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Neuroticism and Somatic Complaints: Concomitant Effects of Rumination and Worry

Published online by Cambridge University Press:  07 November 2018

Andrew Denovan*
Affiliation:
Department of Psychology, Manchester Metropolitan University, Manchester, UK
Neil Dagnall
Affiliation:
Department of Psychology, Manchester Metropolitan University, Manchester, UK
George Lofthouse
Affiliation:
Department of Psychology, Manchester Metropolitan University, Manchester, UK
*
Correspondence to Andrew Denovan, Department of Psychology, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester M15 6GX, UK. E-mail: a.denovan@mmu.ac.uk

Abstract

Background: Neuroticism is associated with inflated somatic symptom reporting. Worry and rumination are a cognitive concomitant of neuroticism and potentially mediate the neuroticism–somatic complaint relationship. Aims: The present study examined the degree to which worry and rumination mediated the relationship between neuroticism and somatic complaints. Method: A sample of 170 volunteers, recruited via convenience sampling, took part. Participants completed a series of self-report measures: the Eysenck Personality Questionnaire Revised-Short Form, Penn State Worry Questionnaire, the Ruminative Response Scale and the Somatic Symptom Scale-8. Results: Analysis revealed significant positive correlations between neuroticism, rumination and worry. Neuroticism, rumination and worry also correlated positively with somatic complaints. Using structural equation modelling, a mediational model indicated that rumination fully mediated the relationship between neuroticism and somatic complaints. Conclusions: Findings are consistent with the symptom perception hypothesis and have implications for healthcare in terms of managing individuals who present with multiple somatic complaints. Future research would benefit from adopting a longitudinal approach to test how rumination interacts with neuroticism and somatic complaints over time.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Addis, M. E. and Martell, C. R. (2004). Ending Depression One Step at a Time: The New Behavioral Activation Approach to Getting Your Life Back. Oakland, CA: New Harbinger.Google Scholar
Anderson, J. C. and Gerbing, D. W. (1988). Structural equation modeling in practice: a review and recommended two-step approach. Psychological Bulletin, 103, 411423. doi: 10.1037/0033-2909.103.3.411Google Scholar
Barlow, D., Ellard, K., Sauer-Zavala, S., Bullis, J. and Carl, J. (2014). The origins of neuroticism. Perspectives on Psychological Science, 9, 481496. doi: 10.1177/1745691614544528Google Scholar
Barsky, A. J., Orav, E. J. and Bates, D. W. (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Archives of General Psychiatry, 62, 903910. doi: 10.1001/archpsyc.62.8.903Google Scholar
Borkovec, T. D. (1994). The nature, functions, and origins of worry. In Davey, G. C. L. and Tallis, F. (eds), Worrying. Perspectives on Theory, Assessment and Treatment (pp. 533). New York, NY: Wiley.Google Scholar
Borkovec, T. D., Ray, W. J. and Stober, J. (1998). Worry: a cognitive phenomenon intimately linked to affective, physiological, and interpersonal behavioral processes. Cognitive Therapy and Research, 22, 561576. doi: 10.1023/A:1018790003416Google Scholar
Borkovec, T. D., Robinson, E., Pruzinsky, T. and DePree, J. (1983). Preliminary exploration of worry: some characteristics and processes. Behaviour Research and Therapy, 21, 916. doi: 10.1016/0005-7967(83)90121-3Google Scholar
Brosschot, J. F. and van der Doef, M. (2006). Daily worrying and somatic health complaints: testing the effectiveness of a simple worry reduction intervention. Psychology and Health, 21, 1931. doi: 10.1080/14768320500105346Google Scholar
Browne, M. W. and Cudeck, R. (1993). Alternative ways of assessing model fit. In Bollen, K. A. and Long, J. S. (eds), Testing Structural Equation Models (pp. 136162). Beverly Hills, CA: Sage.Google Scholar
Cioffi, D. (1991). Beyond attentional strategies: a cognitive-perceptual model of somatic interpretation. Psychological Bulletin, 109, 2541. doi: 10.1037/0033-2909.109.1.25Google Scholar
Claridge, G. and Davis, C. (2001). What's the use of neuroticism? Personality and Individual Differences, 31, 383400. doi: 10.1016/S0191-8869(00)00144-6Google Scholar
Clark, L. A. and Watson, D. (2008). Temperament: an organizing paradigm for trait psychology. In John, O. P. and Robins, R. W. (eds), Handbook of Personality: Theory and Research (3rd edn, pp. 265286). New York, NY: Guilford Press.Google Scholar
