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Conceptualization, Measurement, and Analysis of Negative Affective Risk Factors

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Handbook of Behavioral Medicine

Abstract

A variety of negative affective characteristics have been studied as risk factors for the onset and course of physical illness. Symptoms of anxiety, depression, and anger, related personality traits, and related diagnosable disorders have most often been studied one at a time in this research. Given well documented and substantial associations among anxiety, depression, and anger, and among symptoms, traits, and disorders, effects of any one affective risk factor on health outcomes could reflect (1) the specific characteristic assessed, (2) a related but unmeasured characteristic, or (3) a general and multi-faceted negative affective characteristic. Moving beyond the “one at a time” approach to negative affective risk factors is essential in the development and implementation of risk-reducing interventions. Empirically supported conceptual models of the domain of negative affective risk factors are an essential guide to measurement and quantitative analysis in psychosocial research on the role of these risk factors in the development and course of disease. This chapter reviews these conceptual, measurement, and analytic issues as considerations in the critical interpretation of prior studies and in the design of future research.

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References

  • Agatisa, P. K., Matthews, K. A., Bromberger, J. T., Edmundowicz, D., Chang, Y. F. et al (2005). Coronary and aortic calcification in women with a history of major depression. Arch Intern Med, 165, 1229–1236.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.

    Google Scholar 

  • Beck, R., & Perkins, T. S. (2001). Cognitive content-specificity for anxiety and depression: A meta-analysis. Cognitive Therapy Research, 25, 651–663.

    Google Scholar 

  • Benton, T., Staab, J., and Evans, D. L. (2007). Medical co-morbidity in depressive disorders Ann Clin Psychiatry, 19, 289–303.

    Article  PubMed  Google Scholar 

  • Bhattacharyya, M. R., and Steptoe, A. (2007). Emotional triggers of acute coronary syndromes: strength of evidence, biological processes, and clinical implications. Prog Cardiovascular Dis, 49, 353–365.

    Article  Google Scholar 

  • Block, J. (1995). A contrarian view of the five-factor approach to personality description. Psychol Bull, 117, 187–215.

    Article  PubMed  CAS  Google Scholar 

  • Boyle, S. H., Michalek, J. E., and Suarez, E. C. (2006). Covariation of psychological attributes and incident coronary heart disease in U.S. Air Force veterans of the Vietnam War. Psychosom Med, 68, 844–850.

    Article  PubMed  Google Scholar 

  • Broman-Fulks, J. J., Ruggerio, K. J., Green, B. A., Kilpatric, D. G., Danielson, C. K. et al (2006). Taxometric investigation of PTSD: data from two nationally representative samples. Behav Ther, 37, 364–380.

    Article  PubMed  Google Scholar 

  • Campbell, D. T., and Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull, 56, 81–105.

    Article  PubMed  CAS  Google Scholar 

  • Carver, C. S., and Harmon-Jones, E. (2009). Anger is an approach-related affect: evidence and implications. Psycho Bull, 135, 183–204

    Article  Google Scholar 

  • Chida, Y., and Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. J Am Coll Cardiol, 53, 774–778.

    Article  Google Scholar 

  • Christenfeld, N. J. S., Sloan, R. P., Carroll, D., and Greenland, S. (2004). Risk factors, confounding, and the illusion of statistical control. Psychosom Med, 66, 868–875.

    Article  PubMed  Google Scholar 

  • Clark, L. A., and Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence taxonomic implications. J Abnorm Psychol, 100, 316–336.

    Article  PubMed  CAS  Google Scholar 

  • Cole, D. A., Peek, L. G., Martin, J. N., Truglio, R., and Seroczynski, A. D. (1998). A longitudinal look at the relation between depression and anxiety in children and adolescents. J Consult Clin Psychol, 66, 451–460.

    Article  PubMed  CAS  Google Scholar 

  • Costa, P. T., Jr., Bagby, R. M., Herbst, J. H., and McCrae, R. R. (2005). Personality self-reports are concurrently reliable and valid during acute depressive episodes. J Affect Dis, 89, 45–55.

    Article  PubMed  Google Scholar 

  • Costa, P. T., Jr., and McCrae, R. R. (1992). NEO-PI-R Professional Manual. Lutz, FL: Psychological Assessment Resources.

    Google Scholar 

  • Coyne, J. C., Pepper, C. M., and Flynn, H. (1999). Significance of prior episodes of depression in two patient populations. J Consult Clin Psychol, 67, 76–81.

