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The present study sought to determine the associations between executive functioning and Big Five personality traits in an undergraduate sample.
Method:
Participants included 200 undergraduates (73% women), with a mean age of approximately 21 years. Participants completed the Big Five Inventory-44 and a psychological assessment battery, which included the Trail Making Test and the Semantic Fluency Test.
Results:
Results from multiple regression analyses suggested agreeableness was negatively associated with Semantic Fluency – Animals (β = −0.310, p < 0.001). Moreover, conscientiousness was positively associated with Trail Making Test B-A (β = 0.197, p = 0.016), but negatively associated with Trail Making Test A (β = −0.193, p = 0.017).
Conclusions:
Overall results identified that executive function association with personality varies by construct. Given conscientiousness’ differential associations within the executive function task performances, future research should examine the conscientious threshold that would result in psychological symptomatology associated with extreme lows and highs in conscientiousness.
Using [18F]altanserin, a serotonin 2A receptor (5-HT2AR) antagonist Positron Emission Tomography (PET) tracer, a positive association between cortical 5-HT2AR binding and the inward-directed facets of neuroticism has been demonstrated in healthy individuals. Psilocybin, a 5-HT2AR agonist, shows promise for the treatment of depression, reducing neuroticism and mood symptoms potentially via hypothalamic-pituitary-adrenal (HPA) modulation. 5-HT2AR and neuroticism are both modulated by HPA axis function.
Aims
In this study, we examined whether the association between 5-HT2AR binding and the inward facets of neuroticism can be replicated in an independent healthy cohort using the new 5-HT2AR agonist tracer [11C]Cimbi-36, and if their association is moderated by cortisol awakening response (CAR), an index of HPA axis function. If so, this could advance mechanistic insights into interventions that target the 5-HT2AR and reduce neuroticism.
Method
Eighty healthy volunteers underwent [11C]Cimbi-36 PET scans and completed the NEO personality inventory (NEO-PI-R) for the assessment of neuroticism. Salivary samples were available for determination of CAR in 70 of the participants. Using linear latent variable models, we evaluated the association between 5-HT2AR binding and inward facets of neuroticism, namely depression, anxiety, self-consciousness and vulnerability to stress, and whether CAR moderated this association.
Results
The study confirms the positive association between 5-HT2AR binding and the inward facets of neuroticism (β = 0.01, 95% CI = [0.0005: 0.02], P = 0.04), and this association is independent of CAR (P = 0.33).
Conclusions
The findings prompt consideration of whether novel interventions such as psilocybin that actively targets 5-HT2AR and causes changes in personality could be particularly beneficial if implemented as a targeted approach based on neuroticism profiles.
There is substantial evidence that personality traits, in particular neuroticism and extraversions predict depressive and anxiety episodes as well as suicidal ideation. However, little research has examined whether these traits predict the first onset of depressive and anxiety disorders and suicidal ideation. Moreover, the few studies to date have not adjusted for pre-existing subthreshold symptoms, assessed dimensionally. In this study, 144 adolescents were assessed at baseline, 9-, and 18-month follow-ups. Neuroticism and extraversion were assessed via self-report, and depressive and anxiety disorders and suicidal ideation were assessed with diagnostic interviews. Adjusting for age, sex, and baseline symptoms, logistic regression analyses showed that neuroticism predicted the first onset of depressive disorders. However, neither neuroticism nor extraversion predicted first onsets of anxiety disorders, extraversion did not predict depressive disorders, and neither trait predicted suicidal ideation onset or severity after adjusting for baseline symptoms. Neuroticism and extraversion may respectively predispose youth to depressive or anxiety disorders but not to suicidal ideation over and above pre-existing symptoms. Results have implications for the early identification of at-risk youth and prevention of depressive and anxiety disorders and suicidal ideation.
