Neuroticism: a non-informative marker of vulnerability to psychopathology

Depressive symptoms and neuroticism mediate the association between traumatic events and suicidality - A latent class mediation analysis of UK Biobank Database

BACKGROUND

Mental disorders that follow traumatic experience may increase risk of suicidality, but a comprehensive approach to understand how these mental disorders mediate the association between psychological traumatic experience and suicidality should be elucidated. In this study, we attempted to provide comprehensive evidence on how depressive symptoms and neuroticism can mediate the association between psychological traumatic experiences and suicidal behaviours including suicidal ideation, suicidal planning, and suicide attempts.

METHODS

We analyzed 111,931 participants from UK Biobank who had completed mental health web-based questionnaire from 2016 to 2017. "Self-harm and suicidal behaviour and ideation (SSBI) score" was calculated by the response from suicidal behaviours and self-harm questionnaires. Conducting multivariate linear regression, depressive symptoms, anxiety symptoms, and neuroticism were selected as potential mediators. We constructed a latent class mediation model estimated direct effect of psychological traumatic events on suicidality and indirect effect of psychological traumatic events mediated by depressive symptoms and neuroticism.

RESULTS

Psychological traumatic events were positively associated with suicidal behaviours. Depressive symptoms and neuroticism significantly mediated the effect of psychological traumatic events on suicidality. Anxiety symptoms did not mediate the association between psychological traumatic events and suicidality.

CONCLUSION

Psychological traumatic events, irrespective of life stage of occurrence, are associated with suicidality. The association between psychological traumatic events and suicidality can be partially explained by depressive symptoms and neuroticism of those who were exposed to psychological trauma.

Distribution of Psychological Instability Among Surgeons

BACKGROUND

High emotional instability (i.e., neuroticism) is associated with poor mental health. Conversely, traumatic experiences may increase neuroticism. Stressful experiences such as complications are common in the surgical profession, with neurosurgeons being particularly affected. We compared the personality trait neuroticism between physicians in a prospective cross-sectional study.

METHODS

We used an online survey using the Ten-Item Personality Inventory, an internationally validated measure of the 5-factor model of personality dimensions. It was distributed to board-certified physicians, residents, and medical students in several European countries and Canada (n = 5148). Multivariate linear regression was used to model differences between surgeons, nonsurgeons, and specialties with occasional surgical interventions with respect to neuroticism, adjusting for sex, age, age squared, and their interactions, then testing equality of parameters of adjusted predictions separately and jointly using Wald tests.

RESULTS

With an expected variability within disciplines, average levels of neuroticism are lower in surgeons than nonsurgeons, especially in the first part of their career. However, the course of neuroticism across age follows a quadratic pattern, that is, an increase after the initial decrease. The acceleration of neuroticism with age is specifically significant in surgeons. Levels of neuroticism are lowest towards mid-career, but exhibit a strong secondary increase towards the end of the surgeon's career. This pattern seems driven by neurosurgeons.

CONCLUSIONS

Despite initially lower levels of neuroticism, surgeons suffer a stronger increase of neuroticism together with age. Because, beyond well-being, neuroticism influences professional performance and health care systems costs, explanatory studies are mandatory to enlighten causes of this burden.

Neuroticism and Stress in Older Adults: The Buffering Role of Self-Esteem

BACKGROUND

Chronic stress is associated with accelerated aging and poor health outcomes in older adults. According to the Transactional Model of Stress (TMS), distress is experienced when one perceives the stressor, or threat, to outweigh the ability to cope. The experience of distress is correlated with trait neuroticism, which is associated with greater perceptions of stress and stress reactivity, as well as a tendency to engage in maladaptive coping strategies. However, as individual personality traits do not act in isolation, this study aimed to investigate the moderating role of self-esteem in the relationship between neuroticism and distress using a TMS framework.

METHODS

A total of 201 healthy older adults (Mage = 68.65 years) completed questionnaires measuring self-esteem, neuroticism, perceived stress, and positive coping.

RESULTS

Greater neuroticism was significantly associated with less positive coping at low (b = -0.02, p < 0.001) and mean self-esteem levels (b = -0.01, p < 0.001), but not at high self-esteem levels (b = -0.01, p = 0.06). No moderating effect was found for perceived stress or overall distress.

CONCLUSION

The results support the association between trait neuroticism and indices of stress and suggest a potential buffering effect of self-esteem in moderating the negative association between neuroticism and positive coping.

The contribution of copy number variants to psychiatric symptoms and cognitive ability

Copy number variants (CNVs) are deletions and duplications of DNA sequence. The most frequently studied CNVs, which are described in this review, are recurrent CNVs that occur in the same locations on the genome. These CNVs have been strongly implicated in neurodevelopmental disorders, namely autism spectrum disorder (ASD), intellectual disability (ID), and developmental delay (DD), but also in schizophrenia. More recent work has also shown that CNVs increase risk for other psychiatric disorders, namely, depression, bipolar disorder, and post-traumatic stress disorder. Many of the same CNVs are implicated across all of these disorders, and these neuropsychiatric CNVs are also associated with cognitive ability in the general population, as well as with structural and functional brain alterations. Neuropsychiatric CNVs also show incomplete penetrance, such that carriers do not always develop any psychiatric disorder, and may show only mild symptoms, if any. Variable expressivity, whereby the same CNVs are associated with many different phenotypes of varied severity, also points to highly complex mechanisms underlying disease risk in CNV carriers. Comprehensive and longitudinal phenotyping studies of individual CNVs have provided initial insights into these mechanisms. However, more work is needed to estimate and predict the effect of non-recurrent, ultra-rare CNVs, which also contribute to psychiatric and cognitive outcomes. Moreover, delineating the broader phenotypic landscape of neuropsychiatric CNVs in both clinical and general population cohorts may also offer important mechanistic insights.

Examining the Factor Structure and Incremental Utility of the Contrast Avoidance Questionnaires via Bifactor Analysis

The negative emotional contrast avoidance model posits that pathological worry is maintained by the avoidance of negative emotional shifts. The Contrast Avoidance Questionnaires (CAQ-Worry and CAQ-General Emotion) aim to assess contrast avoidance beliefs and behaviors. Questions remain around the factor structures of the CAQs, whether such structures replicate in nonundergraduate samples, and whether their domain-specific factors are valid for independent use. This study used bifactor analysis in a large community sample (N = 827) to address these gaps in the literature. Results supported bifactor models of both measures. Complementary analyses supported the multidimensionality of the CAQ-Worry, including its strong general factor and independent use of two domain-specific factors, rather than the original three domain-specific factors. The CAQ-General Emotion's general factor was strong, but the merits of the Discomfort domain-specific factor require more exploration, and use of the Avoidance domain-specific factor is discouraged.