    Article  PubMed  CAS  Google Scholar 

  • Coyne, J. C., Thompson, R., & Racioppo, M. W. (2001). Validity and efficiency of screening for history of depression by self-report. Psychological Assessment, 13, 163–170.

    Google Scholar 

  • Dantzer, R, Castanon, N., Lestage, J., Moreau, M., and Capuron, L. (2007). Inflammation, sickness behaviour and depression. In A. Steptoe (Ed.), Depression and Physical Illness (pp. 265–279). Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • De Fruyt, F., Van Leeuwen, K., Bagby, R. M., Rolland, J. P., and Rouillon, F. (2006). Assessing and interpreting personality change and continuity in patients treated for major depression. Psychol Assess, 18, 71–80.

    Article  PubMed  Google Scholar 

  • Dumenci, L., and Windle, M. (1996). A latent trait-state model of adolescent depression using the Center for Epidemiologic Studies Depression Scale. Multivariate Beh Res, 31, 313–330.

    Article  Google Scholar 

  • ENRICHD Investigators. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction. JAMA, 289: 3106–3116.

    Article  Google Scholar 

  • Eysenck, H. J. (1952). The scientific study of personality. New York: Praeger.

    Google Scholar 

  • Fava, M., Hwang, I., Rush, A. J., Sampson, N., Walters, E. E., and Kessler, R. C. (2009). The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey replication. Mol Psychiatry. doi: 10.1038/mp.2009.20

    Google Scholar 

  • Feldman, L. A. (1993). Distinguishing depression and anxiety in self-report: evidence from confirmatory factor analysis on nonclinical and clinical samples. J Consul Clin Psychol, 61, 631–638.

    Article  CAS  Google Scholar 

  • Frasure-Smith, N., and Lesperance, F. (2003). Depression and other psychological risks following myocardial infarction. Arch Gen Psychiatry, 60, 627–636.

    Article  PubMed  Google Scholar 

  • Frasure-Smith, N., and Lespérance, F. (2008). Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry, 65, 62–71.

    Article  PubMed  CAS  Google Scholar 

  • Goodwin, R. D., Davidson, K. W., and Keyes, K. (2009). Mental disorders and cardiovascular disease among adults in the United States. J Psychiatric Res, 43, 239–246.

    Article  Google Scholar 

  • Grossardt, B. R., Bower, J. H., Geda, Y. E., Colligan, R. C., and Rocca, W. A. (2009). Pessimistic, anxious, and depressive personality traits predict all-cause mortality: The Mayo Clinic Cohort Study of personality and aging. Psychosom Med, 71, 491–500.

    Article  PubMed  Google Scholar 

  • Haslam, N. (2007). The latent structure of mental disorders: a taxometric update on the categorical vs. dimensional debate. Curr Psychiatry Rev, 3, 172–177.

    Article  Google Scholar 

  • Izard, C. E. (1991). The Psychology of Emotions. New York: Plenum Press.

    Google Scholar 

  • Kenny, D., and Zautra, A. (1995). The trait-state-error model for multi-wave data. J Consult Clin Psychol, 63, 52–59.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Cocarro, E. F., Favia, M., Jaeger, S., Jin, R. et al (2006). The prevalence and correlates of DSM-IV intermittent explosive disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry, 63, 669–678.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Gruber, M., Hettema, J. M., Hwang, I., Sempson, N. et al (2008). Co-morbid major depression and generalized anxiety disorders in the National Comorbidity Survey follow-up. Psychol Med, 38, 365–374.

    PubMed  CAS  Google Scholar 

  • Ketterer, M. W., Denollet, J., Goldberg, A. D., McCullough, P. A., John, S. et al (2002). The big mush: psychometric measures are confounded and non-independent in their association with age at initial diagnosis of ischaemic coronary heart disease. J Cardiov Risk, 9, 41–48.

    Article  Google Scholar 

  • Kotov, R., Schmidt, N., Lerew, D., Joiner, T., and Ialongo, N. (2005). Latent structure of anxiety: taxometric exploration. Psychol Assess, 17, 369–374.

    Article  PubMed  Google Scholar 

  • Kubzansky, L. D., Cole, S. R., Kawachi, I., Volonas, P., and Sparrow, D. (2006). Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: a prospective study in the normative aging study. AnnBehav Med, 31, 21–29.

