Neuroticism and stress are closely related, as individuals high in neuroticism are more prone to experiencing chronic worry and anxiety. Chronic worrying has numerous negative effects on one's health, including physical, mental, and emotional symptoms.
Physically, chronic worrying can lead to increased blood pressure, heart disease, and other stress-related illnesses. Mentally, individuals with neuroticism and chronic worrying may experience difficulty concentrating, memory problems, and decreased cognitive function. Emotionally, chronic worrying can lead to feelings of irritability, anxiety, and depression.
Individuals high in neuroticism may also have a more difficult time managing stressors, as they may be more likely to perceive everyday stressors as threatening or overwhelming. This can lead to a cycle of worry and stress, as the individual becomes increasingly anxious and stressed about their ability to cope with stressors.
Fortunately, there are ways to manage chronic worrying and its negative effects on health. These may include cognitive-behavioral therapy, mindfulness meditation, and relaxation techniques. By learning to manage negative thoughts and emotions, individuals with neuroticism can reduce their overall stress levels and improve their overall health and well-being.
The Strong Link Between Neuroticism and Mental Disorders
Neuroticism is consistently and strongly linked to various mental disorders throughout a person's life. These disorders include internalizing psychopathology, externalizing psychopathology, and personality disorders. Multiple studies have shown significant associations between neuroticism and these disorders (Clark & Watson, 1991; Klein, Kotov, & Bufferd, 2011; Tackete, 2006; Widiger & Smith, 2008). Meta-analytic evidence indicates large effect sizes for Axis disorders (Cohen's d > 1.0; Cohen, 1992), and small to medium effect sizes for Axis II disorders (Cohen's d = 0.02 for Narcissistic to d = 0.55 for Borderline; Saulsman & Page, 2004). Even in children and adolescents, neuroticism is associated with psychopathology, as measured by scales that do not directly assess symptoms of mental disorders (Lahey et al., 2008, 2010). In summary, there is a clear and significant relationship between neuroticism and major forms of psychopathology, ranging from moderate to strong.
In addition to its relationship with individual mental disorders, Neuroticism is also associated with increased comorbidity among different disorders. People with comorbid conditions are at a higher risk for various negative outcomes, including more persistent and severe disorders, as well as greater utilization of expensive mental health services (Barlow et al., 2014; Khan et al., 2005; Lahey, 2009). It is important to recognize that the presence of Neuroticism can contribute to a complex pattern of multiple disorders and have significant implications for individuals' well-being and healthcare utilization (Kessler, Chiu, Demler, Merikangas, & Walters, 2005).
Understanding the mechanisms that contribute to comorbidity is crucial. Recent evidence suggests that a bifactor modeling approach, which includes a "general factor" accounting for shared variance among specific disorders, can be a valuable way to rethink the common internalizing-externalizing disorder framework. This approach captures the remaining covariance in separate factors for internalizing and externalizing disorders (Caspi et al., 2014; Lahey et al., 2012). The general factor of psychopathology identified in this framework largely overlaps with the trait of Neuroticism, both at the observable and underlying levels (Tackett et al., 2013). This highlights the importance of Neuroticism as a significant transdiagnostic mechanism underlying various forms of psychopathology (Barlow, Sauer-Zavala, Carl, Bullis, & Fllard, 2014).
The Relationship Between Neuroticism and Psychopathology
Various explanations have been proposed to understand the associations between personality traits and psychopathology. These explanations have been discussed in other studies (Klein et al., 2011; Lahey, 2009; Littlefield & Sher, 2010; Tackett, 2006; Widiger & Smith, 2008). It is important to note that these explanations are not mutually exclusive and can coexist. When it comes to trait Neuroticism, multiple mechanisms are likely to contribute to its association with different disorders in different individuals (Ormel, Jeronimus, et al., 2013). One explanation is the vulnerability hypothesis, which suggests that specific personality traits act as independent factors that increase the risk of developing psychopathology later in life (as supported by prospective associations).
