SL John's
Neuroticismas a potendal moderalor inthe Eustress-Healthrelationship
By
NashwaIrian.(Honours) B.Sc.
A thesls submittedto the Schoolof Graduale Studiesin partialfulfillmentnfthe
requirements forthedegree of Master of Science
DepartmentofPsychology MemorialUniversity of Newfoundland
1996
Newfoundland
1+1
NalionalU brBfy otCanada AcquisillOO~and Bibliographic servicesBranch 395Wei1'ngIOllSlJOOl~~'C:ifWi'Kl
Oirection des acQuisilions el des servicesbibliographiques 395.,oo Welington Ollawa(00I3/lO) K1A 0N4
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Abstract
Eustrcsswasconceptualizedasthepositiveaffect resultingfrompositive events. A moderator modelwas proposedwhich postulatedthatneuroticismmoderates therelationship betweeneusuess and health. Due10 thepossibilityof specificationerror [i.e.,datamay reflect linearor mediatingproperties asopposedtointeractiveor moderating properties), anexploratory mediationmodel wasdeveloped totestforaaymediating effectseustress mayhaveinthe neuroticism-healthrelationship.Specifically,the directeffectshypotheses forthis mediation model proposed that upliftsleadto eustress, whichin turn reducesreportedsymptoms ofpoor health.Neuroticism reduces eustress,whichin tum leadstosymptoms(i.e.•eustressmediatesthe relationshipbetweenneuroticismand health). Neuroticismalso leads 10 symptomsviaother mechanismsnot involvingeustress(e.g.,cognitiveinterpretation(Harkins,Price&Braith,1989), or physiologicalprocesses(Friedman&Booth-Kewley,1987».11tr1~hundred andtwenty-two participantscompletedmeasuresof positive affect, tlpliftS,neuroticism,andsomatic complaintsin the firstphase of atwophase prospective study.One hundredandninety-sixparticipants from the originalsubjectpoolcompleted the positiveaffect,uplifisandsomatic complaintsmeasures twoweekslater.Theresultsprovidedsupport for conceptualizingeustress as the positiveaffect arising from positiveevents.With respect10themoderator model, the results failed to support the hypothesisthat neuroticismmoderates the relationshipbetweeneustress and health.The mediatormodelwas not found to havea good fit to thedata.Thehypothesisthatupliftsleadto eustrcsswhichintunlreducessymptomswassupported.However,the hypothesisthat neuroticismleadstosomaticcomplaints through reducingeustress(i.e.,that eustress mediatesthe relationshipbetween neuroticismand health)as well as through othermechanisms,was not
supported. Analysis00tralurormeddatashowedsome support rortheh)'Pothesized model However . sincethis resultWISbasedontransformeddati.itshouldbeinterpretedwithcaudon.
AJternativemediatormodelsfitthedata and suppo rtedthefinding thatupliftslead to eusrress resultingin low symptoms. Since mediatormodelsfitthe dati.specificationerrorcould hive resultedfrom onlytestinga moderatormodel Inotherwards.tbc dati mayhi ve largely reflected linear (mediator)relationships as opposed to interactive(modeutor) relationships.Possible explanations forthepresentfindings andsuggestions for future research arediscussed.
AcknowledgmeDtt
Iwouldlike 10 thankDr.TedHannah for hisopen-mindedIltitude,motivation, inspiration.and kind supportinsupervising this thesis.Iwouldalsolike10thankDr.Cathy Dutton andDr.ChristineArlen ....bo are mernbenon mysupervisorycommittee.Inaddition.I would liketo thank my colleague and mend.DavidKorotkov,forhistremendoussupport.Thank youDaveforallof your helpespecially regardingthemethodology .nd iI.listical techniques used.
Dedication
I wouldliketo dedicate this project tomy father,mother.and brother.Theirtremendous supportand help in makingthisthesispossiblewillalwaysberemembered.
Thankyou.
Introdudion rm~ductoryR~
TIlepresent studyisinterested inexamining theroleof'thepersonalitytraitneuroticismin the relationship between eustress (positivestress)and health. Adetaileddiscussion focusingon custrcss . neuroticism.,and health,including thereasoningand evidence for focusingon neuroti cism as amoderator in theeustress-health relationship,willbeprovided later.However, for purposesof clarification,beforeonediscussestheconceptofeustress, a discussion of the conceptua lizationofstress ingeneral mustfirstbe provided.
Conceptuali zation of Stress
Thereis substantial disagr eement over the definition of stress.Someresear chers conceptualizestressasa stressor (Holmes&Rahe,1967),asa cognitive response (Lazarus, 1966),or as abiologicalresponseto variousstimuli(Selye,1976 ). Altbough this discrepancy concerningthedefinition ofstressmaybeviewedby some as indicative of instabilityinthe stress field,this absenceofconsensus moreproperlyreflectsthe rapid expansionofstres s researchin manydivergent directions{Breznitz&Goldberger,1982).All threedefinitionsfocu son one factor,be it astimulus (stre ssor),anappraisal, or a biologicalresponse . For instanc e, stress conceptualized as astimulus,focuseson tbechange oradaptation required byan individualin response(0astressor (forexample,lifeevent s).A definitionbased on cognitive appraisal concentrat eson the type ofinfonnat ionaboutthestresso ravailableto tbeindividual(for example, situationalcontext) andhow it is processed.A biologicaldefinition focuseson the body's physiologicalreactiontoastressor.
Abrief examinationofthesethree definitions will nowbepre sented
S!.~$$_Au...itln.l1,!.lu~.Stressconceivedas a stimulushasbeenused todescribe situat ions characterize dasnew.intense.rapidlychanging,sudde nor unexpected.However. stressfulstimuli can also includ e stimulus deficit. absence of expecte dstimulation.highly persistent stimulation.
fatigueand boredom [Zegans, I982a).Holmes and Rahe (1967)viewedstressas a stimulus in theirreasoning that life eventscan be concep tuahzcd as stressfulstimuli. Theymaintained that stressmay be conceptualizedasdiscrete,timelimitedeventsrequiringchangeoradaptation,In their originalwork.HolmesandR!We(1967) scaled life events.for example,marriage. changein residence.etc.,interms of the intensity and lengthoftime necessary toaccommodate10alife event regardless ofitsdesirability(Rabkin&Strueni ng, 1976).Their initial measure.called TIle ScheduleofRecentExperience(SRE),contained 43 events anda subject'slifestressscorewas the number ofeventsheor shereportedexperiencingduringa recentintervalorti me(usually6- 24months).HolmesandRahe soon recogn ized thatsomeorthe43 SREitems. forexample.
death ofspouse,requ ired considerably more change andadaptationthaodid ethers, for example.
Christmas.Inresponse tothis,a subsequen tinstrument,The Social Readjustment RatingSeale (SRRS) (Holme s&Rahe,1967 ),wasdevel oped .This scaleweightedeach event using a ratio scale to estimatethe amount of change or readjust ment requiredonthe part of theindivid ual experiencingthe event.Based on thislife events researchmodel,it ispossible to make predictions abo ut stressand susceptibility to a wide array ofdiseases (infectious, neoplastic, autoimmune) by detennining themagnitude of critica l tifecbangestakingplacewitbinalimited span oftime(Zegans,1982b) .Researchershave sincefounda significant relationship between the experienceof stress,as assessed by tife events,andphysieal illness(Dobrenwend ,Pearlin,
Clayton.Hamburg,Riley.Rose.&.Dchrea wend,1982;Dohrenwend&.Dohrenwend.1981;
Jacobs&.Charles,1980).
So urceof...sID~gnitive.1ppr.1iplandcoping.Stresscanbedefined relationallyby
reference to both thepersonandthe environment(Co)11e&.Lazarus,1980).Stressrequires a judgement thatCnv1rOllrnctllalandlorinlernal demandsexceedtheindn iduafsresour cesfor man.1gingthem. Thisjudgementandthe individu.1rs effort sto manage and shapethe stress experience areconceptualizedinterms oftl vointeractingprocesses:appraisalandcop ing (LI7.llnJs&.Folkman,1982).
Appraisalreferstotheevaluative processassociated'oVilhasituati onal encounterwhich providesmeaningfortheindividulLAppraisal!1-canbeseparatedintothesethatareconcerned with therecognitionthatthe individual is injeopardy(appraisalof whatis atSlake)and those that are concerned primarilywith theevaroation of resources andoptionsavailable formanaging potentialoractualhann (appraisalofcoping).Appraisalofwbalisatstakereferstothe
judgementthatanencount erisIrrelevant, positive , orstressful toOutwt~being.Stressful appraisals canbefartherplacedinto threecategori es: appraisalsof lhr eat,appraisals ofhann-Io ss.
andappraisals ofchanenge.Appraisals oftbrea tand hann-Ioss aredistinguishedprimarilybytheir time perspective,withthreatreferringtothe anticipatio nofimminent barmandharm-loss referringto the judgementthat damage hasalreadyoccurred.Cballenge involvesnot onlythe judgementthat an encountercontainsthe potential for hann or thepotentialfor masteryorgain, butalsothatthe outcom ecanbeinfluenced bytheindividual.Thus.appraisalsofchallenge involve an interactionofappraisalofst lkes and asense of positwe control
Theterm"coping"refersbroadlytoeffortstomanageenvircumectal aadinternal demands
andconflictsamong demands (lazarus, 1981 ).Such tho ughts andacts areectwely involvedin thecoping process.