    Google Scholar 

  • Kubzanski, L. D., Davidson, K. W., and Rozanski, A. (2005). The clinical impact of negative psychological states: expanding the spectrum of risk for coronary artery disease. Psychosom Med, 67, S10–S14.

    Article  Google Scholar 

  • Lazarus, R. S. (1991). Emotion and Adaptation. New York: Oxford University Press.

    Google Scholar 

  • Lett, H. S., Sherwood, A., Watkins, L, and Blumenthal, J. A. (2007). Depression and prognosis in cardiac patients. In A. Steptoe (Ed.), Depression and Physical Illness (pp. 87–108). Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Linden, W., Phillips, M. J., and Leclerc, J. (2007). Psychological treatment of cardiac patients: a meta-analysis. Eur Heart J, 28, 24, 2964–6.

    Article  Google Scholar 

  • Linke, S., Rutledge, T., Johnson, B., Vaccarino, V., Bittner, V., Cornell, C. et al (2009). Depressive symptom dimensions and cardiovascular prognosis among women with suspected myocardial ischemia. Arch Gen Psychiatry, 66, 499–507.

    Article  PubMed  Google Scholar 

  • Lynam, D. R., Hoyle, R. H., and Newman, J. P. (2006). The perils of partialling: cautionary tales from aggression and psychopathy. Assessment, 12, 328–341.

    Article  Google Scholar 

  • McClosky, M. S., Lee, R., Berman, M. E., Noblett, K. L., and Coccaro, E. F. (2008). The relationship between impulsive verbal aggression and intermittent explosive disorder. Aggress Behav, 35, 51–60.

    Article  Google Scholar 

  • McFall, R. M. (2005). Theory and utility—key themes in evidence-based assessment: comment on the special section. Psychol Assess, 17, 312–333.

    Article  PubMed  Google Scholar 

  • Moffitt, T. D., Harrington, H., Caspi, A., Kim-Cohen, J., Goldberg, D. et al (2007). Depression and generalized anxiety disorder: cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Arch Gen Psychiatry, 64, 651–660.

    Article  PubMed  Google Scholar 

  • Mrocek, D., and Spiro, A. (2007). Personality change influences mortality in older men. Psychol Sci, 18, 371–376.

    Article  Google Scholar 

  • Nicholson, A., Kuper, H., and Hemingway, H. (2006). Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146,538 participants in 54 observational studies. Eur Heart J, 27, 2763–2774.

    Article  PubMed  Google Scholar 

  • Phillips, A. C., Batty, G. D., Gale, C. R., Deary, I. J., Osborn, D. et al (2009). Generalized anxiety disorder, major depressive disorder and their comorbidity as predictors of all-cause and cardiovascular mortality: The Vietnam Experience Study. Psychosom Med, 71, 395–403.

    Article  PubMed  CAS  Google Scholar 

  • Prisciandaro, J., and Roberts, J. (2005). A taxometric investigation of unipolar depression in the National Comorbidity Survey. J Abnormal Psychol, 114, 718–728.

    Article  Google Scholar 

  • Roy-Byrne, P. P., Davidson, K. W., Kessler, R. C., Asmundson, G. J. G., Psych, R. D., Goodwin, R. D. et al (2008). Anxiety disorders and comorbid mental illness. Gen Hosp Psychiatry, 30, 208–225.

    Article  PubMed  Google Scholar 

  • Ruscio, J. Brown, T. A., and Ruscio, A. M. (2009). A taxometric investigation of DSM-IV major depression in a large outpatient sample. Assessment, 16, 127–144.

    Article  PubMed  Google Scholar 

  • Rutledge, T., Reis, S. E., Olson, M. B., Owens, J., Kelsey, S. F. et al (2006). Depression symptom severity and reported treatment history in the prediction of cardiac risk in women with suspected myocardial ischemia: the NHLBI-sponsored WISE study. Arch Gen Psychiatry,63, 874–80.

    Article  PubMed  Google Scholar 

  • Shen, B. -J., Avivi, Y. E., Todaro, J. F., Spiro, A., Laurenceau, J., Ward, K. D., and Niaura, R. (2008). Anxiety characteristics independently and prospectively predict myocardial infarction in men. J Am Coll Cardiol, 51, 113–119.

    Article  PubMed  Google Scholar 

  • Smith, P. N., & Mumma, G. H. (2008). A multiwave web-based evaluation of cognitive content specificity for depression, anxiety, and anger. Cognitive Therapy Research, 32, 50–65.

