Deborah J. Wiebe

Health practices and hardiness as mediators in the stress-illness relationship.

Two stress and illness models that include the joint mediating effects of health practices and hardiness were tested prospectively over a 2-month period. At the beginning of one academic quarter, 60 female and 26 male undergraduate students completed five subscales indexing hardiness. Stress, health practices, and illness for the prior month were assessed at this time as well as 1 and 2 months later. Stress was measured by the number of negatively rated stressors reported on the Life Experiences Survey. Health practices were measured by the Self Care Inventory. In the first model, illness was measured by the severity of physical symptoms reported on the Seriousness of Illness Rating Scale; in the second model, it was measured by the number of symptoms reported. Correlations between all measures of stress and illness were typical for life events research (r = .22 to .29). In both models, path analyses revealed that stress acted directly to affect illness as well as indirectly by changing health practices. Hardiness also had a direct effect on illness as well as in indirect effect through health practices. Hardiness did not appear to have a stress-buffering effect on illness; rather, its effects on illness appeared to be independent of its effects on stress. Implications for life events research are discussed.

Hardiness and stress moderation: a test of proposed mechanisms.

High and low hardy male and female undergraduates completed an evaluative threat task that was manipulated to influence appraisals of the task in a manner consistent with hardiness theory. High hardy subjects displayed higher frustration tolerance, appraised the task as less threatening, and responded to the task with more positive and less negative affect than did low hardy subjects. Although all subjects displayed increased heart rate (HR) in response to the experimental task, high hardy men displayed lower HR elevations during the task than did low hardy men. Hardiness did not influence HR responses among women. Manipulations of task appraisal revealed a similar pattern where men in the high hardiness appraisal conditions displayed lower levels of physiological arousal during the task than did men in the low hardiness appraisal conditions. Appraisal manipulations had either no effect or the opposite effect among women.

Self-regulating interest: the moderating role of hardiness and conscientiousness.

Sansone, Weir, Harpster, and Morgan (1992) found that individuals intentionally regulated their interest in an activity when they had both the need (the task was boring) and a reason to exert the effort (an ostensible health benefit). The present study examined Hardiness and Conscientiousness as moderators of this self-regulatory process when individuals had the option of quitting in addition to the options of persisting and of engaging in interest-enhancing strategies. Undergraduates performed a boring copying activity under instructions to stop when they felt they could evaluate the task. Half were told that their evaluations would help researchers develop good jobs for others (Benefit). Results indicated high hardy individuals copied more letters when they were provided the additional Benefit information, and this effect was mediated through their attempt to make the task more interesting. High conscientious individuals persisted longer than individuals lower in conscientiousness independently of the benefit manipulation or strategy use. Implications of individual differences in self-regulation of motivation are discussed.

Coping processes as mediators of the relationship between hardiness and health.

Hardiness has been hypothesized to moderate the impact of stress on health by influencing coping responses, but little attention has been focused upon these associations. This study examined the relationship among hardiness, coping, and illness while attending to recent criticisms of the hardiness literature including the potential overlap with neuroticism, whether hardiness is a unitary construct, and the predominant use of male samples. Hardiness was found to be positively related to adaptive coping variables and negatively related to maladaptive coping variables. Problem-focused, support-seeking, and avoidant coping were found to mediate the hardiness-illness relationship. Although these hardiness-coping relationships were partially independent of the influence of neuroticism, the relationship of both coping and hardiness with self-reported illness appeared to result from the common influence of neuroticism. Consistent with previous research, the commitment and control components correlated most consistently with coping variables, and predicted hardiness effects were most consistently demonstrated for males.

Life events, fitness, hardiness, and health: A simultaneous analysis of proposed stress-resistance effects.

The effects of exercise participation, self-perceived fitness level, and dispositional hardiness for promoting stress resistance were examined in a sample of 373 college students. Self-report measures of stressful life experience and recent physical illness were positively correlated, and fitness and hardiness were negatively correlated with illness as expected. Multiple regression analyses indicated that neither fitness nor hardiness provided a stress-moderator effect because neither was found to significantly interact with stress in the prediction of illness scores. Structural equation analyses suggested that hardiness may affect health indirectly by first influencing either the occurrence or subjective interpretation of stressful life events. No direct effect on health was found for exercise participation, although exercise may reduce illness indirectly by improving fitness. Implications for the multivariate modeling of proposed stress-resistance-enhancing effects are discussed.

