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Public health significance of neuroticism
Open accessAbstract
The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss. Individuals in the population vary markedly on this trait, ranging from frequent and intense emotional reactions to minor challenges to little emotional reaction even in the face of significant difficulties. Although not widely appreciated, there is growing evidence that neuroticism is a psychological trait of profound public health significance. Neuroticism is a robust correlate and predictor of many different mental and physical disorders, comorbidity among them, and the frequency of mental and general health service use. Indeed, neuroticism apparently is a predictor of the quality and longevity of our lives. Achieving a full understanding of the nature and origins of neuroticism, and the mechanisms through which neuroticism is linked to mental and physical disorders, should be a top priority for research. Knowing why neuroticism predicts such a wide variety of seemingly diverse outcomes should lead to improved understanding of commonalities among those outcomes and improved strategies for preventing them.
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“NNE is prospectively linked with such a broad range of negative physical and mental health outcomes, including harmful alcohol use, sleep problems, suicide risk, and others that it has been characterized as among the most important risk factors in public health (49–52).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [49]
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“It is of interest that some authors consider neuroticism as a psychological endophenotype of affective disorders (58) as well as a personality characteristic independently leading to PD with adjunctive vulnerability to stressful life events, sleep disorders, and hormonal changes (13–15).”
From Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy (2022) · cites this paper as [58]
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Montag, C., & Reuter, M. (2015) · Studies in neuroscience, psychology and behavioral economics · doi:10.1007/978-3-319-07242-5_6 · Cited by 20
Cortical Gyrification Patterns Associated with Trait Anxiety
Miskovich, T. A., Pedersen, W. S., Belleau, E. L., Shollenbarger, S. G., Lisdahl, K. M., & Larson, C. L. (2016) · PLoS ONE · doi:10.1371/journal.pone.0149434 · Cited by 23
Kann, S. J., O’Rawe, J. F., Huang, A., Klein, D. N., & Leung, H. (2017) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsx079 · Cited by 22
“Identifying the neural correlates of NE, and how they are manifested in development, is critical for understanding how this trait contributes to so many forms of psychopathology (Lahey, 2009; Ormel et al., 2013; Shackman et al. 2016).”
BackgroundYalch, M., & Levendosky, A. (2017) · Psychological Trauma · doi:10.1037/tra0000311 · Cited by 21
“In contrast, high NEM is associated with poor psychosocial functioning, including less effective methods of coping with stress and high rates of psychiatric symptoms and diagnoses (Kotov, Gamez, Schmidt, & Watson, 2010; Lahey, 2009; Ozer & Benet-Martinez, 2006).”
BackgroundGraßmann, C., & Schermuly, C. C. (2017) · Coaching An International Journal of Theory Research and Practice · doi:10.1080/17521882.2017.1381755 · Cited by 20
“neuroticism presents a risk factor for impaired health and well-being (Friedman & Kern, 2014; Lahey, 2009) and is related to negative affectivity, emotional instability and inability to cope with challenging situations (McCrae & Costa, 2006).”
BackgroundTang, X., Tang, S., Ren, Z., & Wong, D. F. K. (2019) · Children and Youth Services Review · doi:10.1016/j.childyouth.2019.104680 · Cited by 21
Neuroticism predicts fear of falling after hip fracture
Bower, E. S., Wetherell, J. L., Petkus, A. J., & Lenze, E. J. (2020) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5261 · Cited by 20
“Neuroticism predicts negative mental and physical health outcomes such as depression and cardiovascular disease, and was found to be an independent predictor of FoF in a cross-sectional study of community-dwelling older women.(18,19) Although physical”
BackgroundGame Transfer Phenomena and Problematic Interactive Media Use: Dispositional and Media Habit Factors
de Gortari, A. B. O., & Gackenbach, J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.585547 · Cited by 22
“Understanding the role of neuroticism in GTP is very important, since neuroticism denotes tendencies to respond with negative emotions to threat, frustration, or loss (Lahey, 2009), suggesting that individuals high in neuroticism traits may be more likely to experience GTP as aversive.”
BackgroundSippel, L. M., Mota, N. P., Kachadourian, L. K., Krystal, J. H., Southwick, S. M., Harpaz‐Rotem, I., & Pietrzak, R. H. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.06.040 · Cited by 21
Intergenerational effects of high neuroticism in parents and their public health significance.
