Public health significance of neuroticism

“Table 1 presents effect sizes for the strength of association with the mental disorder, expressed as d (Cohen, 1988).”

“There also is consistent evidence that the short allele of 5-HTTLPR is associated with increased risk for depression among persons who have experienced stressful life events (Caspi et al., 2003; Lotrich & Pollock, 2004; Uher & McGuffin, 2008).”

“…numbers of markers selected from across the genome to examine patterns of inheritance within families, have not yielded consistent findings (Fullerton et al., 2003; Nash et al., 2004), perhaps partly because of limitations in the statistical power of linkage studies (Risch & Merikangas, 1996).”

“…or negative affectivity, is included in nearly all major models of personality traits (Matthews, Deary, & Whiteman, 2003), including three-factor (Eysenck, 1947; Tellegen, 1982) and five-factor models (Costa & McCrae, 1992b; Goldberg, 1993; Zuckerman, Kuhlman, Teta, Joireman, & Kraft, 1993).”

“…of neuroticism, in the sense of maintaining rank-order position relative to other persons, increases with age from adolescence through adulthood (Roberts & DelVecchio, 2000), mean neuroticism scores peak in late adolescence and decline moderately through adulthood (Costa et al., 1986; McCrae et…”

“This is important because lower social support is associated with increased risk for health problems (Uchino, 2006) and stress increases risk for health problems, particularly when it is unremitting and the individual is older or in poor health (Schneiderman, Ironson, & Siegel, 2005).”

“To consider just one specific example of neuroticism influencing risk for negative life events, a number of longitudinal studies have shown that the neuroticism scores of both partners measured before marriage predict future separation or divorce (Donnellan, Conger, & Bryant, 2004; Karney & Bradbury, 1997; Kelly & Con…”

“In addition, functional magnetic resonance imaging has revealed that variations in alleles of 5-HTTLPR are related to variations in the activation of the amygdala and related brain structures in response to threatening stimuli (Brown & Hariri, 2006; Hariri et al., 2002; Passamonti et al., 2008).”

“The extensive literature on associations between personality traits and aspects of subjective well being has been reviewed recently and will not be repeated here (Ozer & Benet-Martinez, 2006; Steel, Schmidt, & Shultz, 2008).”

“There also is extensive evidence that neuroticism is correlated with a number of Axis II personality disorders (Clark et al., 1994; Costa & Widiger, 2002; Krueger & Markon, 2001; Saulsman & Page, 2004; Sher & Trull, 1994).”

“In addition, the results of a number of cognate studies of non-human animals are consistent with the hypothesis that variants of the serotonin transporter gene interact with stress levels to influence negative emotionality (Caspi & Moffitt, 2006).”

“…rank-order position relative to other persons, increases with age from adolescence through adulthood (Roberts & DelVecchio, 2000), mean neuroticism scores peak in late adolescence and decline moderately through adulthood (Costa et al., 1986; McCrae et al., 2002; Roberts & Mroczek, 2008).”

“Depression and anxiety disorders are associated with disrupted immune functioning (Maier & Watkins, 1998; Pace et al., 2006; Robles et al., 2005), abnormalities in cardiac functioning (Barger & Sydeman, 2005), and increased mortality among individuals with other risk factors for cardiac disease…”

“For example, participants with high neuroticism scores responded to a standard negative mood induction task with more negative affect than participants lower in neuroticism (Larsen & Ketelaar, 1991).”

“…with Physical Health Persons with high scores on neuroticism scales are more likely to express medically unfounded somatic complaints (Chaturvedi, 1986; Costa & McCrae, 1987) and to have catastrophic thoughts about symptoms that lead to medical service use (Goubert, Crombez, & Van Damme, 2004).”

“…& Watkins, 1998; Pace et al., 2006; Robles et al., 2005), abnormalities in cardiac functioning (Barger & Sydeman, 2005), and increased mortality among individuals with other risk factors for cardiac disease (Penninx et al., 2001; Robles et al., 2005; Simonsick, Wallace, Blaser, & Gerkman, 1995).”

“For example, it has been suggested that mental health clinicians routinely administer a five-factor personality scale to determine if more extensive assessments of personality disorders related to neuroticism and other traits should be conducted (Widiger & Trull, 2007).”

“As shown in Table 2, a meta-analytic review of this literature (Saulsman & Page, 2004) found medium effect sizes for associations between neuroticism and borderline, avoidant, and dependent personality disorders, and smaller effect sizes for schizotypal, paranoid, and antisocial personality…”

“Keywords Neuroticism; personality traits; public health; predictive utility Personality traits quantify the marked variations in typical responding to the environment that distinguish one person from another (Mischel, 2004).”

“There is both indirect and direct evidence linking neuroticism with many kinds of serious physical health problems (Brickman, Yount, Blaney, Rothberg, & De-Nour, 1996; Drossman et al., 2000; T. W. Smith & MacKenzie, 2006; Suls & Bunde, 2005).”

“Moreover, these risk factors were related to suicide attempts multiplicatively, such that the risk for a suicide attempt among youth with both high neuroticism scores and other risk factors was 60 times greater than for low risk youth (Fergusson et al., 2000).”

“Depression and anxiety disorders are associated with disrupted immune functioning (Maier & Watkins, 1998; Pace et al., 2006; Robles et al., 2005), abnormalities in cardiac functioning (Barger & Sydeman, 2005), and increased mortality among individuals with other risk factors for cardiac disease…”

“This can happen when the shared environment operates through geneenvironment interactions (Jinks & Fulker, 1970; Johnson, 2007; Robinson, 2004).”

