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).”

“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).”

“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…”

“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).”

“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).”

“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).”

“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).”

“…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).”

“…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).”

“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 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).”

“…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).”

“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).”

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

“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…”

“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,…”

“, 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).”

“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).”

“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).”

“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).”

“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).”

“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.”

“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).”

“…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).”

“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).”

“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).”

“…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…”

“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…”

“…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).”

“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).”

“…& 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,…”

“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).”

“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).”

“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…”

“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…”

“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…”

“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).”

“…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.”

“…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).”

“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).”

“…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.”

“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…”

“…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.,…”

“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).”

“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).”

“…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…”

“…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).”

“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…”

“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).”

“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).”

“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, 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…”