Ill look after my health later an investigation of procrastination and health Fuschia M
140K - views

Ill look after my health later an investigation of procrastination and health Fuschia M

Sirois Michelle L MeliaGordon Timothy A Pychyl DepartmentofPsychologyCarletonUniversityB550LoebBuilding1125ColonelByDriveOttawaONCanadaK1S5B6 Received 8 March received in revised form September accepted ctober Abstract A recent study on the ne

Tags : Sirois Michelle
Download Pdf

Ill look after my health later an investigation of procrastination and health Fuschia M

Download Pdf - The PPT/PDF document "Ill look after my health later an invest..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.

Presentation on theme: "Ill look after my health later an investigation of procrastination and health Fuschia M"— Presentation transcript:

Page 1
Ill look after my health, later: an investigation of procrastination and health Fuschia M. Sirois , Michelle L. Melia-Gordon, Timothy A. Pychyl DepartmentofPsychology,CarletonUniversity,B550LoebBuilding,1125ColonelByDrive,Ottawa,ON,Canada,K1S5B6 Received &8 March ())(* received in revised form &) September ())(* accepted () ,ctober ())( Abstract A recent study on the negative health consequences of procrastination suggested that procrastination was associated with higher stress and poor health /Tice 0 1aumeister, &2234. The current investigation sought to clarify and

extend these findings by examining the mediational role of stress and health behaviors in the procrastinationillness relationship. It was hypothesized that in addition to stress, a behavioral pathway would be implicated, with poor weliness behaviors and delay in seeking treatment for health problems mediating the effects of procrastination on health. The model was tested with a sample of uni- versity students (n :&((4 during a high stress period. As expected, the results indicated that procrastina- tion related to poorer health, treatment delay, perceived stress, and fewer

weilness behaviors. The process analyses supported the mediational role of stress and treatment delay, but not weliness behaviors, in the procrastinationillness relationship. The model is consistent with current conceptualizations of the per- sonalityhealth relationship, and presents procrastination as a behavioral style that may increase vulner- ability for negative health outcomes. ()); Elsevier Ltd. All rights reserved. Keywords: Procrastination* =ealth* =ealth behaviors* Stress* Treatment delay 1.Introduction Procrastination has been described as a behavioral style that reflects

self-regulation failure Ferrari, ())& 4, and involves delay in the start and/or completion of a task / Ferrari 0 Tice, ())) 4. Research indicates that procrastination is linked to a number of negative mental health states, including anxiety / 1eswick, Rothblum, 0 Mann, &288* Ferrari, &22&* =aycock, Mc@arthy, 0 Skay, &228* Lay, Edwards, Parker, 0 Endler, &282* Rothblum, Solomon, 0 Murakami, &28A* )&2&-88A2/);/B - see front matter ()); Elsevier Ltd. All rights reserved. doi:&).&)&A/S)&2&-88A2/)(4));(A-C Personality and Individual Differences ;E /());4 &&A3&&8C *

@orresponding author. Tel.: F&-A&;-E()-(A))* fax: F&-A&;-E()-;AA3. ()mailaddress: /F. M. Sirois4.
Page 2
Senecal, Hoestner, 0 Iallerand, &22E* Solomon 0 Rothblum, &28C 4, depression / 1eswick et al., &288* Martin, Flett, =ewitt, Hrames, 0 Szanto, &22A* Saddler 0 Sacks, &22;* Senecal et al., &22E* Solomon 0 Rothblum, &28C 4, and higher perceived stress / Flett, 1lankstein, 0 Martin, &22E* Tice 0 1aumeister, &223 4. =owever, little attention has been given to the relationship between pro- crastination and physical health status. An initial investigation by Tice

and 1aumeister /&2234 of the health costs of pro- crastination suggests that procrastination may be associated with higher stress and poorer health. Jniversity students who rated high on procrastination reported better health and less stress at the beginning of the academic term, but were more stressed and had poorer self-rated health by the end of term. =owever, the reasons for this relationship were not empirically explored. Tice and 1aumeister /&2234 speculated that the higher stress experi- enced by the procrastinators may have been responsible for their diminished state of health at the

end of term. In this paper we briefly review the current formulations of the personalityhealth rela- tionship, followed by a conceptualization of how procrastination may relate to health outcomes. A mediational model that reflects these hypothesized relationships is then presented and tested. 1.1. Overviewofpersonalityhealthmodels @urrent theoretical and empirical research on the relationship between personality and health offers some support for the associations between procrastination, stress and health suggested by Tice and 1aumeister /&2234 . Investigations of the

effects of stress on the immune system have been a fruitful area of research in human psychoneuroimmunology /PKI4 for over a decade. This growing body of literature suggests that stressful life events are related to increased vulnerability to infectious conditions such as the common cold / @ohen, Tyrrell, 0 Smith, &22&* @ohen 0 Lilliamson, &22&* Lacey et al., ()))* Stone et al., &22(* Turner @obb 0 Steptoe, &22A 4, as well as poor health status / Morgensen, Frankowski, 0 @arey, &222 4. Sergerstrom /()))4 proposes that the personalityimmune system relationship may be explained by several

psychosocial mediators, including the impact of stress as suggested by PKI research. Specifically, the quantity or quality of stress experienced may be a function of person- ality, and this stress in turn affects the immune system. As Sergerstrom suggests, this relationship is a complex one, with personality implicated in both the exposure to stressors and the subsequent reactivity to these stressful events. Moreover, other psychosocial and behavioral factors may influence immune functioning and the subsequent changes in health status, either interacting with or independent

of stressful events / Sergerstrom, ())) 4. Similarly, Friedman /()))4 states that there are two general types of mechanisms that mediate the relationship between personality and health: /&4 psychophysiological reaction patterns that include changes in immune function due to stress* and /(4 health behaviors. ,ther formulations of how personality affects health outcomes refer to these two routes as direct and indirect path- ways / @ontrada, Leventhal, 0 ,Leary, &22) 4. The former refers to the psychophysiological reactivity associated with activation of the stress response and its

associated neuroendocrine pathways, whereas the latter reflects behavioral paths and the interaction of personality with the environment. &&A8 ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145
Page 3
1.2. 6conceptualizationofprocrastinationandhealth In terms of procrastination, the indirect behavioral pathway may be the more salient route for understanding the possible deleterious effects of procrastination on health. This is not to imply that the stress experienced by procrastinators does not involve changes in immune functioning that may

compromise health. Indeed, the association between negative mood states and pro- crastination is well established / 1eswick et al., &288* Ferrari 0 1eck, &228* Ferrari, Mohnson, 0 Mc@own, &22E* Fo rrari 0 Tice, ()))* Martin et al., &22A* Pychyl, Lee, Thibodeau, 0 1lunt, ()))* Senecal et al., &22E* Solomon 0 Rothblum, &28C 4, and these affective changes are known to negatively impact immune system functioning / @ohen et al., &22E* Irwin, Daniels, Smith, 1loom, 0 Leiner, &283 4. =owever, according to Milgram /&22&4 the emotional upset experienced by procrastinators is a result of the

