PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN Williams et al. / NEUROTICISM AND SYMPTOM REPORTS Examination of the Neuroticism–Symptom Reporting Relationship in Individuals With Type 2 Diabetes Paula G. Williams Washington State University Craig R. Colder State University of New York at Buffalo James D. Lane Cynthia C. McCaskill Mark N. Feinglos Richard S. Surwit Duke University Medical Center The current study utilized a within-subject, experience sampling methodology (ESM) to examine the relationship between neuroticism (N) and physical symptom reports. Individuals with type 2 diabetes monitored diabetes-related symptoms, rated negative and positive affect (NA and PA), estimated their blood glucose (BG) levels, and tested their actual BG levels with a glucometer four times per day for 7 days. Multilevel modeling analyses indicated that N, NA, and PA were related to reported symptom frequency. Neuroticism moderated the relation between PA and symptom reports: Lower PA was more strongly related to symptom reports among high-N individuals. In addition, there was evidence that symptoms mediated the relationship between N and state NA. Finally, N was related to overestimation of BG, beyond that accounted for by state NA. Results are discussed with respect to potential effects of N on the processing of negative self- relevant information and on self-regulatory behavior in health contexts. In recent years, a major focus of research on personality and health has been on the relationship between neuroticism (N) and other anxiety-related dispositions (e.g., trait anxiety, trait negative affectivity [NA]) and both self-assessed and objective health. Initial reports on these relationships (e.g., Costa & McCrae, 1987; Watson & Pennebaker, 1989) noted that N may bear a stronger relationship to perceptions of health status than to actual health status. One consequence of this sugges- tion, however, has been a shift toward conceptualizing N as a “confound” in health research and controlling for it statistically. Certainly, in some instances, controlling for the effects of N is warranted. However, further research is still needed to fully understand the mechanisms by which N is related to both objective and subjective health. A second consequence of previous research on the relation between N and symptom reports has been a ten- dency to dismiss the utility of self-report measures of health. Whereas the accuracy of self-report measures of health status compared to “objective” (e.g., immune functioning) measures warrants evaluation, one can argue that self-report measures are important in their own right, regardless of their veridicality. After all, when we make important self-care decisions (e.g., when to take medication, when to go to a physician, when to stay home from work) we use our subjective impression of our health and rarely do we check it against an objective measure. Moreover, the manner in which we describe our health to practitioners affects diagnosis and treat- 1015 Authors’ Note: Portions of these data were presented at the 21st annual meeting of the Society of Behavioral Medicine, April 2000, Nashville, Tennessee. This research was supported by a National Research Service Award (Grant 5T32-MH-19109) and National Institute of Health Grants 1 R01 DK 49066 and K05 MH00303. One-Touch II blood glu- cose meters were provided by Lifescan, Inc., Milpitas, California. Thanks to Greg Bailey, Irena Persky, Cori Scalzo, Michelle Wasserman, and Venette Westhoven for assistance with data entry and checking. Special thanks to Don Hedeker for invaluable advice on multilevel modeling. Correspondence concerning this article should be ad- dressed to Paula G. Williams, Department of Psychology, Washington State University, Pullman, WA 99164-4820; e-mail: pwillms@wsu.edu. PSPB, Vol. 28 No. 7, July 2002 1015-1025 © 2002 by the Society for Personality and Social Psychology, Inc.