“There is strong evidence that neuroticism is robustly correlated with many Axis I and II mental disorders from childhood through adulthood (Clark, Watson, & Mineka, 1994; Khan, Jacobson, Gardner, Prescott, & Kendler, 2005; Krueger & Markon, 2001; Sher & Trull, 1994; Watson et al., 1994).”

“…Disorders There is strong evidence that neuroticism is robustly correlated with many Axis I and II mental disorders from childhood through adulthood (Clark, Watson, & Mineka, 1994; Khan, Jacobson, Gardner, Prescott, & Kendler, 2005; Krueger & Markon, 2001; Sher & Trull, 1994; Watson et al., 1994).”

“This is the case both when the life events are subjectively judged to be stressful by the individual and when they are objectively rated by experimenters blind to neuroticism scores (Bolger & Zuckerman, 1995; Gunthert et al., 1999; Hankin et al., 2005; Kendler et al., 2003; Magnus et al., 1993; Suls & Martin, 2005; va…”

“A meta-analysis of associations between neuroticism and diagnoses of Axis I mental disorders was conducted based on 33 population-based samples (Malouff et al., 2005).”

“…was measured, each 1 standard deviation (SD) unit difference in higher neuroticism scores was associated with a 90–100% increase in the odds of developing major depression for the first time during the next 12 months in women (Kendler et al., 1993) and an 85% increase in men (Fanous et al., 2007).”

“…shown that the neuroticism scores of both partners measured before marriage predict future separation or divorce (Donnellan, Conger, & Bryant, 2004; Karney & Bradbury, 1997; Kelly & Conley, 1987; Roberts et al., 2007; Rogge, Bradbury, Hahlweg, Engl, & Thurmaier, 2006; Tucker, Kressin, Spiro, &…”

“There is evidence that persons high in neuroticism use fewer problem-focused and more emotion-focused strategies to cope with stress (Watson & Hubbard, 1996).”

“…studies have controlled for shared items and concurrent depressive states and still found significant associations between the construct of neuroticism and measures of depression (Fergusson, Horwood, & Lawton, 1989; Schmutte & Ryff, 1997; Spijker, de Graaf, Oldehinkel, Nolen, & Ormel, 2007).”

“…with friends, experience stressful physical health problems, and lose employment (Bolger & Zuckerman, 1995; Gunthert, Cohen, & Armeli, 1999; Hankin, Fraley, & Abela, 2005; Kendler, Gardner, & Prescott, 2003; Magnus, Diener, Fujita, & Pavot, 1993; Suls & Martin, 2005; van Os, Park, & Jones, 2001).”

“In turn, these enhanced physiological responses to stress may contribute to health problems (Contrada et al., 1999; Friedman, 2000;T. W. Smith & MacKenzie, 2006).”

“There also is consistent evidence that the short allele of 5-HTTLPR is associated with increased risk for depression among persons who have experienced stressful life events (Caspi et al., 2003; Lotrich & Pollock, 2004; Uher & McGuffin, 2008).”

“Although much remains to be learned, prescription medication might provide a way to reduce neuroticism (Knutson et al., 1998), but only if the benefits outweighed the side effects and costs.”

“…rank-order position relative to other persons, increases with age from adolescence through adulthood (Roberts & DelVecchio, 2000), mean neuroticism scores peak in late adolescence and decline moderately through adulthood (Costa et al., 1986; McCrae et al., 2002; Roberts & Mroczek, 2008).”

“This conclusion is consistent with findings that variations in the serotonin transporter gene in mice are related to behaviors suggestive of emotionality that may be analogous to neuroticism (Leonardo & Hen, 2006; Murphy & Lesch, 2008).”

“Given the enormous personal distress and impairment associated with these mental disorders and their overall impact on the economy (Merikangas et al., 2007), the association of neuroticism with mental disorders is no small matter.”

“Persons high in neuroticism are markedly more likely to smoke (Breslau, Novak, & Kessler, 2004; Malouff et al., 2006; Morissette, Tull, Gulliver, Kamholz, & Zimering, 2007; Terracciano & Costa, 2004) and to become dependent on alcohol and other drugs (Larkins & Sher, 2006).”

“There also is extensive evidence that neuroticism is correlated with a number of Axis II personality disorders (Clark et al., 1994; Costa & Widiger, 2002; Krueger & Markon, 2001; Saulsman & Page, 2004; Sher & Trull, 1994).”

“A plausible working model for future studies is that that the etiology of each mental and physical health disorder results from the combined interplay of general-risk genes and environments and disorder-specific genes and environments (Gillespie et al., 2004; Khan et al., 2005; Lahey & Waldman, 2003).”

“N IH -PA Author M anuscript N IH -PA Author M anuscript N IH -PA Author M anuscript test hypotheses prospectively regarding the causal influence of specific experiences on later neuroticism (Rutter, 2007b).”

“…Disorders There is strong evidence that neuroticism is robustly correlated with many Axis I and II mental disorders from childhood through adulthood (Clark, Watson, & Mineka, 1994; Khan, Jacobson, Gardner, Prescott, & Kendler, 2005; Krueger & Markon, 2001; Sher & Trull, 1994; Watson et al., 1994).”

“Furthermore, higher neuroticism is associated with greater use of mental health services even when the number of comorbid mental disorders is controlled (Jylha & Isometsa, 2006; ten Have, Oldehinkel, Vollebergh, & Ormel, 2005).”