Ellenbogen, M. A., Ostiguy, C. S., & Hodgins, S. (2010) · American Psychologist · doi:10.1037/a0018512 · Cited by 19
Maternal personality traits and risk of preterm birth and fetal growth restriction
Chatzi, L., Koutra, K., Vassilaki, M., Vardiampasis, A., Georgiou, V., Koutis, A., Lionis, C., Bitsios, P., & Kogevinas, M. (2013) · European Psychiatry · doi:10.1016/j.eurpsy.2011.11.006 · Cited by 19
“Personality traits determine the appraisal of external stressors [23] and the nature, availability and efficiency of copying mechanisms [15], as well as the utilization of (personal and social) support systems [23].”
BackgroundLauderdale, S. A., Martin, K. J., & Moore, J. M. (2018) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-018-0302-x · Cited by 26
On the ubiquity and importance of antagonism
Lynam, D. R., & Miller, J. D. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-814627-9.00001-3 · Cited by 23
Parker, H. A., Ranson, J., McCrea, M., Hoelzle, J. B., deRoon‐Cassini, T. A., & Nelson, L. D. (2021) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617720001423 · Cited by 22
“The fact that internalizing personality traits predicted chronic mTBI symptoms was not surprising in light of a large literature linking personality traits, such as neuroticism and negative affect, and general health outcomes, including symptom recovery following mTBI (e.g., Broshek et al., 2015; Lahey, 2009).”
BackgroundPersonality predicts smoking frequency: An empirical examination separated by sex
Kang, W. (2022) · Personality and Individual Differences · doi:10.1016/j.paid.2022.111843 · Cited by 20
A Systematic Review of the Inter-individual Differences in Avoidance Learning
Wong, A. H. K., Aslanidou, A., Malbec, M., Pittig, A., Wieser, M. J., & Andreatta, M. (2023) · Collabra Psychology · doi:10.1525/collabra.77856 · Cited by 23
“Both constructs are highly related with each other (Watson & Clark, 1984) and are risk factors for clinical anxiety, major depressive disorder, eating disorders, and substance abuse disorders (Böhnke et al., 2014; Joiner & Lonigan, 2000; Kotov et al., 2010; Lahey, 2009).”
BackgroundSeven dimensions of personality pathology are under sexual selection in modern Spain
Vall, G., Gutiérrez, F., Peri, J. M., Gárriz, M., Baillés, E., Garrido, J. M., & Obiols, J. E. (2015) · Evolution and Human Behavior · doi:10.1016/j.evolhumbehav.2015.10.004 · Cited by 20
Lee, S. A., & Guajardo, N. R. (2011) · Personality and Individual Differences · doi:10.1016/j.paid.2010.11.036 · Cited by 20
“…from the areas of neuroscience (e.g., Haas, Omura, Constable, & Canli, 2007) and genetics (e.g., Kendler, Gatz, Gardiner, & Pedersen, 2006) suggests that neuroticism has a biological basis (Eysenck, 1967), which may explain its strong connection with mental and physical disorders (see Lahey, 2009).”
BackgroundDiagnosis of personality disorder using the five-factor model and the proposed DSM-5.
Widiger, T. A., Costa, P. T., & McCrae, R. R. (2012) · American Psychological Association eBooks · doi:10.1037/13939-019 · Cited by 19
Neuroticism Predicts Subsequent Risk of Major Depression for Whites but Not Blacks
Assari, S. (2017) · Behavioral Sciences · doi:10.3390/bs7040064 · Cited by 22
“Neuroticism (N) is a psychological trait with considerable public health significance [1].”
BackgroundLee‐Winn, A. E., Mendelson, T., & Johnson, R. M. (2018) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2018.06.005 · Cited by 21
“However, findings from several prospective studies indicate that maladaptive personality traits are likely to develop before substance use initiation and may predict maintenance and treatment outcome (Bogg & Roberts, 2013; Hengartner, Kawohl, Haker, Rössler, & Ajdacic-Gross, 2016; Lahey, 2009).”
BackgroundDevelopment of a Multidimensional Measure to Examine Fear of Dementia
Page, K. S., Hayslip, B., Wadsworth, D., & Allen, P. A. (2018) · The International Journal of Aging and Human Development · doi:10.1177/0091415018784737 · Cited by 19
Neuroticism and emotion regulation through music listening: A meta-analysis
Miranda, D., & Blais-Rochette, C. (2018) · Musicae Scientiae · doi:10.1177/1029864918806341 · Cited by 21
Mu, W., Zhu, D., Wang, Y., Li, F., Ye, L., Wang, K., & Zhou, M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17176074 · Cited by 21
“The personality trait of neuroticism refers to relatively stable tendencies to respond with negative emotions to threat, frustration, or loss [14].”
