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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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Somma, A., Borroni, S., Kelley, S. E., Edens, J. F., & Fossati, A. (2018) · Psychological Assessment · doi:10.1037/pas0000547 · Cited by 12
“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).”
BackgroundDeng, Y., Li, S., Zhou, R., & Walter, M. (2019) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2019.00102 · Cited by 12
“…102 because people with high neuroticism are often at risk of many forms of psychopathology and behavioral problems, especially the common mental disorders, such as mood disorders and substance abuse (for review, see Lahey, 2009; Kotov et al., 2010; Ormel et al., 2013b; Jeronimus et al., 2016).”
BackgroundAnxiety in Late-Life Depression: Determinants of the Course of Anxiety and Complete Remission
van der Veen, D. C., Gulpers, B. J. A., van Zelst, W. H., Köhler, S., Comijs, H. C., Schoevers, R. A., & Voshaar, R. C. O. (2020) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2020.12.023 · Cited by 13
Martyr, A., Gamble, L. D., Nelis, S. M., Collins, R., Alexander, C. M., Morris, R. G., Quinn, C., Pentecost, C., Rusted, J. M., Victor, C. R., et al. (2022) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000524607 · Cited by 18
“neuroticism and lower conscientiousness have been associated with increased risk of developing dementia [37] and higher neuroticism has been associated with both mental and physical disorders [63].”
BackgroundMental health trajectories after juridical divorce: Does personality matter?
Hald, G. M., Wimmelmann, C. L., Øverup, C. S., Ciprić, A., Sander, S., & Strizzi, J. M. (2022) · Journal of Personality · doi:10.1111/jopy.12737 · Cited by 18
“…dimension in health research is neuroticism and there is solid evidence of associations between this trait and a wide range of negative psychological factors, including depression, anxiety, somatization, stress, and lower satisfaction with life (e.g., Lahey, 2009; Wimmelmann et al., 2020).”
BackgroundResultInfluentialPersonality traits and mental health care utilization: Longitudinal findings from the MIDUS
Goktan, A. J., Weston, S. J., Luo, J., Graham, E., & Mroczek, D. (2022) · Journal of Research in Personality · doi:10.1016/j.jrp.2022.104260 · Cited by 10
“…to be linked to general and specific mental health problems, particularly mood and anxiety disorders, partially mirroring the relationship of traits to physical health (Bienvenu et al., 2004; Dash et al., 2019; Goodwin & Friedman, 2006; Hengartner et al., 2016; Kotov et al., 2010; Lahey, 2009).”
BackgroundPerceived anabolic–androgenic steroid use is associated with perceived neuroticism
Sagoe, D., Huang, K. T. L., Molde, H., Andreassen, C. S., & Pallesen, S. (2015) · Journal of Substance Use · doi:10.3109/14659891.2015.1009510 · Cited by 12
“…& McCrae, 1992b; Egan, 2009; Fridberg et al., 2011; Goldberg, 1993) as well as psychological syndromes such as antisocial personality disorder (Lahey, 2009), our finding corroborates evidence that perceived AAS use negatively impacts the construal of the perceived user’s personality or social…”
ResultSáez‐Francàs, N., Valero, S., Calvo, N., Gomà‐i‐Freixanet, M., Alegre, J., de Sevilla, T. F., & Casas, M. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.02.031 · Cited by 12
“However, according to the results of the present study, interventions should be specifically addressed at least at diminishing the well established negative impact of neuroticism on health and behavior by addressing symptomatology of depression, and promoting an “extraverted” role by focusing on the enhancement of ada…”
ResultClinical Implications of Impaired Sleep
Terre, L. (2014) · American Journal of Lifestyle Medicine · doi:10.1177/1559827614521955 · Cited by 13
Alika, H. I., Akanni, D. O., & Akanni, O. O. (2016) · International Journal of Psychology and Counselling · doi:10.5897/ijpc2016.0451 · Cited by 12
“Psychological distress refers to a vulnerable emotional state or mood, characterized by feelings of sadness, tension, anxiety, irritability, and selfconsciousness (Lahey, 2009).”
BackgroundRealo, A., van der Most, P. J., Allïk, J., Esko, T., Jeronimus, B. F., Kööts‐Ausmees, L., Mõttus, R., Tropf, F. C., Snieder, H., & Ormel, J. (2016) · Journal of Personality · doi:10.1111/jopy.12297 · Cited by 16
Schreuder, M. J., Schirmbeck, F. N., Meijer, C. J., & de Haan, L. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.04.030 · Cited by 12
Spatial and temporal expression patterns of genes around nine neuroticism-associated loci
Ohi, K., Shimada, T., Yasuyama, T., Kimura, K., Uehara, T., & Kawasaki, Y. (2017) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2017.04.019 · Cited by 12
“There is growing evidence that neuroticism is a psychological and genetic trait of profound public health significance (Lahey, 2009; Smith et al., 2016).”
BackgroundEMDR-Based Divorce Recovery Group: A Case Study
Wong, S.-L. (2018) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.12.2.58 · Cited by 12
“On the other hand, research has shown that neuroticism, the stable tendency to react to threat, frustration, and loss with negative affects, such as anger, sadness, anxiety, self-consciousness, and vulnerability, is a robust predictor of many mental and physical disorders (Lahey, 2009).”