“A fourth meta-analysis initially did not find a significant association between 5-HTTLPR and neuroticism (Munafo et al., 2003), but a revised and updated report of this meta-analysis confirmed the significant association between 5-HTTLPR and neuroticism (Munafo, Clark, & Flint, 2005).”

“Sen S, Burmeister M, Ghosh D. 5-HTTLPR and anxiety-related personality traits meta-analysis revisited: Response to Munafo and colleagues.”

“Molecular studies of other promising candidate genes that may be associated with neuroticism have yielded less consistent findings to date (Hettema, An et al., 2006; Lang et al., 2005; Sen et al., 2003; Willis-Owen et al., 2005).”

“A number of detailed causal models of the multiple mechanisms linking neuroticism and physical health outcomes have been proposed (Contrada et al., 1999;T. W. Smith, 2006).”

“Moreoever, there is replicated evidence from longitudinal studies that persons with high neuroticism scores are more likely than other persons to develop anxiety and depression following negative life events (Fanous et al., 2002; Hutchinson & Williams, 2007; Jacobs et al., 2006; Kendler et al., 2004; Ormel & Wohlfarth…”

“N IH -PA Author M anuscript N IH -PA Author M anuscript N IH -PA Author M anuscript test hypotheses prospectively regarding the causal influence of specific experiences on later neuroticism (Rutter, 2007b).”

“A number of studies suggest that neuroticism itself is associated with a wide range of physical health problems (T. W. Smith & MacKenzie, 2006), such as cardiovascular disease (Suls & Bunde, 2005), atopic eczema (Buske-Kirschbaum, Geiben, & Hellhammer, 2001), asthma (Huovinen, Kaprio, & Koskenvuo,…”

“Molecular studies of other promising candidate genes that may be associated with neuroticism have yielded less consistent findings to date (Hettema, An et al., 2006; Lang et al., 2005; Sen et al., 2003; Willis-Owen et al., 2005).”

“, 2007; Vogeltanz & Hecker, 1999), greater cardiovascular reactivity (Muth, Koch, & Stern, 2000), and higher morning levels of cortisol (Portella, Harmer, Flint, Cowen, & Goodwin, 2005), but have blunted cortisol response to stress (Oswald et al., 2006; Phillips, Carroll, Burns, & Drayson, 2005).”

“There also is consistent evidence that the short allele of 5-HTTLPR is associated with increased risk for depression among persons who have experienced stressful life events (Caspi et al., 2003; Lotrich & Pollock, 2004; Uher & McGuffin, 2008).”

“For example, irritable bowel syndrome is associated with neuroticism (Spiller, 2007) and the short allele of 5-HTTLPR has been found to be associated with irritable bowel syndrome in humans (Yeo et al., 2004) and with analogous bowel dysfunctions in mice (Murphy & Lesch, 2008).”

“In addition, persons with comorbid mental disorders have significantly poorer physical health and are more likely to be high-end users of medical services (Rush et al., 2005).”

“Because anatomic and functional variations in the same brain structures have been linked to variations in neuroticism (Canli, 2004; Haas, Omura, Constable, & Canli, 2007; Omura, Constable, & Canli, 2005), this research also supports the hypothesis that polymorphisms of 5-HTTLPR are linked to neuroticism.”

“…shown that divorce predicts mental health problems, substance abuse, and mortality (Hemström, 1996; Ikeda et al., 2007;C. Lee & Gramotnev, 2007; S. Lee et al., 2005; Overbeek et al., 2006; Perreira & Sloan, 2001), it is reasonable to hypothesize that neuroticism indirectly promotes adverse…”

“Persons high in neuroticism are markedly more likely to smoke (Breslau, Novak, & Kessler, 2004; Malouff et al., 2006; Morissette, Tull, Gulliver, Kamholz, & Zimering, 2007; Terracciano & Costa, 2004) and to become dependent on alcohol and other drugs (Larkins & Sher, 2006).”

“This is the case both when the life events are subjectively judged to be stressful by the individual and when they are objectively rated by experimenters blind to neuroticism scores (Bolger & Zuckerman, 1995; Gunthert et al., 1999; Hankin et al., 2005; Kendler et al., 2003; Magnus et al., 1993; Suls & Martin, 2005; va…”

“After early adulthood, the heritability of neuroticism declines gradually with age in both sexes, but slightly more so in males, resulting in somewhat greater heritability in females during later adulthood (Eaves, Eysenck, & Martin, 1989; Lake et al., 2000).”

“It is essential that future studies of causal environmental influences on neuroticism not be conducted in isolation, however, but take the interplay of genes and environments fully into consideration (Johnson, 2007; Robinson, 2004).”

“…predicts mental health problems, substance abuse, and mortality (Hemström, 1996; Ikeda et al., 2007;C. Lee & Gramotnev, 2007; S. Lee et al., 2005; Overbeek et al., 2006; Perreira & Sloan, 2001), it is reasonable to hypothesize that neuroticism indirectly promotes adverse outcomes partly by…”

“There is both indirect and direct evidence linking neuroticism with many kinds of serious physical health problems (Brickman, Yount, Blaney, Rothberg, & De-Nour, 1996; Drossman et al., 2000; T. W. Smith & MacKenzie, 2006; Suls & Bunde, 2005).”