Functional somatic disorder (FSD) is a unifying diagnosis that includes functional somatic syndromes such as irritable bowel, chronic widespread pain (CWP) and chronic fatigue. Several psychological factors are associated with FSD. However, longitudinal population-based studies elucidating the causal relationship are scarce.
Aims
To explore if neuroticism, perceived stress, adverse life events (ALEs) and self-efficacy can predict the development of FSD over a 5-year period.
Method
A total of 4288 individuals who participated in the DanFunD baseline and 5-year follow-up investigations were included. FSD was established at both baseline and follow-up, with symptom questionnaires and diagnostic interviews. Neuroticism was measured with the short-form NEO Personality Inventory, perceived stress with the Cohen's Perceived Stress Scale, ALEs with the Danish version of the Cumulative Lifetime Adversity Measure and self-efficacy with the General Self-Efficacy Scale. Associations were investigated with multiple logistic regression models.
Results
Perceived stress predicted incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.04–1.17). Neuroticism predicted incident FSD and chronic fatigue (odds ratios: 1.03–1.16). ALEs predicted incident FSD, CWP and chronic fatigue (odds ratios: 1.06–1.18). An increase in perceived stress from baseline to follow-up was associated with incident FSD, irritable bowel, CWP and chronic fatigue (odds ratios: 1.05–1.22). Contrary, an increase in self-efficacy seemed to be a protective factor (odds ratios: 0.89–0.99).
Conclusions
High neuroticism, high perceived stress and a high number of ALEs are risk factors for the development of FSD. Particularly perceived stress seems to be an important contributor to the onset of FSD.
Neuroticism is a significant predictor of adverse psychological outcomes in patients with cancer. Less is known about how this relationship manifests in those with noncancer illness at the end-of-life (EOL). The objective of this study was to examine the impact of neuroticism as a moderator of physical symptoms and development of depression in patients with amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), end-stage renal disease (ESRD), and frailty in the last 6 months of life.
Methods
We met this objective using secondary data collected in the Dignity and Distress across End-of-Life Populations study. The data included N = 404 patients with ALS (N = 101), COPD (N = 100), ESRD (N = 101), and frailty (N = 102) in the estimated last 6 months of life, with a range of illness-related symptoms, assessed longitudinally at 2 time points. We examined neuroticism as a moderator of illness-related symptoms at Time 1 (∼6 months before death) and depression at Time 2 (∼3 months before death) using ordinary least squares regression.
Results
Results revealed that neuroticism significantly moderated the relationship between the following symptoms and depression measured 3 months later: drowsiness, fatigue, shortness of breath, wellbeing (ALS); drowsiness, trouble sleeping, will to live, activity (COPD); constipation (ESRD); and weakness and will to live (frailty).
Significance of Results
These findings suggest that neuroticism represents a vulnerability factor that either attenuates or amplifies the relationship of specific illness and depressive symptoms in these noncancer illness groups at the EOL. Identifying those high in neuroticism may provide insight into patient populations that require special care at the EOL.
The present study examines whether neuroticism is predicted by genetic vulnerability, summarized as polygenic risk score for neuroticism (PRSN), in interaction with bullying, parental bonding, and childhood adversity. Data were derived from a general population adolescent and young adult twin cohort. The final sample consisted of 202 monozygotic and 436 dizygotic twins and 319 twin pairs. The Short Eysenck Personality questionnaire was used to measure neuroticism. PRSN was trained on the results from the Genetics of Personality Consortium (GPC) and United Kingdom Biobank (UKB) cohorts, yielding two different PRSN. Multilevel mixed-effects models were used to analyze the main and interacting associations of PRSN, childhood adversity, bullying, and parental bonding style with neuroticism. We found no evidence of gene–environment correlation. PRSN thresholds of .005 and .2 were chosen, based on GPC and UKB datasets, respectively. After correction for confounders, all the individual variables were associated with the expression of neuroticism: both PRSN from GPC and UKB, childhood adversity, maternal bonding, paternal bonding, and bullying in primary school and secondary school. However, the results indicated no evidence for gene–environment interaction in this cohort. These results suggest that genetic vulnerability on the one hand and negative life events (childhood adversity and bullying) and positive life events (optimal parental bonding) on the other represent noninteracting pathways to neuroticism.