behavior sequence of postponement* therefore, these negative mood states are largely the result of the behavioral manifestations of procrastination rather than the cause of the dilatory behavior. Jnlike other personality constructs, such as the Type A behavioral pattern, which may be linked to health primarily through reactive or direct pathways / Friedman 0 Rosenman, &23C with behavior as a secondary route, procrastination can be thought of as influencing health pri- marily through indirect behavioral means. @onsequently, we argue that the tendency of procras- tinators to delay tasks is

the proximal cause of their negative mood states and increased stress, as opposed to an innate physiological proneness to react to situations in a stressful way, that may predispose them to poor health. This conceptualization of procrastination as a behavioral style affecting physical health fits one of the three maOor routes suggested by Suls and Rittenhouse /&22)4 to explain the relationship between personality and increased illness risk. According to the personality as predictor of dangerous behavior model, certain personality profiles lead to the creation or choice of

situations that elicit reactivity, create unnecessary stress, promote unhealthy behaviors, or hinder preventative beha- viors. Moreover, it is a combination of unhealthy habits, such as poor diet, lack of activity, exposure to stressors, and non-compliance with medical regimens, that is key for predicting illness risk rather than the frequency or magnitude of any one behavior / Suls 0 Rittenhouse, &22) 4. 1.2.1. Big)fivefactors,healthbehaviors,andprocrastination Although the relationship between procrastination and health behaviors has not been formally investigated, previous research

suggests that certain higher-order personality dimensions may be associated with a variety of health-related behaviors. Much of this research has employed the five-factor model of personality / @osta 0 Mc@rae, &28E 4 as a framework for understanding the relationship between personality and health behavior patterns. Two consistent predictors of health behaviors that have emerged from this research are conscientiousness and neuroticism. @onscientiousness, the tendency towards persistence, goal-directedness, and organization, was found in one study to be substantially related to higher

rates of wellness behaviors /e.g. proper diet, sleep and exercise4, accident control /e.g. fixing household hazards4, and lower rates of traPc risk-taking and substance-related risk-taking / 1ooth-Hewley 0 Iickers, &22C 4. ,ther studies have linked low conscientiousness to lower levels of health promoting behaviors such as exercise, and higher levels of unhealthy behaviors, such as smoking and excessive drinking / @aspi et al., &223* Friedman et al., &22E* Lemos-Giraldez 0 Fidalgo-Aliste, &223* Tucker et al., &22E 4.

,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&A2
Page 4
Keuroticism, a disposition to experience strong negative emotions and vulnerability to stress, may also affect the immune system through a health behavior pathway / Sergerstrom, ())) 4. Research suggests that both increased harmful health practices and fewer positive health beha- viors are associated with this maOor personality trait / 1ooth-Hewley 0 Iickers, &22C* Lemos- Giraldez 0 Fidalgo-Aliste, &223* Mechanic 0 @leary, &28)* Iingerhoets, @room, Meninga, 0 Menges, &22) 4. Recent

investigations of the relation between procrastination and the five-factor model have identified conscientiousness / Mohnson 0 1loom, &22E* Lay, &223* Lay 0 1rokenshire, &223* Lay, Hovacs, 0 Danto, &228* Milgram 0 Tenne, ()))* Schouwenburg 0 Lay, &22E 4 and neuroticism Mohnson 0 1loom, &22E* Milgram 0 Tenne, ()))* Schouwenburg 0 Lay, &22E* Latson, ())& 4as the two main factors associated with procrastination. These studies indicate that conscientious- ness is highly, negatively related to procrastination and makes a significant contribution to the variance in procrastination

scores, especially task avoidance procrastination / Milgram 0 Tenne, ())) 4. Konetheless, when compared to conscientiousness, procrastination is the better predictor of trait-specific dilatory behavior / Lay, &223 4. Keuroticism, however, is positively associated with procrastination, and is primarily related to goal-directed tentativeness / Schouwenburg 0 Lay, &22E 4 and decisional procrastination / Milgram 0 Tenne, ())) 4. 1.2.2. -ediatorsoftheprocrastinationhealthrelationship The connection between procrastination and conscientiousness /and to a lesser extent neuroti- cism4, and the

impact of these higher-order personality factors on health behaviors, provides a plausible explanation for the mediation of the effects of procrastination on health. As Serger- strom /()))4 has suggested, the mediational role of health behaviors may work in conOunction with or independent of the role of stress. Lellness behaviors are health promoting or maintaining behaviors /e.g. exercise, proper diet4 that may help buffer the effects of stress as well as enhance health states. =owever, these health behaviors are often viewed as challenging and/or unpleasant Turk 0

Meichenbaum, &22& 4. Given that task aversiveness is related to procrastination / 1lunt 0 Pychyl, &228, ()))* @lark 0 =ill, &22C* Lay, &22(* Milgram, Marshevsky, 0 Sadeh, &22C* Mil- gram, Sroloff, 0 Rosenbaum, &288 4, it is likely that procrastinators may put off many health behaviors, such as wellness behaviors, that are viewed as unpleasant. Procrastination may also relate to important therapeutic health behaviors such as treatment- seeking. Treatment-seeking delay is a health-specific dilatory behavior often referred to as patient delay and defined as the period

of time between the individuals first awareness of a symptom and the time of medical consultation / Andersen, @acioppo, 0 Roberts, &22E* Safer, Quincy, Mackson, 0 Leventhal, &232 4. Delay in seeking treatment for health problems has been conceptualized as a multi-stage process comprised of delays in the appraisal of symptoms as signs of illness /appraisal delay4, the decision to seek treatment /illness delay4, acting on this decision /behavioral delay4, and actually being seen by a medical professional /scheduling delay4 / Andersen et al., &22E 4. It is possible that procrastination, a

personality variable that directly affects behavior, may influence the behavioral delay stage of treatment-seeking. In the present study, we sought to clarify and extend the findings of Tice and 1aumeister /&2234 regarding the relationships between procrastination and health. Tice and 1aumeister found that procrastination was related to both higher stress levels and increased symptom reporting at the end of the academic term. =owever, self-reported symptoms are often inflated by the presence of &&3)