“…problems, substance abuse, and mortality (Hemström, 1996; Ikeda et al., 2007;C. Lee & Gramotnev, 2007; S. Lee et al., 2005; Overbeek et al., 2006; Perreira & Sloan, 2001), it is reasonable to hypothesize that neuroticism indirectly promotes adverse outcomes partly by increasing the likelihood of…”

“…rank-order position relative to other persons, increases with age from adolescence through adulthood (Roberts & DelVecchio, 2000), mean neuroticism scores peak in late adolescence and decline moderately through adulthood (Costa et al., 1986; McCrae et al., 2002; Roberts & Mroczek, 2008).”

“, 2006; Jang & Livesley, 1999) and many different physical health problems (Johnson & Krueger, 2005; McCaffery et al., 2006).”

“Moreoever, there is replicated evidence from longitudinal studies that persons with high neuroticism scores are more likely than other persons to develop anxiety and depression following negative life events (Fanous et al., 2002; Hutchinson & Williams, 2007; Jacobs et al., 2006; Kendler et al., 2004; Ormel & Wohlfarth…”

“…& Bunde, 2005), atopic eczema (Buske-Kirschbaum, Geiben, & Hellhammer, 2001), asthma (Huovinen, Kaprio, & Koskenvuo, 2001), and irritable bowel syndrome (Spiller, 2007), even when depression and other risk factors such as social support are controlled (Bouhuys et al., 2004; Russo et al., 1997).”

“Similarly, a 6-year longitudinal study of a representative sample of 6,158 adults 65 years of age and older found that a high level of neuroticism in the first assessment predicted 33% more deaths from all causes compared to low neuroticism, controlling age, sex, race-ethnicity, education, medical conditions, and init…”

“…large numbers of markers selected from across the genome to examine patterns of inheritance within families, have not yielded consistent findings (Fullerton et al., 2003; Nash et al., 2004), perhaps partly because of limitations in the statistical power of linkage studies (Risch & Merikangas,…”

“This conclusion is consistent with findings that variations in the serotonin transporter gene in mice are related to behaviors suggestive of emotionality that may be analogous to neuroticism (Leonardo & Hen, 2006; Murphy & Lesch, 2008).”

“A wide range of physical health problems are more common among individuals with mood and anxiety disorders, which are strongly correlated with neuroticism (Currie & Wang, 2005; Robles, Glaser, & Kiecolt-Glaser, 2005; Sareen, Cox, Clara, & Asmundson, 2005; Watkins et al., 2006).”

“At the molecular level, persons with at least one copy of the short allele of 5-HTTLPR have been found to have higher resting cortisol levels than persons with two long alleles (Jabbi et al., 2007).”

“Similarly, adaptations of cognitive and behavioral interventions like those developed for stress management (Antoni et al., 2000; Cruess et al., 2000; Hampel, Meier, & Kummel, 2008), to prevent anxiety disorders and depression (Bienvenu & Ginsburg, 2007; Stice, Rohde, Seeley, & Gau, 2008), or to…”

“In addition, neuroticism is robustly associated with dysthymia (Akiskal et al., 2006) and there is extensive evidence that higher neuroticism is related to the use and abuse of psychoactive substances, from nicotine and alcohol to heroin (Kornør & Nordvik, 2007; Malouff, Thorsteinsson, Rooke, & Schutte, 2007; Malouff…”

“…recent genome-wide association study of unrelated individuals failed to find significant associations between single nucleotide polymorphisms (SNPs) and neuroticism (Shifman et al., 2008), but another recent study found associations of neuroticism and SNPs in MAMDC1 (van den Oord et al., 2008).”

“This is the case both when the life events are subjectively judged to be stressful by the individual and when they are objectively rated by experimenters blind to neuroticism scores (Bolger & Zuckerman, 1995; Gunthert et al., 1999; Hankin et al., 2005; Kendler et al., 2003; Magnus et al., 1993; Suls & Martin, 2005; va…”

“Moreoever, there is replicated evidence from longitudinal studies that persons with high neuroticism scores are more likely than other persons to develop anxiety and depression following negative life events (Fanous et al., 2002; Hutchinson & Williams, 2007; Jacobs et al., 2006; Kendler et al., 2004; Ormel & Wohlfarth…”

“Depression and anxiety disorders are associated with disrupted immune functioning (Maier & Watkins, 1998; Pace et al., 2006; Robles et al., 2005), abnormalities in cardiac functioning (Barger & Sydeman, 2005), and increased mortality among individuals with other risk factors for cardiac disease…”

“For example, neuroticism strongly predicts the course of renal deterioration in type I diabetics (Brickman et al., 1996) and patients with cardiac disease (Murberg, 2004).”

“…was measured, each 1 standard deviation (SD) unit difference in higher neuroticism scores was associated with a 90–100% increase in the odds of developing major depression for the first time during the next 12 months in women (Kendler et al., 1993) and an 85% increase in men (Fanous et al., 2007).”

“…in adults and their retrospective recall of intrusive parenting (Reti et al., 2002), having been abused during childhood (Allen & Lauterbach, 2007; Roy, 2002), lack of religious upbringing (Willemsen & Boomsma, 2007), and low parental involvement (McCrae & Costa, 1988) when they were children.”

“Because other longitudinal studies have shown that divorce predicts mental health problems, substance abuse, and mortality (Hemström, 1996; Ikeda et al., 2007;C. Lee & Gramotnev, 2007; S. Lee et al., 2005; Overbeek et al., 2006; Perreira & Sloan, 2001), it is reasonable to hypothesize that…”

“…recent genome-wide association study of unrelated individuals failed to find significant associations between single nucleotide polymorphisms (SNPs) and neuroticism (Shifman et al., 2008), but another recent study found associations of neuroticism and SNPs in MAMDC1 (van den Oord et al., 2008).”