BackgroundYoung, J. J., Balachandran, S., Garg, G., Balasubramaniam, M., Gupta, A., Tampi, D. J., & Tampi, R. R. (2019) · Neurodegenerative Disease Management · doi:10.2217/nmt-2018-0044 · Cited by 12
Kushner, S. C., Bagby, R. M., & Harkness, K. L. (2016) · Personality Disorders Theory Research and Treatment · doi:10.1037/per0000194 · Cited by 13
Motivation but not valence modulates neuroticism‐dependent cingulate cortex and insula activity
Deng, Y., Li, S., Zhou, R., & Walter, M. (2018) · Human Brain Mapping · doi:10.1002/hbm.23942 · Cited by 12
“anxiety, anger, sadness, irritability, self-consciousness, and vulnerability (Lahey, 2009) and is one of the three basic elements of personality (Eysenck, 1990).”
BackgroundInfluentialNoise sensitivity and diminished health: the role of stress-related factors
Hill, E. M. (2012) · Tuwhera (Auckland University of Technology) · Cited by 12
Dong, H., Zhu, Y., Shen, J., & Xue, S. (2025) · The Internet and Higher Education · doi:10.1016/j.iheduc.2025.101041 · Cited by 11
Emotional intelligence as a mediator in the relationship between neuroticism and L2 achievement
Ożańska-Ponikwia, K., Piechurska-Kuciel, E., & Skałacka, K. (2020) · Applied Linguistics Review · doi:10.1515/applirev-2020-0008 · Cited by 12
Kremyar, A. J., & Wygant, D. B. (2023) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-023-10048-6 · Cited by 11
“These types of psychopathology can cause significant distress and impairment and lead to adverse outcomes, such as future development of other psychopathological or physical health problems, economic hardship related to health service utilization, difficulties with activities of daily living and, at more severe levels…”
BackgroundThe HEXACO Personality Space Before and After Re-Rotation to Approximate the Big Five Dimensions
Ashton, M. C., Lee, K., Anglim, J., Bucher, M. A., Horwood, S., & Samuel, D. B. (2023) · Journal of Personality Assessment · doi:10.1080/00223891.2023.2229427 · Cited by 11
“For example, Lahey (2009) has documented the significance of Neuroticism for public health, noting its associations with various mental and physical disorders and with poorer quality of life (see, e.g., Anglim et al., 2020, for links with well-being).”
BackgroundNeuroticism facets and mortality risk in adulthood: A systematic review and narrative synthesis
Butler, M., Turiano, N. A., Buckley, L., McGeehan, M., & O’Súilleabháin, P. S. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111500 · Cited by 16
“There has been a myriad of research implicating neuroticism as a psychological trait of profound public health significance [4,36,41,58].”
Zheng, S., Wang, J., Lu, S., & Xiao, J. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.151 · Cited by 11
Peters, H., Garbe, A., Breil, S. M., Oberst, S., Selch, S., & Holzhausen, Y. (2024) · BMC Medical Education · doi:10.1186/s12909-024-05434-x · Cited by 14
“Individuals high in neuroticism tend to become anxious, worried and irritable more easily or intensely than others [28].”
BackgroundNeuroticism and the sales profession
Habel, J., Kadić‐Maglajlić, S., Hartmann, N. N., de Jong, A., Zacharias, N. A., & Kosse, F. (2024) · Organizational Behavior and Human Decision Processes · doi:10.1016/j.obhdp.2024.104353 · Cited by 12
The relationship between neuroticism as a personality trait and mindfulness skills: a scoping review
Angarita‐Osorio, N., Escorihuela, R. M., & Cañete, T. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1401969 · Cited by 17
“Neuroticism, a well-known personality trait with established negative effects on well-being and relationships with several mental, physiological, or cognitive health problems (Lahey, 2009).”
Zhao, L. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1498458 · Cited by 13
Verschoor, E., & Markus, C. R. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2011.12.003 · Cited by 11
“Trait neuroticism refers to individual differences in emotional stability, negative emotional responses to threat, frustration, or loss and is operationally defined by items referring to irritability, sadness, worry and self-consciousness (Lahey, 2009).”
BackgroundNeuroticism modulates mood responses to pharmacological sex hormone manipulation in healthy women
Stenbæk, D. S., Budtz–Jørgensen, E., Pinborg, A. B., Jensen, P. S., & Frøkjær, V. G. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.10.016 · Cited by 12
Who wants to change their personality and what do they want to change?
Allan, J. A., Leeson, P., & Martin, L. S. (2014) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2014.9.1.8 · Cited by 11
Kristensen, P., Corbett, K., Mehlum, I. S., & Bjérkedal, T. (2011) · Occupational and Environmental Medicine · doi:10.1136/oemed-2011-100144 · Cited by 12
Why do People Worry and Ruminate? Investigating Factors that Maintain Repetitive Negative Thought
Kingston, R. E. F. (2013) · Open Research Exeter (University of Exeter) · doi:10.5127/jep.027712
“As such, it has been hypothesised that events like abuse and maltreatment early in development may contribute to the development of neuroticism (e.g., Goldberg, 2000; Lahey, 2009; Roy, 2002).”
BackgroundNijjar, R., Ellenbogen, M. A., & Hodgins, S. (2016) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-015-0112-x · Cited by 14
“Trait neuroticism may be amenable to a range of interventions (Lahey 2009; Ormel et al. 2013), including those designed to aid in stress management (e.”
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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