Body Mass Index (BMI) is an informative factor on body fatness which has been associated to higher levels of Perinatal Depression (PD) and complications during pregnancy. We aimed to explore the impact of pre-pregnancy and postnatal BMI on the risk of Perinatal Depression and pregnancy outcomes among women recruited at their third trimester of pregnancy.
Methods
We report on findings from a large multi-centre study conducted in the South of Italy and involving 1611 women accessing three urban gynaecological departments from July to November 2020. Pregnant women were assessed at their third trimester of pregnancy (T0) and after the childbirth (T1) ;The Edinburgh Postnatal Depression Scale (EPDS) has been employed for the screening of PD over time (T0 and T1) as well as other standardized measures for neuroticism, resilience, and quality of life at baseline. BMI (T0 and T1) and other socio-demographic and clinical characteristics have been collected.
Results
Over-weight and obesity (higher levels of BMI) were associated with higher risk of PD (higher scores of EPDS), higher neuroticism and poorer subjective psychological well-being among enrolled women. Also, obesity and over-weight were associated with lower education, higher number of physical comorbidities, medical treatments and complications during pregnancy.
Conclusions
Over-weight and obesity may impact on mental health and pregnancy outcome of women enrolled. Psycho-educational interventions aimed to improve the management of physical and emotional issues may reduce the risk of PD and complications during pregnancy.
The integration of virtual reality into everyday life is changing sociocultural practices, including those related to cyberaggression, which causes negative consequences for mental health and well-being. Particular attention needs to be paid to the poorly researched but widespread roles of bystanders and defenders in cyberaggression (Machackova, 2020; Polanco-Levican, Salvo-Garrido, 2021).
Objectives
The aim is to study the behavioral witness strategies in cyberaggression in VR and their relation to personal and psychophysiological characteristics.
Methods
50 adolescents aged 14-18 years old (50% female) witnessed cyberaggression in an experimental situation in the virtual space of VR-chat. Participants also filled Ten-Item Personality Inventory (Gosling et al., 2003; Egorova, Parshikova, 2016), I7-Impulsiveness (Eysenck, Eysenck, 1985; Kornilova, Dolnikova, 2011), Prosocial Behaviour (Furmanov, Kuhtova, 1998). To determine the functional state Heart rate variability (UPTF 1/30 Psychophysiologist, Mediсom) was measured before and after the experiment.
Results
Behavioral strategies in VR-aggression were divided into uninvolved bystanders (58%) and defenders (42%). All participants experienced stress and functional state decline when faced with cyberaggression, but the defenders were more affected (U=207, p<0.043). Defenders were more likely to have higher social responsibility (U=207, p<0.056) and lower neuroticism (U=208, p<0.054). There were no significant differences in impulsiveness.
Conclusions
Cyberaggression in a virtual environment is stressful, especially for active defenders, who are more included in the situation compared to passive bystanders. The prosocial role of a defender rather than a passive bystander may be related to such characteristics as social responsibility and emotional stability, but not to impulsiveness. The research was supported by RSF (project No. 18-18-00365)
Disclosure
This work was supported by the Russian Science Foundation, project # 18-18-00365.
Research on cyberbullying has focused on the psychological characteristics of victims and aggressors, but the important roles of bystanders and defenders have not been sufficiently explored (Escortell et al., 2020; Polanco-Levican, Salvo-Garrido, 2021; Schultze-Krumbholz et al., 2018).
Objectives
The aim is to compare neuroticism, empathy, and Internet addiction in adolescents in different roles in cyberbullying.