The concepts of spectrum and common cause explanations, although sometimes seen as separate, actually have significant overlap. This implies that personality traits and mental disorders can be understood as lying on related spectra, with shared underlying causes that go beyond the boundaries of personality and psychopathology. The spectrum model aligns with a recent shift in psychopathology research towards emphasizing transdiagnostic mechanisms, as seen in initiatives like the Research Domain Criteria (RDC) project (Insel et al., 2010).
Trait Neuroticism as a Predictor of Psychopathology
Several studies have investigated the ability of trait Neuroticism to predict the development of psychopathology in prospective studies, which supports the vulnerability model perspective. The most compelling evidence has been found for the prospective prediction of major depression onset (Fanous, Neale, Aggen, & Kendler, 2007; Kendler, Neale, Kessler, Heath, & Eaves, 1993). These studies have utilized large sample sizes and have shown predictive validity up to 25 years later (Kendler, Gatz, Gardner, & Pedersen, 2006). Other research has similarly demonstrated the predictive value of Neuroticism for later schizophrenia (van Os & Jones, 2001) and suicide (Fergusson, Woodward, & Horwood, 2000).
Several studies have investigated the usefulness of trait Neuroticism in predicting the development of psychopathology in prospective studies, supporting the vulnerability model perspective. Significant evidence has been found for the prospective prediction of major depression onset (Fanous, Neale, Aggen, & Kendler, 2007; Kendler, Neale, Kessler, Heath, & Eaves, 1993). These studies have involved large sample sizes and have demonstrated the ability to predict major depression up to 25 years later (Kendler, Gatz, Gardner, & Pedersen, 2006). Other research has also shown the predictive value of Neuroticism for later schizophrenia (van Os & Jones, 2001) and suicide (Fergusson, Woodward, & Horwood, 2000).
Evidence supporting the idea of a spectrum concept is found in studies that have identified common underlying causes for both Neuroticism and various forms of psychopathology (e.g., Carey & DiLalla, 1994; Fanous, Gardner, Prescott, Cancro, & Kendler, 2002; Hettema, Neale, Myers, Prescott, & Kendler, 2006; Mikolajewski, Allan, Hart, Lonigan, & Taylor, 2013; Silberg, Rutter, Neale, & Eaves, 2001; Stein & Stein, 2008; Tackett et al., 2012, 2013). Furthermore, research has indicated that Neuroticism may mediate the associations between the 5-HTTLPR polymorphism and depression (Jacobs et al., 2006; Muna, Clark, Roberts, & Johnstone, 2006).
Similarly, research has found that amygdala activation is commonly associated with various forms of internalizing psychopathology and high levels of Neuroticism (Barlow et al., 2014; Ormel et al., 2013). This suggests that there may be shared genetic and neurobiological mechanisms underlying the associations between Neuroticism and multiple forms of psychopathology. However, it is important to note that cross-sectional correlations between phenotypic constructs (such as measures of Neuroticism and psychopathology) do not provide strong evidence for the spectrum model and could be influenced by other explanatory mechanisms.
Common Cause Explanations for Neuroticism-Psychopathology Associations
Although the current evidence supports both vulnerability/risk and spectrum/common cause explanations for the associations between Neuroticism and psychopathology, it can be challenging to differentiate between these explanations. Especially in prospective studies, it is often difficult to determine if longitudinal predictions are solely due to common causes unless those causes are measured and controlled for at the same time. Longitudinal relationships observed between early Neuroticism and later psychopathology may actually be a result of heterotypic continuity, where similar underlying factors (e.g., genetic influences) are linked to distinct constructs at different time points. However, other findings indicate that Neuroticism also exhibits bidirectional relationships with mental disorders over time, suggesting that Neuroticism and features of psychopathology interact dynamically throughout life.