BackgroundBuilding Emotional Resilience with Big Five Personality Model Against COVID-19 Pandemic
Sahni, S., Kumari, S., & Pachaury, P. (2020) · FIIB Business Review · doi:10.1177/2319714520954559 · Cited by 23
“The vast literature on personality reveals that out of all five traits, neuroticism is a psychological trait which is of utmost importance to psychological and mental health (Lahey, 2009).”
BackgroundCorrelation between Gut Microbiota and Six Facets of Neuroticism in Korean Adults
Park, E., Yun, K. E., Kim, M.-H., Kim, J., Chang, Y., Ryu, S., Kim, H., Kim, H., & Jung, S. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11121246 · Cited by 20
“Since the gut microbiota play a central role in the gut–brain axis that regulates mood and behavior, they can affect various aspects of normal psychology, such as emotion, cognition, stress management, and social behavior in addition to physical health [6,12].”
BackgroundStudy of generic quality of life in patients operated on for post‐prostatectomy incontinence
Holm, H. V., Fosså, S. D., Hedlund, H., & Dahl, A. A. (2013) · International Journal of Urology · doi:10.1111/iju.12077 · Cited by 19
Krueger, R. F., DeYoung, C. G., & Markon, K. E. (2010) · Behavioral and Brain Sciences · doi:10.1017/s0140525x10000646 · Cited by 19
Personality Pathology and Increased Use of Medical Resources in Later Adulthood
Powers, A. D., Strube, M., & Oltmanns, T. F. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2013.10.009 · Cited by 19
Morack, J., Infurna, F. J., Ram, N., & Gerstorf, D. (2013) · International Journal of Behavioral Development · doi:10.1177/0165025413492605 · Cited by 21
“Consistent with many reports (Bolger & Schilling, 1991; Costa & McCrae, 1987; Lahey, 2009; Neeleman et al., 2004), people higher in neuroticism tended to report poorer physical and mental health.”
BackgroundResultPersonality, Stress and Resilience
Matthews, G., Lin, J., & Wohleber, R. W. (2017) · Psihologijske teme · doi:10.31820/pt.26.1.6 · Cited by 19
“High neuroticism is linked to numerous adverse health and wellbeing outcomes (Lahey, 2009; Matthews et al., 2009).”
BackgroundHu, N., Luo, J., Xiang, W., Yang, G., Huang, T., Guan, L., Xu, J., & Peng, B. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05594-6 · Cited by 23
“Neuroticism is a personality trait referring one’s tendency to experience negative emotions (e.g., anger, sadness, anxiety, worry, hostility, etc.) manifested according to individual differences in negative emotional responses to threats, setbacks, or losses [17].”
BackgroundHoppe, J. M., Frick, A., Åhs, F., Linnman, C., Appel, L., Jonasson, M., Lubberink, M., Långström, B., Frans, Ö., von Knorring, L., et al. (2018) · Translational Psychiatry · doi:10.1038/s41398-018-0163-1 · Cited by 18
Elpidorou, A. (2025) · doi:10.1093/9780197564363.001.0001 · Cited by 20
The Brain Derived Neurotrophic Factor and Personality
Montag, C. (2014) · Advances in Biology · doi:10.1155/2014/719723 · Cited by 18
“Many personality traits, such as neuroticism, are known to be of large importance for public health outcomes [5].”
Background
Metadata
- Authors
- Lahey, B. B.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Lahey, Benjamin B.
- ORCID
- Lahey, Benjamin B.
- Venue
- American Psychologist
- Published
- 2009
- Volume
- 64
- Issue
- 4
- Pages
- 241-256
- ISSN
- 0003-066X (ISSN-L)
- 1935-990X
- PMC
- PMC2792076
- OpenAlex
- W1982330837
- Cited by
- 1,901
- References
- 233
- Citations by year
- 2026: 118 · 2025: 125 · 2024: 129 · 2023: 157 · 2022: 149 · 2021: 166 · 2020: 202 · 2019: 106 · 2018: 100 · 2017: 108 · 2016: 113 · 2015: 99 · 2014: 77 · 2013: 78 · 2012: 68
- FWCI
- 58.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Psychologist (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH059111)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- neuroticism, personality traits, public health, mental illness, physical disorders, comorbidities, health care utilization, quality of life, longevity, emotional reactivity, prevention
- MeSH terms
- Arousal, Mental Disorders, Character, Emotions, Humans, Neurotic Disorders, Prognosis, Public Health, Risk Factors, Risk-Taking, Somatoform Disorders, Health Behavior, Comorbidity
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