The role of personality, coping style and social support in health-related quality of life in HIV infection A.P. Burgess, M. Carretero, A. Elkington, E. Pasqual-Marsettin, C. Lobaccaro & J. Catala n Division of Neuroscience and Psychological Medicine, Imperial College of Science, Technology & Medicine, London, UK Accepted in revised form 14 June 2000 Abstract Objective: To determine the role of health status, personality and coping style, on self-report health-related quality of life (QoL). Methods: Participants were HIV seropositive individuals at all disease stages from three samples (a) gay/bisexual men from the UK, (b) injecting drug users from the UK, (c) injecting drug users from Italy. All participants completed questionnaires evaluating QoL, personality, coping style and social support. Explicit models of the relationships between the measured variables based on a review of the literature were tested using structural equation modelling. Results: Health status was modestly associated with the physical but not the psychological aspects of QoL (b = 0.44). Neuroticism was strongly associated with psychological QoL (b = )0.73) but only weakly with physical QoL (b = )0.21). The samples did not dier in either the pattern or the magnitude of these relationships. Mediating factors such as coping style, social support and other personality variables had only a weak in¯uence on the role of Neuroticism. Conclusions: Neuroticism had a strong in¯uence on health-related QoL that was independent of health status. Neuroticism was more strongly associated with the psychological aspects of QoL than health status. Coping styles and the other psychological variables assessed had only a weak mediating in¯uence on this relationship. Key words: Coping style, Personality, Quality of life, Statistical-modelling Abbreviations: CDC ± Centers for Disease Control; ECVI ± Akaike Information Criterion; EPQ-R ± Eysenck personality questionnaire ± revised; HIV ± human immuno-de®ciency virus; IDU ± injecting drug user; MOS ± medical outcomes survey; QoL ± Quality of Life; RMSEA ± root mean square error of approximation; S-COPE ± short version of the COPE Introduction Although the importance of health-related quality of life (QoL) in HIV infection is widely recognised, relatively little is known about what factors are important in determining how individuals come to evaluate their own QoL. Clearly health status is an important associate of QoL but it is by no means the only one. Psychological factors have been considered [1±5], but most emphasis has been on mood state [2±5]. Mood states, however, are not useful in this context as they are generally considered to be constituents of QoL rather than its determinants, which makes them of little use as explanatory factors. Health-related QoL, of course, cannot be con- sidered as a unitary construct. Most de®nitions and measurement scales include an evaluation of the impact of health on several domains including the psychological, social, occupational and physi- cal [6±8]. Factor analyses of existing scales, how- ever, typically suggest that at least two factors are required [2, 9±11]. One factor assesses physical and functional limitations and may be considered to be Quality of Life Research 9: 423±437, 2000. Ó 2000 Kluwer Academic Publishers. Printed in the Netherlands. 423