Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 39, Issue 11, pp 906–912 | Cite as

Neuroticism: a non-informative marker of vulnerability to psychopathology

  • Johan OrmelEmail author
  • Judith Rosmalen
  • Ann Farmer
SPECIAL ISSUE

Abstract.

Background:

Neuroticism measures are very popular in psychopathological research, but it is unclear how useful neuroticism is in studies of the aetiology of psychopathology.

Method:

A conceptual examination was made of the literature on the association of neuroticism and psychopathology, the ontological status of neuroticism, the purport of neuroticism questionnaires, and causal issues.

Results:

The research on which neuroticism is built has historically been based solely on the factor analyses of the common adjectives used to describe usual behaviours. An abundance of studies have shown that neuroticism scores predict life stress, psychological distress, emotional disorders, psychotic symptoms, substance abuse, physical tension-related symptoms, medically unexplained physical symptoms, and health care utilisation. This evidence suggests that neuroticism scales index vulnerability to many forms of negative affect and psychiatric disorder. However, the associations do not clarify the nature of this vulnerability nor the underlying psychobiological mechanisms. We present evidence that neuroticism scores reflect a person’s characteristic (or mean) level of distress over a protracted period of time. In this perspective, even prospective associations of neuroticism with mental health outcomes are basically futile, and largely tautological since scores on any characteristic with substantial within-subject stability will predict, by definition, that characteristic and related variables at later points in time.

Conclusion:

Neuroticism is not an explanatory concept in the aetiology of psychopathology, since it measures a person’s characteristic level of distress over a protracted period of time. This situation will not change until knowledge becomes available about: (i) the mechanisms that produce high neuroticism scores (and, therefore, also psychopathology) and (ii) its neurobiological substrate. Only then will we understand why neuroticism appears to ‘predict’ the outcomes it predicts.