Methods
1505 adolescents aged 12-17 years old from 8 Federal regions in Russia appraised their experience of cyberbullying (as aggressors, victims, passive bystanders and defenders) using vignettes and filled Aggression Questionnaire (Buss, Perry, 1992), Ten-Item Personality Inventory (Gosling et al., 2003; Egorova, Parshikova,2016); Interpersonal Reactivity Index (Davis, 1983; Karyagina, Kukhtova, 2016) and Chen Internet Addiction Scale (in adaptation Malygin, Feklisov, 2011).
Results
More than one-third of adolescents (37%) reported experience of cyberbullying in different roles, mostly as passive bystanders (52%). Among the active roles were 30% defenders, 10% victims and 7% aggressors. Aggressors have the lowest empathy scores on the scales of Fantasy (F= 5.424, p=0.001) and Empathic Concern (F= 2.914, p=0.034) and Neuroticism (F= 3.060, p=0.028), while defenders, on the contrary, have the highest levels. The level of these psychological characteristics in victims is lower than in defenders and bystanders. These results are coherent with a number of studies (Escortell et al., 2020; Schultze-Krumbholz et al., 2018). There are no significant differences in Internet addiction between adolescents in different cyberbullying roles.
Conclusions
Results can be used to effective intervention and prevention of cyberbullying based on specific personality role profiles. The research was supported by RSF (project No. 18-18-00365)
Disclosure
This work was supported by the Russian Science Foundation, project # 18-18-00365.
Mental health was only modestly affected in adults during the early months of the COVID-19 pandemic on the group level, but interpersonal variation was large.
Aims
We aim to investigate potential predictors of the differences in changes in mental health.
Method
Data were aggregated from three Dutch ongoing prospective cohorts with similar methodology for data collection. We included participants with pre-pandemic data gathered during 2006–2016, and who completed online questionnaires at least once during lockdown in The Netherlands between 1 April and 15 May 2020. Sociodemographic, clinical (number of mental health disorders and personality factors) and COVID-19-related variables were analysed as predictors of relative changes in four mental health outcomes (depressive symptoms, anxiety and worry symptoms, and loneliness), using multivariate linear regression analyses.
Results
We included 1517 participants with (n = 1181) and without (n = 336) mental health disorders. Mean age was 56.1 years (s.d. 13.2), and 64.3% were women. Higher neuroticism predicted increases in all four mental health outcomes, especially for worry (β = 0.172, P = 0.003). Living alone and female gender predicted increases in depressive symptoms and loneliness (β = 0.05–0.08), whereas quarantine and strict adherence with COVID-19 restrictions predicted increases in anxiety and worry symptoms (β = 0.07–0.11).Teleworking predicted a decrease in anxiety symptoms (β = −0.07) and higher age predicted a decrease in anxiety (β = −0.08) and worry symptoms (β = −0.10).
Conclusions
Our study showed neuroticism as a robust predictor of adverse changes in mental health, and identified additional sociodemographic and COVID-19-related predictors that explain longitudinal variability in mental health during the COVID-19 pandemic.
Personality traits (e.g. neuroticism) and the social environment predict risk for internalizing disorders and suicidal behavior. Studying these characteristics together and prospectively within a population confronted with high stressor exposure (e.g. U.S. Army soldiers) has not been done, yet could uncover unique and interactive predictive effects that may inform prevention and early intervention efforts.
Methods
Five broad personality traits and social network size were assessed via self-administered questionnaires among experienced soldiers preparing for deployment (N = 4645) and new soldiers reporting for basic training (N = 6216). Predictive models examined associations of baseline personality and social network variables with recent distress disorders or suicidal behaviors assessed 3- and 9-months post-deployment and approximately 5 years following enlistment.
Results
Among the personality traits, elevated neuroticism was consistently associated with increased mental health risk following deployment. Small social networks were also associated with increased mental health risk following deployment, beyond the variance accounted for by personality. Limited support was found for social network size moderating the association between personality and mental health outcomes. Small social networks also predicted distress disorders and suicidal behavior 5 years following enlistment, whereas unique effects of personality traits on these more distal outcomes were rare.