Cohen, S., Doyle, W., Skoner, D., Fireman, P., Gwaltney, J. and Newsom, J. (1995). State and trait negative affect as predictors of objective and subjective symptoms of respiratory viral infections. Journal of Personality and Social Psychology, 68, 159169. doi: 10.1037/0022-3514.68.1.159Google Scholar
Coffman, D. L. and MacCallum, R. C. (2005). Using parcels to convert path analysis models into latent variable models. Multivariate Behavioral Research, 40, 235259. doi: 10.1207/s15327906mbr4002_4Google Scholar
Costa, P. T. Jr and McCrae, R. R. (1987). Neuroticism, somatic complaints, and disease: Is the bark worse than the bite? Journal of Personality, 55, 299316. doi: 10.1111/j.1467-6494.1987.tb00438.xGoogle Scholar
Costa, P. T. Jr and McCrae, R. (1992). Four ways five factors are basic. Personality and Individual Differences, 13, 653665. doi: 10.1016/0191-8869(92)90236-IGoogle Scholar
Dagnall, N., Denovan, A., Drinkwater, K., Parker, A. and Clough, P. (2016). Toward a better understanding of the relationship between belief in the paranormal and statistical bias: the potential role of schizotypy. Frontiers in Psychology, 7, 1045. doi: 10.3389/fpsyg.2016.01045Google Scholar
Danielsson, N. S., Harvey, A. G., MacDonald, S., Jansson-Fröjmark, M. and Linton, S. J. (2013). Sleep disturbance and depressive symptoms in adolescence: The role of catastrophic worry. Journal of Youth and Adolescence, 42, 12231233. doi: 10.1007/s10964-012-9811-6Google Scholar
De Gucht, V. and Maes, S. (2006). Explaining medically unexplained symptoms: toward a multidimensional, theory-based approach to somatization. Journal of Psychosomatic Research, 60, 349352. doi: 10.1016/j.jpsychores.2006.01.021Google Scholar
Denovan, A., Dagnall, N., Dhingra, K. and Grogan, S. (2017). Evaluating the Perceived Stress Scale among UK university students: implications for stress measurement and management. Studies in Higher Education, 114. Advance online publication. doi: 10.1080/03075079.2017.1340445Google Scholar
Ehring, T. and Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1, 192205. doi: 10.1521/ijct.2008.1.3.192Google Scholar
Eysenck, S., Eysenck, H. and Barrett, P. (1985). A revised version of the psychoticism scale. Personality and Individual Differences, 6, 2129. doi: 10.1016/0191-8869(85)90026-1Google Scholar
Flint, J. (2004). The genetic basis of neuroticism. Neuroscience and Biobehavioral Reviews, 28, 307316. doi: 10.1016/j.neubiorev.2004.01.004Google Scholar
Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L. and Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: the relationship of cognitive production to negative affective states. Cognitive Therapy and Research, 26, 179188. doi: 10.1023/A:1014517718949Google Scholar
Gierk, B., Kohlmann, S., Kroenke, K., Spangenberg, L., Zenger, M., Brähler, E. and Löwe, B. (2014). The Somatic Symptom Scale-8 (SSS-8). JAMA Internal Medicine, 174, 399407. doi: 10.1001/jamainternmed.2013.12179Google Scholar
Gray, J. A. (1982). The Neuropsychology of Anxiety: An Enquiry into the Functions of the Septo-Hippocampal System. New York, NY: Oxford University Press.Google Scholar
Hecht, D. (2013). The neural basis of optimism and pessimism. Experimental Neurobiology, 22, 173199. doi: 10.5607/en.2013.22.3.173Google Scholar
Hogan, B. E. and Linden, W. (2004). Anger response styles and blood pressure: at least don't ruminate about it! Annals of Behavioral Medicine, 27, 3849. doi: 10.1207/s15324796abm2701_6Google Scholar
Hooper, D., Coughlan, J. and Mullen, M. (2008) Structural equation modelling: guidelines for determining model fit. Electronic Journal of Business Research Methods, 6, 5360.Google Scholar
Howren, M. B. and Suls, J. (2011). The symptom perception hypothesis revised: depression and anxiety play different roles in concurrent and retrospective physical symptom reporting. Journal of Personality and Social Psychology, 100, 182195. doi: 10.1037/a0021715Google Scholar
Hoyer, J., Gloster, A. T. and Herzberg, P. Y. (2009). Is worry different from rumination? Yes, it is more predictive of psychopathology! GMS Psycho-Social-Medicine, 6. doi: 10.3205/psm000062Google Scholar
Jacobs, R. H., Watkins, E. R., Peters, A. T., Feldhaus, C. G., Barba, A., Carbray, J. and Langenecker, S. A. (2016). Targeting ruminative thinking in adolescents at risk for depressive relapse: rumination-focused cognitive behavior therapy in a pilot randomized controlled trial with resting state fMRI. PLOS ONE, 11, e0163952. doi: 10.1371/journal.pone.0163952Google Scholar