“Indeed, twin studies indicate that one-third to two-thirds of the genetic variance in broad range of mental disorders is shared with neuroticism (Carey & DiLalla, 1994; Fanous, Gardner, Prescott, Cancro, & Kendler, 2002; Hettema, Neale et al., 2006).”

“Assuming for the sake of argument that they were effective in reducing neuroticism, encouraging people with high neuroticism scores to use inexpensive interventions with few adverse side effects such as participation in moderate physical exercise (Koukouvou et al., 2004) or taking omega-3 dietary supplements (Conklin…”

“…anxiety disorders and depression (Bienvenu & Ginsburg, 2007; Stice, Rohde, Seeley, & Gau, 2008), or to treat borderline personality disorder (Woodberry & Popenoe, 2008) could possibly prove to be costeffective for reducing the broad dimension of neuroticism if they were implemented in group…”

“…in adults and their retrospective recall of intrusive parenting (Reti et al., 2002), having been abused during childhood (Allen & Lauterbach, 2007; Roy, 2002), lack of religious upbringing (Willemsen & Boomsma, 2007), and low parental involvement (McCrae & Costa, 1988) when they were children.”

“…more prolonged suppression of secretory immunoglobulin following a stressor (Hennig, Possel, & Netter, 1996), atypical response of natural killer cells to stress (Borella et al., 1999), diminished antibody response to vaccination (Phillips et al., 2005), and higher leukocyte counts (Daruna, 1996).”

“…associated with disrupted immune functioning (Maier & Watkins, 1998; Pace et al., 2006; Robles et al., 2005), abnormalities in cardiac functioning (Barger & Sydeman, 2005), and increased mortality among individuals with other risk factors for cardiac disease (Penninx et al., 2001; Robles et al.,…”

“This could be important because social support is linked with depression and partially mediates the association between neuroticism and depression (Finch & Graziano, 2001; Kendler et al., 2002; Kendler, Gardner et al., 2006).”

“Hormonal challenge studies suggest that this blunted cortisol stress response in individuals with high neuroticism scores may reflect down-regulation of the HPA system due to prolonged cortisol elevation (McCleery & Goodwin, 2001; Zobel et al., 2004).”

“…numbers of markers selected from across the genome to examine patterns of inheritance within families, have not yielded consistent findings (Fullerton et al., 2003; Nash et al., 2004), perhaps partly because of limitations in the statistical power of linkage studies (Risch & Merikangas, 1996).”

“A wide range of physical health problems are more common among individuals with mood and anxiety disorders, which are strongly correlated with neuroticism (Currie & Wang, 2005; Robles, Glaser, & Kiecolt-Glaser, 2005; Sareen, Cox, Clara, & Asmundson, 2005; Watkins et al., 2006).”

“…(Akiskal et al., 2006) and there is extensive evidence that higher neuroticism is related to the use and abuse of psychoactive substances, from nicotine and alcohol to heroin (Kornør & Nordvik, 2007; Malouff, Thorsteinsson, Rooke, & Schutte, 2007; Malouff et al., 2006; Sher & Trull, 1994).”

“In addition, functional magnetic resonance imaging has revealed that variations in alleles of 5-HTTLPR are related to variations in the activation of the amygdala and related brain structures in response to threatening stimuli (Brown & Hariri, 2006; Hariri et al., 2002; Passamonti et al., 2008).”

“Hormonal challenge studies suggest that this blunted cortisol stress response in individuals with high neuroticism scores may reflect down-regulation of the HPA system due to prolonged cortisol elevation (McCleery & Goodwin, 2001; Zobel et al., 2004).”

“…with few adverse side effects such as participation in moderate physical exercise (Koukouvou et al., 2004) or taking omega-3 dietary supplements (Conklin et al., 2007) might be cost-effective, even if they yielded only modest reductions in each of the many adverse outcomes associated with…”

“Several studies have found modest correlations between neuroticism scores in adults and their retrospective recall of intrusive parenting (Reti et al., 2002), having been abused during childhood (Allen & Lauterbach, 2007; Roy, 2002), lack of religious upbringing (Willemsen & Boomsma, 2007), and low…”

“…are subjectively judged to be stressful by the individual and when they are objectively rated by experimenters blind to neuroticism scores (Bolger & Zuckerman, 1995; Gunthert et al., 1999; Hankin et al., 2005; Kendler et al., 2003; Magnus et al., 1993; Suls & Martin, 2005; van Os et al., 2001).”

“…for stress management (Antoni et al., 2000; Cruess et al., 2000; Hampel, Meier, & Kummel, 2008), to prevent anxiety disorders and depression (Bienvenu & Ginsburg, 2007; Stice, Rohde, Seeley, & Gau, 2008), or to treat borderline personality disorder (Woodberry & Popenoe, 2008) could possibly…”

“In addition, persons high in neuroticism are much more likely to engage in unprotected sex, perhaps as a way to cope with aversive mood states or due to emotional impulsiveness or lack of assertiveness (Cooper, Agocha, & Sheldon, 2000; Trobst et al., 2000).”

“…longitudinal studies have shown that divorce predicts mental health problems, substance abuse, and mortality (Hemström, 1996; Ikeda et al., 2007;C. Lee & Gramotnev, 2007; S. Lee et al., 2005; Overbeek et al., 2006; Perreira & Sloan, 2001), it is reasonable to hypothesize that neuroticism…”

“…studies that persons with high neuroticism scores are more likely than other persons to develop anxiety and depression following negative life events (Fanous et al., 2002; Hutchinson & Williams, 2007; Jacobs et al., 2006; Kendler et al., 2004; Ormel & Wohlfarth, 1991; Parslow et al., 2006).”