Taking Heart: Cardiac Symptoms and Nightmares Differentiate Nightmare Proneness and Psychological Distress among Young Adults

Introduction  Nightmare proneness, a trait-like disposition to experience frequent nightmares, has been strongly related to psychological distress. The aim of the present study was to examine if cardiac symptoms and hypothetically-related variables, nightmares, and perceived physical health could be used to differentiate nightmare proneness and psychological distress. Materials and Methods  In the present cross-sectional study, 254 young adults completed measures of nightmare proneness, psychological distress, cardiac symptoms, nonspecific and posttraumatic nightmares, nightmare distress, health behaviors, perceptions of physical health, perceived stress, Type-D personality, sleep fragmentation, and dream recall. Results  After controlling for psychological distress, nightmare proneness remained significantly correlated with nightmares, nightmare distress, cardiac symptoms, sleep fragmentation, physical health, perceived stress, and Type-D personality. After controlling for nightmare proneness, distress remained correlated with perceived stress and Type-D personality. Regression analyses indicated that after accounting for all variables, nightmare distress, physical health, and nightmare proneness predicted cardiac symptoms. Posttraumatic nightmares, sleep fragmentation, distress, perceived stress, Type-D personality, and chest pain predicted nightmare proneness. Conclusion  Nightmare proneness and psychological distress can be considered separate constructs. The findings were consistent with those of previous research and supported the theoretical propositions that nightmare proneness includes hyperarousal, vulnerability to stressors, and concretization, a mental process in which vague internal states are made more concrete.

High Perceived Stress and Low Self-Efficacy are Associated with Functional Somatic Disorders: The DanFunD Study

Objective

Several psychological factors have been proposed to be associated with functional somatic disorders (FSD) including functional somatic syndromes, such as irritable bowel, chronic widespread pain, and chronic fatigue. However, large randomly selected population-based studies of this association are sparse. This study aimed to investigate the association between FSD and perceived stress and self-efficacy, respectively, and to investigate if FSD differed from severe physical diseases on these aspects.

Methods

This cross-sectional study included a random sample of the adult Danish population (n = 9656). FSD were established using self-reported questionnaires and diagnostic interviews. Perceived stress was measured with Cohen's Perceived Stress Scale and self-efficacy with the General Self-Efficacy Scale. Data were analysed with generalized linear models and linear regression models.

Results

FSD were associated with higher perceived stress and lower self-efficacy, especially for the multi-organ and the general symptoms/fatigue FSD types and for chronic fatigue. However, controlling for the personality trait neuroticism altered the associations with self-efficacy so it became insignificant. The analysis did not support an important interaction between perceived stress and self-efficacy on the likelihood of having FSD. Individuals with FSD presented levels of perceived stress that were not equal, ie higher, to those in individuals with severe physical diseases.

Conclusion

FSD were positively associated with perceived stress and negatively associated with self-efficacy. Our study may point to stress being part of the symptomatology of FSD. This underlines the severity of having FSD and stresses the relevance of the resilience theory in the understanding of the condition.

Associations Between Personality and Depressive Symptoms in an Adolescent Clinical Population: Consideration of Personality Stability

The study used trait-state-occasion TSO models to explore longitudinal personality stability in young adolescents with the onset of depressive symptoms and to quantify time-invariant and time-varying personality components in predicting the course of depressive symptoms. A total of 326 young clinical adolescents were recruited from high schools, and only 290 adolescents (112 boys; 178 girls) were followed up for 4 time points. Personality measures were implemented twice each year with an interval of 6 months, providing four assessment waves (T1 to T4); depression measures were administered at the initial stage (T1) and the third wave (T3), respectively. The results showed that five domains of personality in adolescents with depressive symptoms were largely characterized by the stable trait factor (65%-81%). The average autoregressive effects across the four waves were significant for all Big Five personality domains except openness. Moreover, excluding time-varying variance, conscientiousness, extraversion and agreeableness were negatively associated with T1 depressive symptoms; however, only the latter two domains retained significant relationships in the second year of intervention. An elevated level of neuroticism was consistently associated with higher levels of depressive symptoms over interventions. Trait factors of extraversion, agreeableness and neuroticism were associated with depressive symptoms in early adolsecnets, providing some implications for clinical practitioners.

Personality Traits and Inflammation in Depressive Disorders

Depression is a psychiatric disorder of heterogeneous etiology. One of the leading theories suggests an inflammatory background to it. It is often found in the scientific literature that certain personality traits, such as high neuroticism, low extroversion and conscientiousness, are being associated with depression. We combined biochemical tests of IL-1 and IL-6 serum levels and scores in the personality test EPQ-R among 50 depressed patients and 37 healthy participants. The results confirmed increased serum levels of IL-1 and IL-6 in a study group when compared to healthy volunteers. Additionally, personality traits (psychoticism and neuroticism) were increased in the depressed group when compared to healthy volunteers. The authors analyzed correlations in both groups. However, only one statistically significant link was observed in IL-6 and K levels (scale associated with the need for social acceptance) in the control group.

Familial risk for depressive and anxiety disorders: associations with genetic, clinical, and psychosocial vulnerabilities

BACKGROUND

In research and clinical practice, familial risk for depression and anxiety is often constructed as a simple Yes/No dichotomous family history (FH) indicator. However, this measure may not fully capture the liability to these conditions. This study investigated whether a continuous familial loading score (FLS), incorporating family- and disorder-specific characteristics (e.g. family size, prevalence of depression/anxiety), (i) is associated with a polygenic risk score (PRS) for major depression and with clinical/psychosocial vulnerabilities and (ii) still captures variation in clinical/psychosocial vulnerabilities after information on FH has been taken into account.

METHODS

Data came from 1425 participants with lifetime depression and/or anxiety from the Netherlands Study of Depression and Anxiety. The Family Tree Inventory was used to determine FLS/FH indicators for depression and/or anxiety.

RESULTS

Persons with higher FLS had higher PRS for major depression, more severe depression and anxiety symptoms, higher disease burden, younger age of onset, and more neuroticism, rumination, and childhood trauma. Among these variables, FH was not associated with PRS, severity of symptoms, and neuroticism. After regression out the effect of FH from the FLS, the resulting residualized measure of FLS was still associated with severity of symptoms of depression and anxiety, rumination, and childhood trauma.

CONCLUSIONS

Familial risk for depression and anxiety deserves clinical attention due to its associated genetic vulnerability and more unfavorable disease profile, and seems to be better captured by a continuous score that incorporates family- and disorder-specific characteristics than by a dichotomous FH measure.

Untangling the tingle: Investigating the association between the Autonomous Sensory Meridian Response (ASMR), neuroticism, and trait & state anxiety

The Autonomous Sensory Meridian Response (ASMR) is an intensely pleasant tingling sensation originating in the scalp and neck and is elicited by a range of online video-induced triggers. Many individuals now regularly watch ASMR videos to relax, and alleviate symptoms of stress and insomnia, all which are indicative of elevated levels of anxiety. Emerging literature suggests that ASMR-capable individuals are characterised by high trait neuroticism, which is associated with a tendency to experience negative emotional states such as anxiety. To date however no literature has empirically linked these personality constructs and watching ASMR videos on the effect of reducing anxiety. In the current study, 36 ASMR-experiencers and 28 non-experiencers watched an ASMR video, and completed assessments of neuroticism, trait anxiety, and pre- / post-video state anxiety. MANCOVA with Group as the independent measures factor showed that ASMR-experiencers had significantly greater scores for neuroticism, trait anxiety, and video engagement than non-experiencers. Pre-video state anxiety was also significantly greater in the ASMR-experiencers and was significantly attenuated on exposure to the ASMR video, whereas non-experiencers reported no difference in state anxiety pre- and post-video. Thus, watching ASMR alleviated state anxiety but only in those who experienced ASMR. Subsequent mediation analyses identified the importance of pre-existing group differences in neuroticism, trait and (pre-video) state anxiety in accounting for the group difference in the reduction of state anxiety. The mediation analysis further lends support for watching ASMR videos as an intervention for the reduction of acute state anxiety. Future areas for research are discussed.

