Neuroticism, coronary artery disease, and chest pain complaints: Cross-sectional and longitudinal studies

Cardiovascular disease increases with age, but some of the factors thought to be related to CAD, including the personality disposition of neuroticism, show a pattern of lifelong stability. In the present paper, chest pain reports and other CAD symptoms are analyzed in the context of a model of personality and health which emphasizes the role of the enduring disposition of neuroticism as a determinant of perceptions of health. In the first study, the association between chest pain complaints and psychological distress measured by depression and low general well-being is documented for both sexes and for age groups from 25 to 74 in a national sample. Chest pain complaints increased with age, but an hypothesized age by chest pain group interaction was not found. In the second study, the direction of the causal connection is investigated in a longitudinal retrospective-predictive study of CAD diagnoses in a sample of 123 men followed for periods of up to 20 years. Personality variables did not predict the development of CAD, but emotional instability and diffuse somatic complaints were predictive of anginal diagnoses in subjects who showed no other signs of CAD. Alternate interpretations of the differential prediction of anginal complaints from neuroticism are discussed.