“Neuroticism also is related to disruption of circadian rhythms (Murray, Allen, Trinder, & Burgess, 2002) and is correlated with abnormalities of the immune system (Bouhuys et al., 2004).”

“…that many of the genes influencing neuroticism function as pleiotropic general risk genes that also influence risk for many different mental disorders (Hettema, Neale et al., 2006; Jang & Livesley, 1999) and many different physical health problems (Johnson & Krueger, 2005; McCaffery et al., 2006).”

“…interest because (a) it is a functional polymorphism that influences gene products that influence activity of the serotonin transporter on neurons (Haddley et al., 2008), and (b) because the serotonin transporter is the target of some medications that are effective in treating anxiety and…”

“…more prolonged suppression of secretory immunoglobulin following a stressor (Hennig, Possel, & Netter, 1996), atypical response of natural killer cells to stress (Borella et al., 1999), diminished antibody response to vaccination (Phillips et al., 2005), and higher leukocyte counts (Daruna, 1996).”

“For example, neuroticism strongly predicts the course of renal deterioration in type I diabetics (Brickman et al., 1996) and patients with cardiac disease (Murberg, 2004).”

“For example, there is growing evidence that conscientiousness is related to physical health through positive health practices (Hagger-Johnson & Whiteman, 2007), and sensation seeking is inversely related to injuries from traffic accidents (Heino, van der Molen, & Wilde, 1996; Schwebel, Severson,…”

“In addition, functional magnetic resonance imaging has revealed that variations in alleles of 5-HTTLPR are related to variations in the activation of the amygdala and related brain structures in response to threatening stimuli (Brown & Hariri, 2006; Hariri et al., 2002; Passamonti et al., 2008).”

“In addition, Lahey (2009), summarizing the growing evidence for the public-health significance of neuroticism, documented that neuroticism is strongly associated with and predicts many different mental and physical disorders, as well as treatment seeking for not only mental disorders but also…”

“The contribution of neuroticism to the development of physical health problems, financial difficulties, and dissolution of relationships and other negative life outcomes (21) will result in a considerable amount of stress, with which persons high in neuroticism would have an inherent difficulty emotionally surmounting.”

“Neuroticism is also associated with important outcomes like occupational attainment, divorce, and mortality (Lahey, 2009; B. W. Roberts, Kuncel, Shiner, Caspi, & Goldberg, 2007).”

“Considerable research has supported predictive associations both between temperament neuroticism and negative emotionality (NE) and depression and between low positive emotionality (PE) and depression (for reviews, see, e.g., Klein et al. 2011, Lahey 2009, Ormel et al. 2013).”

“Given the public health implications of high levels of neuroticism observed in the population (for a review, see Lahey, 2009), it is not surprising that this trait has been the focus of intensive theorizing and research.”

“These behavioural tendencies have shown substantial associations with future behaviour and behavioural outcomes, such as educational and vocational success and health (Iwasa et al., 2008; Lahey, 2009; Noftle & Robins, 2007; Ozer & BenetMartinez, 2006; Roberts, Kuncel, Shiner, Caspi, & Goldberg, 2007).”

“In contrast, constraint has been found to be inversely correlated with externalizing psychopathology across the life span, but positively, albeit weakly, associated with the internalizing domain (Hink et al., 2013; Krueger, 1999a; Krueger & Markon, 2006b; Krueger, McGue, & Iacono, 2001; Lahey, 2009; Lahey et al., 2010…”

“They also tend to be vigilant and overreactive to potential stressors (Lahey, 2009) and, of particular relevance to the MRP given the open-ended nature of many microaggressions, prone to interpreting ambiguous stimuli in a negative light (Brief, Burke, George, Robinson, & Webster, 1988).”

“This is because underlying personality dimensions confer risk for psychopathology in coherent ways (e.g., neuroticism confers risk for diverse forms of behavioral dysfunction; Lahey, 2009).”

“Although neuroticism has been hypothesized to be an important predictor of physical diseases,[51] recent studies with larger sample sizes have shown that low conscientiousness may be the only personality trait that is consistently associated with chronic diseases and risk factors such as obesity,[52] diabetes,[53] and…”

“Studies examining the longitudinal relationship of personality traits with mortality report similar effect sizes as our meta-analysis reveals (Ferguson & Bibby, 2012; Kern & Friedman, 2008; Lahey, 2009).”

“Chronically hostile individuals show greater cardiovascular reactivity in negative (but not positive) social interactions (HoltLunstad, Smith, & Uchino, 2008) and are at greater risk for cardiovascular disease (Chida & Steptoe, 2009), and neuroticism is associated with objective assessments of disease incidence and mo…”

“…IH -PA Author M anuscript N IH -PA Author M anuscript In the present study, we focus on NE because it is robustly correlated with a wide range of mental and physical health problems (Lahey, 2009; Meijer, de Vries, & van Bruggen, 2011; Tellegen et al., 2006; Watson, Clark, & Harkness, 1994).”

“A síndrome de FOMO tem sido associada ao traço de personalidade do neuroticismo [29, 86], um dos fatores de risco mais conhecidos para o desenvolvimento de transtorno de humor [91].”