Metacognitive beliefs and emotional eating in adolescents

PURPOSE

Metacognition refers to how people think about their own thoughts. Existing studies have found that compared to healthy controls, individuals with eating disorders manifest elevated levels of dysfunctional metacognitive beliefs. No studies to date have investigated what role metacognitive beliefs play in the manifestation of emotional eating, a well-known risk factor for the development of eating disorders. The purpose of the current study was to assess the associations between metacognitive beliefs and emotional eating in a community sample of adolescents.

METHODS

Participants were 135 middle school students (Mean age = 13.62 years; SD = 0.57) who completed the Emotional Eating Scale Adapted for Children and Adolescents-Short-Form, Metacognition Questionnaire for Children, Positive and Negative Affect Schedule for Children, and a demographic questionnaire.

RESULTS

Participants classified as high emotional eaters reported statistically significant higher negative metacognitive beliefs (Mean = 15.56; SD = 4.22) compared to participants classified as low emotional eaters (Mean = 12.85; SD = 4.31; p ≤ 0.001; t =  - 3.69). There was a significant positive association between emotional eating and negative metacognitive beliefs in the hierarchical multiple linear regression analysis (standardized beta coefficient = 0.25; p < 0.05) after controlling for socio-demographic variables and negative affect.

CONCLUSIONS

The current findings provide preliminary evidence that negative metacognitive beliefs may play a role in the manifestation of emotional eating in adolescents. Future prospective studies are needed to elucidate the temporal associations between emotional eating and negative metacognitive beliefs in this population.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Mindful of personality trait change: Are treatment effects on personality trait change ephemeral and attributable to changes in states?

OBJECTIVE

Are treatment effects on personality trait change ephemeral and attributable to change in clinical states? Data of an intervention study were used to examine if change in clinical states (e.g., stress or depression) accounts for change in personality traits and to test whether both changes in traits and clinical states were independently associated with substance use.

METHOD

Seventy-nine substance use patients (M_age = 25.3, SD = 2.7; 35% female) took part at a 4-week intervention and completed a total of 15 bi-monthly assessments across 28 weeks to measure change in traits and states during and after treatment.

RESULTS

The results suggest that participants showed large trait and state changes over time, which happened rapidly with the majority occurring during the first four weeks. Trait and state changes were highly correlated, but not perfectly redundant. Significant variance in personality trait change remained after controlling for change in clinical states. Moreover, both trait and state change independently predicted substance use.

CONCLUSION

Personality trait change occurred relatively fast and was maintained until the last follow-up assessment six months after the end of the intervention. Also, the findings point to the notion that the conceptual distinction between traits and states may not be as important as originally thought.

Psychosomatic Symptoms and Neuroticism following COVID-19: The Role of Online Aggression toward a Stigmatized Group

The present study investigated the effect of interpersonal mistreatment on the perpetrators' mental health. We proposed that the threat of COVID-19 will increase people's mental health problems through their on-line aggression toward stigmatized groups accused of spreading the disease and that there might be potential gender differences in such effects. We tested our predictions among a sample of U.S. residents (Study 1) and a large sample of Chinese residents living out of Hubei province (Study 2) during a heightened period of concern about COVID-19, February 2020. Specifically, we measured U.S. residents' on-line aggressive behaviors toward Chinese people (Study 1) and Chinese non-Hubei residents' on-line aggressive behaviors toward Hubei residents (Study 2) as well as their neuroticism (Study 1) and mental health states (Study 2). In line with our predictions, both studies showed that perceived infection of COVID-19 can induce on-line aggression toward stigmatized groups, thereby increasing people's mental health problems. Moreover, the relationship between COVID-19 vulnerability, on-line aggression, and psychosomatic symptoms was more prominent in men than in women. These results offer insights into people's responses toward COVID-19 and add to the understanding of people's mental and physical health during the epidemic stage of contagious diseases.

Psychological Wellbeing during the COVID-19 Pandemic: The Influence of Personality Traits in the Italian Population

Coronavirus disease 19 (COVID-19) has had a strong psychological impact on the Italian population. Italy was heavily affected by the virus before other countries in Europe, experiencing the highest number of deaths. Unknown symptoms in the early stages of the pandemic and the absence of clear transmission links affected people's wellbeing. Individual personality differences played a key role in perceived psychological wellbeing during the pandemic. The present exploratory study sought to evaluate the impact of COVID-19 on psychological health and identify how psychological wellbeing is influenced by personality traits. A total of 2103 participants (64% female and 36% male) completed an online survey that included the Psychological General Wellbeing Index (PGWBI), the Italian Short Personality Inventory (ITAPI), and a general questionnaire. Descriptive statistics and hierarchical regressions were performed using SPSS 25.0 (IBM Corp., Armonk, NY, USA) (The findings showed poor psychological wellbeing in the Italian population. Young people reported the lowest scores. Vulnerability traits negatively influenced some PGWBI domains, such as the total score (β = -0.62), anxiety (β = -0.55), depression (β = -0.46), positivity and wellbeing (β = -0.51), vitality (β = -0.45), general health (β = -0.12), and self-control (β = -0.52). On the other hand, dynamism traits positively affected vitality (β = 0.12) and positivity and wellbeing (β = 0.14). In other words, personality factors related to vulnerability in particular created risk, whereas dynamism offered protection. The results highlight how COVID-19 helped to trigger anxious and depressive states. People feel helpless and vulnerable when facing new, unexpected conditions caused by the virus. These findings may assist mental healthcare professionals in safeguarding psychological wellbeing during emergencies such as the pandemic.

Genome-wide gene-environment interactions in neuroticism: an exploratory study across 25 environments

Gene-environment interactions (GxE) are often suggested to play an important role in the aetiology of psychiatric phenotypes, yet so far, only a handful of genome-wide environment interaction studies (GWEIS) of psychiatric phenotypes have been conducted. Representing the most comprehensive effort of its kind to date, we used data from the UK Biobank to perform a series of GWEIS for neuroticism across 25 broadly conceptualised environmental risk factors (trauma, social support, drug use, physical health). We investigated interactions on the level of SNPs, genes, and gene-sets, and computed interaction-based polygenic risk scores (PRS) to predict neuroticism in an independent sample subset (N = 10,000). We found that the predictive ability of the interaction-based PRSs did not significantly improve beyond that of a traditional PRS based on SNP main effects from GWAS, but detected one variant and two gene-sets showing significant interaction signal after correction for the number of analysed environments. This study illustrates the possibilities and limitations of a comprehensive GWEIS in currently available sample sizes.

