Iowa, Iowa City, IA 52242. E-mail: jerry-suls{at}uiowa.edu

Objective: To examine the roles of depressive symptomatology and neuroticism/negative affect (N/NA) on common physical symptom reporting in a sample of community residents.

Methods: Community-residing women (n = 108) participated in a combined concurrent-retrospective design. Physical symptoms were assessed concurrently over 21 consecutive days followed by a retrospective assessment of the collective symptom experience for the same time period.

Results: Based on evidence of differences in cognitive processing of emotion-relevant material, we predicted and found that depressive symptomatology (at baseline) was a stronger predictor of inflated physical symptom recall than N/NA. Depressive symptomatology was also a stronger, independent predictor of concurrent physical symptoms. Notably, these results were obtained even when physical depressive symptoms in both the physical symptom checklist and the baseline depression assessment were eliminated.

Conclusions: The results suggest that the classic symptom perception hypothesis should be refined and operationalized in terms of depressive symptomatology rather than N/NA. This study demonstrates how cognitive-affective processing differences associated with depressive symptomatology can shed additional light on the psychology of symptom perception. Implications for treatment seeking, medical diagnoses, and treatment decisions are discussed.

Key Words: symptom perception • depressive symptomatology • neuroticism • negative affect

Abbreviations: BDI = Beck Depression Inventory; N = neuroticism; NA = negative affect; NEO-PI-R = Revised NEO Personality Inventory; SPH = symptom perception hypothesis.