Page 5
neuroticism / Latson 0 Pennebaker, &282 4. Therefore, it is unclear if the higher reports of illness by the procrastinators were attributable to neuroticism, inasmuch as neuroticism is positively associated with procrastination / Mohnson 0 1loom, &22E* Milgram 0 Tenne, ()))* Schouwen- burg 0 Lay, &22E* Latson, ())& 4. To address this potential confound we used an illness checklist rather than a symptom checklist. The former reflects more concrete and enduring physical health concerns, rather than

passing symptoms that are often exacerbated by concurrent negative mood states / Latson 0 Pennebaker, &282 4. Le also assessed neuroticism in order to control for its possible confounding effects on self-reported health. The findings of Tice and 1aumeister /&2234 also suggest that stress mediated the effect of pro- crastination on health status. =owever, this mediating role was not directly tested. ,ur first obOective in the current study was to assess the hypothesized mediating role of stress in the pro- crastinationillness relationship. ,ur second obOective was to

explore the role of other factors in mediating the possible relationships between procrastination and health. In accordance with current models of the personalityhealth relationship, it was expected that procrastination would influence health through a behavioral pathway. In addition, wellness behaviors such as exercise and proper diet, are well known to be affected by stress levels / 1aum 0 Posluszny, &222* =udd et al., ()))* Steptoe, Lardie, Pollard, 0 @anaan, &22A 4, especially in student populations / =udd et al., ()))* Lawrence 0 Schank, &22; 4. Given the negative association

between procrastination and conscientiousness, and the positive relationship between conscientiousness and positive health behaviors, it was expected that procrastination would be associated with fewer wellness behaviors. Thus, it was expected that wellness behaviors would be associated with both high stress and poor health /see Fig. & 4. A final health behavior that may mediate the procrastinationillness relationship, and yet has received little attention with respect to personality, is treatment delay. =ealth pro- blems that are not treated promptly or at all may linger or worsen, and

may contribute to a poorer overall state of health. 1y definition, treatment-seeking delay is a dilatory health behavior. Therefore, it was hypothesized that trait procrastination would be related to treatment delay, and that treatment-seeking delay would mediate the procrastinationillness relationship, Fig &. Proposed mediational model of the procrastinationillness relationship. ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&3&
Page 6
independent of stress. In sum, it may be that putting off looking after ones health both pre- ventatively

and therapeutically, rather than stress alone, is responsible for procrastinators poorer health. The proposed relationships between procrastination, stress, and health were examined with a population of predominately first-year university students. The first year of university presents students with many challenges and demands / Arthur, &228* =oldaway 0 Helloway, &283 4 that may compromise student well-being / =udd et al., ())) 4. Jnderstanding the associations between procrastination, stress, health behaviors, and physical health may also provide useful insights for enhancing

student well-being. 2.Method 2.1. Sample A sample of &(( students /C& males, 8& females, mean age:(&.( years, S.D.:E.E;, range:&3EA years4 attending @arleton Jniversity, ,ttawa, @anada, completed a questionnaire package on campus during the final weeks of term. ,verall, the sample was relatively young with 8&R of the sample comprised of students age (& and under, and EER of the sample falling in the &3&2 years age range. The maOority of the students were enrolled in the first year of university /32.ER4, and an additional &E.AR were in their second year. The remaining students

were enrolled in the third or fourth year of university. Most of the students were enrolled full time /8A.&R4. Students were recruited in one of three ways: by a poster campaign advertising the study that was distributed campus-wide* by a sign-up for extra credits towards an introductory psychology course* or by phone from a list of names obtained through a mass testing of introductory psy- chology students. As an added incentive, students who participated also had their name entered into a draw for a chance to win B()). 2.2. -easures 2.2.1. Demographics General questions about age, gender,

and year of university enrollment were included to assess the demographic characteristics of the sample. 2.2.2. Procrastination Trait procrastination was assessed with Lays General Procrastination scale /GP4 / Lay, &22C 4. Ferrari /&22(4 suggests that the JP is an effective measure of dilatory behavior across different situations, and therefore this measure was considered an appropriate choice for assessing the relationship between procrastination and health behaviors in the current study. This ()-item scale assesses global tendencies towards procrastination across a variety of

daily tasks. Items such as I am continually saying Ill do it tomorrow are scored on a E-point Likert-type scale ranging from & for falseofme to E for trueofme. The scale includes ten reverse-scored items, and the mean of all items yields a single composite score with high values indicating a higher tendency to procrastinate. The GP has demonstrated good internal &&3( ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145
Page 7
consistency /@ronbach alpha:).8(4 / 1lunt 0 Pychyl, &228* Lay, &28A 4, and good stability with a test-retest reliability of ).8) /

Ferrari, &282 4. The internal consistency for the current sample was very good, @ronbachs alpha:).82. 2.2.1. Stress The frequency and severity of daily stressors occurring within the past month was assessed with an abbreviated version of the =assles Scale / Hanner, @oyne, Schaefer, 0 Lazarus, &28& 4. This A)- item measure lists common daily stressors and asks the respondent to indicate whether the stres- sor occurred within the last month. The severity of the stressor is also rated with & for somewhat severe, ( for moderatelysevere, or ; for extremelysevere. A severity score is calculated

from a sum of the ;-point ratings of the stressors and can range from ) to &8), indicating the level of sub- Oective stress experienced. Research suggests that daily hassles assessments are better indicators of subOective stress and its effects on health than life events assessments / DeLongis, @oyne, Dakof, Folkman, 0 Lazarus, &28(* Hanner et al., &28& 4. 2.2.5. :ellnessbehaviors The frequency of preventative and health maintaining behaviors was assessed with a Lell- ness 1ehavior @hecklist /L1@4, an original measure created for the current study. It consists of &) items that assess how

often a variety of wellness behaviors are performed. Iickers, @onway, and =ervig /&22)4 suggest that preventative health behaviors are multidimensional, and that wellness maintenance behaviors form an empirically distinct subset of health behaviors separate from those related to accident control and substance use. The items in the L1@ were chosen to reflect a set of health behaviors from this model related to health maintenance and enhancement, such as diet, exercise, and rest/relaxation. For example, items such as I eat at least ; meals a day and I eat fresh fruits and/or

vegetables reflected dietary habits. Physical activity was assessed with items such as I walk as much as possible, for example, I take the stairs not the elevator, etc. and I exercise for () continuous min- utes or more, to the point of perspiration. The frequency of these behaviors was rated on a E-point scale with possible responses ranging from & for lessthanonceaweek to E for everyday for each of the listed behaviors. After reversing the score for ( items, a mean of the &) items was calculated to produce an overall wellness behavior score with higher scores indicating more

fre- quent wellness behaviors. The L1@ has demonstrated good internal consistency in other samples of university students /e.g. @ronbachs alpha:).3E ,n :(E3* Sirois 0 Pychyl, ())( 4. Reliability analysis of the L1@ in the current study revealed adequate internal consistency /@ronbach alpha:).A8, :&((4. 2.2.5. Physicalhealthproblems The number of health problems experienced and whether or not these problems were treated promptly was assessed with a 1rief Medical and Treatment =istory questionnaire adapted for this study from a brief medical history questionnaire developed previously / Sirois 0