Exploring the autism spectrum: Moderating effects of neuroticism on stress reactivity and on the association between social context and negative affect

Neuroticism is associated with increased stress reactivity. In autism spectrum disorders (ASD), emotional stress reactivity is increased and there is some evidence for an increased negative affect (NA) when with less familiar people. The aim of this study was to compare adults with ASD and controls on levels of neuroticism and on interactions between neuroticism and appraised stress or social context in models of NA. This is a cross-sectional observational study comprising a group of 50 adults with ASD and 51 controls. Experience sampling method (ESM) reports were collected for 10 days to measure daily life stress, mood, and social context. Multilevel regression analyses revealed significantly higher neuroticism levels in ASD than in controls. Adults with ASD who scored high on neuroticism showed a significantly stronger association between activity/social stress and NA (i.e., higher stress reactivity) than those with low scores. Furthermore, the association between neuroticism and NA was stronger when adults with ASD were with less familiar people compared with being alone or with familiar people. No consistent corresponding significant interactions were found in the control group. In conclusion, in ASD, neuroticism moderates the association between appraised stress and NA as well as the association between social context and NA.

Higher levels of Depressive Symptoms are Associated with Increased Resting-State Heart Rate Variability and Blunted Reactivity to a Laboratory Stress Task among Healthy Adults

Laboratory stress tasks induce strong changes in linear and non-linear indices of heart rate variability (HRV) among healthy adults, due to a task-induced parasympathetic withdrawal. Previous findings suggested that negative affectivity and its correlates (i.e., depressive symptoms, anxiety, hostility, type D personality, and situational stress) could profoundly affect autonomic activity. However, to date no studies considered these psychological dimensions simultaneously while trying to disentangle their acute effects on HRV during a laboratory stress task. A total of 65 healthy participants completed a battery of questionnaires and later underwent a psychosocial stress protocol, which involves a stressful and a non-stressful mental arithmetic task, with the latter serving as a control condition for the former. During the entire procedure, autonomic activity was recorded through a portable ECG device. We analysed longitudinal changes in HRV indices using Mixed Models, taking into account respiration rates and the associations between psychophysiological variables through bivariate Pearson's r (partial) correlation indices. We found significant changes in linear (e.g., HF power, RMSSD) and non-linear (e.g., Poincaré Plot and Correlation Dimension D2) HRV indices during the procedure, with the lowest point reached during the stressful mental arithmetic task. Interestingly, only depressive symptomatology was significantly and positively related to a higher resting-state HRV and to a blunted reactivity to the stress task, even after controlling for baseline values. Results suggest that healthy individuals with higher levels of depressive symptoms could experience atypical cardiovascular responses to stressful events: several speculative interpretations, considering autonomic, behavioral, and motivational dysregulations, are discussed.

Predictors of recurrence of major depressive disorder

A total of 201 patients with major depressive disorder from four hospitals in Malaysia were followed up for 5 years to determine the prognostic factors of recurrent major depressive disorder that could potentially contribute to improving the management of MDD patients. For each individual patient, at the time of recruitment as part of a case-control study, information was collected on recent threatening life events, personality and social and occupational functioning, while blood samples were collected to genotype single nucleotide polymorphisms of vitamin D receptor (VDR), zinc transporter-3 (ZnT3), dopamine transporter-1 (DAT1), brain-derived neurotropic factor (BDNF), serotonin receptor 1A (HT1A) and 2A (HT2A) genes. Kaplan-Meier and Cox-regression were used to estimate hazard functions for recurrence of major depressive disorder. Individuals with severe MDD in previous major depressive episodes had five and a half times higher hazard of developing recurrence compared to mild and moderate MDD (HR = 5.565, 95% CI = 1.631–18.994, p = 0.006). Individuals who scored higher on social avoidance had three and a half times higher hazard of recurrence of MDD (HR = 3.525, 95% CI = 1.349–9.209; p = 0.010). There was significant interaction between ApaI +64978C>A single nucleotide polymorphism and severity. The hazard ratio increased by 6.4 times from mild and moderate to severe MDD for A/A genotype while that for C/A genotype increased by 11.3 times. Social avoidance and severity of depression at first episode were prognostic of recurrence. Screening for personality factors at first encounter with MDD patients needs to be considered as part of the clinical practice. For those at risk of recurrence in relation to social avoidance, the psychological intervention prescribed should be customized to focus on this modifiable factor. Prompt and appropriate management of severe MDD is recommended to reduce risk of recurrence.

The Big Six Personality Traits and Mental Distress: Dynamic Modeling in a Population Panel Study Reveals Bidirectional Relationships Involving Neuroticism, Extraversion, and Conscientiousness

In a single comprehensive model, using a large nationally representative sample, we investigate longitudinal relationships between mental distress and "Big Six" personality using an analysis approach sensitive to dynamic effects (i.e., to effects of deviations from individual trajectories). We find that, consistent with a mechanism involving scarring by distress, upward deviations (flare-ups) in distress predict flare-ups in Neuroticism 12 months later. Among younger adults (n = 4,775), distress flare-ups predict dips in Conscientiousness. Consistent with a dynamic precursor model, (a) flare-ups in Neuroticism and Extraversion predict subsequent flare-ups in distress among older adults (n = 11,167), and (b) slopes of distress correlate with slopes of a number of traits (e.g., positively for Neuroticism, and, among older adults, negatively for Extraversion). While demonstrating these scarring and dynamic precursor effects, we draw attention to a nuanced direction of dynamic effect for Extraversion, a newly discovered dynamic effect of Conscientiousness, and previously undocumented dynamic effects of traits on each other.

Teasing Apart the Effect of Depression Specific and Anxiety Specific Symptoms on Academic Outcomes

Research shows that adolescents' performance in school can be negatively affected by depression and anxiety. However, past studies have used nonspecific measures of depression and anxiety that preclude researchers from understanding their unique effects. The current study addressed this gap in the literature by teasing apart the effects of depression specific and anxiety specific symptoms on end of semester grade point average (GPA) and the likelihood of dropping a course. We used a 3-month longitudinal design with a sample of 130 United States (U.S.) undergraduates. Results showed that only cumulative GPA and ACT score predicted end of semester GPA. However, high levels of anxiety specific (anxious arousal), but not depression specific (anhedonia), symptoms predicted whether or not a student dropped a course. These results suggest that targeting anxiety specific symptoms in schools may be effective in improving academic outcomes.

The contributions of affective traits and emotion regulation to internalizing disorders: Current state of the literature and measurement challenges

Dysfunctional affective processes are central to the experience of internalizing disorders (e.g., depression, anxiety, and related disorders). Specifically, extreme positive affect and elevated negative affect each have unique and robust patterns of associations with internalizing symptoms. This article examines affect as both an individual difference and a within-person dynamic process that unfolds over time. Recent research is reviewed that clarifies the hierarchical structure of affect and facet-level associations with symptoms, affect-laden traits that confer risk for internalizing psychopathology, models of emotion regulation, and how emotion regulation abilities and strategies contribute to or detract from psychological well-being. Several measurement challenges in this literature are identified and discussed, including possible conceptual and content overlap, mood-state distortion, naturalistic assessment in daily life, and the benefits and limitations of self-reported affective experience. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Emotional stability is associated with the MAOA promoter uVNTR polymorphism in women

BACKGROUND

Neuroticism is associated with low emotional stability, and it is characterized by a tendency to perceive ordinary situations as threatening and difficult to manage. This personality trait has been associated with psychological distress and predicts some mental disorders. Previous studies have shown that women tend to be more neurotic than men and, in general, females have also a higher incidence of anxious and depressive disorders.

