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The Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future
Abstract
We highlight the role of neuroticism in the development and course of emotional disorders and make a case for shifting the focus of intervention to this higher-order dimension of personality. Recent decades have seen great emphasis placed on differentiating disorders into Diagnostic and Statistical Manual of Mental Disorders diagnoses; however, evidence has suggested that splitting disorders into such fine categories may be highlighting relatively trivial differences. Emerging research on the latent structure of anxiety and mood disorders has indicated that trait neuroticism, cultivated through genetic, neurobiological, and psychological factors, underscores the development of these disorders. We raise the possibility of a new approach for conceptualizing these disorders—as emotional disorders. From a service-delivery point of view, we explore the possibility that neuroticism may be more malleable than previously thought and may possibly be amenable to direct intervention. The public-health implications of directly treating and even preventing the development of neuroticism would be substantial.
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“Adolescents with elevated ID levels often have underlying emotional vulnerabilities in 3 areas: negative emotional reactivity, in the form of more frequent experiences of intense negative emotions and less flexible reactions to these; affect intolerance, such that emotional experiences are perceived as difficult to endure; and emotional avoidance, wherein adolescent respond to affect intolerance”
From Family Support Protocol for Adolescent Internalizing Disorders: Protocol for a Pre-Post Quantitative Treatment Development Study (2024) · cites this paper as [56]
In the citing paper
“Therefore, intervening on this mechanism would allow us to address through a single treatment, a wide number of disorders (Barlow et al., 2014).”
From Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial (2023) · cites this paper as Barlow et al., 2014
In the citing paper
“Contrary to previous psychological interventions, the UP is not focused on specific symptoms associated with different disorders if not on shared factors, for example neuroticism, which can explain the development and maintenance of these emotional disorders.”
From Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial (2023) · cites this paper as Barlow et al., 2014
In the citing paper
“These findings contribute to the study of the malleability of neuroticism proposed by Barlow [86], who suggests that personality dimensions may be malleable over time.”
From Negative and positive affect regulation in a transdiagnostic internet-based protocol for emotional disorders: Randomized controlled trial (2021) · cites this paper as [86]
In the citing paper
“Among these processes, neuroticism has been strongly associated with both anxiety and depressive disorders [86,108].”
From Negative and positive affect regulation in a transdiagnostic internet-based protocol for emotional disorders: Randomized controlled trial (2021) · cites this paper as [86]
In the citing paper
“These findings suggest that the IU construct, which is in part related to the need for predictability/controllability facet of the neuroticism construct (16), is more predictive of threat extinction learning than trait anxiety constructs that strongly overlap with multiple facets of the neuroticism construct (60,61).”
From I Doubt It Is Safe: A Meta-analysis of Self-reported Intolerance of Uncertainty and Threat Extinction Training (2021) · cites this paper as [61]
In the citing paper
“These conditions are characterized by frequent and intense negative emotions that prompt aversive, emotionally avoidant reactions (Barlow et al., 2014).”
From Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol. (2024) · cites this paper as Barlow et al., 2014
In the citing paper
“A growing body of research indicates that psychopathology is hierarchically structured with a general psychopathology factor (p factor) contributing to higher-order externalizing and internalizing dimensions that subdivide into more specific dimensions [22,23,83,84].”
From Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology (2019) · cites this paper as [84]
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Metadata
- Authors
- Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K.
- Affiliations
- Boston University (US)
- Harvard University (US)
- Corresponding author
- Barlow, David H.
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2013-10-14
- Volume
- 2
- Issue
- 3
- Pages
- 344-365
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- OpenAlex
- W2030238393
- Semantic Scholar
- c2529746b7cc11c8c7d746b6b02015245fcddee3
- Cited by
- 850
- References
- 228
- Citations by year
- 2026: 40 · 2025: 57 · 2024: 87 · 2023: 78 · 2022: 92 · 2021: 65 · 2020: 111 · 2019: 48 · 2018: 60 · 2017: 73 · 2016: 67 · 2015: 44 · 2014: 24 · 2013: 2
- FWCI
- 50.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychological Science (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- neuroticism, emotional disorders, anxiety disorders, mood disorders, personality traits, public health implications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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