Appraisalandcopingabilities may illustrate thecognitive processesinvolved inthestress experience foran individual. However,anotherimportantmechanisminvolvedintile experienc e of stress isinco rpo rate d in thephysiological reactionstostress.
The Stress Response. Considerable research has beenconductedto examine the relationship betweenstressand illness.One ofthe majorcontributorstothis lineofresearch, Hans Selye,definedstressastile "body's non-specific response to anydemandplaced onit, whetherpleasantor unpleasant" (5elye, 1976 ).Hemaintainedthatseess is indicatedby evidence of adrenalstimulation,shrinkageoflym phaticorgans,gastrointest inalulcers, and loss of body weightwithcharacterist icalterationsin the chemicalcompositionof the body.The body'Snon- specific responseto anydemand waslaterfoun dto comprise many otherchanges,collectively referredto as thegeneraladaptationsyndrome(GAS.).According to Selye(1976),theGAS.
incorporates thre e stages-alarm, resistance,andexhaust ion- and sequentialprogressionthro ugh these stagesresults inagradualdeteriorationofthebody's defense mechanismsand ultimately resultsinabre akdown of specific physiologicalprocesses.
Intissuesmore direct lyaffecte dby stress,there develops alocal adaptationsyndrome (LAS.).For example,inflammation occurswheremicrobes enter thebody.Chemicalalarm signals are sentout by the directly stressed tissues,from theL.A.S.areato centres of coordinationin the nervous system, andhencetothe endocrineglands, especially the pituitaryand the adrenals.These glands produceadaptive hormonesto combatdeteriorationin the body. The adaptive ho rmones fallintotwo categories:(a)the anti-inflammatoryorglucocorticoi d hormones
(ACTH, cortisone.cortisol).whichinhibitexcessivedefensivereactions,and (b) the pro- inflammatory and/or mineracorticoidhormones(5TH,aldosterone,DOC)whichstimulate defensivereactions.TIleeffects ofthese substancescan bemodifiedorconditionedbyother hormones(e.g.,adrenaline.or thyroidhonnones),nervousreactions,dietand heredity(Selye, 1976).
Selye(1976)maintainedthatderailmentsof the G.AS .mechanismproduce diseasesof adaptation, orstress diseases,forexample.highblood pressure,diseasesof theheart,diseasesof thekidney, eclampsia (periodsofcoma following convulsions duringpregnancy),rheumatoid arthritis.amongothers.Selyealso maintainedthere are other less severe symptomsorsomatic complaints one may experience whensubjectedtostress. Suchsomatic complaintsinclude:
drynessoffhethroatand mouth,feelings of weaknessordizziness, predilectionto become fatigued,insomnia, sweating, frequentneedtourinate, diarrhea.indigestion,queasinessin stomach. vomiting, migraineheadaches.paininlower back or neck. aod excessiveloss of appetite.
It mayseem reasonabletoconceptualize stressas an interactionbetweenabiological mechanismand a cognitivemechanisminrespondingto a stressor,suchas a changeinlifeevents.
Stressmayreferto the entire processby which one both cognitively appraises and biologically respondsto the stressor.TIICbody mayrespondin acertain way toaparticular cognitive appraisalofastressor.For example,psychologicalstates such aschallengeareassociatedwith honnonalresponse patternsthatare not as physiologicallyhannfutasthose associatedwiththreat (Lazarus.Cohen,Folkman,Kanner.&Schaefer,1980a).Researchsuggeststhat threatis associatedwithelevationsin both catecholamines andcortisol levels,whereaschallengeis
associated only with elevationsincatecholamine levels. withcortisol levels remaining normal or even declining {Frankenhaeuser,1980).
Disress and Eustress
Selye(1976) maintainedthat stress isthebody'snonspecificresponseto!illYdemand placedon it,whether itis caused bypleasant orunpleasantconditions. Oneshould, however, differentiate within tbe generalconcept ofstressbetweentheunpleasantor harmfulvariety,called 'distress',and the pleasanttypecalled'eustress'(Selye,1976).Despite Selye's distinction.distress is still usuallyreferred to by the term'stress'andis characterized by anegativepsychological state.
Thisslate reflects anegativediscrepancybetweenan individual'sperceived stateand hisor her desired state,providedtbat the presenceofthisdiscrepancy isconsidered important bythe individual(Edwards&Cooper, 1988).Verylittleresearchhasbeen conductedexamining eustress.Bustressis characterized by apositive psychologicalstateand isoften referredto as 'positivestress' or'goodstress'(Mullis,Youngs,Mullis,&Rathge,19( 3).Itshould benoted that some researchersconceptualizeeustressas the individuafs experience of encounteringevents requiring change and adaptationhut which,atthesame time,are growth producing andwelcome, that is, havingpositive emotionalconsequences(Greenberg, 1987).However.the dominantview holds thateustress is thepositive affectarisingfrom experiences with positive events (Edwards&
Cooper, 1988).This isthe workingdefinitionusedforpurposesof thepresent study.
Qyerviewofproposed model
To date.mostresearchhasfocused on the health consequences resultingfrommajor
negativelife events,for example,divorce ordeathof spouse {Kjccolt,Janice,Kennedy,MalkoR:
&Fisher,1988;Williams&Siegel.1989),or from dailyminornegative eventstermed hassles. for
example,minorfinancialproblems(Dcl.ongls,Folkman.&lazarus,1988;land reveille&Vezina, 1992; zarskl. West,Gintner,&Carlson,1987),Inthis relatio nship,undesirablenegativelife events andlorhassles arepresumed 10give riseto negativeaffect {i.e.jdistress).In otherwords, distresscan be conceptualizedas the negative affectwhich resultsfrom undesirablenegative stressfulevents.Itshouldbe noted that negativelife eventsassessed onlyaccording to thechange and adaptati on requiredbytheindividua l and indepeudently of the emotionsarising from these negat iveliCe eveuts,arenotnecessarilyindicative of distress.Distressinvolves thenegativeaffect resultingfrom undesirableevents (Sarason , Jolmson,& Siegel, 1978;Pearlin,1989).The negative emotionalconse quenceofundesirable events is presumedto giverise to poor health.In othe rwords,chronic orlong-termdistressisthought tohavedetriment al effects onhealth (Williams&Siegel1989 ).Much research maintainsthat focusing solelyon achangeoflife events score indepe ndentofthe event's desirability isnot a good predictor offuturebealthproblems (Depue&Mo nroe,1986:Maddi, Bartone,&Puccett~1987;Rutter&Sandberg,1992).
Researchmaintainingthat perceived undesirability of an eventis a strongerpredictor of illness tllanlife changeshows thatpositivelife eventssuch as getting marriedareless physicallyharmful than negativelife eventssuchasbeing fired (Anderson&Amoult, 1989, Brown&McGill,1989).
Therelationship between distress and poorhealthmaybe moderatedbycertain variables sucb as socialsupport(Cohen&Hobennao, 1983;Sarason,Sarason, Potter,&Antoni, 1985), positive events(Cohen&Hoberman,19 8 3),and locus of control(Denney&Friscb,1981).For prese ntpurposes.itshould benot edthat avariable, for example,x,isa moderato rifthe
10 relations hipbetweenanindependent anddependentvariableis a functionofthelevel of:<. Moderatorvariables willbe discussedinmore detail later in theintroduction. Figu reIisan exampleofamoderator modelwhichportrays therelationshipbetweendistressandpoorhcnlth moderatedby socialsupport.
Thepresent studyproposesa paraUel lineoheasoningwithrespect to major positivelife events(e.g., marriage)ordailyminorpositiveeventstermeduplifts(e.g.•winningthe office hockeypool).In this relationship, desirablepositivelifeeventsor upliftsgiverise to positive affect,termed custress.Inother words,eustre ssisconceptualizedas the positiveaffect which resultsfrom positive events.Eustress,intum,is presumed10havebeneficialeffects on health .(Edwards&Cooper,1988).
Asinthe case ofnegativelife events,wherethe relationshipbetweendistressand poor he;;lthmay be moderatedby certain variables,therelationship betweeneustressand goodhealth lDJly alsobemoderatedby certainvariables.ThepresentstUdyfocusesonthepersonalitytrait of neuroticismas a possiblemoderatingvariableintheeustress-healthrelati onship.Thereasoning andevidencefor examiningneuroticism85a moderatorvariablein the presentstudy willbe discussedlater.Thebasic modeloCthepresent study issho'Mlinfigure2.This modelpositsthat individualswhoexperienceeustress resulting frompositiveevents, have few somaticcomplaints or health problems.However,neuroticismmaymoderate this relationshipsuchthai those individualswhoobjectivelyexperience eustress but are alsohigh on neuro ticismwillesperiencc moresomaticcomplaintsthantbose individualswho experienceeustressand arelowon neuroticism.
Before consideringthevarious comp onentscfthe presentstudy, itshould be notedth. t
Negative life events ---+
and/or hassles
~.Socialsupportas a moder.lorinthedistrcss-iDnessrclatioDship.
INeuroticisml
Positive life events - - - .
and/or uplifts ~ 1 IGoodhealthl
~.l.Neuroticism as a moderatorinthe eustress-healthrelationship.