METHODS

We analyzed in a sample of 99 female university students (from 18 to 26 years old) if emotional stability, measured using the Big Five Questionnaire, was linked to polymorphic variants in candidate genes related to dopaminergic and serotonergic systems, and other personality variables.

RESULTS

We found that emotional stability and its subdimensions are genetically associated with MAOA-uVNTR polymorphism. Thus, women carriers of the 3-repeat allele (lower MAO-A expression) showed higher levels of emotional stability. No associations were found with other polymorphisms analyzed, including COMT Val¹⁵⁸ Met, 5-HTTLPR, and DAT 3'UTR VNTR. Furthermore, our results showed a negative correlation between emotional stability and depression, state anxiety, and trait anxiety. In fact, MAOA-uVNTR and trait anxiety also explained emotional stability and its subdimensions. We also found that other genetic characteristic, phenylthiocarbamide tasting, explained impulsivity, specifically tasters controlled impulses better than nontasters.

CONCLUSION

Our results indicate that neuroticism might be regulated by MAOA and could be a common factor between different phenotypes, such as aggressive behaviors or personality disorders, observed in women with higher activity genotype who had been exposed to negative environments during childhood. This study could lead to a better understanding of the basis of emotional stability and could lead to future projects for this purpose.

Demands and resources associated with mental health among Norwegian professional musicians

BACKGROUND

Previous studies indicate a variety of health challenges among musicians. Despite this, less is known concerning the roles of work-related and personal factors associated with the musicians' mental health.

OBJECTIVE

We wanted to investigate personal and work-related demands and resources associated with psychological distress in professional musicians.

METHODS

Based on a sample of 1,607 of professional Norwegian musicians, we conducted a hierarchical multiple regression analysis.

RESULTS

We found that personal factors such as level of neuroticism and sense of mastery had the strongest association with PD. Extraversion, openness to experience, conscientiousness, job demands and social support did also contribute to distress in our final statistical model, but to a lesser degree. Somewhat surprisingly, work-family conflict, effort-reward imbalance and job control were not associated with PD in our final model.

CONCLUSIONS

Our results show that both work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with PD among musicians in this cross-sectional study. Prospective research is needed in order to investigate these associations further. Meanwhile, we suggest to emphasize early development of sense of mastery and social support in music education and industry.

Are rumination and neuroticism genetically or environmentally distinct risk factors for psychopathology?

Neuroticism, a dispositional trait of heightened negative emotionality, is a vulnerability factor for psychopathology. Given neuroticism's strong association with rumination, a repetitive thought pattern that intensifies and prolongs emotions, some question whether these constructs capture the same or unique information about vulnerability for psychopathology. The present study examined whether neuroticism is genetically and environmentally distinct from two clinically relevant ruminative subtypes-anger and depressive rumination-and whether genetic and environmental influences specific to rumination versus shared with neuroticism overlap with internalizing and externalizing psychopathology. These analyses were conducted on 439 same-sex twin pairs in the Colorado Longitudinal Twin study. Rumination and neuroticism latent variables were created from multiple rumination questionnaires administered at age 23 and shortened Eysenck Personality Questionnaires administered at ages 17 and 21, respectively. Lifetime psychopathology symptoms, assessed by two structured clinical interviews, were used to create ordinal composite variables. Multivariate Cholesky decompositions indicated that neuroticism, anger rumination, and depressive rumination have common genetic and nonshared environmental influences but are differentiated by nonshared environmental influences specific to each ruminative subtype. Genetic influences common to rumination and neuroticism explained considerable variance in internalizing psychopathology, suggesting possible genetic mediation or common genetic causes. Genetic and environmental influences on externalizing psychopathology did not substantially overlap with those on neuroticism and rumination. These findings suggest that rumination and neuroticism share most genetic influences yet are influenced by distinct environmental influences. Furthermore, our results indicate that a comprehensive understanding of transdiagnostic risk factors must include an examination of both genetic and environmental influences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trait neuroticism and emotion neurocircuitry: Functional magnetic resonance imaging evidence for a failure in emotion regulation

Though theory suggests that individual differences in neuroticism (a tendency to experience negative emotions) would be associated with altered functioning of the amygdala (which has been linked with emotionality and emotion dysregulation in childhood, adolescence, and adulthood), results of functional neuroimaging studies have been contradictory and inconclusive. We aimed to clarify the relationship between neuroticism and three hypothesized neural markers derived from functional magnetic resonance imaging during negative emotion face processing: amygdala activation, amygdala habituation, and amygdala-prefrontal connectivity, each of which plays an important role in the experience and regulation of emotions. We used general linear models to examine the relationship between trait neuroticism and the hypothesized neural markers in a large sample of over 500 young adults. Although neuroticism was not significantly associated with magnitude of amygdala activation or amygdala habituation, it was associated with amygdala-ventromedial prefrontal cortex connectivity, which has been implicated in emotion regulation. Results suggest that trait neuroticism may represent a failure in top-down control and regulation of emotional reactions, rather than overactive emotion generation processes, per se. These findings suggest that neuroticism, which has been associated with increased rates of transdiagnostic psychopathology, may represent a failure in the inhibitory neurocircuitry associated with emotion regulation.

Regional cortical thickness and neuroticism across the lifespan

Neuroticism is associated with greater reactivity to stress and lifetime psychopathology. In the present study we examined the association between neuroticism and regional and total cortical thickness (CT) across the lifespan, accounting for gender. We also assessed interactions among these factors. 450 subjects between 19 and 80 years were included. Participants completed the International Personality Item Pool and a structural MRI scan. Total CT and the mean values of CT in five regions of interest were examined. We also investigated the interaction effect among age, gender and neuroticism on CT. There was no significant association between neuroticism and regional/total CT. A significant interaction between neuroticism, age, and gender on the thickness of the anterior cingulate was found. Women high in neuroticism showed a thinner anterior cingulate cortex than women low in neuroticism, with increasing age. In contrast, men high in neuroticism had a thicker anterior cingulate cortex compared to men low in neuroticism, with increasing age. Overall, high neuroticism was associated with differential cortical thickness in the anterior cingulate among men and women with increasing age.

Neuroticism Level and Life Satisfaction in Women Undergoing Breast Augmentation Surgery (a Preliminary Report)

Background

The aim of the present study was to verify the relationship between the level of neuroticism and selected aspects of life satisfaction in women undergoing breast augmentation surgery.

Methods

The study group included 109 women, aged 18–46 years, who completed the self-developed survey measuring selected psychological traits before and after (1 year) surgery. Four questions in this survey were related to the level of neuroticism and two pertained to the self-assessment of leading character traits and the level of life satisfaction. Three questions made up the lie scale.

Results

The studied women were constant in their truthfulness. No statistically significant difference in the level of neuroticism before and after surgery was noticed. However, an increase in the subjective life satisfaction after surgery was highly significant (p < 0.001). Statistically significant negative correlations of neuroticism level with the self-assessment of positive character traits (r_s = − 0.236; p = 0.013) and life satisfaction (r_s = − 0.277; p = 0.004) were found before surgery. Also, a significant positive correlation was observed between neuroticism and the change in life satisfaction 1 year after surgery (r_s = 0.302; p = 0.001).