“and general health service use (Hills & Argyle, 2001; Ozer & Benet-Martínez, 2006; Roberts et al. 2007; Steel et al. 2008; Lahey, 2009), among others.”

“Neuroticism also has shown robust relations with many of the outcomes reviewed herein, including mortality [57, 90, 91].”

“This is because broad domains of personality have demonstrated replicable relations not only to the PDs (Samuel & Widiger, 2008), but also to common mental disorders (Kotov et al., 2010; Lahey, 2009).”

“…programmes perhaps best target self-control and neuroticism in addition to the mental disorders as these temperamental traits seem to play an important role in the development of co-morbidity and associated life outcomes (Oldehinkel et al. 2004; Lahey, 2009; Moffitt et al. 2011; Ormel et al. 2013).”

“…is a longstanding acceptance that psychological distress (PD) in the form of anxiety, sadness, irritability, self-consciousness and emotional vulnerability is strongly correlated with physical morbidity, reduced quality and duration of life, and increased use of health services (e.g. Lahey 2009).”

“…and across multiple research domains including education (e.g., Poropat, 2009), work (e.g., Judge, Heller, & Mount, 2002), and romance (e.g., Bouchard, Lussier, & Sabourin, 1999), as well as physical (e.g., Marshall, Wortman, Vickers, Kusulas, & Hervig, 1994) and mental health (e.g., Lahey, 2009).”

“(2018) also demonstrated associations between higher WCA and the personality trait of neuroticism, a general risk factor for psychopathology, particularly internalizing disorders including depression and anxiety (Lahey, 2009).”

“acceptance, relationship conflict or marital status (29,30).”

“High neuroticism contributes to many health disorders [112] and relates to increased age-related cognitive change and clinical Alzheimer’s disease in longitudinal studies [113–115].”

“Neuroticism has been found to relate to many mental and physical disorders as well as to negatively predict overall quality and longevity of life ( Lahey, 2009 ; Steel, Schmidt, & Schultz, 2008 ).”

“There have been repeated calls to include personality information in health behaviour interventions [37,38].”

“its mechanisms(20) - provide a strong rationale for large-scale GWAS to identify its genetic”

“In fact, Neuroticism has been argued to be of general public health significance because it is associated with so many negative outcomes [111, 112].”

“For example, since neuroticism predicts various mental and physical health disorders there would be clear benefits to both individuals and societies from reducing the prevalence of neuroticism (Lahey, 2009).”

“It might be possible to inexpensively screen large numbers of individuals in the community for high neuroticism scores, for instance, via web-based questionnaires (Chapman, Hampson, & Clarkin, 2014; Lahey, 2009).”

“because they are a strong predictor of impairment, health service use and psychiatric morbidity and are associated with considerable economic costs (Lahey 2009; Cuijpers, Smit et al. 2010).”

“For example, there is extensive structural evidence for the existence of a pervasive neuroticism or negative emotionality dimension in psychopathology data underlying essentially all forms of psychological maladjustment (Lahey, 2009).”

“To date, research on dimensions of temperament that increase vulnerability for both depression and anxiety has focused mainly on negative emotionality (Barlow, Ellard, Sauer-Zavala, Bullis, & Carl, 2014; Lahey, 2009).”

“This s important given that neuroticism is a strong predictor of health isorders 35 (2015) 88–102 service use, impairment, and psychiatric morbidity and is associated with considerable economic costs (Lahey, 2009; Cuijpers et al., 2010).”

“This is because underlying personality dimensions confer risk for psychopathology in coherent ways (e.g., neuroticism represents a risk factor for diverse forms of behavioral dysfunction; Lahey, 2009).”

“…has increasingly drawn the attention of educators, social scientists, neurobiologists, clinicians, economists, and public policymakers (Duckworth & Allred, 2012; Ferguson, Heckman, & Corr, 2011; Lahey, 2009; Moffitt, Poulton, & Caspi, 2013; Roberts, Kuncel, Shiner, Caspi, & Goldberg, 2007).”

“This is consistent with prior research on the relationship between stress, chronic illness and psychological morbidity in the general population (Hammen et al., 2009; Lahey, 2009).”

“We focus on neuroticism, a personality trait that has far-reaching public health significance (Lahey, 2009).”

“…example, higher savings rates (Ameriks et al., 2003; Ameriks et al., 2007), prosocial activities (Binder & Freytag, 2013), or better health behaviors (Lahey, 2009; O’Connor, Conner, Jones, McMillan, & Ferguson, 2009)—unemployment may pose additional difficulties beyond the simple economic.”

“The personality traits of neuroticism and trait anxiety are linked more widely with a number of mental and physical disorders that have bearing on the quality and longevity of people's life.(70,71) Coping strategies marked by higher levels of avoidance and/ or rumination have also been associated with a number of nega…”

“It has been shown in many studies that negative emotionality, especially with respect to the personality dimension of Neuroticism represents a risk factor for instigating and promoting affective disorders (Lahey, 2009).”

“Emotional stability was a significant predictor for all the measures of mental health problems, which was expected given the large body of research that has shown that this trait is associated with several mental disorders and physical health problems, and that this is not an artefact of the overlapping of some sympto…”

“It came to be seen as redundant and prone to problematic co-occurrence, because all of the PDs are already saturated with neuroticism (Lahey, 2009; Samuel & Widiger, 2008).”

“Neuroticism, usually a health and risk behavior liability (Lahey, 2009), nevertheless may make people susceptible to “fear appeals” (dire warnings) to change behavior (Awagu & Basil, 2016).”