11 since somaticcomplaintsarea major focus
or
thisstudy,a distinction shouldbemaderegarding thetypesof reportsusedto assesshealthsta tus.Subjective health isusu ally assessed th rough self- re portsof somatic complaints .Theseself-rep o rts areoft en associa tedwithactualphysical illness orobjec tivehealth,however arenot synonymouswithphysical illness.The termillness behav iour describesthe way peop lerespon d to bodilyindicationswhichtheype rceive as abnormal. Illness behaviourinvolvesthemannerinwhich people monitortheir bodies. defineand interprettheir symptoms,take remedialact ionsandurilizethehealth-ca resystem (Mechanic, 1983 ).Examples ofillnessbehaviour include visilingaphysic ian,taking medicine,stayinghome from work.andcomplainingafpa inor othersymp toms.Actualillnessis more strongly assoc iatedwit h illness behaviour than self- reportsofsomaticcomplaints.Somaticcomp laints constituteone type ofillnessbeha viourrel a tedto actualobj ec tive health status.Howeve r,somatic comp laintsdo notnecessarily refl ec t objectivehealth.Inadditioo, itisimport an t to notethat illnes s and illnessbehavio urareno tperfectl y corre lated.Forinstance,one'sillness behaviourmay be excessive,as in thecaseofthehypCH.:hondrl acal individua l,or unusually restra ined,as inthe caseof thestoic. Although healthcomplaint s have been empiricaUylinkedto objective, concu rrent hea lth status (e.g.,Linn&Linn,1980)andsubseq uent obje ctivehealth outco mes such ISmort ality{e.g.,Idler,K.RS1,&Le mke,199 0),these associat ionsreflec tonly modest amounts of commonvariance.Thus,muchofthe varianceinself-repo rt measuresofhealthref lects somatic compl a intsinthe absence of disease (Smith&Willia ms,199 2). Thus,reference tohealt h and essessrnent of healthinthe presen tstUdywillreflect reportsofsympto malologyas opposed to obje etiv e healthsta tus.Thevariouscomp onentsoftheproposedmodelwillDOWbe discussedindetail.
12 Re!alion sbipbetw een positiveeventsandBood health.ResearchhasshownthltthereisII positiverelatio nshipbetween positiveeventsandgoodhealth(Svensson&'rbeoreu,1983 ).
Miller and Wilcox(1986) administeredahassles scale,anuplifts scale.andpsych ological and physicalhealth scalesto 30 subjectsaged 69-93yearsinanursing home.Their resultsindicated that hassles were negativelyrelated topsychologicalandphysical health,whileuplifts were positivelyrelated topsychological and physical health.Otherstudieshave 5110wnthat theabsence of positiveeventsmayleadtopoorhealth(Kanner.Kafry,&Pines.1978).For instance,Evans andEdgerto n (1991)had 100subjects check,attheendofeach day, avarietyofitemsdealing withevents, mood states.and health. Asubsamplethat had provided severalweeksofdataand bad sufferedatleas:onecommoncold episode wasselected foranalysis.Resultsshowe d there was a significant decrease inthefrequency ofdesira bleevent s(compared tothenumberof desirableeventsnormaUyexperienced bytheseindividuals) experienced priorto coldonse t.This finding indicatesapossiblenegative relationshipbetw een positive even tslindhealth problems.
Thus.ingeneral, positive eventslead to good health.Conversely,1Ireduc tionin positive events mayleadtnsomaticcomplaints.
Animportantpointtoconsideristhatuplifts maybestrongerpredictorsofhealthstatus thanpositivelifeevents.For comparison purposes, research focusingon hasslesas oppo sedto negativelife eventsas predictorsofbealth willbebrieflypresented.
Kanner, Coyne,Schaefer,&Lazarus (1981) comparedmajor negativelife events withdaily hasslesinpredicting:health. Theyfoundthat hassles weremorestronglyassociatedwith concurrent and subsequenthealththanwerelifeevents.Majorlifeeventshadlittleeffect independent ofdailyhassles,howeverhassles cont ributed to sympto msindepen dent of majorlife
13 event s.15prediclilgrep ortedsymptoms,aswbSllotialrelationshipremainedfor busies evee .flertheeifrct duetolifeeventshadbeeuremoved.Moreover, theremainS,relationship betwee n hasslesandreponedsymp tomswasgeaeraUygrealertIwlbetwCCIIfife events and reportedS)mploms.Thus.akhough dailyhasslesoverlapconsiderablywithlifecvenl5.they also operatequ~cstronglyandindependcatly(,flifc event sinpredictingsymptoms.Otherstudies hivealsofound thatmcasuresefda iJy hasilcsaremo reslronglyretated to healthstatusthanIre measuresofmaj orfifeeve nts(DeLangis,Coyne.Dak or.Folkman,&Lazarus,19 82;Monroe, 19R3,Weinberger,Hiocr,&Tierne y,1981;Zarski,1984).Apossible explanationfarthese findingsislhnhasslesdisruptthechan cteristiccopingprocessesrequired todealwithnegative lifeevents,Hasslesmay fimctionascriticaleventmedisters,thatis,even tswhichdetermineifaD
indepen dentvariablelends toadepeudeat variable(James&.Brett,1984).illthe negativelife event-he~lthoutcomerelationship.They ma yindicatebow a person'sdailyroutineisbeing affectedbylifecbmges andthusbebetterpl"edidorsofhealt haatus as opposed tolifeeveeu Thisnotionof themediumSrole ofhuslesintherela.tiOllship betweennegativelife eventsand healthisgenera lly supponed(Kanneretal, 1931;RusseD&.Cutrona,1991~
Consistent withthereasoningthatda ily hassles maybe betterpredictorsofheahbproblems ISopp osed10 majorneg.tivelifeevents,oneCaD.also suggesttbat upliftsmaybe betterpredictors ofhe.lthISopposedtomajor positivelifeevents.Littlete~arcbbasbeencondu ctedtil compare theutilityofupliftsversusDlIjor positivelifeeventsinpredictingwell-being.However,reportsof upliftsare more reliablethanreports ofpositivelifeevents whenassessedeversimilar peri odsof timeand rcportiagupliftshaslessbiasassoc iatedwiththem.thanreporting positivelifeevents.
Forinstancc.memorylossisdowforexperi encewithpositive lifeeven tspossib lyresultingill
, .
higherfrequ encyseo resforrepcru ef desin bJelife events. There islittleevic!e-"ce.however. for bias orreactivitywithregard s toreportsofe.xpc ricacinguplifts.Aceun cyofself.rep o rtsof uplifts Iuve beCIIexp lored by ham gpeersob~rvesubject slDdco mpn mgthetwoestimatesof eventfrequency.Re sulushowed.mo derateco rrelationbeweenpmandsubject frequmcy ratings(r=.63.Reich&lIutra,1988). ItispossibteIbat upliftsalsooperat eas med ia torsinthe positivelifeevent-hca~brelationshipperhapsbyenhanci oglhceffeclsof powivclifeevents on hea lth.Based on thisreason ing, thepresent stud y willfocus onup lifts,ISopposed(0major positivelife events, as thepredominantprecursorof'eustres s.
Some debatebas arisenconcerning thequestionofwhether theinflue nceofpoHitnrcevents on wen·beingisdeterminedprimarilyby cognitive~banismsoraffectivem«banism s.
Vmo kurand Clplan(1986)foundthatpositivee...eeuIre easier 10adjult10 lbmlIega tM events.Throughapositivecognitiveappnis&lofpositiv eeeets,due10 theireaseofl djust rncnt.
positiveeve n tsmay haveben elicilleffe ct s011weD-bcing.Theexperienc eofp(tsitiveeveetshas alsobeenassociatedwUthe perception ofbavin gcontroloverthepositive evealThis,intUI1II, maylead Co greaterwell-being(Reicb&1.II1tra .1988~bulrlandReich(1980)exploredthe relationship between lifeeven tsand subjectiveratingsofwell-being.Results slJowedthaiPOsiti'o'll originexperiences(Le. expe rienceswhichevo lv edpersomlcontr ol) ledCorepcn sof peater well-beingandless maladjustmenllhanpa\Wevents(te.,expenmce1whil;hdidnotinvolve pe rsonal control)whichwere eitherpo sklveor negativeinIlatun:.Reich andZiulra(1988) mainllmtha t positiveeventsinfIl1encewelJ.bein gthroughI mediatingmecbanismof'persona l maste!)'includingcognitivecontrol Theyreasonthltindividualsfeel causallyf¢spo nsiblefor positiveeventsintheirjvesandpositiveevent senhanceont lsenseofcontroloverthe events..
15 one'slife.This, in turn, may leadtopositivewell-being.
OIherfactorsinadditiontoper c eived adjustmentandcontro loverpositivee-vents may also playa roleintheinfluenceof' pesitiveeventsonwell-being.Forexample,Csikszen"tmihalyiand Figu rski(1982)foun dthat a senseof beingengagedwithaneven tvoluntarilyratberthan asa requirementwas related10its positivity.Thevoluntarynatureofaneventmay,inturn,le a d to goodbealth.
Vino kurandCaplan(1986~however.suggestth a t theaffectiveresponse toanC\',",'.~~ mo rereliablenndmor einfluentislinpredictingbeahhthan acognitivemecbanisu 'Theymaintain thatthequality of the affectivereactionlhalaccompaniestbeeventmay bethe most::important facetof llow tbe event iscxperiencl:dandhencetheultimateinfluence 00health.Othersalsohold thatthe affectthatis generatedbypositiveeventsregardlesscrwhejerclearcognitions are presentor no t,may heImoreaccura teindicato roftheultimate influenceoftheeventon health (Zajonc,19 8 0 )
SummarY.Positive eventsareassociate dwithgo odhealth.Upliftsmayhebetter predictorsofbealthtbAApositivelife events. Thisstudywillthereforefocusonupliftsinsteadof positivelifc eventsirl givingrisetoeustress,Muchdebatehasarisenconcernillgwh e therpos~ive eventskidto goodIteakhthroughcognitive oraffective mechan ismTher eisevidencefor hoth.