Conclusions

Breast augmentation surgery did not affect neuroticism level, which proves that constitutional personality traits in women undergoing such operations are not significantly influenced by a surgical intervention. However, neuroticism may play the role of a modulator of the psychological changes in women after breast augmentation (e.g., an increased postsurgical life satisfaction). The preliminary results obtained in our study should be confirmed on a larger sample size in the future.

Level of Evidence IV

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Validating psychosocial pathways of risk between neuroticism and late life depression using a polygenic score approach

Neuroticism is a stable and heritable personality trait that is strongly linked to depression. Yet, little is known about its association with late life depression, as well as how neuroticism eventuates into depression. This study used data from the Wisconsin Longitudinal Study (WLS; N = 4,877) to examine the direct and indirect effects of neuroticism on late life depression at 3 points in the life course-ages 53, 64, and 71-via stressful life events (i.e., independent and dependent) and social supports measured across adulthood and into later life. Neuroticism was assayed using multiple methods, including self-report measures (phenotypic model) and a polygenic score (polygenic model) informed by a meta-analytic genome-wide association study. Results indicated that the phenotypic model of neuroticism and late life depression was partially mediated via dependent stressful life events experienced after the age of 53 and by age 64 social support. This association was replicated in the polygenic model of neuroticism, providing key evidence that the findings are robust. No indirect effects emerged with respect to age 53 social support, age 71 social support, adult dependent stressful life events (experienced between age 19 and 52), and adult and late life independent stressful life events in either the phenotypic or polygenic models as they pertained to late life depression. Results are consistent with previous findings that individuals with high neuroticism may be vulnerable to late life depression through psychosocial risk factors that are, in part, attributable to their own personality. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The role of intolerance of uncertainty in current and remitted internalizing and externalizing psychopathology

Intolerance of uncertainty (IU) is a putative key, transdiagnostic factor in internalizing psychopathologies. However, it is unclear if elevated levels of IU, as measured by the Intolerance of Uncertainty Scale, short form (IUS-12) and its subscales (prospective and inhibitory IU), persist into remission of internalizing psychopathologies (or particular types of internalizing psychopathologies; e.g., fear vs. distress-misery disorders). It is also unknown if IU is specifically characteristic of internalizing (vs. externalizing) psychopathology and whether this relationship is independent of neuroticism/negative affectivity (N/NA). A large community sample (n = 517) completed a diagnostic interview and self-report measures of IU and N/NA. Results indicated that, independent of N/NA, IU was elevated in current fear and distress/misery disorders, but not externalizing disorders. Individuals with remitted fear disorders also displayed significantly elevated levels of IU in comparison to healthy controls after adjusting for levels of N/NA. In terms of subscales, elevated levels of inhibitory IU, and not prospective IU, demonstrated more reliable relationships with internalizing psychopathologies. In summary, IU was more consistently related to fear disorders, demonstrated incremental validity over and above the effects of N/NA, and may be a key, transdiagnostic mechanism in fear disorders.

Neuroticism as mental noise: Evidence from a continuous tracking task

OBJECTIVE

Prominent theories of Neuroticism emphasize its potential link to threat- or punishment-sensitivity processes. Even in the absence of external threats, though, Neuroticism may predispose people to a sort of "mental noise," or cognitive instability, that creates problems for ongoing efforts after control. If this is the case, cognitive views of Neuroticism might be needed to complement the primarily emotion-related views that currently exist.

METHOD

In a four study program of research (total N = 541), momentary forms of monitoring and control were assessed using variants of a continuous tracking task.

RESULTS

As hypothesized, the dimension of Neuroticism was consistently linked to performance deficits, regardless of whether aversive sounds were present or not (Studies 1-3), and the relevant deficits also predicted daily levels of negative affect (Study 4).

CONCLUSIONS

The results support the idea that momentary self-regulation is noisier in the context of higher levels of Neuroticism.

What Lies Beneath Trait-Anxiety? Testing the Self-Regulatory Executive Function Model of Vulnerability

Vulnerability to psychological disorder can be assessed with constructs such as trait anxiety and neuroticism which among others are transdiagnostic risk factors. However, trait-anxiety and related concepts have been criticised because they don't illuminate the etiological mechanisms of psychopathology. In contrast, the metacognitive (S-REF) model offers a framework in which metacognitive knowledge conceptualised in trait terms is part of a core mechanism underlying trait-anxiety and related constructs. The present study therefore set out to explore metacognitions as potential underlying factors in trait-anxiety (the propensity to depression and anxiety). Nine hundred and eighty two participants completed self-report measures of metacognitions and trait-anxiety at time 1, and 425 individuals completed the same measures 8 weeks later. At the cross-sectional level, metacognitions accounted for 83% of the variance in anxiety- and 64% of depression propensity. Furthermore, despite both domains of trait-anxiety showing high stability over time, negative- and positive metacognitive beliefs were significant prospective predictors of both domains of vulnerability. These findings suggests that metacognitive beliefs may be an underlying mechanism of vulnerability attributed to trait-anxiety with the implication that the metacognitive (S-REF) model informs conceptualization of psychological vulnerability, and that metacognitive therapy applications might be employed to enhance psychological resilience.

Personality variables modify the relationship between childhood maltreatment history and poor functional outcomes

Childhood maltreatment history is a prevalent risk factor for substance use disorder and has lifelong adverse consequences on psychiatric wellbeing. The role of personality variations in determining childhood maltreatment-associated outcomes is poorly understood. This study sought to test neuroticism and agreeableness as mediator and moderator, respectively, of functional outcomes associated with having a history of childhood maltreatment and presence/absence of cocaine dependence. Ninety-four participants completed the Structured Clinical Interview for DSM-IV (SCID-IV), Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and the Addiction Severity Index (ASI). The distribution-of-the-product strategy tested if neuroticism mediated the relationship between CTQ and ASI scores. Agreeableness was tested as a moderator using bootstrapped multiple regression analyses with agreeableness*CTQ interaction terms as predictors of ASI scores. Analyses covaried for cocaine dependence to determine its influence. Neuroticism mediated the relationship between severity of childhood maltreatment history and family (ASI-Family) and psychiatric (ASI-Psychiatric) dysfunction in adulthood, independent of cocaine dependence. Agreeableness negatively moderated the effect of childhood maltreatment severity on family dysfunction. Exposure to emotional neglect and abuse selectively drove the mediation and moderation effects. Personality-directed interventions that reduce neuroticism or increase agreeableness may be promising approaches to uncouple childhood maltreatment history from lifelong social and psychiatric dysfunction.