Individual differences in self-assessed health : Gender, neuroticism and physical symptom reports

The current study utilized a path analytic strategy to examine the relationship between gender, neuroticism (N) and physical symptom reports. Trait self-focused attention and state negative affect (NA) were included as potential mediators. Results indicated that both gender and N have significant direct effects on symptom reports when considered in the same model. State NA partially mediated the relationship between N and symptom reports. Trait self-focused attention partially mediated the effects of N on symptom reports for women but not men. Findings are discussed with respect to the information processing aspects of individual differences in self-assessed health and directions for future research are suggested.

Parent-adolescent discrepancies in adolescents' competence and the balance of adolescent autonomy and adolescent and parent well-being in the context of Type 1 diabetes.

This study examined whether intrafamily discrepancies in perceptions of the adolescents competence and independence were associated with autonomy and well-being for adolescents and parents. The ways in which mothers and fathers consistently differed from their adolescent across measures of independence and competence regarding Type 1 diabetes, a stressful context for families, were examined with the latent discrepancy model. A sample of 185 adolescents (mean age = 12.5 years, SD = 1.3), their mothers, and participating fathers completed measures of the adolescents independence in completing diabetes tasks, problems with diabetes management, adherence to the medical regimen, measures of well-being, and metabolic control. The latent discrepancy model was conducted via structural equation modeling that generated latent discrepancies from the adolescent for mothers and fathers. Both mothers and fathers viewed the adolescents competence more negatively than did the adolescent. These discrepancies related to more parental encouragement of independence and adolescent autonomy but also to poorer metabolic control and poorer parental psychosocial well-being. The results are interpreted within a developmental perspective that views discrepancies as reflecting normative developmental processes of autonomy but as being associated with disruptions in well-being in the short term.

Chapter 34 – Personality and Health: Progress and Problems in Psychosomatics

Publisher Summary This chapter focuses on the four models that are developed to explain the processes by which personality may influence health. Multiple models are often utilized to explain the way a specific personality dimension may be related to health. Many approaches to personality and health assign a central role to the concept of stress, which has been widely implicated in the development of disease. Demonstrated stress-illness relations are quite weak. The stress-moderation model assumes that stress causes illness and that dispositional factors make one more or less vulnerable to its pathogenic effects. Stress-moderation model is limited in some respects. Although the straightforward approach is appealing, researchers have generally been unable to identify stable categories of coping responses that are consistently adaptive or maladaptive. In contrast to the direct physiological linkages of the stress-moderation model, the health behavior model proposes that personality affects health via the quality of ones health practices. Health behaviors are increasingly recognized as contributing to the association between personality and disease. Constitutional predisposition model posits that individuals may be genetically predisposed to certain patho-physiological processes that influence both the development of subsequent illness and the behavioral, cognitive, and emotional aspects of measured personality. In illness behavior model, personality is hypothesized to affect illness behavior rather than actual illness. Illness can be defined as the presence of objectively measured patho-physiological processes— such as high blood pressure, documented organic disease, or death. Illness behavior refers to actions people take when they perceive themselves as ill.

A preliminary measurement of the surgical personality

BACKGROUND We used the Revised NEO Personality Inventory (Psychological Resources, Inc.) to test for a distinct surgical personality. METHODS The NEO-PI-R is a compilation of 240 statements. Subjects agree or disagree with the statements, generating a score in five personality traits according to the five factor theory: neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). Each score is compared with that for the general population. RESULTS Twenty-four male and 15 female surgical residents voluntarily took the inventory. Compared to the general population, males scored lower in N (p <0.05), higher in E (P <0.001), O (P <0.05) and C (p <0.001), and average in A (no significant difference). Females scored average in N and A (no significant difference), and higher in E (p <0.001), O (P <0.05), and C (P <0.001). CONCLUSIONS The similarity of trait variance from the general population in both male and female surgical residents supports the concept of a surgical personality.

Gender differences in adherence to type 1 diabetes management across adolescence: The mediating role of depression

This study examined whether gender differences in adherence and metabolic control among adolescents with type 1 diabetes are mediated by depression. In a sample of 127 adolescents with type 1 diabetes (ages 10 to 15 years), gender interacted with age to predict symptoms of depression and adherence, but did not interact to predict metabolic control. Among girls, age was associated with higher depression and poorer adherence; among boys, age-related associations were weaker or in the opposite direction. Moderated mediation analyses revealed that depression partially mediated the Gender × Age interaction predicting adherence. Clinical implications of viewing depression as a risk factor for poor diabetes management among adolescent females are discussed.