However, affective rl!5pOnse stopositiveeventsmaybemorereliableandinfluentia linpr edicting health.
!kIA:tions!tipbetweenpositive: evenUandpQsh~. Somerese archbasbeen conductedtosupp o rttheno t ionthatpositiveeventsare correlat e dwithpositiveafE"ect.Fo r exa mple,Cla rk andWatson (1988) studieddaily mood ratings and correspo nding diaJ)'entries10
16 determinelherelatio nshipberweeecammal!eventsalldtwoindependentmoo d r.clors-positive affect.ndnegativeaffect -ina$:Impleof18youngaduhs over e3-monlb.period.Then~suks indicated.nespeciaUyrobustrelationshipbetween positive .fftctandJqlorted positi\.-e social im e uctions.particular ly physically.ctiv esocial events.Othershave fouadsim ilarrelati ons betweenpositiveeven tsandpositiveaffect(Drandstaller.1983: MacPhiU.my&Lewinsohs,
19 8 2;Reich&Zautra.19S1;Stone,1981;lIutra.198J;ZauIT'&' Reich.1980;Zautra&Reich.
1983~Thereseemstobemuchevidenceto supp o rt thatpositiveeventsarerelated10posilivc affecl.
Relati onship betwttnpo sitiveaffll:iC!and go od health.Eviden ceexistsshowingthai po sitiveaffe ctispositivelyrelated to goodhealth (Croyle&Urct&ky.1987;
nul
&.Price1992) Lu bin,Zuck elllW1.Br~spraak,ud BuU (1988)exploredthe relationshipbetwetll positiveaffeCI andhalth .Theyadministered the revised MultipleAffectCheck List (MAAC l.-R)10a national probabilitysampleof 1.5-43 adulls.The seadultsalsoprovi deddemographicdata andself.fIIings ofhcallh,mediationusc,andsociIl .ctivitics.Resuhssbowcdlh.tpositiveafi'ed wlSrelated directlyto self.utingsor~oodhealth.Aneg ativerela tionh. salsobeen foundbetweenpositiveaffeC11J1d rep ortsofsomllic compltiDts(Jenkins.StantOD,Klein,SavagealJ,&Dwight,1983;KAsi&.Cobb ,1982).Moro spec ificaUy,evidencesuggests thatthe absenceof'positiveaffectisassociatedwithsomatic co mplaints(Veit&.Ware,19 8 3).ClarkandWat so n(1988)studied therelationshipbetween reports ofphysical symptomsand tlrepo sitive affe ctarisingITomdaiJy events.Resultsshowed thatlowpositiveaffectwasco rrelated withhealthcomplaints-Br.dbul11 (1969)found th. t.I. ck ofpositiveaffedis significant ly relatedtolowwell-being.Thisrelationshipisindcpeudculofthe
17 presenceofnegalivc affectISasource oflawwell-being.
SomerCSUICh has also foundInegaliverelationshipbec~positivemood IDdjJ2iD (Cogan, Cogan,Waltz;&;McCu e.1987; StaDing,1992~Foresaece,5t.tlling(1992) conducted
ao experimentcuminingthere lationshipbetweenmoodandpain.Mood wasexperimen tally inducedInd painWISmeasuredbyself-reponedbodyachesin2Sbodyareas.Resultsindicated Ihal",bileneg ativemoodhadnoeffect onpain,the reWI Sa negativerelationshipfoundbetween positivemoo dandpain.Positivemoodwas associatedwitha reductioninpainratings.
Basedon theevidenceto date,itappears that anincre aseinpositive affect leadstolow somaticcomp laints. Conversely,a reductioninpositiveaffectleadsto moresomaticcomplaints.
Summary.Researchbas providedevidenceforthefollowingrelationships:
J.Positive eventsarcpositivelyrelat edtogoodhealth.
2.ThereisapositiverelatioDbetweenpositive events and positiveaffect 3.Thereisapositiverelatieebetween positiveaffectandgood health 4.AnegativerelalieDe:oristsbetweenpositiveaffect andsomat iccompla ints.
Hu edon thisevideece,itisreasonabletc suggestthat thepositivealfeetfrom desirable evenubasapositiveimpactODhealth.Inotherwords.eustressleads togood health.Coevesely, low eastressleads to somaticcomplaints.
Proce sse sinyolyedintheinfluenceofeustres!ionhealth'Theimpactofneuroticism Therearetwomajor processesbywhich eustrcssmayiD1lueoce health.Oneproce ss involves the directeffe cts ofeusresson health.Eu stressmay evokecertainphysiological responses,which,inthelongrun, mayserve10 improveor prolecthealth.A seceedprocessmay involvethe effectof eustressoncofliDg.Ratherthanaffecting healthdirectly,eustressmay
18 influencehe alth indir ectlyby facilitatingattempts to copewith existingdistress,such thaIthe copingprocess actsas a moderato rcftherelation shipbetweeneustressend health[L azarus, Kanner,&Folkman.I980b).Thereis evidenceforbolhofthese processes. Thefollowingwill first discussbothdirectandindirectinfluenceson eustress. Then.adiscussionofhowandwhy ne uroticism mayserve asIpotential moderator of theeust r ess-health relationshipwill be pr esented.
Withrespectto directeffects, Karasek,Ru ssell, and Theorell (1982) describepathwaysby whichsituati onsinvolvinghighdemand s combinedwithhigh cont ro lmayproducephy siological growth andregenera tio n. The situatio nofhigb demandand highcontrol is consistentwith Edwardsand Cooper's(1988) conceptualizationof eustress. Inthe ir view,highcontr ol implies theabilityto meet the demandsplacedon theindividual. If theindividualde sires to meerrhese demandsand considersmeetingthemimportant, theneustresswillresult.Itis suggestedtbat thesesituati onsstimu latethe production of horrn cnes, such asHDL choleste rol,test osterone, insulin, adren aline,and growth hormone.Whenthe balanceofthese anabolichormonesexcee ds catabolichormones(e.g.,cortisol1physiologicalgrowthmayoccur.Forexample,test osterone andgrowth.hormone mayactua llyenhanceproteinsynth.;::sisinthe myocard ium(l.e.,beart muscle),thuscontrib utingtoa decreaseintbe probabilityofcoron aryheartdisease.While tbis processis speculative,itnone thelesssuggestspathways by whicheustressmayinnuence physiologic almechanisms which u1ti.matelyimprove~~ysieathealth(Karase ketel,1982).
Eust ressmay alsoinfluencehealth indirec tlybyfac ilitating anempts to cope witbedsting distress.Ingeneral,eustress mayfacilitatecopingbyenhancingindividualabilities relcvllltto co piDg and/or stimul atingincreased effortdirectedtowar dcoping.Itshoul d benoted tbltthese
19 effectsfoeus onthereduct ionofphysiologica ldamage associated wichexistingdist ress rather thanthe productio n ofphy siologicalbene6tassociatedwith eust ress(Ed wards&Cooper,(98 8).
Theeffe ctsof'eustressoncopingarediscusse dbyLazarusetal. (1980b).Theyidenti fythre e mechanisms bywhic heustressmayfacilitatecoping.Fir st.eusrr ess mayserveasa breatherfrom ongoingdistress. Thesebreathers orbreaks presumably facilita tecopingby allowingperiodsfor creativeproblem-so lving.Second. eusrressmayactasasustainer ofongo ingcopingincreasin g the likelihoodthatcopingeffortswillpersist.Third,eust ressmay serveas a resto re r, replenish ing damagedordepletedresources ordevelop ingnew resources. Forinstance,positive experienc emaybolsterdamagedself-esteem,wbichmay,illtum,renewcopingeffo rts.
~.Eustress mayinflnencehealthtbrough bothdir ectsad indirectprocesses, Witb respecttodirectprocesses,eustressmaystimu latethe productionofbeneficial bormones.With respect toindirectprocesses,eustressmayfacili Ulebette rattem pts10 co pewithexi stingdistress, thereby re ducing th e negat ivepbysiologicalconsequenc esof dist ress.
A briefdiscussionofmoderat orvariableswin no wbepre sentedfollowedbya discussio nof howand whyneur oticismmayserveasImoderatorin the eustress-heelth relationship.
The natureandstren gthoftherelation shipbetwe endistressfullife eventsandillnessis influencedby othervariables(Schro eder&Cost a,1984),forexample,socialsupp o rt(Cohen&
Hoberman,1983).Somepeopledevelopchronic diseas e and psy chietricdisorderafter exposure todistres sfulcondi tions, and otbersdonol.Mereexposuretonegativeeventsalone is almo st nevera sufficientexplanatio n forthe eesetofillDessinordinaryhumanexperienceandother factors thatinfluencetheir impactrequire consi deration.Thus,the questionofwh ether distre ssful lifeevent scommo nlyprec e detheonset ofa wide variet y of physicaland psychiatri c disordersin
1G populatiOMlendsitselfto theconsideration ofissues suchasmoderatingfactors (Nowack. 1990; Williams,1989).