Gick, ())( 4. Fourteen physical problems were listed along with an additional item /other4 which provided blank space for the respondent to fill in as necessary. Participants indicated whether they were currently experiencing the health problem or had experienced it within the last year. For each problem experienced, participants were asked to indicate whether they sought treatment ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&3;
Page 8
promptly. Prompt treatment was coded as ), and delayed or no treatment coded as & for each health

problem listed. The total number of non-chronic health problems was summed for each participant, and excluded chronic or life-threatening conditions such as cancer, heart pro- blems, diabetes, arthritis, and chronic pain. These latter problems were excluded in order to compensate for any long-term health conditions that may be more related to long-standing factors than to procrastination per se. 2.2.6. Treatmentdelay A Treatment Delay Index /TDI4 was designed for the current study and calculated to deter- mine the extent to which treatment for health problems was delayed, while controlling for

dif- ferences in the number of health problems reported. @ertain health problems may require immediate or ongoing attention and would tend to be treated promptly by most people, while others tend not to elicit treatment-seeking because they may be perceived as less serious or trouble- some. @ancer and infections were deemed to be serious/acute issues that would likely be treated quickly or would include ongoing treatment once diagnosed and would therefore be treated by the maOority of people. =owever, headaches and flus/colds are often not treated immediately or at all. It was expected

that the treatment delay ratings for these health issues would show very little var- iance and they were therefore excluded from the calculation of the TDI. Although heart problems are indeed serious health issues /and relatively rare in a sample of undergraduates4, research suggests that treatment delay of this health problem is prevalent and may be influenced by indi- vidual difference factors / Dracup 0 Moser, &223* =ome, Mames, Petrie, Leinman, 0 Iincent, ())) 4. Therefore, this health item was included in the TDI calculation. The TDI was calculated according to the following

formula, where health problems exclude cancer, infections, headaches, and flus/colds: TDI sumoftreatmentdelayscoresforhealthproblems numberofhealthproblems The TDI values can range from ) 00 , indicating that no treatment delay occurs across the various health problems, to & 00 suggesting a global tendency to delay the treatment of health issues. Thus, the numeric value of the TDI reflects the proportion of all health problems reported for which treatment was delayed. 2.2.3. Neuroticism A direct magnitude scale of the Five Factor Model of personality traits / Little, ())) 4 was

used to assess this personality factor. This brief measure of the Five Factor Model of Personality is based on the KE, Personality Inventory / @osta 0 Mc@rae, &28E 4 and assesses each of the five personality factors on an &&-point scale. Ratings range from ) to &), with ) indicating the most identification with a particular dimension, and &) indicating the least identification with a domain. The ratings for Keuroticism were reverse scored so that higher values reflected stronger identification with this dimension. 1urisch /&28C4 has argued that self-ratings are

more directly communicable, more economical, and potentially more valid than their lengthier questionnaire counterparts. &&3C ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145
Page 9
3.Results 1.1. Dataanalysis The proposed mediational model of the effect of procrastination on health was tested using a process analysis. According to Mudd and Henny /&28&4 three conditions need to be satisfied in order to demonstrate mediation. First, the predictor variable /procrastination4 must be related to the outcome variable /illness4. Second, the proposed

mediator variable/s4 /stress, treatment delay, and wellness behaviors4 must each be associated with the predictor variable to establish the first link in the causal chain. In addition, the mediator variable/s4 must also be related to the outcome variable /health status4 after controlling for the predictor variable. Finally, mediation is estab- lished when, after controlling for the mediating variable, the predictor variable exerts no effect upon the outcome variable. The relations among the model variables were assessed by first calculating the Pearson product moment

correlation coePcients between procrastination and the health-related variables. Multi- ple regression analyses were then performed in order to satisfy the requirements of process analyses necessary to establish mediation / Mudd 0 Henny, &28& 4. 1.2. Preliminaryanalyses The data were first screened for missing values and missing data points were replaced with the value of the variables overall mean. Two students did not report any health issues and were subsequently excluded from the analyses because calculation of a TDI score was not possible. The remaining sample of &() students was

included in the testing of the mediational model. Potential associations between neuroticism, procrastination and illness were also assessed with a correlational analysis in order to establish if neuroticism presented a possible confound to the procrastinationillness relationship. Keuroticisin was not significantly related to either procrasti- nation (r ).)(4 or illness (r :).&&4 in the current sample, and therefore was not entered into the regression equations. 1.1. Descriptivestatistics The procrastination scores of the current sample (- :(.8A, S.D.:).A84 were comparable to those

reported in previous research with a university student sample /e.g. :(.8&, S.D.:).A(* / 1lunt 0 Pychyl, ())) 4. ,verall, the participants were fairly healthy, reporting few non-chronic health problems (- :;.C2, S.D.:&.3)4 and an average frequency of wellness behaviors (- :;.)C, S.D.:).A(* scale midpoint:;4. =owever, the tendency to delay treatment of health issues was high, with participants reporting that treatment was delayed for nearly three-quarters of the health problems /TDI mean:).3;, S.D.:).;C4. @onversely, per- ceived stress was relatively low (- :;E.(A, S.D.:().)24 given the

possible maximum score of &8) with the hassles scale and the time when the data was collected /i.e. Oust before and during final exams4. ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&3E
Page 10
1.5. Correlationalanalyses The zero-order correlations between procrastination and the health-related variables are pre- sented in Table & . As expected, procrastination was associated with higher reports of stress and illness, paralleling the results reported by Tice and 1aumeister /&2234 for the end-of-term student sample. Procrastination was also

associated with a tendency to delay treatment of health issues and with the practice of fewer wellness behaviors. 1oth stress and treatment delay were related to illness reporting. =owever, stress and treatment delay were not associated. @ontrary to what was expected, the practice of wellness behaviors was not significantly related to health status or perceived stress. 1.5. -ediationalanalyses The results of the proposed mediation models of the procrastinationillness relationship are presented in Table ( . The standardized regression coePcients for each predictor are presented, as well

as the change in variance attributable to each variable entered into the regression equation (R change4. Lhen two predictor variables are included in the same analyses, the regression statistics reflect the effect of each variable when entered into the regression equation last. 1.5.1. Stressasamediatorofprocrastinationillness The results support a mediational model for stress in the procrastinationillness relationship as speculated by Tice and 1aumeister /&2234 . Stress had a significant effect on illness, was predicted by procrastination scores, and uniquely

predicted a significant portion of the variance in illness reports when procrastination was controlled. @onsistent with current literature on the impact of stress on health status, the unique proportion of variance in illness reporting explained by stress was considerably higher than the proportion of variance accounted for by procrastination. Accordingly, when the effects of stress on illness were controlled for by entering stress first into the regression analyses, procrastination no longer significantly predicted illness. 1.5.2.