Janca, A., Isaac, M. and Ventouras, J. (2006). Towards better understanding and management of somatoform disorders. International Review of Psychiatry, 18, 512. doi: 10.1080/09540260500466766Google Scholar
Jylhä, P. and Isometsä, E. (2006). The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depression and Anxiety, 23, 281289. doi: 10.1002/da.20167Google Scholar
Johnson, M. (2003). The vulnerability status of neuroticism: over-reporting or genuine complaints? Personality and Individual Differences, 35, 877887. doi: 10.1016/S0191-8869(02)00303-3Google Scholar
Lackner, R. J. and Fresco, D. M. (2016). Interaction effect of brooding rumination and interoceptive awareness on depression and anxiety symptoms. Behaviour Research and Therapy, 85, 4352. doi: 10.1016/j.brat.2016.08.007Google Scholar
Lam, D., Smith, N., Checkley, S., Rijsdijk, F. and Sham, P. (2003). Effect of neuroticism, response style and information processing on depression severity in a clinically depressed sample. Psychological Medicine, 33, 469479. doi: 10.1017/S0033291702007304Google Scholar
Lauriola, M. and Iani, L. (2015). Does positivity mediate the relation of extraversion and neuroticism with subjective happiness? PLOS ONE, 10, e0121991. doi: 10.1371/journal.pone.0121991Google Scholar
Magnus, K., Diener, E., Fujita, F. and Pavot, W. (1993). Extraversion and neuroticism as predictors of objective life events: a longitudinal analysis. Journal of Personality and Social Psychology, 65, 10461053. doi: 10.1037/0022-3514.65.5.1046Google Scholar
Marcus, D. K., Hughes, K. T. and Arnau, R. C. (2008). Health anxiety, rumination, and negative affect: a mediational analysis. Journal of Psychosomatic Research, 64, 495501. doi: 10.1016/j.jpsychores.2008.02.004Google Scholar
McLaughlin, K. A. and Nolen-Hoeksema, S. (2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49, 186193. doi: 10.1016/j.brat.2010.12. 006Google Scholar
Meyer, T., Miller, M., Metzger, R. and Borkovec, T. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487495. doi: 10.1016/0005-7967(90)90135-6Google Scholar
Miers, A. C., Rieffe, C., Terwogt, M. M., Cowan, R. and Linden, W. (2007). The relation between anger coping strategies, anger mood and somatic complaints in children and adolescents. Journal of Abnormal Child Psychology, 35, 653664. doi: 10.1007/s10802-007-9120-9Google Scholar
Muris, P., Roelofs, J., Meesters, C. and Boomsma, P. (2004). Rumination and worry in non-clinical adolescents. Cognitive Therapy and Research, 28, 539554. doi: 10.1023/B:COTR.0000045563.66060.3eGoogle Scholar
Muris, P., Roelofs, J., Rassin, E., Franken, I. and Mayer, B. (2005). Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Personality and Individual Differences, 39, 11051111. doi: 10.1016/j.paid.2005.04.005Google Scholar
Neeleman, J., Bijl, R. and Ormel, J. (2004). Neuroticism, a central link between somatic and psychiatric morbidity: path analysis of prospective data. Psychological Medicine, 34, 521531. doi: 10.1017/S0033291703001193Google Scholar
Neeleman, J., Sytem, S. and Wadsworth, M. (2002). Propensity to psychiatric and somatic ill-health: evidence from a birth cohort. Psychological Medicine, 32, 793803. doi: 10.1017/S0033291702005901Google Scholar
Nigg, J. T., Nikolas, M., Miller, T., Burt, S. A., Klump, K. L. and von Eye, A. (2009). Factor structure of the Children's Perception of Interparental Conflict Scale for studies of youths with externalizing behavior problems. Psychological Assessment, 21, 450456. doi: 10.1037/a0016564Google Scholar
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569582. doi: 10.1037/0021-843X.100.4.569Google Scholar
Nolen-Hoeksema, S. (1998). Ruminative coping with depression. In Heckhausen, J. and Dweck, C. S. (eds), Motivation and Self-Regulation Across the Life Span (pp. 237256). New York, NY: Cambridge University Press.Google Scholar
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504511. doi: 10.1037/0021-843X.109.3.504Google Scholar
Ozer, D. and Benet-Martínez, V. (2006). Personality and the prediction of consequential outcomes. Annual Review of Psychology, 57, 401421. doi: 10.1146/annurev.psych.57.102904.190127Google Scholar
Pennebaker, J. (1982). The Psychology of Physical Symptoms. New York, NY: Springer-Verlag. doi: 10.1007/978-1-4613-8196-9Google Scholar