“Lahey BB. (2009). Public health significance of neuroticism.”

“Similarly, although neuroticism has been associated with anxiety disorders including OCD,([89]) it has also been associated with a range of other psychiatric disorders.([90]) There may be some differences in personality disorder comorbidity between anxiety disorder and OCD, although again further systemic research is…”

“People high in neuroticism are at greater risk of poor mental and physical health [10] and increased mortality [11].”

“Insights into change in neuroticism and the determinants of change are therefore important (Lahey, 2009) and may lead to new interventions to target vulnerability to mental disorders rather than the manifesta­ tions of those disorders.”

“One well-known transdiagnostic view is the idea that trait neuroticism increases general vulnerability to psychopathology (e.g., Kotov et al., 2010; Lahey, 2009).”

“(Lahey, 2009), including depressive symptoms (e.”

“Research has also shown that, across samples and cultures, negative emotionality is one of the primary factors extracted from individual difference measures of personality ( John et al. 2008, Lahey 2009, Markon et al. 2005).”

“For example, childhood trauma and adversity (King et al. 1999 ; Iversen et al. 2007), neuroticism (Miller et al. 2004 ; Rubin et al. 2008 ; Lahey, 2009), worries about families and civilian life while deployed (Vogt et al. 2005), subsequent life stressors (King et al. 1998 ; Dirkzwager et al. 2003…”

“…study we asked if perceived social support, a resource for coping with adversity, moderates the link between amygdala reactivity to threat-related cues and the expression of trait anxiety, a well-established personality risk factor for psychopathology (Kendler, Kuhn, & Prescott, 2004; Lahey, 2009).”

“This is quite sensible as personality is known to relate with a wide variety of life outcomes (Ozer & Benet-Martinez, 2006) and has great public health significance in its own right (Hengartner, 2015; Lahey, 2009).”

“The FFM domains and traits have been shown to be useful in predicting a substantial number of important life outcomes, both positive and negative, such as subjective well-being, social acceptance, relationship conflict, marital status, academic success, criminality, unemployment, physical health, mental health, job sa…”

“Emotional disorders are the most common psychological disorders and are associated with significant impairment across all areas of life, as well as substantial direct and indirect costs (Kessler, Petukhova, Sampson, Zaslavsky, & Wittchen, 2012; Lahey, 2009; Mojtabai et al., 2015).”

“Tendencies to experience negative emotionality (e.g., anxiety, depression, and emotional volatility) are a robust predictor of mental and physical health problems (Lahey 2009) thus reduced vulnerability is reflected in the lower scores seen in microdosers.”

“sitivity, as well as mental and physical disorders [2].”

“Joining the list of prime predictors of depression or moderators of the stress–depression link, neuroticism is a core human trait reflecting the tendency to interpret the world as dangerous and threatening, coupled with negative emotional reactions in response to stress [38] and is highly predictive of mood and anxiet…”

“Additionally, a number of longitudinal studies have controlled for the periodic occurrence of anxious or depressive symptoms and still found neuroticism to act independently in predicting anxiety and mood (Lahey, 2009; Spijker, 2007).”

“…a substantial number of important life outcomes, both positive and negative, such as subjective well-being, social acceptance, relationship conflict, criminality, unemployment, physical health, mortality, and occupational satisfaction (John et al., 2008; Lahey, 2009; Ozer & Benet-Martinez, 2006).”

“For example, the trait of neuroticism is associated with a spectrum of internalizing clinical disorders such as depression, anxiety, anorexia, panic disorders, and phobias (Clark, Watson, & Mineka, 1994; Hettema, Neale, Myers, Prescott, & Kendler, 2006; Lahey, 2009).”

“High neuroticism is prospectively associated with psychopathology (Ormel et al. 2004b ; Malouff et al. 2005; Lahey, 2009) and life-course outcomes across multiple domains, for example occupational attainment, divorce and mortality (Roberts et al. 2007).”

“This likely underestimates the impact of psychopathology (Lahey, 2009; Ruscio, 2019).”

“The only exception to this distinct alignment was a relationship of Neuroticism with social impairment, albeit this is consistent with previous research and expectations (Lahey, 2009).”

“Linking this research to health, individuals high in neuroticism are known to be at greater risk of inflammation-related diseases including depression, cardiovascular disease, asthma, and irritable bowel syndrome, compared to their lowneuroticism counterparts (Lahey, 2009).”

“…U niversity of G lasgow on June 29, 2015 http://hum upd.oxfordjournals.org/ D ow nloaded from physiology and health, but the data suggest it does (Lahey, 2009) and it could therefore be of clinical importance to infertility patients, as well as of psychological significance to their treatment…”

“Consistent with research that names a neurotic personality style as a risk factor for multiple different mental disorders (Kendler, Gatz, Gardner, & Pedersen, 2006; Lahey, 2009), we found that Study members who showed little evidence of strong negative emotions in childhood were more likely to experience enduring ment…”

“Either the relation between personality and postoperative weight changes is mediated by postoperative eating behaviour or specific personality traits independently predict postoperative weight outcome because they predispose to elevated stress levels [80,81] which in turn have been shown to have a negative effect on m…”

“There is a weight of evidence linking Neuroticism in particular with risk of psychological distress, somatic complaints and poorer perceived health (Charles, Gatz, Kato, & Pedersen, 2008; Costa & McCrae, 1987; Jerram & Coleman, 1999; Lahey, 2009; Ozer & Benet-Martinez, 2006; Roberts et al., 2007).”