    Google Scholar 

  • Smith, T. W. (2007). Measurement in health psychology research. In R. Silver & H. S. Friedman (Eds.), Foundations of Health Psychology (pp. 19–51). Oxford, UK: Oxford Press.

    Google Scholar 

  • Smith, T. W., Traupman, E., Uchino, B. N., and Berg, C. A. (2010). Interpersonal circumplex descriptions of psychosocial risk factors for physical illness: application to hostility, neuroticism, and marital adjustment. J Personal, 78, 1011–1036.

    Google Scholar 

  • Smith, T. W., and MacKenzie, J. (2006). Personality and risk of physical illness. Ann Rev Clin Psychol, 2, 435–467.

    Article  Google Scholar 

  • Smith, T. W., Uchino, B. N., Berg, C. A., Florsheim, P., Pearce, G. et al (2008). Self-reports and spouse ratings of negative affectivity, dominance and affiliation in coronary artery disease: where should we look and who should we ask when studying personality and health? Health Psychol, 27, 676–684.

    Article  PubMed  Google Scholar 

  • Steptoe, A. (Ed.). (2007a). Depression and Physical Illness. Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Steptoe, A. (2007b). Depression and specific health problems. In A. Steptoe (Ed.), Depression and Physical Illness (pp. 53–86). Cambridge, UK: Cambridge University Press.

    Google Scholar 

  • Stewart, J. C., Janicki, D. L., Muldoon, M. F. Sutton-Tyrell, K. and Kamarch, T. W. (2007). Negative emotions and 3-year progression of subclinical atherosclerosis. Arch Gen Psychiatry, 64, 225–233.

    Article  PubMed  Google Scholar 

  • Suls, J. and Bunde, J. (2005). Anger, anxiety, and depression as risk factors for cardiovascular disease: the problems and implications of overlapping affective dispositions. Psychol Bull, 131, 260–300.

    Article  PubMed  Google Scholar 

  • Tully, P. J., Baker, R. A. and Knight, J. L. (2008a). Anxiety and depression as risk factors for mortality after coronary artery bypass surgery. J Psychosom Res, 64, 285–290.

    Article  PubMed  Google Scholar 

  • Tully, P. J., Baker, R. A., Turnbull, D., and Winefield, H. (2008b). The role of depression and anxiety symptoms in hospital readmissions after cardiac surgery. J Beh Med, 31, 281–290.

    Article  Google Scholar 

  • Watson, D. (2000). Mood and Temperament. New York: Guilford Press.

    Google Scholar 

  • Watson, D. (2005). Rethinking the mood and anxiety disorders: a quantitative hierarchical model for DSM-V. J Abnormal Psychol, 114, 522–536.

    Article  Google Scholar 

  • Watson, D. (2009a). Differentiating the mood and anxiety disorders: a quadripartite model. Ann Rev Clin Psychol, 5, 221–247.

    Article  Google Scholar 

  • Watson, D. (2009b). Locating anger in the hierarchical structure of affect: comment on Carver and Harmon-Jones (2009). Psychol Bull, 135, 205–208.

    Article  PubMed  Google Scholar 

  • Watson, D., and Clark, L. A. (1984). Negative affectivity: the disposition to experience aversive emotional states. Psychol Bull, 96, 465–490.

    Article  PubMed  CAS  Google Scholar 

  • Watson, D., O’Hara, M. W., and Stuart, S. (2008). Hierarchical structures of affect and psychopathology and their implications for the classification of emotional disorders. Depress Anxiety, 25, 282–288.

    Article  PubMed  Google Scholar 

  • Weinstock, L. M., and Whisman, M. A. (2006). Neuroticism as a common feature of the depressive and anxiety disorders: a test of the revised integrative hierarchical model in a national sample. J Abnormal Psychol, 115, 68–74.

    Article  Google Scholar 

  • Widiger, T. A., and Smith, G. T. (2008). Personality and psychopathology. In O. P. John, R. W. Robbins, & L. A. Pervin (Eds.) Handbook of Personality: Theory and Research, 3rd Ed. (pp. 743–769). New York: Guilford Press.

    Google Scholar 

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Smith, T.W. (2010). Conceptualization, Measurement, and Analysis of Negative Affective Risk Factors. In: Steptoe, A. (eds) Handbook of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09488-5_12

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