Treatmentdelayasamediatorofprocrastinationillness The mediational role of treatment delay in the procrastinationillness relationship was also supported. As hypothesized, procrastination was related to treatment delay, which in turn was Table & Sero-order correlations between procrastination and health-related variables /Kote: :&()4 Iariables & ( ; C &. Procrastination (. Stress ).() ;. Treatment delay ).&2 ).&) C. Lellness behaviors ).(C ** ).&E ).&( E. Illness ).() ).(C ** ).(& ).)2 ).)E. ** ).)&. &&3A ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145

associated with illness reporting. Treatment delay continued to exert an influence over illness when the effects of procrastination were controlled, and explained an additional ;R of the var- iance in illness reporting beyond that explained by procrastination. =owever, the influence of procrastination on illness was no longer significant once the effects of treatment delay were removed. Treatment delay mediated the effects of procrastination on illness independent of per- ceived stress, because stress and treatment delay were not significantly

associated (r :).)24. 1.5.1. :ellnessbehaviorsasamediatorofprocrastinationillness As expected, procrastination was associated with less frequent wellness behaviors. =owever, wellness behaviors did not predict illness, and had no effect on the procrastinationillness rela- tionship when its influence was removed from the regression by entering the equation first (R change:).))4. Thus, the mediational role of this variable in the procrastinationillness relation- ship was not supported. Fig. ( presents the revised mediational model of the procrastinationillness relationship

sup- ported by the current analyses. Lellness behaviors have been trimmed from the model, leaving both stress and treatment delay as plausible variables to explain the relationship between pro- crastination and health. Table ( Regression analyses of the proposed procrastination-illness mediational model / :&()4 ,utcome variable Predictor variable tR change Stress Illness Procrastination ).() (.(3 ).)C E.&C Stress Procrastination ).() (.&2 ).)C C.C& Illness Stress ).(A (.82 *** ).)3 8.;A ** Illness &. Stress ).(; (.E3 ** ).)E A.A& ** (. Procrastination ).&C &.E& ).)( (.(8 Treatmentdelay Illness

Procrastination ).() (.(3 ).)C E.&C Treatment delay Procrastination ).&2 (.)8 ).)C C.;C Illness Treatment delay ).(& (.;8 ).)E E.A3 Illness &. Treatment delay ).&8 (.)& ).); C.)C (. Procrastination ).&3 &.88 ).); ;.E( :ellnessbehaviors Illness Procrastination ).() (.(3 ).)C E.&C Lellness Procrastination ).(C (.AE ** ).)A A.28 ** Illness Lellness behaviors ).)2 ).22 ).)& ).AE Illness &. Lellness behaviors ).)E ).C2 ).)) ).&; (. Procrastination ).&2 (.)8 ).)C ;.;8 Lhen two predictor variables are included in the same analyses, the regression statistics reflect the effect of each

vari- able when entered into the regression equation last. Lhen & predictor is entered, value is for /&, &&84 degrees of freedom* when two predictors are entered, value is for /&, &&34 degrees of freedom. ).)E. ** ).)&. *** ).))&. ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&33
Page 12
4.Discussion It will be recalled that we sought to clarify and extend the initial findings of Tice and 1aume- ister /&2234 regarding the relationship between procrastination and health. ,ur findings confirm the mediational role of stress in the

procrastinationillness relationship as speculated by Tice and 1aumeister /&2234 . Procrastinators experienced more stress, which in turn was related to higher reports of illness. Moreover, the current study offered an additional explanation for the procras- tinators higher reports of illness. Procrastination was associated with a greater tendency to delay treatment of existing health problems, and treatment delay explained a significant amount of variance in illness reporting after accounting for the effects of procrastination. ,ur findings sug- gest that the

relationship between procrastination and health is mediated through a behavioral pathway* specifically through health behaviors. The mediation of the effects of procrastination on health may be best understood through Suls and Rittenhouses /&22)4 personality as a predictor of dangerous behavior model. According to this model, certain personality traits confer greater risk of illness through an indirect beha- vioral pathway, both by greater physiological reactivity due to different lifestyle choices and because of greater tendency towards risky or unhealthy behaviors /

Suls 0 Rittenhouse, &22) 4. The influence of heightened physiological reactivity is similar to Sergerstroms /()))4 conOecture that personality is an integral part of the choices that may lead to the exposure and occurrence of stressful events, as well as the subsequent reactivity to these stressors. The tendency of procrasti- nators to delay unpleasant yet important tasks, such as completing a term paper, may result in more stress as the deadline approaches and the task demands completion. For example, Ferrari and 1eck /&2284 found that procrastinators experienced more negative

affect following fraudulent excuse making for term work that was not completed on time. The higher stress levels experi- enced due to this behavioral style may lead to negative immune changes that put procrastinators at increased risk for illness. Indeed, in both the current study and the Tice and 1aumeister /&2234 investigation, procrastinators reported experiencing greater stress at a time when the demand for task completion was high /i.e. at the end of term4. ,ur mediational model of the effects of procrastination on health is also in accordance with the health behavior route

suggested by Suls and Rittenhouse /&22)4 . In addition to creating situations that elicit reactivity by creating unnecessary stress, procrastination may lead to poorer health Fig. (. Revised mediational model of the procrastinationillness relationship. Kumbers reflect standardized regression coePcients. * ).)E. &&38 ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145
Page 13
because it hinders the practice of preventative health behaviors. The procrastinators in our study indicated that they delayed or omitted treatment of their existing health problems.

Further, the delay in treating health problems reported by the procrastinators mediated the effects of this personality trait on health. 1y putting off looking after their current health issues, procrastinators may allow health problems to worsen, which may further negatively impact health status. As expected, the tendency of procrastinators to delay treatment of health problems was not related to perceived stress. Therefore, procrastinators may habitually put off a variety of impor- tant health-related tasks that include aspects of self-care and health maintenance regardless

of other stressful demands. =owever, this may not be true for other types of health-related beha- viors that are more sensitive to changes in stress levels. Indeed, the personality as a predictor of dangerous behavior model / Suls 0 Rittenhouse, &22) 4 suggests that another behavioral route between personality and health involves the engagement in unhealthy or risky behaviors such as smoking, alcohol and drug abuse. These types of behaviors are often associated with both stress Anisman 0 Merali, &222 4 and avoidant coping styles / @arver 0 Scheier, &22C* @arver, Scheier, 0 Leintraub, &282

4. Therefore, procrastination may be linked to other types of unhealthy beha- viors, because it is related to stress. For example, a recent investigation found that procrastina- tors used more avoidant coping styles, specifically drug and alcohol disengagement, to cope with stress / Sirois 0 Pychyl, ())( 4. Procrastination in the current study was also associated with the practice of fewer wellness behaviors, supporting the conceptualization of procrastination as a personality trait that hinders the practice of healthy behaviors in general. Surprisingly, wellness behaviors did not

mediate the procrastinationillness relationship and were not related to illness reporting in the current study. Several factors may account for this finding. Although wellness behaviors such as dietary habits and physical activity are important health behaviors subOect to negative changes during the col- lege years / Patrick, Grace, 0 Lovato, &22( 4, it may be that prolonged change in these key health behaviors are necessary before they negatively affect health. Future investigations of the role of wellness behaviors in the procrastinationillness relationship should therefore

take into account the long-term health effects of these behaviors. 5.1. Limitations 1ecause the sample for the current study consisted of predominately young and healthy uni- versity students who may make decisions to treat health problems differently from a general population with more diverse health concerns, the genaralizability of the results to other popu- lations with more serious or chronic health problems is limited. Further, delay of treatment may not have had as significant an effect on such a young and healthy sample as it would on other adult populations.