Does Twitter language reliably predict heart disease? A commentary on Eichstaedt et al. (2015a)

We comment on Eichstaedt et al.'s (2015a) claim to have shown that language patterns among Twitter users, aggregated at the level of US counties, predicted county-level mortality rates from atherosclerotic heart disease (AHD), with "negative" language being associated with higher rates of death from AHD and "positive" language associated with lower rates. First, we examine some of Eichstaedt et al.'s apparent assumptions about the nature of AHD, as well as some issues related to the secondary analysis of online data and to considering counties as communities. Next, using the data files supplied by Eichstaedt et al., we reproduce their regression- and correlation-based models, substituting mortality from an alternative cause of death-namely, suicide-as the outcome variable, and observe that the purported associations between "negative" and "positive" language and mortality are reversed when suicide is used as the outcome variable. We identify numerous other conceptual and methodological limitations that call into question the robustness and generalizability of Eichstaedt et al.'s claims, even when these are based on the results of their ridge regression/machine learning model. We conclude that there is no good evidence that analyzing Twitter data in bulk in this way can add anything useful to our ability to understand geographical variation in AHD mortality rates.

Associations between dimensions of anorexia nervosa and obsessive-compulsive disorder: An examination of personality and psychological factors in patients with anorexia nervosa

OBJECTIVE

Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are highly comorbid. However, the factors that account for this comorbidity are poorly understood. We examined the core dimensions of AN and OCD and psychological and personality factors shared by both disorders.

METHOD

In path analyses (N = 732 women with either current AN or recovered from AN), we examined which factors were uniquely and independently associated with the core dimensions of AN and OCD. We also examined recovery from AN as a moderator.

RESULTS

When individuals with AN reported greater concern over mistakes, they endorsed more severity in both AN and OCD core dimensions. These unique associations existed above and beyond all other transdiagnostic personality and psychological factors and regardless of AN recovery status.

CONCLUSIONS

Concern over mistakes partially accounts for severity in the core dimensions of both AN and OCD. Concern over mistakes may represent an important target in the aetiology of AN and OCD.

Linking Stressful Experiences and Psychological Problems: The Role of Self-Esteem

Stressful experiences have repeatedly been related to psychological problems. The current study extends previous work on stress and psychological problems by examining the link between stressful experiences and both internalizing (INT) and externalizing (EXT) problems. Additionally, individual differences are investigated by testing the moderating role of self-esteem. Questionnaire data of 750 adolescents aged 12–18 were collected and analyzed using multiple regression analyses. Analyses were controlled for sex and socioeconomic status. Results indicated that adolescents who report more stressful experiences are more likely to experience both INT and EXT problems, and these relationships were stronger for adolescents with low self-esteem. Post hoc analyses (e.g., different thresholds for determining stressful experiences) support the robustness of our findings. The findings on self-esteem emphasize the importance of taking individual differences into account in the relation between stressful experiences and psychological problems. The results can be seen as a next step in cross-sectional research.

Trait and facet-level predictors of first-onset depressive and anxiety disorders in a community sample of adolescent girls

BACKGROUND

Individual differences in neuroticism, extraversion, and conscientiousness are associated with, and may predict onset of, internalizing disorders. These general traits can be parsed into facets, but there is a surprising paucity of research on facet risk for internalizing disorders. We examined general traits and facets of neuroticism, extraversion, and conscientiousness in predicting first onsets of depressive and anxiety disorders.

METHODS

A community sample of 550 adolescent females completed general and facet-level personality measures and diagnostic interviews. Interviews were re-administered 18 months later.

RESULTS

First onsets of depressive disorders were predicted by neuroticism, extraversion, and conscientiousness. Facets predicting first onset of depression included depressivity (neuroticism facet) and lower positive emotionality and sociability (extraversion facets). First onsets of generalized anxiety disorder (GAD) were predicted by neuroticism, and particularly the facet of anxiousness. First onsets of social phobia were predicted at the facet level by anxiousness. First onsets of specific phobia were predicted by neuroticism, low conscientiousness, and all neuroticism facets. In multivariate analyses, first onsets of depression were uniquely predicted by depressivity, and onsets of GAD and social phobia were uniquely predicted by anxiousness over and above the general trait of neuroticism.

CONCLUSIONS

General traits predict first onsets of depressive and anxiety disorders. In addition, more specific associations are evident at the facet level. Facets can refine our understanding of the links between personality and psychopathology risk, and provide finer-grained targets for personality-informed interventions.

The Emotion Mapping Activity: Preliminary evaluation of a mindfulness-informed exercise to improve emotion labeling in alexithymic persons

Alexithymia is a psychoemotional trait associated with many treatment-resistant psychological and social difficulties. Research suggests that these difficulties stem primarily from an inability to appropriately apply linguistic labels to emotional experiences and content. The present research introduces and preliminarily evaluates a novel mindfulness-informed exercise to improve emotion-labeling ability in alexithymic persons. Based in culturally universal patterns of somatic experience, the Emotion Mapping Activity (EMA) directs alexithymic persons to reflect on their internal, somatic experiences as a source of information for interpreting and labeling emotional experiences. In the present study, 67 alexithymic persons completed a series of emotion-labeling tasks either with or without assistance of the EMA. Results suggest that completion of the EMA may improve ability to label emotions that would be otherwise misinterpreted - without interfering with labeling that is already intact. Though further research is necessary, the present study suggests that the EMA may hold the potential to be incorporated into psychotherapy protocols as an exercise for improving emotion-labeling ability in alexithymic clients.

Risk factors for recurrence in depression in the Lundby population, 1947-1997

BACKGROUND

Depression is a common disorder in both men and women, and the recurrence rate is high. The aim of this study was to identify risk factors for recurrence in depression in the Lundby Study.

METHODS

The Lundby Study is a community-based longitudinal study with focus on mental health. The study started in 1947 and three follow-ups have been carried out since, the last one in 1997. The population consists of 3563 subjects. Data from 508 subjects afflicted by depression was gathered. Premorbid factors (gender, socioeconomic status, marital status, personality and heredity) and factors related to the first depressive episode (age, degree of impairment and melancholic depression) were investigated regarding their influence on the risk for recurrence in depression. Multiple logistic regression was used in the calculations.

RESULTS

Risk factors associated with recurrent depression were melancholic depression at first onset (OR 3.52 [95% CI 1.62-7.66, p < 0.001]), young age as compared to old age at first onset (OR 0.51 [95% CI 0.28-0.92, p = 0.03]) and a premorbid nervous/tense personality (OR 1.77 [95% CI 1.22-2.56, p < 0.01]). Demographic factors, including gender, had no effect on the odds of recurrence.

LIMITATIONS

The Lundby Study spans over 50 years, making the results vulnerable to changes in diagnostic regimes and recall bias.

CONCLUSION

Melancholia at onset, regardless of severity of symptoms, had the greatest impact on the risk of recurrence in depression in the Lundby Study. Information about risk factors for recurrence in depression are useful in offering effective preventive measures in the form of psychotropic drugs and psychotherapy, and deciding the length of follow-up.

Predictors of Pharmacotherapy Response in Generalized Anxiety Disorder: A Systematic Review

BACKGROUND

Pharmacotherapy for generalized anxiety disorder (GAD) may be effective in reducing symptoms in the majority of patients. The study of moderators and predictors of treatment response may help clinicians both to select appropriate interventions to maximize the probability of response and to inform the general prognosis.

METHODS

A systematic literature search of electronic databases, selected authors, and reference lists was used to identify articles that reported trials of drug monotherapy in GAD. Data on predictors and moderators were extracted. Quality of evidence was determined by the presence of a priori hypotheses, number of variables investigated, adequate quality of the measurement, and use of interaction-effects testing.