Key words

neuroticism negative affectivity psychopathology physical health explanatory power causality 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aluja A, Garcia O, Garcia LF (2002) A comparative study of Zuckerman’s three structural models for personality through the NEO-PI-R, ZKPQ-III-R, EPQ-RS and Goldberg’s 50-bipolar adjectives. Pers Indiv Diff 33:713–726CrossRefGoogle Scholar
  2. 2.
    Bolger N, Schilling EA (1991) Personality and the problems of everyday life: the role of neuroticism in exposure and reactivity to daily stressors. J Pers 59:355–386PubMedGoogle Scholar
  3. 3.
    Bolger N, Zuckerman A (1995) A framework for studying personality in the stress process. J Pers Soc Psychol 69:890–902CrossRefPubMedGoogle Scholar
  4. 4.
    Bolger N (1990) Coping as a personality process: a prospective study. J Pers Soc Psychol 59:525–537CrossRefPubMedGoogle Scholar
  5. 5.
    Cacioppo JT (1994) Social neuroscience: autonomic, neuroendocrine, and immune responses to stress. Psychophysiol 31:113–128Google Scholar
  6. 6.
    Carney RM, Freedland KE, Stein PK (2000) Anxiety, depression, and heart rate variability. Psychosom Med 62:84–87PubMedGoogle Scholar
  7. 7.
    Carney RM, Freedland KE, Veith RC, Cryer PE, Skala JA, Lynch T, Jaffe AS (1999) Major depression, heart rate, and plasma norepinephrine in patients with coronary heart disease. Biol Psychiatry 45:458–463CrossRefPubMedGoogle Scholar
  8. 8.
    Claridge G, Davis C (2001) What’s the use of neuroticism? Pers Indiv Diff 31:383–400CrossRefGoogle Scholar
  9. 9.
    Clark LA, Watons D, Mineka S (1994) Temperament, personality, and the mood and anxiety disorders. J Abn Psychol 103:103–116CrossRefGoogle Scholar
  10. 10.
    Cloninger CR (1986) A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatr Developm 4:167–226Google Scholar
  11. 11.
    Cloninger CR, Przybeck TR, Svrakic DM, Wetzel RD (1994) The temperament and character inventory (TCI): a guide to its development and use. Center for Psychobiology of Personality, St. LouisGoogle Scholar
  12. 12.
    Conley JJ (1984) Longitudinal consistency of adult personality: self-reported psychological characteristics across 45 years. J Pers Soc Psychol 47:1325–1333CrossRefPubMedGoogle Scholar
  13. 13.
    Costa PT Jr, McCrae RR (1980) Influence of extraversion and neuroticism on subjective well-being: happy and unhappy people. J Pers Soc Psychol 38:668–678CrossRefPubMedGoogle Scholar
  14. 14.
    Costa PT Jr, McCrae RR, Arenberg D (1980) Enduring dispositions in adult males. J Pers Soc Psychol 38:793–800CrossRefGoogle Scholar
  15. 15.
    Costa PT Jr, McCrae RR (1986) Personality stability and its implications for clinical psychology. Clin Psychol Rev 6:407–423CrossRefGoogle Scholar
  16. 16.
    Costa PT Jr, McCrae RR (1987) Neuroticism, somatic complaints, and disease: is the bark worse than the bite? J Pers 55:299–316PubMedGoogle Scholar
  17. 17.
    Costa PT Jr, McCrae RR (1991) Trait psychology comes of age. Nebr Symp Motiv 39:169–204PubMedGoogle Scholar
  18. 18.
    Costa PT Jr, McCrae RR (1992a) Normal personality assessment in clinical practice: The NEO Personality Inventory. Psychol Ass 4:5–13CrossRefGoogle Scholar
  19. 19.
    Costa PT Jr, McCrae RR (1992b) The five-factor model of personality and its relevance to personality disorders. J Pers Dis 6:343–359Google Scholar
  20. 20.
    Duggan CF, Lee AS, Murray RM (1990) Does personality predict long-term outcome in depression? Br J Psychiatry 157:19–24PubMedGoogle Scholar
  21. 21.
    Eaves L, Heath A, Martin N, Maes H, Neale M, Kendler KS, Kirk K, Corey L (1999) Comparing the biological and cultural inheritance of personality and social attitudes in the Virginia 30,000 study of twins and their relatives. Twin Res 2:62–80CrossRefPubMedGoogle Scholar
  22. 22.
    Eysenck HJ, Eysenck SBG (1968) Manual for the Eysenck Personality Inventory. Educational and Testing Service: San DiegoGoogle Scholar
  23. 23.
    Eysenck HJ (1985) A genetic model of anxiety. Issues Ment Health Nurs 7:159–199PubMedGoogle Scholar
  24. 24.
    Farmer A, Harris T, Redman K, Sadler S, Mahmood A, McGuffin P (2000) Cardiff depression study. A sib-pair study of life events and familiality in major depression. Br J Psychiatry 176:150–155CrossRefPubMedGoogle Scholar
  25. 25.
    Farmer A, Redman K,Harris T, Mahmood A, Sadler S, Pickering A, McGuffin P (2002) Neuroticism, extraversion, life events and depression. The Cardiff Depression Study. Br J Psychiatry 181:118–122PubMedGoogle Scholar
  26. 26.
    Fergusson DM, Horwood LJ (1987) Vulnerability to life events exposure. Psychol Med 17:739–749PubMedGoogle Scholar
  27. 27.