=owever, the present study provides an individual difference perspective on the reason for treatment delay in student populations and how this may impact health. Although the relation between procrastination and illness was no longer significant after con- trolling for treatment delay, this relation was only modestly attenuated, suggesting that treatment delay may only partially mediate the effects of procrastination on health / Mudd 0 Henny, &28& 4. Further, in order to fully establish the causal relationships implied by the mediational model, the direction of the proposed

causal effects should be evaluated longitudinally / Hline, &228 4. Ideally, the mediating variables should be measured prior to the assessment of health status if causality is ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&32
Page 14
to be assumed. @onclusions about the causal relationships regarding procrastination and health are therefore limited by the single data collection of the current study. Despite these limitations, the current study did assess the possible confound of negative affect on self-reported health, as this variable is

well-known to influence illness reporting / Latson 0 Pennebaker, &282 4, and is associated with procrastination / Milgram et al., &22C* Schouwenburg 0 Lay, &22E 4. Given that we found no association between neuroticism and illness reporting, our health status assessment was not biased by this reporting variable. The use of a medical inventory rather than a symptom checklist also suggests our health status measure was a more accurate reflection of actual health problems. 5.Conclusionsandfuturedirections ,verall, the results of the current study are consistent with current

conceptualizations of the personalityhealth relationship that suggest personality influences health through both direct or reactive pathways, and indirect or behavioral routes / @ontrada et al., &22)* Friedman, ()))* Sergerstrom, ())) 4. Procrastination, a personality trait marked by delay in the initiation and/or completion of tasks / Ferrari 0 Tice, ())) 4, may lead to greater perceived stress, as well as the delay or omission of important health behaviors. @onsequently, procrastinators may experience poor health as a result of each of these influences. The present study adds to

the current research on the possible negative consequences of procrastination / Flett et al., &22E* Tice 0 1aumeister, &223 4 by demonstrating that procrastination is a personality style associated with increased vul- nerability for negative physical health outcomes. In the current study, procrastination was examined with respect to two health-related beha- viors /treatment-seeking and wellness behaviors4. Future research could expand the range of health behaviors investigated and include areas such as safety-related behaviors /e.g. changing smoke alarm batteries, reducing household hazards4

and medical regimen adherence, as it is likely that the tendency to procrastinate extends to other behaviors necessary for the maintenance of health. Although the health behaviors suggested may not be individually directly implicated in the causal pathways associated with illness outcomes, they may nonetheless reflect the types of risky health behaviors suggested by Suls and Rittenhouse /&22)4 to negatively affect health when they occur in combination. Further research is needed to assess the combined effects of unhealthy behaviors associated with procrastination on health to

provide a more com- plete picture of the behaviorally mediated health risks associated with procrastination. References Andersen, 1. L., @acioppo, M. T., 0 Roberts, D. @. /&22E4. Delay in seeking a cancer diagnosis: delay stages and psychophysiological comparison processes. BritishJournalofSocialPsychology 15 , ;;E(. Anisman, =., 0 Merali, S. /&2224. Jnderstanding stress: characteristics and caveats. 6lcohol Research and Health 21 /C4, (C&(C2. Arthur, K. /&2284. Gender differences in the stress and coping experiences of first year postsecondary students. Journal

ofCollegeStudentPsychotherapy 12 /C4, (&;A. &&8) ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145
Page 15
1aum, A., 0 Posluszny, D. M. /&2224. =ealth psychology: mapping biobehavioral contributions to health and illness. 6nnualReviewofPsychology 50 , &;3&A;. 1eswick, ,., Rothblum, E. D., 0 Mann, L. /&2884. Psychological antecedents of student procrastination. 6ustralian Psychologist 21 /(4, ()3(&3. 1lunt, A., 0 Pychyl, T. A. /&2284. Iolitional action and inaction in the lives of undergraduate students: state orienta- tion, boredom and procrastination.

Personalityand/ndividualDifferences 25 /A4, 8;38CA. 1lunt, A., 0 Pychyl, T. A. /()))4. Task aversiveness and procrastination: a multi-dimensional approach to task aversiveness across stages of personal proOects. Personalityand/ndividualDifferences 25 /A4, 8;38CA. 1ooth-Hewley, S., 0 Iickers, R. R. /&22C4. Associations between maOor domains of personality and health behavior. JournalofPersonality 62 /;4, (8&(28. 1urisch, M. /&28C4. Approaches to personality inventory construction: a comparison of merits. 6mericanPsychologist 19 /;4, (&C((3. @arver, @. S., 0 Scheier, M. F.

/&22C4. Situational coping and coping dispositions in a stressful transaction. Journalof PersonalityandSocialPsychology 66 /&4, &8C&2E. @arver, @. S., Scheier, M. F., 0 Leintraub, M. H. /&2824. Assessing coping strategies: a theoretically based approach. JournalofPersonalityandSocialPsychology 56 /(4, (A3(8;. @aspi, A., 1egg, D., Dickson, K., =arrington, =., Langley, M., MoPtt, T. E., 0 Silva, P. A. /&2234. Personality differences predict health-risk behaviors in young adulthood. Journal of Personality and Social Psychology 31 /E4, &)E(&)A;. @lark, M. L., 0 =ill, ,. M. /&22C4.