Conclusions
Heightened neuroticism and small social networks predict a greater risk for negative mental health sequelae, especially following deployment. Social ties may mitigate adverse impacts of personality traits on psychopathology in some contexts. Early identification and targeted intervention for these distinct, modifiable factors may decrease the risk of distress disorders and suicidal behavior.
Despite statistical evidence of a general factor of psychopathology (i.e., p-factor), there is little agreement about what the p-factor represents. Researchers have proposed five theories: dispositional negative emotionality (neuroticism), impulsive responsivity to emotions (impulsivity), thought dysfunction, low cognitive functioning, and impairment. These theories have primarily been inferred from patterns of loadings of diagnoses on p-factors with different sets of diagnoses included in different studies. Researchers who have directly examined these theories of p have examined a subset of the theories in any single sample, limiting the ability to compare the size of their associations with a p-factor.
Methods
In a sample of adults (N = 1833, Mage = 34.20, 54.4% female, 53.3% white) who completed diagnostic assessments, self-report measures, and cognitive tests, we evaluated statistical p-factor structures across modeling approaches and compared the strength of associations among the p-factor and indicators of each of these five theories.
Results
We found consistent evidence of the p-factor's unidimensionality across one-factor and bifactor models. The p-factor was most strongly and similarly associated with neuroticism (r = .88), impairment (r = .88), and impulsivity (r = .87), χ2(1)s < .15, ps > .70, and less strongly associated with thought dysfunction (r = .78), χ2(1)s > 3.92, ps < .05, and cognitive functioning (r = −.25), χ2(1)s > 189.56, ps < .01.
Conclusions
We discuss a tripartite definition of p that involves the transaction of impulsive responses to frequent negative emotions leading to impairment that extends and synthesizes previous theories of psychopathology.
The majority of supervisor organizational embodiment (SOE) research has focused on its role as an important boundary condition in the context of leadership and management studies. In a multi-source field study, we seek to extend this research stream by examining an antecedent and outcome of SOE. Specifically, we leverage social cognitive theory to develop and test a trickle-down model of organizational embodiment across three organizational levels (i.e., upper-level managers, middle-level supervisors, and lower-level employees). Subsequently, we propose and demonstrate that manager organizational embodiment (MOE) trickles down and positively impacts SOE. In turn, SOE trickles down and positively impacts employee organizational embodiment. Furthermore, supervisor neuroticism strengthens the relationship between MOE and SOE when supervisor neuroticism is relatively high compared to relatively low. The findings provide evidence for a trickle-down model of organizational embodiment. Theoretical contributions, practical implications, and future research are discussed.
Drawing on detailed questionnaire data (including personal, religious and psychological factors) provided by 416 pairs of curates and training incumbents, the present study addresses two core research questions. The first research question develops and tests a new measure: the Smith Attitude toward Training Incumbents Scale (SATIS). The second research question explores the influence of personal, religious and psychological characteristics of both the curate and the training incumbent in predicting curates’ positive attitude toward the training incumbent. The data demonstrated that religious factors (Catholic or Evangelical, Liberal or Conservative, Charismatic or not Charismatic) were not significant. However, both personal and psychological factors of the curates themselves were significant. The curates who rated their training incumbent more highly were older and more emotionally stable. Personal factors were also significant for the training incumbents, but not psychological factors. The curates rated more highly the experience of working with younger training incumbents. The most satisfactory experience of curacy was associated with older and emotionally stable curates working with younger training incumbents.
Wellbeing has a fundamental role in determining life expectancy and major depressive disorder (MDD) is one of the main modulating factors of wellbeing. This study evaluated the modulators of wellbeing in individuals with lifetime recurrent MDD (RMDD), single-episode MDD (SMDD) and no MDD in the UK Biobank.