Rosmalen, J., Neeleman, J., Gans, R. and de Jonge, P. (2007). The association between neuroticism and self-reported common somatic symptoms in a population cohort. Journal of Psychosomatic Research, 62, 305311. doi: 10.1016/j.jpsychores.2006.10.014Google Scholar
Ryckman, N. A. and Lambert, A. J. (2015). Unsuccessful suppression is associated with increased neuroticism, intrusive thoughts, and rumination. Personality and Individual Differences, 73, 8891. doi: 10.1016/j.paid.2014.09.029Google Scholar
Scheuren, R., Sütterlin, S. and Anton, F. (2014). Rumination and interoceptive accuracy predict the occurrence of the thermal grill illusion of pain. BMC Psychology, 2, 22. doi: 10.1186/2050-7283-2-22Google Scholar
Segerstrom, S., Tsao, J., Alden, L. and Craske, M. (2000). Worry and rumination: repetitive thought as a concomitant and predictor of negative mood. Cognitive Therapy and Research, 24, 678688. doi: 10.1023/A:1005587311498Google Scholar
Steimer, T. (2002). The biology of fear-and anxiety-related behaviors. Dialogues in Clinical Neuroscience, 4, 231249.Google Scholar
Suls, J. and Martin, R. (2005). The daily life of the garden-variety neurotic: reactivity, stressor exposure, mood spillover, and maladaptive coping. Journal of Personality, 73, 14851510. doi: 10.1111/j.1467-6494.2005.00356.xGoogle Scholar
Thompson, B. and Melancon, J. G. (1996). Using Item “Testlets”/“Parcels” in Confirmatory Factor Analysis: An Example Using the PPSDQ-78. ERIC Document No. ED 404 349.Google Scholar
Thomsen, D. K., Mehlsen, M. Y., Olesen, F., Hokland, M., Viidik, A., Avlund, K. and Zachariae, R. (2004). Is there an association between rumination and self-reported physical health? A one-year follow-up in a young and an elderly sample. Journal of Behavioral Medicine, 27, 215231. doi: 10.1023/B:JOBM.0000028496.41492.34Google Scholar
Tiwari, S., Verma, P. C., Singh, P. K. and Tuli, R. (2009). Plants as bioreactors for the production of vaccine antigens. Biotechnology Advances, 27, 449467. doi: 10.1016/j.biotechadv.2009.03.006Google Scholar
Treynor, W., Gonzales, R. and Nolen-Hoeksema, S. (2003). Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research, 27, 247259. doi: 10.1023/A:1023910315561Google Scholar
Tylee, A. and Gandhi, P. (2005). The importance of somatic symptoms in depression in primary care. Primary Care Companion to the Journal of Clinical Psychiatry, 7, 167176. doi: 10.4088/PCC.v07n0405Google Scholar
Villemure, C. and Bushnell, C. M. (2002). Cognitive modulation of pain: how do attention and emotion influence pain processing? Pain, 95, 195199. doi: 10.1016/S0304-3959(02)00007-6Google Scholar
Watkins, E. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 163206. doi: 10.1037/0033-2909.134.2.163Google Scholar
Watkins, E. and Moulds, M. L. (2007). Reduced concreteness of rumination in depression: a pilot study. Personality and Individual Differences, 43, 13861395. doi: 10.1016/j.paid.2007.04.007Google Scholar
Watkins, E., Scott, J., Wingrove, J., Rimes, K., Bathurst, N., Steiner, H., Kennell–Webb, S., Moulds, M. and Malliaris, Y. (2007). Rumination-focused cognitive behaviour therapy for residual depression: a case series. Behaviour Research and Therapy, 45, 21442154. doi: 10.1016/j.brat.2006.09.018Google Scholar
Watson, D. and Pennebaker, J. (1989). Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychological Review, 96, 234254. doi: 10.1037/0033-295X.96.2.234Google Scholar
Williams, P. G., O'Brien, C. D. and Colder, C. R. (2004). The effects of neuroticism and extraversion on self-assessed health and health-relevant cognition. Personality and Individual Differences, 37, 8394. doi: 10.1016/j.paid.2003.08.001Google Scholar
Yang, M., Kim, B., Lee, E., Lee, D., Yu, B., Jeon, H. and Kim, J. (2014). Diagnostic utility of worry and rumination: a comparison between generalized anxiety disorder and major depressive disorder. Psychiatry and Clinical Neurosciences, 68, 712720. doi: 10.1111/pcn.12193Google Scholar
Zhao, X., Lynch, J. G. and Chen, Q. (2010). Reconsidering Baron and Kenny: myths and truths about mediation analysis. Journal of Consumer Research, 37, 197206. doi: 10.1086/651257Google Scholar
Zhong, J., Wang, C., Li, J., and Liu, J. (2009). Penn State Worry Questionnaire: structure and psychometric properties of the Chinese version. Journal of Zhejiang University Science B, 10, 211218. doi: 10.1631/jzus.B0820189Google Scholar
Zoccola, P. M. (2010). Prolonging the Physiological Stress Response: The Role of Rumination and Recall. University of California, Irvine.Google Scholar
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