Academic procrastination among African-American students. PsychologicalReports 35 , 2;&2;A. @ohen, S., Doyle, L. M., Skoner, D. P., Fireman, P., Gwaltner, M. M. M., 0 Kewsom, M. T. /&22E4. State and trait negative affect as predictors of obOective and subOective symptoms of respiratory viral infections. JournalofPerson) alityandSocialPsychology 64 , &;2&A2. @ohen, S., Tyrrell, D. A. M., 0 Smith, A. P. /&22&4. Psychological stress and susceptibility to the common cold. New (nglandJournalof-edicine 125 , A)AA&(. @ohen, S., 0 Lilliamson, ,. M. /&22&4. Stress and infectious disease in

humans. PsychologicalBulletin 109 , E(C. @ontrada, R. M., Leventhal, =., 0 ,Leary, A. /&22)4. Personality and health. In L. A. Pervin /Ed.4, Handbook of personality:theoryandresearch /pp. A;8AA24. Kew Tork: The Guilford Press. @osta, P. T. Mr, 0 Mc@rae, R. R. /&28E4. Neo five factor inventory: form S . ,dessa, FL: Psychological Assessment Resources. DeLongis, A., @oyne, M. @., Dakof, ,., Folkman, S., 0 Lazarus, R. S. /&28(4. Relationship of daily hassles, uplifts, and maOor life events to health status. HealthPsychology /(4, &&2&;A. Dracup, H., 0 Moser, D. H. /&2234. 1eyond

sociodemographics: factors influencing the decision to seek treatment for symptoms of acute myocardial infarction. HeartandLung 26 /C4, (E;(A(. Ferrari, M. R. /&2824. Reliability of academic and dispositional measures of procrastination. PsychologicalReports 65 &)E3&)E8. Ferrari, M. R. /&22&4. @ompulsive procrastination: some self-reported characteristics. PsychologicalReports 64 /(4, CEE CE8. Ferrari, M. R. /&22(4. Psychometric validation of two adult measures of procrastination: arousal and avoidance measures. JournalofPsychopathologyandBehavioral6ssessment 15 , 23&)). Ferrari, M.

R. /())&4. Procrastination as self-regulation failure of performance: effects of cognitive load, self- awareness, and time limits on working best under pressure. (uropeanJournalofPersonality 15 , ;2& C)A. Ferrari, M. R., 0 1eck, 1. L. /&2284. Affective responses before and after fraudulent excuses by academic procrastina- tors. (ducation 114 , E(2E;3. Ferrari, M. R., Mohnson, M. =., Mc@own, L. ,. /Eds.4. /&22E4. Procrastination,andtaskavoidance:theory,research,and treatment . Kew Tork: Plenum Press. Ferrari, M. R., 0 Tice, D. M. /()))4. Procrastination as a self-handicap for

men and women: a task-avoidance strategy in a laboratory setting. JournalofResearchinPersonality 15 , 3;8;. Flett, G. L., 1lankstein, H. R., 0 Martin, T. R. /&22E4. Procrastination, negative self-evaluation, and stress in depression ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&8&
Page 16
and anxiety: a review and preliminary model. In M. R. Ferrari, M. =. Mohnson, 0 L. ,. McGowan /Eds.4, Procrasti) nationandtaskavoidance:theory,research,andtreatment /pp. &;3&A34. Kew Tork: Plenum Press. Friedman, =. S. /()))4. Long-term relations of personality and

health: dynarnisms, mechanisms, tropisms. Journalof Personality 64 /A4, &)82&&)3. Friedman, =. S., Tucker, M. S., Schwartz, M. E., Martin, L. R., Tomlinson-Heasey, @., Lingard, L. R., 0 @riqui, M. =. /&22E4. @hildhood conscientiousness and longevity: health behaviors and cause of death. JournalofPersonalityand SocialPsychology 64 , A2A3);. Friedman, M., 0 Roseninan, R. =. /&23C4. Type6behaviorandyourheart . Kew Tork: Hnopf. =aycock, L. A., Mc@arthy, P., Skay, @. L. /&2284. Procrastination in college students: the role of self-ePcacy and anxiety. JournalofCounselingandDevelopment,36 /;4.

=oldaway, E. A., 0 Helloway, H. R. /&2834. First year at university: perceptions and experiences of students. Canadian JournalofHigher(ducation 13 /&4, C3A;. =ome, R., Mames, D., Petrie, H., Leinman, M., 0 Iincent, R. /()))4. Patients interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction. Heart 41 /C4, ;88;2;. =udd, S. S., Dumlao, M., Erdmann-Sager, D., Murray, D., Phan, E., Soukas, K., 0 Tokozuka, K. /()))4. Stress at college: effects on health habits, health status and self-esteem. CollegeStudentJournal 15 /(4, (&3((3. Irwin, M.,

Daniels, M., Smith, T. L., 1loom, E., 0 Leiner, =. /&2834. Impaired natural killer cell activity during bereavement. Brain,Behavior,and/mmunity , 28&)C. Mohnson, M. L., 0 1loom, M. /&22E4. An analysis of the contribution of the five factors of personality to variance in academic procrastination. Personallyand/ndividualDifferences 14 /&4, &(3&;;. Morgensen, R. S., Frankowski, M. M., 0 @arey, M. P. /&2224. Sense of coherence, negative life events and appraisal of physical health among university students. Personalityand/ndividualDifferences 23 /A4, &)32&)82. Mudd, @. M., 0

Henny, D. A. /&28&4. Process analysis: estimating mediation in treatment evaluations. (valuation Review , A)(A&2. Hanner, A. D., @oyne, I. @., Schaefer, @., 0 Lazarus, R. S. /&28&4. @omparison of two modes of stress measurement: daily hassles and uplifts versus maOor life events. JournalofBehavioral-edicine /&4, &;2. Hline, R. 1. /&2284. StructuraleAuationmodelling . Kew Tork: The Guilford Press. Lacey, H., Saharia, M. D., GiiPths, M., Ravindran, A. I., Merali, S., 0 Anisman, =. /()))4. A prospective study of neuroendocrine and immune alterations associated with the stress of an oral

academic examination among graduate students. Psychoneuroendocrinology 25 /C4, ;;2;EA. Lawrence, D., 0 Schank, M. M. /&22;4. =ealth status, health perceptions, and health behaviors of young adult women. /nternationalJournalofNursingStudies 10 /A4, E(3E;E. Lay, @. =. /&28A4. At last, my research article on procrastination. JournalofResearchinPersonality 20 , C3CC2E. Lay, @. =. /&22(4. Trait procrastination and the perception of persontask characteristics. JournalofSocialBehavior andPersonality /;4, C8;C2C. Lay, @. =. /&22C4. Trait procrastination and affective experiences: describing

past study behavior and its relation to agitation and deOection. -otivationand(motion 14 /;4, (A2(8C. Lay, @. =. /&2234. Explaining lower-order traits through higher order factors: the case of trait procrastination, con- scientiousness, and the specificity dilemma. (uropeanJournalofPersonality 11 /C4, (A3(38. Lay, @. =., 0 1rokenshire, R. /&2234. @onscientiousness, procrastination, and person-task charcateristics in Oob searching by unemployed adults. CurrentPsychology 16 /&4, 8;2A. Lay, @. =., Edwards, M. M., Parker, M. D. A., 0 Endler, K. S. /&2824. An assessment of appraisal,