Methods
Scores of happiness, meaningful life and satisfaction about functioning were condensed in a functioning-wellbeing score (FWS). We evaluated depression and anxiety characteristics, neuroticism-related traits, physical diseases, lifestyle and polygenic risk scores (PRSs) of psychiatric disorders. Other than individual predictors, we estimated the cumulative contribution to FWS of each group of predictors. We tested the indirect role of neuroticism on FWS through the modulation of depression manifestations using a mediation analysis.
Results
We identified 47 966, 21 117 and 207 423 individuals with lifetime RMDD, SMDD and no MDD, respectively. Depression symptoms and personality showed the largest impact on FWS (variance explained ~20%), particularly self-harm, worthlessness feelings during the worst depression, chronic depression, loneliness and neuroticism. Personality played a stronger role in SMDD. Anxiety characteristics showed a higher effect in SMDD and no MDD groups. Neuroticism played indirect effects through specific depressive symptoms that modulated FWS. Physical diseases and lifestyle explained only 4–5% of FWS variance. The PRS of MDD showed the largest effect on FWS compared to other PRSs.
Conclusions
This was the first study to comprehensively evaluate the predictors of wellbeing in relation to the history of MDD. The identified variables are important to identify individuals at risk and promote wellbeing.
Many male traits are well explained by sexual selection theory as adaptations to mating competition and mate choice, whereas no unifying theory explains traits expressed more in females. Anne Campbell's “staying alive” theory proposed that human females produce stronger self-protective reactions than males to aggressive threats because self-protection tends to have higher fitness value for females than males. We examined whether Campbell's theory has more general applicability by considering whether human females respond with greater self-protectiveness than males to other threats beyond aggression. We searched the literature for physiological, behavioral, and emotional responses to major physical and social threats, and found consistent support for females' responding with greater self-protectiveness than males. Females mount stronger immune responses to many pathogens; experience a lower threshold to detect, and lesser tolerance of, pain; awaken more frequently at night; express greater concern about physically dangerous stimuli; exert more effort to avoid social conflicts; exhibit a personality style more focused on life's dangers; react to threats with greater fear, disgust, and sadness; and develop more threat-based clinical conditions than males. Our findings suggest that in relation to threat, human females have relatively heightened protective reactions compared to males. The pervasiveness of this result across multiple domains suggests that general mechanisms might exist underlying females' unique adaptations. An understanding of such processes would enhance knowledge of female health and well-being.
Previous studies didn’t find any connection between Neuroticism and authoritarian personality or social dominance orientation, but xenophobic attitudes might be hold even apart from these constructs.
Objectives
In our study we compared subjects with high Neurtoticism score with controls with a focus on racism and social distance.
Methods
The Bogardus Social Distance Scale (BSDS) is a measure of perceived social distance of a subject towards concrete outgroups. Modern Racism Scale (MRS) and The Blatant and Subtle Prejudice Scales (BSRS) are scales measuring racism. For our study we used the Neuroticism scale of the Eysenck Personality Questionnaire (EPQ). Also, we asked about personal conflicts with outgroup members and how subjects perceived their unpleasantness and importance. We measured the attitudes towards Romani, Vietnamese, foreigners, homeless people, migrants, people with mental disease and people with a physical disability.
Results
People with the high neuroticism score (SD≥1; N=48) showed significantly higher scores in racism. In comparison to control group (CG; N=96), their social distance differed significantly towards Romani, Vietnamese and migrants. Effect sizes were however on the threshold between weak and moderate. After Bonferroni correction, only the social distance towards migrants remained significant. People with the high neuroticism score didn’t report higher rate in conflict with outgroup members than HC.
Conclusions
People with the high neuroticism score showed different pattern in attitudes towards outgroup members, but not in conflict with them, which might point at higher need of internalization of negative attitudes.