    Finn SE (1986) Stability of personality self-ratings over 30 years: evidence for an age/cohort interaction. J Pers Soc Psychol 50:813–818CrossRefPubMedGoogle Scholar
  28. 28.
    Folkman S, Lazarus RS (1988) The relationship between coping and emotion: implications for theory and research. Soc Sc Med 26:309–317CrossRefGoogle Scholar
  29. 29.
    Friedman HS (2000) Long-term relations of personality and health: Dynamism, mechanisms, tropisms. J Pers 68:1089–1107CrossRefPubMedGoogle Scholar
  30. 30.
    Goldsmith HH, Buss AH, Plomin R, Rothbart MK (1987) What is temperament? Four approaches. Child Dev 58:509–529Google Scholar
  31. 31.
    Goodwin RD, Fergusson DM, Horwood LJ (2003) Neuroticism in adolescence and psychotic symptoms in adulthood. Psychol Med 33:1089–1097CrossRefPubMedGoogle Scholar
  32. 32.
    Gray JA (1981) Anxiety as a paradigm case of emotion. Br Med Bull 37:193–197PubMedGoogle Scholar
  33. 33.
    Groenink L, Pattij T, De Jongh R, Van der Gugten J, Oosting RS, Dirks A, Olivier B (2003) 5-HT1A receptor knockout mice and mice overexpressing corticotropin-releasing hormone in models of anxiety. Eur J Pharmacol 463:185–197CrossRefPubMedGoogle Scholar
  34. 34.
    Gurrera RJ, O’Donnell BF, Nestor PG, Gainski J, McCarley RW (2001) The P3 auditory event-related brain potential indexes major personality traits. Biol Psychiatry 49:922–929CrossRefPubMedGoogle Scholar
  35. 35.
    Hansenne M (1999) P300 and personality: an investigation with the Cloninger’s model. Biol Psychol 50:143–155CrossRefPubMedGoogle Scholar
  36. 36.
    Hariri AR, Mattay VS, Tessitore A, Kolachana B, Fera F, Goldman D, Egan MF, Weinberger DR (2002) Serotonin transporter genetic variation and the response of the human amygdala. Science 297:400–403CrossRefPubMedGoogle Scholar
  37. 37.
    ten Have M, Oldehinkel AJ, Vollebergh W, Ormel J (2004) Does neuroticism explain variations in care service use for mental health problems in the general population? Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). in press, 2004Google Scholar
  38. 38.
    Heath AC, Martin NG (1990) Psychoticism as a dimension of personality: a multivariate genetic test of Eysenck and Eysenck’s psychoticism construct. J Pers Soc Psychol 58:111–121CrossRefPubMedGoogle Scholar
  39. 39.
    Heath AC, Neale MC, Kessler RC, Eaves LJ, Kendler KS (1992) Evidence for genetic influences on personality from self-reports and informant ratings. J Pers Soc Psychol 63:85–96CrossRefPubMedGoogle Scholar
  40. 40.
    Heim C, Nemeroff CB (2002) Neurobiology of early life stress: clinical studies. Semin Clin Neuropsychiatry 7:147–159CrossRefPubMedGoogle Scholar
  41. 41.
    Holsboer F (2001) Stress, hypercortisolism and corticosteroid receptors in depression: implications for therapy. J Affect Disord 62:77–91CrossRefPubMedGoogle Scholar
  42. 42.
    Jorm AF, Christensen H, Henderson S, Korten AE, Mackinnon AJ, Scott R (1993) Neuroticism and self-reported health in an elderly community sample. Pers Indiv Diff 15:515–521CrossRefGoogle Scholar
  43. 43.
    Kagan J, Reznick JS, Snidman N (1987) Temperamental variation in response to the unfamiliar. In: Krasnegor NA, Blass EM (eds) Perinatal development: A psychobiological perspective. Academic Press, San Diego. Behav Biol, pp 421–440Google Scholar
  44. 44.
    Katon W, Russo J, Frank E, Barrett JA, Williams JW, Oxman T, Sullivan MD, Cornell JE (2002) Predictors of nonresponse to treatment in primary care patients with dysthymia. Gen Hosp Psychiatry 24:20–27CrossRefPubMedGoogle Scholar
  45. 45.
    Kendler KS, Kessler RC, Neale MC, Heath AC, Eaves LJ (1993) The prediction of major depression in women: toward an integrated etiologic model. Am J Psychiatry 150:1139–1148PubMedGoogle Scholar
  46. 46.
    Kendler KS, Gardner CO, Prescott CA (2003) Personality and the experience of environmental adversity. Psychol Med 33:1193–1202CrossRefPubMedGoogle Scholar
  47. 47.
    Kirschbaum C, Hellhammer DH (1989) Salivary cortisol in psychobiological research: an overview. Neuropsychobiol 22:150–169Google Scholar
  48. 48.
    Krabbendam L, Janssen I, Bak M, Bijl RV, de Graaf R, van Os J (2002) Neuroticism and low self-esteem as risk factors for psychosis. Soc Psychiatry Psychiatr Epid 37:1–6CrossRefGoogle Scholar
  49. 49.
    Loehlin JC (1992) Genes and environment in personality development. Sage Publications, Thousand OaksGoogle Scholar
  50. 50.
    Lucas RE, Fujita F (2000) Factors influencing the relation between extraversion and pleasant affect. J Pers Soc Psychol 79:1039–1056CrossRefPubMedGoogle Scholar
  51. 51.
    MacLeod C, Hagan R (1992) Individual differences in the selective processing of threatening information, and emotional responses to a stressful life event. Behav Res Ther 30:151–161CrossRefPubMedGoogle Scholar
  52. 52.