(i)TIleModerator vs.MediatorVariableDistinct ion.Thereisafundament al distinct iol!
betweenmoderatingandmediating factorsina relations hip.Withrespect tomod e ration.a variable,z,isamoderatorifthe rela tionshipbetween two (ormo re)variables,forexample. x(a predictororindependentvariable)andy(acriterionor dependen tvariable),is afunction.of the levelofz,Zwou ldmoderatethisrel ationship ifthereis asignificantx byzinteractionin prediet ingy (Iam es & Bre tt .(984 ).Figure3portrays amodelofneuroticismmo d erating the effect ofeustress onhealth .Themoderator hypothesis wouldbe supportedifthe interaction effect (thaiis,eustressxneuroticism)significantlypredictshealth (Baron&Kenny.1986).
Mediatorrelations aregenera llyjhoughtnfincausalterms,Influencesof anantecedent or indepe odentvariab learetransmitte d10aconsequence or dependentvari ablethroughan intervening media tor(James&Bre tt, 1984).Figure4 depictsanexample ofapotential mediator model.whereeust ressmediate~theinfluence ofoeurot icismonhealtb(Baron&Kenny,1986).
Intbemoderator-p redictorrelation.both moderatorsandpredic t orsareatthesamelevelwith regardto theirrole ascausalvariablesantece dentto ce rtaincrit erioneffects.In the mediato r, predict orrelation.bcwever,thepredictoris cau....lIyantecedentto themediator. Inother words, modera torvariab lesalway sfunctio nasindependentvariableswhereasmediating eventsshiftroles fromeffectstoca uses,dependingon the foc usoftheanalysis. Moderator variables specifY...men certaineffectswillbold, whilemediatorsindicatebow orwilysucheffe cts eccur (Baron&Kenny.
1986). Themismore evidencesupporting theroleofneuroticism15amoderator asoppo sedto beinga mediator (Aldwin.Levenson.Spiro,&.Dosse.1989;f100d&Endler.1980;King&
Eustres s X Neur oticism (predi ctor X moder ator)
fi.gy[£1.Neuroticism asImoderatorinthe eustress-healthrelationship.
.:
figy[U.Eustress as.mediatorinthe neuroticism-healthrelationship.
21
&Idler,1990;Phillips&Endler.1982).Therefore.the presentstudy wiUfocus primarilyona mcdcreter model in ""hich neuroticismishypothesizedtomoderatetherelationshipbetween custrcssand heahh.
(:I)InternalModcratin&..Yari.~Numerou spersonal variables maybe
considered as moderating variables. Suchindividualfactors may include biologicaland psychologicalthresholdsensitivities,intelligence. verbalskills,morale.psychologicaldefenses, senseofmasteryover one'sfate.and personalitytype(Dohtenwend&,Dohrenwend, 1969).The effects ofmost personal variablesinmoderating distressful conditionsarc fairlyobvious;persons withmoreskillsandassetstend to ferebetter thanindividualswithfewerskills andassets.In general,themorecompetenceindividualshave demonstratedinthepast,tbemorelikelyitis that theywillcope adaptivelywithInegativeevent.The correspondenceofpersonality type to distressreactions andto wlnerability10 diseaseisless clear-cut. Much research,aswill be describedlater, however,provides evidence thatthepersonalitytraittermed neuroticismdelinN asthelendencyto experiencedistressingemotions and topossessassociatedbehavioraland cognitiveInits sucbISfearfulness,irritability,low self-esteem,socialanxiety,poorinhibitionnf impulses. and helplessness (Costl&.McCrae,1987)isrelated10 healtb complaints(Costa&.
McCrae,1987;Roll&.Tbeorell,1987) andis an importantmoderatorvariableinthe distress- illnessrelationship(Aldwin et at ,1989; Depue&.Monroe,1986). Thereislittle research showing Ihalotherpersonality dimensionssuch asextraversion,agreeableness, conscientiousness, andopennessto experience(Digman&.Inouye,1986;McCrae.Costa,d:.Busch, 1986)have strong moderatillg and/ordirectinf}uetl CCSonhealth as contpuedto neuroticism.Neuroticismis alsoa broaddimension(CostlkMcCrae.1987)eucompassmgmany facets suchas anxiety,
22 hostility.depression.self.consciousness.impulsivity,andvulnerability(Dolliver.1987),Onemay thereforesuspectthat ccnaructs such astralt anxietymaybeju'otasusefulmoderatorsas
neuroticism.HO\\ 'CVeT,neuroticism provides01more globalmeasure of negative emotionsIS opposed toothersinglemeasures..such15traitanxiety,whicherefacetsof neuroticism Therefore.itappearsmorereasonabletouseneuroticism asa moderatorvariabkintheeusress- healthrelaricnshjpas opposed to traitanxiety.Individual differencesinneuroticism arequite stableandmeanlevelsneither increasenordecreaseappreciablywithageinadulthood(McCrae&
Costa.1984).II is therefore lmpon ent that neuroticismbe distinguishedfrom episodesof depressionor periodsof distress-relatedanxiety.
Neuroticism referstoa00nixcondition of irritabilityand emotionality(Costa&McCrae, 1987).Negativeaffectivity(NA),Iconstructcharacterizedbyaversivemoodstates includin8 anger,disgust. guilt. fearfulness.anddepression(Walson&Pennebaker,1989),hISbeen proposedasatermtobe usedInterchangeablywith neuroticism(Watson&Clark.1984~
AhhoughNAsharessomecharacteristtcswithneuroticism,itisnot synonymouswithit.SA docs Dotincludetheanxietyandheightenedemotionality whichischaracterislicallyfoundin neuroticism(Depue&Monroe,1986;Mclennan&Bates,199J ).Inaddition,neuroticismis a stableand pervasivetraitwhereasNA isa temporary,unstable Slate(Watson&Pennebaker, 1989).Thus, examiningneuroticisminsteadof NA as a moderatorintheeustress -health relationshipwould providea morestable assessmentofone'spersonalityas opposedto assessing a temporary emotion.Neuroticism is a powerfulvara ble, and manyothermeasuresof personality usedit!.health researchareknownto be correlatedorareplausiblycorrelatedwith neuroticism and reflect its influence(Smith&Wl1liams,1992).Thus,neuroticismis anlmportanlfaCiorin
23
studies of personalilyandhealth. Due 10these reasons,in additionto research which willbe describedshortly,the presentstudy will focuson neuroticismas a potential moderatorvariable in the custress vhealthrelationship.
~.Neuroticismis a stable pervasivetrait whichreflectsa broaddimension of negativeemotions. Past researchaswillbe discussedshortly,providesevidencefor neuroticism, comparedto other personalitydimensionssuch as extraversion,opennessto experience, agreeableness,and cousclcntlcusness,as beingrelated to health complaintsas well asbeingan importantmoderatorinthe distress- illness relationship.Thus,tbepresentstudyfocuseson the trail neuroticismas beinga moderatorintbe eustress-healthrelationship.
Thefollowing discussionwilltheoretically justifythe role ofneuroticismasa potential moderator lntheeustress-healthrelationship.Moderatorresearchwillbe discussedfollowedhy the relationshipbetween neuroticismand healthand the mechanismsoperetinginthis relationship.
(b) Moderator research.Some researchhas shown that neuroticismis asignificant modereter variableintherelationshipbetweendistressand illness.Far example,Aldwinetat., (1989) exploredevidenceofneuroticismmoderating the relationshipbetweendistressasassessed bylifeeventsand hassles andhealth amongagroup of elderlymen. Theyfound that neuroticism moderatedtherelationshipbetween distressas assessed byboth lifeeventsandhassles and health.
Individualsscoring higherinneuroticismexhibited higherlevelsof symptomsunder distress thea did individualssca ring lowerinneuroticism.Thus, neuroticismmaydetermineifindividualswill experienceillnesswhensubjected10distress.
As mentionedearlier,trait anxietyis not synonymouswithneuroticism,howeversincetrait an:tdety is a significantcomponentof neuroticism(Dolliver,1987),for pwposes of illustration,the
14 followingbriefdiscussionofanxietyrc->earcb mayprovidesomesupponfor neuroticismIS.
modem orvariableinthe present study.Trait anxietyhasbeensho\\on tomoderatethe relationship between specific stressfuleventsIndstate anxiety.State In:o.:iet y isconceptu alizedIS.lflnsilory
conditioninvolvingunpleasantfeelings of fearand apprehensionwhileIrait anx.ietyis conceptualized asIrelatively stable personalitycharacteristicindicativeof'tbe predisposition to respond withstatean.xietyunderstressfulconditions(Spielberger,1972).Endler(1988) developeda person-by-situationinteractionmodelof anxiety.Amajor componentor tblsmodel involvedthedistinction betweenstateand traitanxiety.Endlerargued thattraitanxietyisa multidimensionalconstructcomposedof a minimumoffour Iscers(socialevaluation, physical danger,ambiguity,and dailyrolltines)(Endler, 1988).Thedifferentialhypothesis (Flood&
Endler,1980; King&Endler,1990) of the interactionruodelof anxietyspecifiesthat differential changesinstateanxietyforhighand lowtrait anxiouspeople willoccur onlywhenthetype of situational threatiscongruent withthe facet oftrait anxietyunder consideration.A significant person(high vs low traitanxiety)bysitu.don(stressvs non·strm )inter- ctionfor state anxietyis anticipated only ""henthefacet of traitanxiety and situationalstress arccongruent Foreumple.
an individualexhibitinghighambiguoustrait-anxietywillshow morestateanxietyinan ambiguousstressfulsituationcompared to an individualewbiting low ambiguoustrait anxiety (King&Endler,1990).Rescarchhasprovidedevidence-forthismodel (Flood&.Endler, 1980;
Phillips&Endler, 1982).Withrespecttothis model,traitanxiety exacerbates therelationship between specificstressfulstimuliandstateanxiety.