RESULTS

From the 98 articles meeting inclusion criteria, 24 reported a total of 22 factors associated with treatment response. The reported results were heterogeneous, ranging over sociodemographic, clinical, comorbidity, genetic, and functional-imaging studies. Major depressive symptoms were found to moderate treatment outcome in favor of antidepressants versus benzodiazepines. Neuroticism, previous treatment, genetic polymorphisms (including serotonin receptor gene 2A), and functional activation of the anterior cingulate cortex and amygdala were identified as potential predictors of treatment response.

CONCLUSIONS

Correlates of poor emotion regulation predicted poor treatment response, but subclinical depression was the only variable capable of informing treatment selection in this review. Future research should focus on further exploring the value of depression as a moderator and on a narrower list of potential genetic, brain-imaging, and temperament predictors of response to pharmacotherapy in GAD.

Lower-order anxiety sensitivity and intolerance of uncertainty dimensions operate as specific vulnerabilities for social anxiety and depression within a hierarchical model

Within a hierarchical framework for depressive and anxiety disorders, negative affect (NA) is posited to be indirectly related to social anxiety and depression through cognitive vulnerabilities, including intolerance of uncertainty (IU) and anxiety sensitivity (AS). However, few prior studies have considered whether the lower-order dimensions of IU (i.e., prospective and inhibitory IU) and AS (i.e., physical, cognitive, and social concerns) better explain the indirect relation between NA and social anxiety and depression. The indirect relations between NA and social anxiety and depression through these cognitive vulnerabilities were examined using structural equation modeling in a clinical sample (N=298). NA and social anxiety symptoms were indirectly related through AS social concerns and inhibitory IU, although a direct effect of NA was also found. Only AS social concerns explained the relation between NA and a social anxiety disorder diagnosis. AS cognitive concerns was the only cognitive vulnerability factor to indirectly explain the relation between NA and depressive symptoms, although a direct effect of NA was also found. These findings suggest that the lower-order dimensions of AS and IU demonstrate more specific and less transdiagnostic associations with social anxiety and depression.

Clinical Characteristics, Life Adversities and Personality Traits in Monozygotic Twins With, at Risk of and Without Affective Disorders

Background: Affective disorders have a long-term impact on psychiatric health and are caused by multiple interacting factors including familial risk, childhood adversity, life events and personality traits. Methods: In this study, monozygotic twins (MZ) at familial risk (indexed by affective disorder in their co-twin; high-risk group), affected MZ twins (indexed by a diagnosis with affective disorder) and MZ twins with no family history of affective disorder (low-risk group) were identified through cross-linking of nation-wide Danish registers. In total, 204 MZ twins were included and psychopathology, personality traits and life adversity were evaluated by semi-structured interviews and questionnaires. Results: Affected MZ twins presented with more subclinical affective symptoms and were functionally impaired as evidenced by higher unemployment rates and reduced functional status. The affected and the high-risk groups reported more childhood adversity and had experienced more stressful life events than the low-risk group. A direct comparison within the discordant twin pairs showed that the high-risk twins presented fewer affective symptoms, better functional status, more extraversion and lower neuroticism scores than their affected co-twins although they had equal levels of life adversity as their affected co-twins. Conclusion: These findings add to the evidence indicating that patients experience higher neuroticism, persistent subclinical symptoms and reduced socio-occupational function after affective episodes. Additionally, neuroticism and extraversion seem capable of moderating the sensitivity to exposure from the environment.

Genetic and Environmental Associations Between Procrastination and Internalizing/Externalizing Psychopathology

Recent work on procrastination has begun to unravel the genetic and environmental correlates of this problematic behavior. However, little is known about how strongly procrastination is associated with internalizing and externalizing psychopathology, and the extent to which shared genetic/environmental factors or relevant personality constructs (e.g., fear of failure, impulsivity, and neuroticism) can inform the structure of these associations. The current study examined data from 764 young adult twins who completed questionnaires assessing procrastination and personality and structured interviews regarding psychopathology symptoms. Results indicated that procrastination was positively correlated with both internalizing and externalizing latent variables, and that these correlations were driven by shared genetic influences. Moreover, the association between procrastination and internalizing was accounted for by fear of failure and neuroticism, whereas the association between procrastination and externalizing was primarily explained by impulsivity. The role of procrastination in psychopathology is discussed using a framework that highlights common and broadband-specific variance.

Does Personality Matter in Diabetes Adherence? Exploring the Pathways between Neuroticism and Patient Adherence in Couples with Type 2 Diabetes

BACKGROUND

Personality has received some attention in the Type 2 diabetes literature; however, research has not linked personality and diabetes adherence behaviors (diet and exercise), identified pathways through which they are associated, nor taken into consideration important contextual factors that influence behavior (the patient's partner).

METHODS

Dyadic data from 117 married, heterosexual couples in which one member is diagnosed with Type 2 diabetes was used to explore associations between each partner's neuroticism and patient dietary and exercise adherence through the pathways of negative affect, depression symptoms, and couple-level diabetes efficacy (both patient and spouse report of confidence in the patient's ability to adhere to diabetes management regimens).

RESULTS

Results revealed that higher levels of neuroticism were associated with lower patient dietary and exercise adherence through (1) higher levels of depression symptoms (for patients' neuroticism) and negative affect (for spouses' neuroticism), and (2) lower levels of couple-level diabetes efficacy.

CONCLUSIONS

The results from this study provide evidence that both patient and spouse personality traits are associated with patient dietary and exercise adherence through increased emotional distress-albeit different emotional pathways for patients and spouses-and lower couple confidence in the patients' ability to manage their diabetes.

Inhibited Temperament and Hippocampal Volume in Offspring of Parents with Bipolar Disorder

BACKGROUND

Prior studies have suggested that inhibited temperament may be associated with an increased risk for developing anxiety or mood disorder, including bipolar disorder. However, the neurobiological basis for this increased risk is unknown. The aim of this study was to examine temperament in symptomatic and asymptomatic child offspring of parents with bipolar disorder (OBD) and to investigate whether inhibited temperament is associated with aberrant hippocampal volumes compared with healthy control (HC) youth.

METHODS

The OBD group consisted of 45 youth, 24 of whom had current psychiatric symptoms (OBD⁺s) and 21 without any psychiatric symptoms (OBD^-s), and were compared with 24 HC youth. Temperament characteristics were measured by using the Revised Dimensions of Temperament Survey. Magnetic resonance imaging was used to measure hippocampal volumes. The association between temperament and hippocampal volumes was tested by using multiple regression analysis.

RESULTS

Compared with the OBD^-s group, the OBD⁺s group had significantly more inhibited temperament traits, less flexibility, more negative mood, and less regular rhythm in their daily routines. In contrast, the OBD^-s group was more likely to approach novel situations compared with OBD⁺s or HC groups. Within the OBD⁺s group, a more inhibited temperament was associated with smaller right hippocampal volumes.

CONCLUSIONS

In this study, symptomatic OBD were characterized by an inhibited temperament that was inversely correlated with hippocampal volume. Additional longitudinal studies are needed to determine whether inverse correlations between hippocampal volume and inhibited temperament represent early markers of risk for later developing bipolar disorder.