Extensive research has been conducted to examine the longitudinal and bidirectional associations between Neuroticism, stressful life events, and various environmental factors such as relationships, physical health, and occupation. This body of literature provides support for the hypothesis that individuals with higher levels of Neuroticism are more likely to experience negative outcomes in these domains later in life (Bolger & Zuckerman, 1995; Gleason, Powers, & Oltmanns, 2012; Gunthert, Cohen, & Armeli, 1999; Hankin, Fraley, & Abela, 2005; Kendler, Gardner, & Prescott, 2002; Magnus, Diener, Fujita, & Ramírez, 1993; Suls & Martin, 2005; van Os, Park, & Jones, 2001). This has significant implications, as exposure to life events increases the subsequent risk for developing psychopathology (Ehring, Ehlers, & Glucksman, 2006; Kendler et al., 2004; Parslow, Jorm, & Christensen, 2006).
Evidence suggests that individuals with higher levels of Neuroticism are more likely to experience subsequent marital dissolution (Donnellan, Conger, & Bryant, 2004; Karney & Bradbury, 1997; Kelly & Conley, 1987; Roberts et al., 2007; Rogge, Bradbury, Hahlweg, Engl, & Thurmaier, 2006; Tucker, Kressin, Spiro, & Ruscio, 1998). Divorce, in turn, predicts various mental and physical health problems (Hemstrom, 1996; Ikeda et al., 2007; Lee & Gramotnev, 2007; Lee et al., 2005; Overbeek et al., 2006; Perreira & Sloan, 2001). Furthermore, high Neuroticism is associated with lower levels of social support (Kendler, Gardner, & Prescott, 2002, 2006), and social support partially mediates the link between Neuroticism and depression (Finch & Graziano, 2001; Kendler et al., 2002; Kendler, Gardner, & Prescott, 2006). These findings suggest that high levels of Neuroticism may indirectly contribute to adverse health outcomes by increasing the likelihood of divorce and reducing social support networks (Lahey, 2009).
Neuroticism, Coping Strategies, and Internalizing Psychopathology
Research indicates that individuals with higher levels of Neuroticism exhibit greater negative affect in response to various stressors, both controlled and naturalistic (Larsen & Ketelaar, 1991; Zautra, Affleck, Tennen, Reich, & Davis, 2005). They may also find the experience of negative emotions distressing and show impaired regulation of sympathetic activity when faced with negative emotional challenges (Barlow et al., 2014; Di Simplicio et al., 2012). These findings align with evidence showing that individuals with higher levels of Neuroticism are more susceptible to internalizing psychopathology following exposure to stressful life events compared to those with lower levels of Neuroticism who experience the same events (Fanous et al., 2002; Hutchinson & Williams, 2007; Jacobs et al., 2006; Kendler et al., 2004; Parslow et al., 2006). This increased vulnerability may be attributed, in part, to differences in coping strategies, as individuals with higher Neuroticism tend to employ less effective coping mechanisms, such as avoidance, and exhibit difficulties in disengaging attention (Bolger, 1990; Bredemeier, Berenbaum, Most, & Simons, 2011).
It may also be partly explained by a general cognitive response seen in individuals with high levels of Neuroticism, where they tend to have amplified reactions to both uncertain and negative stimuli. Research has shown that individuals higher in Neuroticism exhibit a heightened neurobiological response to ambiguous situations, even more so than their response to negative situations, compared to those with lower Neuroticism (Hirsh & Inzlicht, 2008). Other relevant studies indicate that individuals who perceive stressful life events more negatively are at an increased risk for internalizing disorders (Espejo, Hammen, & Brennan, 2012). While most research has focused on the association between Neuroticism and internalizing psychopathology, similar shared genetic factors between Neuroticism and alcohol use disorders are largely explained by an individual's coping motives (Littlefield et al., 2011). Further investigation is needed to better understand how the extensive literature on Neuroticism's association with internalizing disorders might also apply to its association with externalizing disorders.