(n)Relationshipbetweegpeuroticism andhealth.bIC1Mduaisscoring high on neuroticism report moremedicalcomplaints(Costa.1987;Costa&McCrae,1980;larseu&Kasimatis.
25 199 1;Okunk George.1984;Ormet,1983).MoSlresearch has shown thatwhile neuroticismis related10subjectivehealthindices,itis largelyunrelatedtoobjectivehelhb status,Costa&.
McCrae(1987)examined therelationship between personalityand organicdiseasebycu mining therelationship betweenneuroticism and objectivehealthindices sucbIS:<I) various manifestationsofcoronaryheartdisease(CHO).(b)mortality,and ee)eon-lifethreateningdisease (c.g.• irritablebowel syndrome(l8S».Costa and McCraeconcludedthatneuroticism isrelated tosomatic complaints.butitslinksto diseasehave notbeenproven.
Roll and Theorell(1987) comparedpatientscomplainingofchestpain withoutanyobvious organiccause tohealthy subjectsmatchedwithregard 10agc andsex.Theirresultsindicatedthai thepatientgrouphadsignificantlyhigherscoreson neuroticism.vitalexhaustion,andcritical recentlife events.Othershave also foundpositiverelations betweenneuroticism and somatic complaintsinthe absenceofdistase(Costa,Fleg,McCrae,&.Lakana,1982;Valdes.Tresem, Garcu.Pablo.&.Flores,1988).
~.Muchevidencesuggeststhatneuroticismis positivelyassociatedwithself- reported somaticcomplaints.,howeveritslinksto diseasehaveDotbeenproven.
Research basprovided e:qllaoationsas to howneuroticismnegatively influencesreportsof health.Thesemechanismswillnowbe presented.
(iii)Possiblemechanisms involvedin theinfluenceofneuroljcjSIDonhealth.Numerous mechanismsare involvedintheimpact of neuroticism (Inhealth.They include increasedattention 1(1(Inc'sphysiologicalfunC1i(lo5,cognitive lnterpretaica,pom coping strategies.,po(lrhealth habits,aod physiological mechanisms.These willDOWbe discussedinturn.
(a) lncreued,nentiOD toDOC'Sphysiologicalfunclions,Research hasshownthat
26 increasingattentional focus to one'sbodilyfunctionsmayresultmhighersymptomfqlOnin g.
Fillingim&Fine(1986 ) conducted astudy10 determinethe effectsor intemalvs external Itletllional focusonsymptom perceptionandperformance inan exercise setting.In theinternal focus condition,subjectswere requiredtorun onemile:while.umding totheirOYmbreathingand heanrate.Inthe externalfocuscondition,subjectsran onemileMiile listeningforaUrget word heard repeatedlyover headphones.Results indicated thatparticipantsreportedsignificantly less symptomatology whenthey WCfCfocusingexternally than whenthey werefocusinginternally.
Researchalso shows that individuals who experience anxiety or whoarehigh on neuroticism aremoreattentivetowardtheirbiologicalor physiologicalfunctioning.Thisinternal .l ltenlionalfocus mayintumleadto somaticcomplaints.Pennebaker (1982) maintained that
measures of anxietycanbe viewedISindicatorsof anentivenesstosymptoms. He found that scoresonThePrivateSclf-Consciou!illcssScale(PSC)(Fenigstem,Scheier,&.Buss, IQ7S),I
scale which measures thedegreeto whichsubjectsreport being aware of theirtbough' s lnd moods,were significantlycorrebtedwiththePILL(Pennebaker,1982),aself.reponinventoryof somaticco mplaints. However,PSCscoreswere unrelatedto reportsofbealth-centreuse, aspirin consumptioll,andclassabsences. Costa&.McCrae (1980)maintainedtbat a possibleexplanation astowbyneuroticism is associatedwithsomaticcomplaintsmaybethat individuals bighon neuroticismare more sensitiveorattentive to their bodilystates. Costa&.McCrae(1987)else arguedthatpeoplehighinneuroticismare more vigilantabout bodilychanges. Theyaremorc apt tomisinterpretunusualsignsofillnessandare more likelyto wonyaboutpossiblediseases.
Pennebaker(1982)suggested thattheincreased attentionexhibited by individuals highon neuroticism mayresultinhighsomaticcomplaints lbroughtheamplificatiooofbo diJyconcerns.
27 Affleck,Tennan,Urrows,&Higgins(1992)investigatedneuroticismand the pain-moodrelation inrheumatoid arthritis. 111Cyhad subjectswithrheumatoid arthritissupply dailyreportsof their mood andjoint pain.A path-analysis suggestedthattherelationbetweenneuroticismand chronic painintensitywasmediatedby thepropensityofindividualshigh on neuroticismtoexaggerate their pain.Other researchers havealso concluded that neuroticismor anxietylead 10 amplification
ofbodilysensations resultingillsomatic complaints (Barsky&Klennan.1983;Costa&McCrae, 1987;Watson&Pennebaker.1989).
Summary.Focusingon one'sphysiologicalfunctionsleadsto higher somaticcomplaints lhanfocusingexternally.Individuals whoarehigh on anxietyor neuroticismfocus muchattention on theirinternal biological functioning.This internalfocus exhibitedby individualshigh on neuroticismmaylead to an amplificationof biologicalconcernsresultingin somaticcomplaints.
(b) Cognitiveinterpretation.It has been postulated that the cognitivemeaningthai individualsassociatewithpainhas aprofoundeffecton painperception(Kreider,Caresse.&
Kreitler,1989).Neuroticismis associatedwith an exaggeratedieterpretat ionof'pain. For instance,Wade,Dougherty,Hart,Rafii,&Price(1992) examinedthe relationshipbetween neuroticismand extraversionontbe fourmajorstagesof painprocessing,that of pain sensation intensity,pain unpleasantness,suffering,and pain behaviour,inchronic painpatients.Neither personalityvariable wasrelated to thefirst stage of painprocessing,pain sensationintensity. However,neuroticism was animportantpredictorofthe otherthree stages. Wadeetat concludedthatthelast twostagesof pain,processing,pain sufferingand pain behaviour, presumablyinvolveextensivecognitiveappraisalrelated to the meaningsandimplicationsthat painholds forthe individuals.Neuroticism,('-'Nesotban extraversion,was associatedwith
28 ernotienaldisturbance.negativepainbeliefs.and painbehaviour.and hence Tnlyhiv eresultedin aeexaggeratedperceptionofpiin.Harkins.,Price. and Braith (IQSQ)focused onthe effectsof extraversion and neuroticismonexperimental and clininlpaminIgroupofmyof.1scial pain dysfunction(MPD)patients-Resuluindicated thatpatients scoring high onneuroticismgave higherratingsof emotions relatedto suffering andscoredhigheree itemsrelatedtoaffective disturbanceon the IllnessBehaviourQuestionnaire(I8Q)(Pilowsky&.Spence.1976)as compared to patients scoring low onneuroticism Harkins etII.concludedthatneuroticismdocs not affectsensory mechanismsof nociceptiveprocessing,but doesappearto exert itsinfluenceby meansof cognitive processesrelated10thewaysinwhichpeople constitute themeanings and implicationsof pain.
Hence,neuroticism appears 10 influencethosestages of painprocessing involving the cogniliveappraisalofpain.Neuroticismmayresult in an exaggeratednegativecognitive appraisal of pain.
(c)roOFCoping Strategies.Othershave speculated thai individualshigh on eeuroticism report more somatic:complaintsbecausethey employless effectivepain copingstrategies comparedto individuals low onneuroticism Formsla»cc,AHlecketal(1992) hadseveuy-five individuals withrheumatoidarthritisreport theirpaincoping. mood,and jointpainfor75 consecutive days.Paincopingstrategies usedmost often andconsideredeffectiveincludedlaking directaction toreducethe pain and usingrelaxation strategies.Strategieswhichwereconsidered less effective andusedleast often consistedof elq)ressingemotionsaboutthepain and redefining thepainto IDIke it more bearable.Neuroticismwasrelated to • greateruseof emolional expressionand less use ofrelaxation.This association may elq)lain why neuroticindividuals
19 rcportexperiencingmorepain.
Cd) Poorhealthhabits. Evidencealso suggeststhat individualshigh in neuroticism exhibit avariety of poorhealth habits. includingsmoking,overeating, failure10exercise,andsleep disturbances. Thesepoor healthhabitsmayin turn leadtosubclinical problemsthat appearas somatic complaints(Costa&McCrae,1987).
(e) PhysiologicalMechanisms.Itisalso reasonabletosuspect thatneuroticismhasdirect effects onvarious physiologicalpathwaysresultinginsomaticcomplaints.Forinstance, headaches, colds,backpaln, andirritable bowel syndrome (mS) havelongbeenthoughttobe associatedwith poor psychologicaladjustment.Itispossiblethat physiologicalpathwaysC3nbe identified that will accountforan associationbetweenneuroticismand somatic complaints. Facets of neuroticismsuchas anger, hostility,depressionand anxietyhavebeenassociatedwith elevated levelsofcorticosteroids (such ascortisol) andcatecholamines (such as epinephrine)(Friedman&
Booth-Kewley,1987). Elevations of eithercorticosteroidor catecholamine levels mayresult in immuno-suppressionand metabolicabnormalities (Goodkin,Antoni,&Blaney,1986; Krantz, Baum,&Singer,1983)which,in tum, mayresult in somaticcomplaints.
