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

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Abstract
Objective: To examine the roles of depressive symptomatology and neuroticism/negative affect (N/NA) on common physical symptom reporting in a sample of community residents. Methods: Community-residing women (n = 108) participated in a combined concurrent-retrospective design. Physical symptoms were assessed concurrently over 21 consecutive days followed by a retrospective assessment of the collective symptom experience for the same time period. Results: Based on evidence of differences in cognitive processing of emotion-relevant material, we predicted and found that depressive symptomatology (at baseline) was a stronger predictor of inflated physical symptom recall than N/NA. Depressive symptomatology was also a stronger, independent predictor of concurrent physical symptoms. Notably, these results were obtained even when physical depressive symptoms in both the physical symptom checklist and the baseline depression assessment were eliminated. Conclusions: The results suggest that the classic symptom perception hypothesis should be refined and operationalized in terms of depressive symptomatology rather than N/NA. This study demonstrates how cognitive-affective processing differences associated with depressive symptomatology can shed additional light on the psychology of symptom perception. Implications for treatment seeking, medical diagnoses, and treatment decisions are discussed. BDI = Beck Depression Inventory; N = neuroticism; NA = negative affect; NEO-PI-R = Revised NEO Personality Inventory; SPH = symptom perception hypothesis.