It has long been hypothesized that personality plays a causative role in incidence and outcome of breast cancer (BC), but epidemiological evidence of association between personality and BC is inconsistent.
Method
We used two-sample Mendelian randomization analysis to estimate the impact of personality on the risk and survival of BC. In total, 109 single nucleotide polymorphisms (SNPs) were utilized as instruments of neuroticism from a large-scale Genome-Wide Association Studies (GWAS), and five SNPs were utilized as instruments of extraversion from Genetic of Personality Consortium and 23andMe. Genetic association with the risk and survival of overall and individual subtype BC were obtained from the Breast Cancer Association Consortium.
Result
Neuroticism is significantly associated with the risk of overall BC [odds ratio (OR) 1.06; 95% confidence interval (CI) 1.01–1.11; p = 0.015] and the risk of luminal A BC (OR 1.09; 95% CI 1.03–1.16; p = 0.004). Extraversion is not associated with the risk of BC. None of neuroticism or extraversion is associated with the survival of BC.
Conclusion
Neuroticism was associated with a modest increased risk of BC and particularly luminal A BC.
Most epidemiological studies show a decrease of internalizing disorders at older ages, but it is unclear how the prevalence exactly changes with age, and whether there are different patterns for internalizing symptoms and traits, and for men and women. This study investigates the impact of age and sex on the point prevalence across different mood and anxiety disorders, internalizing symptoms, and neuroticism.
Methods
We used cross-sectional data on 146 315 subjects, aged 18–80 years, from the Lifelines Cohort Study, a Dutch general population sample. Between 2012 and 2016, five current internalizing disorders – major depression, dysthymia, generalized anxiety disorder, social phobia, and panic disorder – were assessed according to DSM-IV criteria. Depressive symptoms, anxiety symptoms, neuroticism, and negative affect (NA) were also measured. Generalized additive models were used to identify nonlinear patterns across age, and to investigate sex differences.
Results
The point prevalence of internalizing disorders generally increased between the ages of 18 and 30 years, stabilized between 30 and 50, and decreased after age 50. The patterns of internalizing symptoms and traits were different. NA and neuroticism gradually decreased after age 18. Women reported more internalizing disorders than men, but the relative difference remained stable across age (relative risk ~1.7).
Conclusions
The point prevalence of internalizing disorders was typically highest between age 30 and 50, but there were differences between the disorders, which could indicate differences in etiology. The relative gap between the sexes remained similar across age, suggesting that changes in sex hormones around the menopause do not significantly influence women's risk of internalizing disorders.
Cohort studies of the long-term outcome of anxiety, depression and personality status rarely join together.
Methods
Two hundred and ten patients recruited with anxiety and depression to a randomised controlled trial between 1983 and 1987 (Nottingham Study of Neurotic Disorder) were followed up over 30 years. At trial entry personality status was assessed, together with the general neurotic syndrome, a combined diagnosis of mixed anxiety–depression (cothymia) linked to neurotic personality traits. Personality assessment used a procedure allowing conversion of data to the ICD-11 severity classification of personality disorder. After the original trial, seven further assessments were made. Observer and self-ratings of psychopathology and global outcome were also made. The primary outcome at 30 years was the proportion of those with no Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis.
Data were analysed using multilevel repeated measures models that adjusted for age and gender. Missing data were assumed to be missing at random, and the models allowed all subjects to be included in the analysis with missing data automatically handled in the model estimation.
Results
At 30 years, 69% of those with a baseline diagnosis of panic disorder had no DSM diagnosis compared to 37–47% of those with generalised anxiety disorder, dysthymia or mixed symptoms (cothymia) (p = 0.027). Apart from those with no personality dysfunction at entry all patients had worse outcomes after 30 years with regard to total psychopathology, anxiety and depression, social function and global outcome.
Conclusions
The long-term outcome of disorders formerly called ‘neurotic’ is poor with the exception of panic disorder. Personality dysfunction accentuates poor recovery.