Summary.Based on the researchfocusingon neuroticism,it appearsthat when neuroticismactsas a moderatorina relationship,such as thedistress- illnessrelationship,or whenneuroticismdirectlyinfluenceshealth,neuroticism isa detrimentalvariable in these relationships.Forexample, with respectto the moderatingrole ofneuroticisminthedistress- illnessrelationship,individualswhoexperience distress andare lowinneuroticismwill.reportless healthproblems than individualswho arehighinneuroticism.Similarly,withrespect to neuroticismdirectlyinfluencinghealth, individualslow on neuroticismwillreportlesssomatic
30 complaintsthan individualshigh on neuroticism.Mechanismsinvolvedin neuroticism's detrimemalimpact on health focusprimarily on neuroticismas exaggerating internalphysiological reactionsand cognitive appraisalsof pain.
However.little attention has been givento mechanismsinvolving affectoremotionsin the relationship between neuroticism and health. In light of the observation that neuroticism may bea detrimentalmoderator variablein a relationship,such asthe distress- illnessrelationship, theoreticalreasoningand evidencefor an additionalsuggestedmechanismof neuroticism's influenceon health,that of neuroticism reducing positive affect resulting in somatic complaints,is now presented.
(f)An additional mechanisminvolvedin neuroticism'sinfluenceon health'Neuroticism mluees the impact QfpmjtiyealIectQnhealth.Much research has focusedonthe possiblerole that cognitiveappraisal may have onthe influenceof neuroticismon health.However,little attentionhas been given to the role of positiveaffect in this relationship.Itis possiblethat neuroticismmayreduce thepositiveaffect experiencedby individualsencounteringpositive events, and hence may result in somaticcomplaints.Evidencesuggests there isa negative relationshipbetween neuroticismand positiveaffect.Boumanand Luteijo(1986) studied the relationsbetween theIDQ2.\lrelated subscaleof the Pleasant EventsSchedule(PES) (MacPbi1lamy
&Lewinsohn,1982), depression,and other psychopathology.Subject!> completedthe PES,the Beck DepressionInventory(Beck. Rush,Shaw,&Emery,1979),the State-Trait Anxiety Inventory(Speilberger,Gorush,&Lushene, 1970),and a test whichparalleledthe EPI·
Neuroticismscale (Eysenck&Eysenck,1963). Principalcomponentsanalysi!> revealedtwo factors,negative affect and positive affect,where the latter was dominatedby PES scores.
31 Results showed thai the PES correlated negativelywith depression aswell aswith anxietyand neuroticism.McFatte r(1994) argues thatneuroti cintrovertsreportexceptionallylowpositive
affect.compared to allother personalitytypes.Others havealso foundanegativerelation between neuroticismand positiveaffect (McCrae&Costa,1991).
Based on the evidence that low positiveaffect maylead to somaticcomplaintsand tbat there is a negative relationbetweenpositiveaffect andneuroticism,itisreasonabletosuggest that neuroticism mayreducepositive affect,resulting insomaticcomplaints.
Summary.Previous research has suggested thefollowing relationships:
I.Positive eventsare associatedwithgood health 2.Positive eventsare positively correlatedwithpositive affect 3.Positive affectis correlatedwithgoodhealth and negativelyrelatedto
somaticcomplaints
4.Neuroticismis correlated with somaticcomplaints 5.Neuroticismisnegatively correlatedwith positive affect 6.Finally,whenneuroticismacts asImoderatorinthe distress - illness
relationship,itappears to exacerbatetherelationship betweendistressand illness
Based on the evidenceprovidedbypast research focusingon neuroticism,eustressand health,thefollowinghypotheses areposited:
I.Conceptualizationof the eustress construct.Itispredictedthat positiveeventswill
32 significantly predict positiveaffect. The positive affectresulting frompositiveeventswillthen be conceptualizedas eustress for the presentstudy.
2.Neurolici~mmoderatestheEustress·heallhrelationship.Individuals high on both
eustress and neuroticismwinreport moresomaticcomplaintsthan individualshigh on custress and low on neuroticism.Individuals lowoneustressand highonneuroticismwillreport more somatic complaintsthan individualslow on eustressandlow on neuroticism. This relationshipis illustratedin FigureS.
It shouldbe noted thatalthoughtbe present study focuses onIImoderator model,there may be a possibilityofspecification error(i.e.,the data of neuroticism.eustress,andreported symptomsofpoor healthmaynot reflectinteractiveor moderatingpropertiesin that neuroticism maynot moderatetherelationship betweeneustress and health,butmayreflect linearor mediating relationships whereeusrressmaymediatethe relationshipbetween neuroticismandhealth).Thus.
as an exploratoryassessment,a pathanalysiswiUbe performed onthe neuroticism,eustress,a!ld symptomsofpoor heallhdatainorderto assess anymediatingeffects,anddirecteffectsbetween neuroticism,eusress and health.
3.Exploratorystudy; This study willassessfor mediationand directe~
neuroticism.eustress. andsymptomsof poor health
(i)Mediation effects. Eustressmediatesthe relationshipbetweenneuroticism and health, andneuroticismalsoinfluences healththrough othermechanismsnot involving eustress.Such mechanismsmayincludepossible physiological processes (Friedman&
Booth-Kewley, 1987) or cognitivefactors(Harkins, Price,&Braith,1989» . This
INeuroticisml
I Upliftsl-' Eustress
(i.e., positive affect)
!
E:im!m2.The eustress-healthrelationshipmoderatedbyneuroticism.
3J relationshipissho....ninFigureO.
(ii)~A directionalinfluenceexistsbetween uplifts and eustress.neurcdclsm andeustress.eustress andsymptoms, andneuroticism andsymptoms
a) uplifts leadtoeustress b)eustressIcadstolowsymptoms c) neuroticismreduceseusrress d)loweusrressleads to symptomsofpoorheallh
e) neuroticism also leadsto symptomsvia mechanismsnotinvolving cus ress
I Uplifts I ~ IEustressl-'lsymptomsl
INeUrOticiSml~
~,Theneuroticism-symptomsrelationship mediatedbyeustress.
34 Method
Subjects
To obtain a power of.80,(Cohen,1992) at thep"'.05levelfor an expected mediumeffect size. approximately109 subjectswere required(Faul &.Erdfelder.199 2),However,in order 10 accountforan expected50% attritionlevel, 218subjectswereneeded.Three hundred and twenty-twoundergraduates (98menand 224 women,Meanage v20.69 years, SO'"2.16years) fromMemorialUniversityof Newfoundland.voluntarilyrecruitedfrom psychologycoursesin personalityand developmentalpsychology,participatedas subjectsforthefirstphaseof thistwo phase prospectivestudy.Onehundredand ninety-sixsubjects fromtheoriginalfirstphasesubject pool then took part in thesecond phasewhich was heldapproximatelytwo weeks later.This representsareturnresponserateof 61%.
Materials
Variousmeasureswereutilizedto assessneuroticism.somaticcomplaints,positiveevents andpositive affect.Measurementoftbelattertwo variablesconstituted an assessmentofeustress.
Althoughit is preferableto administertwo measuresforeachvariablein theattempt to muimize the cons.rucr validityof thevariablesof interest,the presentstudyused onlyone measureforeach variable being assesseddueto time constraints.However,as willbe discussedshortly, alltest measureshave beenfound to be both reliable and valid indicatorsof the proposedtheoretical constructs.
~The normalpersonalitydimensionof neuroticismwas assessedusing.13·
item bipolartrait adjectivechecklist taken fromMcCrae andCosta, (1985;see Appendix:A).
35 McCrae&Costa selectedthese items onthe basisof the 13bighestfactor loadingsfor neuroticism.Eachitemwas scored on a e-point scale(whereI<lowon emotionalityand9'"
highonemotionality),Totalneuroticismscoreswere obtainedby summingthescoreson each independentitem.McCrae andCosta foundthatwith respectto internalreliability,coefficient alpha was greate rthan.80. With respectto validity,convergentcorrelationsranged from.5710 .65 and discriminantcorrelations wereless than .25 (McCrae&Costa, 1985).It shouldbe Doted Illalsince this bipolartraitadjectivechecklist.in additiontobeing reliableandvalid, iscomprised of only13 items.dueto time constraints.it waschoseninfavourof otheralsoreliableand valid. yctlengthiermeasuressuchas the NED-PI (Costa&McCrae,1985).
Somaticcomplaints.Somatic complaintswere assessedusingaIz-ltem somatization subscalefromthe HopkinsSymptomChecklist(HSCL;Derogatis,Lipman, Rickels,Uhlenhuth,&
Covi,1974; see AppendixB).The full HSCL scaleconsistsof fivebasic dimensions- somatization,obsessive-compulsive,interpersonalsensitivity, depressionandanxiety.However, sincethepresent studyfocusedonhow neuroticisminfluencesthe relationshipbetweeneustress andsomaticcomplaints,only thesomatizationsubscalewasadministered.Eachitem was scored on I 5-pointscale (where I'"slightor nocomplaintsand5 '" many complaints). Total symptom scoreswere obtainedby summingthescores00each item. The scatebas shownto bebotb valid andreliable (forexample,alpha'" .87; Derogatisetel.,1974).