anxiety, coping, and procrastination during an examination period. (uropeanJournalofPersonality , &2E()8. Lay, @. =., Hovacs, A., 0 Danto, D. /&2284. The relation of trait procrastination to the big-five factor conscientious- ness: an assessment with primary-Ounior school children based on self-report scales. Personality and /ndividual Differences 25 /(4, &83&2;. Lemos-Giraldez, S., 0 Fidalgo-Aliste, A. M. /&2234. Personality dispositions and health-related habits and attitudes: A cross-sectional study. (uropeanJournalofPersonality 11 /;4, &23()2. Little, 1. R. /()))4. Free

traits and personal contexts: expanding a social ecological model of well-being. In L. 1. Lalsh, H. =. @raik, 0 R. Price /Eds.4, Personenvironmentpsychology:newdirectionsandperspectives /(nd ed.4 /pp. 83&&A4. Mahwah, KM: Lawrence Erlbaum Associates. &&8( ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145
Page 17
Martin, T. R., Flett, ,. L., =ewitt, P. L., Hrames, L., 0 Szanto, ,. /&22A4. Personality correlates of depression and health symptoms: a test of a self-regulation model. JournalofResearchinPersonality 10 /(4, (AC(33. Mechanic, D., 0 @leary, P. D.

/&28)4. Factors associated with the maintenance of positive health behaviour. Preventive -edicine , 8)E8&C. Milgram, K. /&22&4. Procrastination. In R. Dulbecco /Ed.4, (ncyclopediaofhumanbiology /Iol. A4 /pp. &C2&EE4. Kew Tork: Academic Press. Milgram, K., Marshevsky, S., 0 Sadeh, @. /&22C4. @orrelates of academic procrastination: discomfort, task aversive- ness, and task capability. TheJournalofPsychology 129 /(4, &CE&EE. Milgram, K., 0 Tenne, R. /()))4. Personality correlates of decisional task avoidant procrastination. (uropeanJournal ofPersonality 15 /(4, &C&&EA. Milgram, K. A.,

Sroloff, 1., 0 Rosenbaum, M. /&2884. The procrastination of everyday life. JournalofResearchin Personality 22 /(4, &23(&(. Patrick, H., Grace, T. L., 0 Lovato, @. /&22(4. =ealth issues for college students. 6nnualReviewofPublicHealth 11 (E;(A8. Pychyl, T. A., Lee, P. L. =., Thibodeau, R., 0 1lunt, A. /()))4. Five days of emotion: an experience-sampling study of undergraduate student procrastination. JournalofSocialBehaviorandPersonality 15 /E4, (;2(EC. Rothblum, E. D., Solomon, L. M., 0 Murakami, M. /&28A4. Affective, cognitive, and behavioral differences between high and

low procrastinators. JournalofCounselingPsychology 11 , ;83;2C. Saddler, @. D., 0 Sacks, L. A. /&22;4. Multidimensional perfectionism and academic procrastination: relationships with depression in university students. PsychologicalReports 31 /;4, 8A;83&. Safer, M. A., Quincy, I. T., Mackson, T. @., 0 Leventhal, =. /&2324. Determinants of three stages of delay in seeking care at a medical clinic. -edicalCare 13 /&4, &&(2. Schouwenburg, =. @., 0 Lay, @. =. /&22E4. Trait procrastination and the big-five factors of personality. Personality and/ndividualDifferences 14 /C4, C8&C2).

Senecal, @., Hoestner, R., 0 Iallerand, R. M. /&22E4. Self-regulation and academic procrastination. JournalofSocial Psychology 115 /E4, A)3A&2. Sergerstrom, S. @. /()))4. Personality and the immune system: models, methods, and mechanisms. 6nnals of Behavioral-edicine 22 /;4, &8)&2). Sirois, F. M., 0 Gick, M. L. /())(4. An investigation of the health beliefs and motivations of complementary medicine clients. SocialScienceand-edicine 55 /A4, &)(E&);3. Sirois, F. M., 0 Pychyl, T. A. /())(, August4. Academic procrastination: costs to health and well-being. In M. R. Ferrari 0 T. A. Pychyl

/chairs4, 6cademic procrastination: a common event thatBs not commonly understood Symposium presented at the &)th Annual conference of the American Psychological Association, @hicago, IL. Solomon, L. M., 0 Rothblum, 1. D. /&28C4. Academic procrastination: frequency and cognitive behavioral correlates. JournalofCounselingPsychology 11 , E);E)2. Steptoe, A., Lardle, M., Pollard, T. M., 0 @anaan, L. /&22A4. Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise. JournalofPsychosomaticResearch 51 /(4, &3&&8). Stone, A. A., 1ovbOerg, D.

=., Keale, M. M., Kapoli, A., Ialdimarsdottir, =., =ayden, F. G., 0 Gwaltney, M. M. /&22(4. Development of common cold symptoms following experimental rhinovirus infection is related to prior stressful life events. Behavioral-edicine 14 , &&E&(). Suls, M., 0 Rittenhouse, M. D. /&22)4. Models of linkages between personality and disease. In =. S. Friedman /Ed.4, Personalityanddisease /pp. ;8A;4. Kew Tork: Liley. Tice, D. M., 0 1aumeister, R. F. /&2234. Longitudinal study of procrastination, performance, stress, and health: The costs and benefits of dawdling. PsychologicalScience /A4,

CECCE8. Tucker, M. S., Friedman, =. S., Tomlinson-Heasey, @., Schwartz, M. E., Lingard, L. R., 0 @riqui, M. =. /&22E4. @hildhood psychosocial predictors of adulthood smoking, alcohol consumption, and physical activity. Journal of 6ppliedSocialPsychology 25 , &88C&822. Turk, D. @., 0 Meichenbaum, D. /&22&4. Adherence to self-care regimens: the patients perspective. In R. =. Rozensky, M. M. Sweet, 0 S. M. Tovian /Eds.4, Handbookofclinicalpsychology,/:medicalsettings /pp. (C2(AA4. Kew Tork: Plenum. Turner @obb, I. M., 0 Steptoe, A. /&22A4. Psychosocial stress and susceptibility to upper

respiratory tract illness in an adult population sample. Psychosomatic-edicine 54 /E4, C)CC&(. ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145 &&8;
Page 18
Iickers, R. R., @onway, T. L., 0 =ervig, L. H. /&22)4. Demonstration of replicable dimensions of health behaviors. Preventive-edicine 19 , ;33C)&. Iingerhoets, A. M., @room, M., Meninga, A. M., 0 Menges, L. T. /&22)4. Personality and health habits. Personalityand Health , ;;;;C(. Latson, D., 0 Pennebaker, M. L. /&2824. =ealth complaints, stress and distress: exploring the central role of negative

affectivity. PsychologicalReview 96 /34, (;C(EC. Latson, D. @. /())&4. Procrastination and the five factor model: a facet level analysis. Personality and /ndividual Differences 10 /&4, &C2&E8. &&8C ,.-.Siroisetal..Personalityand/ndividualDifferences15(2001211631145