    McCrae RR, Costa PT Jr (1997) Personality trait structure as a human universal. Am Psychol 52:509–516CrossRefPubMedGoogle Scholar
  53. 53.
    Neeleman J, Sytema S, Wadsworth M (2002) Propensity to psychiatric and somatic ill-health: evidence from a birth cohort. Psychol Med 32:793–803CrossRefPubMedGoogle Scholar
  54. 54.
    Neeleman J, Bijl R, Ormel J (2004) Neuroticism, a central link between somatic and psychiatric morbidity: path analysis of prospective data. Psychol Med 34:521–531CrossRefPubMedGoogle Scholar
  55. 55.
    Oldehinkel AJ, Ormel J, Neeleman J (2000) Predictors of time to remission from depression in primary care patients: do some patients benefit more from positive life change than others. J Abn Psychol 109:299–307CrossRefGoogle Scholar
  56. 56.
    Ormel J (1983) Neuroticism and well-being inventories: measuring traits or states? Psychol Med 13:165–176PubMedGoogle Scholar
  57. 57.
    Ormel J, Wohlfarth TD (1991) How neuroticism, long-term difficulties, and life situation change influence psychological distress: a longitudinal model. J Pers Soc Psychol 60:744–755CrossRefPubMedGoogle Scholar
  58. 58.
    Ormel J, Rijsdijk FV (2000) Continuing change in neuroticism during adulthood-structural modelling of a 16-year, 5-wave community study. Pers Indiv Diff 28:461–478CrossRefGoogle Scholar
  59. 59.
    Ormel J, Oldehinkel AJ, Brilman EI (2001) The interplay and etiological continuity of neuroticism, difficulties and life events in the etiology of major and subsyndromal, first and recurrent depressive episodes in later life. Am J Psychiatry 158:885–891PubMedGoogle Scholar
  60. 60.
    Ormel J, Oldehinkel AJ, Nolen WA, Vollebergh W (2004) Vulnerability before, during, and after a major depressive episode. A three-wave population-based study of state, scar and trait effects. Arch Gen Psychiatry 61:387–392CrossRefPubMedGoogle Scholar
  61. 61.
    van Os J, Jones PB (1999) Early risk factors an adult person-environment relationships in affective disorder. Psychol Med 29:1055–1067CrossRefPubMedGoogle Scholar
  62. 62.
    van Os J, Jones PB (2001) Neuroticism as a risk factor for schizophrenia. Psychol Med 31:1129–1134CrossRefPubMedGoogle Scholar
  63. 63.
    Plomin R, Owen MJ, McGuffin P (1994) The genetic basis of complex human behaviors. Science 264:1733–1739PubMedGoogle Scholar
  64. 64.
    Poulton RG, Andrews G (1992) Personality as a cause of adverse life events. Acta Psychiatr Scand 85:35–38PubMedGoogle Scholar
  65. 65.
    Rutter M (1987) Temperament, personality and personality disorder. Br J Psychiatry 150:443–458PubMedGoogle Scholar
  66. 66.
    Schinka JA, Busch RM, Robichaux-Keene N (2004) A meta-analysis of the association between the serotonin transporter gene polymorphism (5-HTTLPR) and trait anxiety. Mol Psychiatry 9:197–202CrossRefPubMedGoogle Scholar
  67. 67.
    Sullivan PF, Kendler KS (1998) Genetic epidemiology of ‘neurotic’ disorder. Curr Opin Psychiatry 11:143–147CrossRefGoogle Scholar
  68. 68.
    Surtees PG, Wainwright NWJ (1996) Fragile states of mind: neuroticism, vulnerability and the long-term outcome of depression. Br J Psychiatry 169:338–347PubMedGoogle Scholar
  69. 69.
    Tambs K, Sundet JM, Eaves L, Solaas MH, Berg K (1991) Pedigree analysis of Eysenck Personality Questionnaire (EPQ) scores in monozygotic (MZ) twin families. Behav Genet 21:369–382PubMedGoogle Scholar
  70. 70.
    Tellegen A (1985) Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In: Hussain Tuma A, Maser J (eds) Anxiety and the anxiety disorders. Erlbaum, Hillsdale, pp 681–706Google Scholar
  71. 71.
    Viken RJ, Rose RJ, Kaprio J, Koskenvuo M (1994) A developmental genetic analysis of adult personality: extraversion and neuroticism from 18 to 59 years of age. J Pers Soc Psychol 66:722–730CrossRefPubMedGoogle Scholar
  72. 72.
    Watson D, Clark LA (1984) Negative affectivity: the disposition to experience aversive emotional states. Psychol Bull 96:465–490CrossRefPubMedGoogle Scholar
  73. 73.
    Watson D, Walker LM (1996) The long-term stability and predictive validity of trait measures of affect. J Pers Soc Psychol 70:567–577CrossRefPubMedGoogle Scholar
  74. 74.
    Widiger TA, Hurt SW, Frances A, Clarkin JF, Gilmore M (1984) Diagnostic efficiency and DSM-III. Arch Gen Psychiatry 41:1005–1012PubMedGoogle Scholar
  75. 75.
    Widiger TA, Trull TJ (1992) Personality and psychopathology: an application of the five-factor model. J Pers 60:363–393Google Scholar

Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  1. 1.Dept. of PsychiatryGroningen University Medical CentreRB Groningenthe Netherlands
  2. 2.MRC Social, Genetic Developmental Psychiatric Research CentreInstitute of PsychiatryLondonUK

Personalised recommendations