The protective role of trait anxiety: a longitudinal cohort study
Abstract
BACKGROUND: Most research has indicated that neuroticism (or trait anxiety) is associated with only negative outcomes. Such a common, heritable and variable trait is expected to have beneficial as well as detrimental effects. We tested the hypothesis that trait anxiety in childhood reduces the risk of dying from accidental causes in early adult life. METHOD: A longitudinal, population-based, birth cohort study of 4,070 men and women born in the UK in 1946. Trait anxiety as judged by teachers when the participants were 13 and 15 years old, and the neuroticism scale of a Maudsley Personality Inventory (MPI) when the participants were 16 years old. Outcomes were deaths, deaths from accidents, non-fatal accidents, and non-fatal accidents requiring medical intervention. RESULTS: Adolescents with low trait anxiety had higher rates of accident mortality to age 25 [low anxiety at 13, hazard ratio (HR) 5.9, low anxiety at 15, HR 1.8]. Low trait anxiety in adolescence was associated with decreased non-accidental mortality after age 25 (low anxiety at 13, HR 0; low anxiety at 15, HR 0.7; low neuroticism at 16, HR 0.7). CONCLUSIONS: High trait anxiety measured in adolescence is associated with reduced accidents and accidental death in early adulthood but higher rates of non-accidental mortality in later life.
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Adolescents with higher levels of trait anxiety have reduced risk of mortality from accidents in later life.
“Adolescents with higher levels of trait anxiety, for example, are found to have reduced risk of mortality from accidents in later life [24].”
From Adaptive function and correlates of anxiety during a pandemic (2021) · cites this paper as [24]
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Sigström, R., Hällström, T., Wærn, M., & Skoog, I. G. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000894 · Cited by 5 · see citing works
“However, one previous study reported that, although low trait anxiety in adolescence was associated with accident-related mortality before age 25 years, it was associated with a reduced risk of nonaccidental death up to age 50 years (19).”
BackgroundKappel, S., Collins, S. A., Mendl, M., & Fureix, C. (2024) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2024.105980 · Cited by 4 · see citing works
“However, this effect might be balanced out by higher rates of non-accidental (medical-related) mortality in later life (Lee et al., 2006), since anxiety is associated with an increased risk of mortality in cardiovascular pathologies, such as coronary heart disease ( e.g., Deter et al., 2023;…”
Underlying domains of anxiety trait in a Costa Rican sample: Preliminary results
Ugalde‐Araya, D., Coto-Vílchez, C., Ávila-Aguirre, A., Chavarría‐Soley, G., Raventós, H., & Rojas, J. C. (2020) · Neurology Psychiatry and Brain Research · doi:10.1016/j.npbr.2020.01.001 · Cited by 4 · see citing works
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“Fear and worry serve an evolutionary function by promoting vigilance and caution in response to potential threats 24 .”
Disorders of Childhood and Adolescence
Mash, E. J., & Wolfe, D. A. (2012) · Wiley eBooks · doi:10.1002/9781118133880.hop208002 · Cited by 3 · see citing works
Loneliness Mindsets: A New Measurement Approach and Implications for Predicting Wellbeing
Burnette, J. L., Earl, S., Hoyt, C. L., & Pollack, J. M. (2025) · Behavioral Sciences · doi:10.3390/bs15091196 · Cited by 2 · see citing works
“Indeed, there is a movement to lean into anxiety and understand the potential enhancing benefits (Dennis-Tiwary, 2022; Lee et al., 2006; Nair et al., 2024).”
Adel, M., & Chung, J. (2024) · European Journal of Personality · doi:10.1177/08902070241272347 · Cited by 1 · see citing works
Dwiyani, B. F., & Widuri, E. L. (2022) · Empowerment Jurnal Pengabdian Masyarakat · doi:10.25134/empowerment.v5i03.6446 · Cited by 2 · see citing works
Impulsivity in anxiety disorders
Carlo, A. D., Benvenuti, M., Dima, F., Cesari, D., Rizzato, S., Casalini, F., Dell’Osso, L., & Perugi, G. (2012) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000423334.62343.80 · Cited by 2 · see citing works
Adaptive function and correlates of anxiety during a pandemicPreprint
Salalι, G. D., Uysal, M. S., & Bevan, A. (2021) · Research Square · doi:10.21203/rs.3.rs-271498/v1 · Cited by 3 · see citing works
Environmental influences on neuroticism in adulthood: A systematic reviewPreprint
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“This finding can also be interpreted considering the need for cognitive closure (NFC), a motivational construct that (Lee et al., 2006 ).”
Electrocortical endophenotypes of anxiety
Mueller, E. M. (2019) · doi:10.1093/oso/9780198793014.003.0015 · Cited by 1 · see citing works
Anxiety, Anger, Personality, and Heart Disease
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An experimental approach to training mood for resilience
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The risks of unconcern: low sensitivity to threat can have unfortunate consequences
Ristvedt, S. L. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1390968 · Cited by 1 · see citing works
“The data for this next analysis were taken from a large longitudinal study that showed a relationship between low anxiety and involvement in accidents—both fatal and nonfatal (Lee et al., 2006).”
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Developmental origins of psychological vulnerability factors for mental disorders
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Road traffic noise, noise sensitivity, psychological and physical health and mortalityPreprint
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Anxiety, Anger, Personality, and Heart Disease
Fusar‐Poli, L., & Arillotta, D. (2020) · Springer eBooks · doi:10.1007/978-3-030-28008-6_19
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WITHDRAWNPreprint
Matar, M., Heeren, A., & 2023, C. G. (2024) · doi:10.31234/osf.io/gv7am
- Authors
- LEE, W. E., WADSWORTH, M. E. J., & HOTOPF, M.
- Affiliations
- King's College London (GB)
- University College London (GB)
- ORCID
- HOTOPF, M.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2006-01-05
- Volume
- 36
- Issue
- 3
- Pages
- 345-351
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2032876276
- Cited by
- 102
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 12 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 3 · 2014: 8 · 2013: 5 · 2012: 6
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Wellcome Trust
- Medical Research Council
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- trait anxiety, neuroticism, accidental death, accident mortality, non-accidental mortality, adolescence, early adulthood, Maudsley Personality Inventory, birth cohort
- MeSH terms
- Accidents, Adolescent, Adult, Age Factors, Anxiety Disorders, Female, Follow-Up Studies, Humans, Male, Middle Aged, Personality Inventory, Population Surveillance, Sampling Studies, Cohort Studies, Observer Variation, Incidence, Sex Distribution
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