~Positive event.rweremeasuredwitha 53-itemuplifts measure(DeLongis, Folkman,&Lazarus, 1988;SeeAppendixC).Thisscaleis a thoroughly revised version oftbe uplifts scaleusedinprior research (Le.,Kanneret al.,1981).Inthis revisedversion,inthe attempt to avoidaconfoundbetween uplifts andbealth,redundant items andwordsthai
36 suggested somaticsymptomswereeliminated.Inorderto avoida confound betw eenessess ing upliftsandpositiveaffect.the present study focusedonanobj ective measureofu pl iftsRsopposed to a subjectiveratingassessment. Thus,thepresentstudywasinterested inthe fre quencyas opposed to the intensityofthe uplifts,where thenumberof itemsindicat edas beinganuplift(Le.•
any upliftitem rated higherthan 0),indepe n dent of intensity,thatis,independentofthe actual valueassignedto theite m. weresummedto gether to producea lolal upliftssco re . Thescalehas been showa todemonstrategood reliability andvalidity( DeL ongiset al.,1988).
Posjtive affect.To assesspositiveaffect,aIO· itempositiveaffect (PA) scalefromthe Positive andNegativeAffectScale (PANA S;Watson,Clark.&Tellegen,1988) wasadministered (See Appendix D).Eacb item was scoredonaSpointscale (whereI=lowpositiveaffect andS
.: higbpositiveaffect). Totalscoreswere obtained by summingeachindividualscore onthe
items. The scalehasbeensho\>lnto bebothreliable(e.g.,coefficientalpha range s from.8 6 10 .90) and blghlyvalid(convergent ccrrelatiousrangefrom.89to.95 and discrimin antcorr elations range from-.02 to-.18;Watsonetat,1988).
Test measureswereadministeredtosubjectsintwophases,spacedtwo weeksapa rt.
~.The phaseone datacollection periodtoo kplacebetween Feb ruary22.1995 and March 3,1995.Pa rticipation wassolelyonIvoluntarybasis andsubjectswe reloldthey were free to withdraw from the studyal anytime.Subjects Weregiven an infonn edconsent form (seeAppendixE) andwerereassuredthataUinformatiollobtainedwouldremain anonymousand thatsubject'sinvolvementwouldin noway influencetheirco ursegrade.S:lbjectswere also given
37 anidentificationcode viaa code-generatorsheet(seeAppendixF),inor de rto matchthedata obtainedinthe twophases.It should be notedthatthe purposeofthccodewasstrictlyto enable theresear cher to matchthe dataobt a inedin phaseonewil~thedataobta inedinpbasetwo,and complet elyretained fullanonymityof allsubjects.Inphase one, twolestorders were randomly administered tothestudents,Subjec tsweregivenone ofthefollowing twotestordersrand omly selected fr oma poolDrS!=120possible lestorders: (a)Hopkin s SymptomChecklist (to statisticallycontro lfcrfheeffects ofbaseline somaticdistress or symptomatology); The positive andnegativeaffectscale; Bipolar trait adjectivechecklist;infonnationconcerningdemograp hics (in orderco statisticallycontrolfor any confoundingeffects ofgenderon symptomatology);and TheUpliftsscale,and(b)ThePositiveandNegativeAffectScale;demographicinformation;The UpliRsscale;Dipolartraitadjectivechecklist; andHopkinsSymptomChecklist.
~.Thephasetwodata collectionperiod took placebetween March10,1995 RJld March 17,199:'. Subjectsineachclass weregiventhe phasetwo measures exactly twoweeks aftertheyccnpteted thephaseonemeasures.Againsubjectswere informedISto the volun tary natureof the study andreassuredoffullanonymity.Individualscompletedtheinformed consent formwhichWIS identicaltotheoneadministere dinPh aseone,andcodegeneratorsheet(see AppendixG).Inphasetwo,twotest ordersweregivento subjects.In thisphasethefollowing twoorde rsnndomlyselectedfromapoolof 41'"24possibletest orders wereadministered:(a) HopkinsSymptomChecklist;ThePositiveandNegative AffectScale;demographic information;
andTheUpliftsscale,and (b)ThePositiveandNegativeAffectscale;TheUpliftsscale;Ho pkins SymptomChecklist;anddemographicinformation. Completio noftest measurestoo k appromn.atcly15minutes.
3B Resul U
Preliminary Data ScreeningandDescrinciyeStatisticS
Histogram frequencie sorallva ri ables werecomputed. Thesereveale d lhatasmallnumber of outlierswerepresent withrespecttothe UpliftsmeasureassessedIItimez,thepositivemo od measure(PANAS)attime2.aoddu:symptomsmeasure(Hopkinssymptom checklist)attime2. Previousresearch ha s shewnthat outlierscanhave asevere impactontheinterpretationofresults obtainedfromregre s sionana lyses,sincetheyinflueacethedelenninaliooofoneof several regressionlines10be utilized(Tabachnik&Pldell, 1989) . Oneprocedurerecommended for reducingtheimpact ofourliers,isto alter tbedeviant scoreoCthe variablesuch that itis either oneunitabo v eor bel owthe nextextremescore(Tabacb.nik&.Fide ll, 1989 ).Transfonned distrib utionsoft hevariables containingoutlierswerecalculated usingIbisprocedure. These tran sformeddistributions subsequently revealedthatall pointsfell withinthedistributionfor up lift s( time 2),mood(lime2)andsymptoms(t ime 2)andnopoin tsweredetachedftomt heir distributions.Themeans,standarddeviationsandalpha coefficient sforaUvariables arcpresented inTableI.
Becausemultipleregressionwasused in tbemainanalyses,theregressiollas swnp tio n sof normality,linea rity,andbom oscedastic itywereassessed.lUstogram ftequenciesrevealed substantialskeweddistributions forsymptomsattimeI (z=7.62, p<.OI),andsympt o msat time2 (z=US,p< .OI).Inadditio n,sCitlerp lotanalysesreveal ed viola t ioosof linc arityand hcm oscedasttdty asscnetionsfOTsymptoms(time I)andsymptoms(time2).Tabac hnik&.FidcJl (198 9) recommendthattransformatio nsshouldbe carrie douton non-normalandno n - linear distributionssincesucbdistributionsviolate assumptionsof regressionanalysis(Tab a chnik&
Tablc I
Intercorrdationsanddcscriptivestatisticsforallvariables
2 10
Sex(Tl)
SeK(T2) .9 9 Age ffl) -.02 -.0 1 Age (T2) -. 0 2 -.01 .99 Symptoms (Tl) .18 .17 -.08 -.07
Symptoms(T2l.09 .0 9 ..12 ·.12 .49
UpUfts(Tl) .18 .19 -.01 ,00 .06 .01
Uplills(T2) .2 5 .2 4 ,01 ,02 ,19 ,0' .82 Mo,d( Tl) .0 0 ·.0 0 -.03 -.04 -.27
-.1'
.2 1 -.0410. Mo, d(T2) .01 .0 1 ,07 .07 -.20 -.32 .2 6 .13 ,54
11, Neuroticis m .11 .10 -.02 .03 .40 .30 -.0 7 .03 -,39 -.25
MelDS 20.6 3 20.70 19,28 17.8332.10 32.1032.01 32:02 57.14 Standard 2.54 2.16 5.21 4.93 7.9S8.3 5 6.07 6.S6 14.62 deviations
alpba(o<.) .73 .77 .88 ,90 ,S! .89 .88
H2JJ:;.p<.05forserr e latieus=.19;P<.O!forcomlation s "'·.39to.1f9.
39 Fidell,1989~Estimatesofstatisticalsigni6c.Dcefor nce-eoenet\,.rlablesarcknown tobe biased.andDOD-linearn:lations.mongvariablesmayalsopose seriousproblemsdue toIpossible underorQ\'ttestimationofvarilbles (Biddle&Mlrlin.t987). HCMa'Cr.thisrecommend.tio nis notunivenaUyac c epted (Kenny,1979).Ingeneralsome researchershave'fJUedthatanalyses fromtra nsformedvariable s maybemoredifficulttoint c flIrel (Ta blchalk&Fidell,1989).Thus.
initialexploralory. stepwise.hierarchicalIndpathana lyseswereperfonnedforboth non- lrlnsfonneddataandtransformedvariables.Inallcase smuhswereessentiaDyidentical.Hence, onlytheresultsfornon-rransfhrmeddata will bepresented.Anydifferencesconcerningtile transfo rmeddata will beindicated.
ConceptU1lizatio D ofeustress
Itwaspredictedth.tpositiveaffectissignifican tly predictedfrom uplifts.Thepositive affectarisillg fromuptiftswiI1beco nteptualizedaseustreerortbepresen tstUdy.Toassessthe ecsressceecept,positivemoodatbothIUneIandtime2",'asregressedusiagSlep wise regressiononthe followingnriables.,sex(timel],symploms(tUncI),uplifts(limeI) IlId neuroti cism.
Resulls indicatedthaiuplifts(timeI) signi6can t lypredietedbothmood(timeI),p<.OS, andmood (time2), p<.OI(seeTlble2).
Thus.forpurposes orthepreseetstudy,concept ulli.tingeuaressas tbe positive affect arisiug fromposit iveeventsappears10bea validassumption.