A recent study conducted by Barrocas and Hankin (2011) directly compared different temporal sequences involving Neuroticism, anxious arousal (an intermediate cognitive response), and stressful life events to predict later depressive symptoms. The researchers examined two pathways: one suggesting that higher levels of Neuroticism in early stages increase perceived exposure to stressful life events, leading to increased anxious arousal and ultimately higher levels of depressive symptoms; and an alternative pathway suggesting that higher levels of Neuroticism lead to increased anxious arousal, which in turn increases perceived exposure to stressful life events and ultimately results in higher depressive symptoms. The study included 350 students ranging from sixth to tenth grade, and the findings supported the initial model, showing a link between higher Neuroticism, perceived life stressors, anxious arousal, and depressive symptoms. Gender and age did not moderate these relationships. This type of longitudinal research design, integrating multiple factors over time, is valuable in understanding the pathways connecting Neuroticism, cognitive processes, stressful life events, and outcomes related to psychopathology.
Irritability
Irritability is a state of excessive sensitivity to stimuli, resulting in a low threshold for experiencing discomfort, annoyance, or anger. It is often accompanied by a sense of frustration or impatience, and may be caused by a variety of factors such as stress, lack of sleep, hunger, hormonal changes, or certain medical conditions. Irritability can affect an individual's personal and professional relationships, as well as their mental and physical health, if left unchecked. It is often associated with conditions such as anxiety, depression, and bipolar disorder, but can also occur as a result of normal life stressors.
Cutting the link between neuroticism and irritability requires a combination of approaches, including both psychological and lifestyle interventions. Here are some potential strategies:
Cognitive-behavioral therapy (CBT): CBT is a type of therapy that helps individuals identify and change negative patterns of thinking and behavior. It can help people with neuroticism learn to recognize their irritability triggers and develop more adaptive coping strategies.
Mindfulness meditation: Mindfulness practices have been shown to reduce stress and increase emotional regulation. By practicing mindfulness, individuals can learn to become more aware of their emotions and cultivate a non-judgmental attitude towards them.
Exercise: Exercise is a great way to reduce stress and promote emotional well-being. Regular physical activity has been shown to reduce symptoms of anxiety and depression and can help individuals with neuroticism manage their irritability.
Sleep hygiene: Getting enough sleep is crucial for emotional regulation. Poor sleep can exacerbate irritability and stress, so it's important to establish healthy sleep habits, such as sticking to a regular sleep schedule and creating a relaxing sleep environment.
Stress management: Stress is a major contributor to irritability. Learning effective stress management techniques, such as deep breathing exercises, progressive muscle relaxation, or biofeedback, can help individuals with neuroticism reduce their stress levels and manage their irritability.
The Worry Cure
Dr. Robert L. Leahy, a clinical psychologist, conducted a study on chronic worrying and its effects on individuals. The study found that chronic worriers experience higher levels of anxiety, fear, and dread, which can lead to physical symptoms such as headaches, muscle tension, and digestive problems.
Leahy's study also found that chronic worriers often engage in unproductive coping strategies, such as avoidance or distraction, which only provide temporary relief from their worrying. Instead, he suggests that cognitive restructuring, a process of changing negative thought patterns, can be a more effective way to manage chronic worrying.
In his book "The Worry Cure," Leahy outlines specific techniques for cognitive restructuring, including identifying and challenging negative thoughts, reframing worry as a problem to be solved, and practicing mindfulness and acceptance of uncertainty.
According to Dr. Leahy, one of the key strategies to stop worrying is to identify and challenge the underlying beliefs and assumptions that fuel the worry. This can involve questioning the evidence for the worry, exploring alternative explanations and outcomes, and examining the potential costs and benefits of worrying.
Another strategy is to practice mindfulness, which involves focusing on the present moment and nonjudgmentally accepting one's thoughts and feelings. This can help to reduce the tendency to ruminate on past events or worry about future outcomes.
Dr. Leahy also recommends developing a more balanced perspective on life, which involves acknowledging the positive aspects of one's life as well as the challenges. This can involve cultivating gratitude and positive emotions, as well as engaging in activities that bring joy and meaning.
Additionally, he suggests engaging in problem-solving and action-oriented strategies to address the sources of worry, rather than simply ruminating or catastrophizing. This can involve setting specific goals and developing plans to achieve them, seeking support and resources from others, and taking steps to address underlying issues such as financial or relationship problems.