Bertus F. Jeronimus

Neuroticism and common mental disorders: meaning and utility of a complex relationship.

Neuroticisms prospective association with common mental disorders (CMDs) has fueled the assumption that neuroticism is an independent etiologically informative risk factor. This vulnerability model postulates that neuroticism sets in motion processes that lead to CMDs. However, four other models seek to explain the association, including the spectrum model (manifestations of the same process), common cause model (shared determinants), state and scar models (CMD episode adds temporary/permanent neuroticism). To examine their validity we reviewed literature on confounding, operational overlap, stability and change, determinants, and treatment effects. None of the models is able to account for (virtually) all findings. The state and scar model cannot explain the prospective association. The spectrum model has some relevance, especially for internalizing disorders. Common causes are most important but the vulnerability model cannot be excluded although confounding of the prospective association by baseline symptoms and psychiatric history is substantial. In fact, some of the findings, such as interactions with stress and the small decay of neuroticisms effect over time, are consistent with the vulnerability model. We describe research designs that discriminate the remaining models and plea for deconstruction of neuroticism. Neuroticism is etiologically not informative yet but useful as an efficient marker of non-specified general risk.

Mutual reinforcement between neuroticism and life experiences: a five-wave, 16-year study to test reciprocal causation.

High neuroticism predicts psychopathology and physical health problems. Nongenetic factors, including major life events and experiences, explain approximately half of the variance in neuroticism. Conversely, neuroticism also predicts these life experiences. In this study, we aimed to quantify the reciprocal causation between neuroticism and life experiences and to gauge the magnitude and persistence of these associations. This longitudinal cohort study included 5 assessment waves over 16 years in a random sample of 296 Dutch participants (47% women) with a mean age of 34 years (SD = 12, range 16-63 years). Neuroticism was assessed with the Amsterdam Biographic Questionnaire. The experiences measured included positive and negative life events, long-term difficulties (LTDs), and change in life quality, all assessed by contextual rating procedures adapted from the Life Event and Difficulties Schedule. We fit structural equation models in Mplus. Results showed that neuroticism consistently predicted negative experiences, decreased life quality, and LTDs (β = 0.15 to 0.39), whereas effects on positive experiences were variable (β = 0.14). LTDs and deteriorated life quality each predicted small but persistent increases in neuroticism (β = 0.18), whereas improved life quality predicted small but persistent decreases (β = -0.13). This suggests set point change in neuroticism. Life event aggregates showed no persistent effects on the neuroticism set point. Neuroticism and life experiences showed persistent, bidirectional associations. Experience-driven changes in neuroticism lasted over a decade. Results support the corresponsive principle (reciprocal causation), suggesting a mixed model of change in neuroticism that distinguishes temporary changes in neuroticism from persistent changes in an individuals neuroticism set point.

Negative and positive life events are associated with small but lasting change in neuroticism

BACKGROUND High neuroticism is prospectively associated with psychopathology and physical health. However, within-subject changes in neuroticism due to life experiences (LEs) or state effects of current psychopathology are largely unexplored. In this 2-year follow-up study, four hypotheses were tested: (1) positive LEs (PLEs) decrease and negative LEs (NLEs) increase neuroticism; (2) LE-driven change in neuroticism is partly long-lasting; and (3) partly independent of LE-driven changes in anxiety/depression; and (4) childhood adversity (before age 16 years) moderates the influence of NLEs/PLEs on neuroticism scores in adult life. METHOD Data came from the Netherlands Study of Depression and Anxiety [NESDA, n = 2981, mean age 41.99 years (s.d. = 13.08), 66.6% women]. At follow-up (T₂) we assessed PLEs/NLEs with the List of Threatening Experiences (LTE) over the prior 24 months and categorized them over recent and distant PLE/NLE measures (1-3 and 4-24 months prior to T₂ respectively) to distinguish distant NLE/PLE-driven change in trait neuroticism (using the Dutch version of the Neuroticism-Extroversion-Openness Five Factor Inventory, NEO-FFI) from state deviations due to changes in symptoms of depression (self-rated version of the 30-item Inventory of Depressive Symptomatology, IDS-SR30) and anxiety (Beck Anxiety Inventory, BAI). RESULTS Distant NLEs were associated with higher and distant PLEs with lower neuroticism scores. The effects of distant LEs were weak but long-lasting, especially for distant PLEs. Distant NLE-driven change in neuroticism was associated with change in symptoms of anxiety/depression whereas the effect of distant PLEs on neuroticism was independent of any such changes. Childhood adversity weakened the impact of distant NLEs but enhanced the impact of distant PLEs on neuroticism. CONCLUSIONS Distant PLEs are associated with small but long-lasting decreases in neuroticism regardless of changes in symptom levels of anxiety/depression. Long-lasting increases in neuroticism associated with distant NLEs are mediated by anxiety/depression.

Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants

BACKGROUND This meta-analysis seeks to quantify the prospective association between neuroticism and the common mental disorders (CMDs, including anxiety, depression, and substance abuse) as well as thought disorders (psychosis/schizophrenia) and non-specific mental distress. Data on the degree of confounding of the prospective association of neuroticism by baseline symptoms and psychiatric history, and the rate of decay of neuroticisms effect over time, can inform theories about the structure of psychopathology and role of neuroticism, in particular the vulnerability theory. METHOD This meta-analysis included 59 longitudinal/prospective studies with 443 313 participants. RESULTS The results showed large unadjusted prospective associations between neuroticism and symptoms/diagnosis of anxiety, depression, and non-specific mental distress (d = 0.50-0.70). Adjustment for baseline symptoms and psychiatric history reduced the associations by half (d = 0.10-0.40). Unadjusted prospective associations for substance abuse and thought disorders/symptoms were considerably weaker (d = 0.03-0.20), but were not attenuated by adjustment for baseline problems. Unadjusted prospective associations were four times larger over short (<4 year) than long (⩾4 years) follow-up intervals, suggesting a substantial decay of the association with increasing time intervals. Adjusted effects, however, were only slightly larger over short v. long time intervals. This indicates that confounding by baseline symptoms and psychiatric history masks the long-term stability of the neuroticism vulnerability effect. CONCLUSION High neuroticism indexes a risk constellation that exists prior to the development and onset of any CMD. The adjusted prospective neuroticism effect remains robust and hardly decays with time. Our results underscore the need to focus on the mechanisms underlying this prospective association.

Timing of Stressful Life Events Affects Stability and Change of Neuroticism

Neuroticism is a predictor of many health problems. To study the determinants of within–subject change in neuroticism, three hypotheses were tested: (i) subjects who experienced stressful life events (SLEs) show an increase in neuroticism; (ii) high baseline neuroticism moderated this effect; and (iii) recent SLEs had a greater impact on neuroticism than distant SLEs. Data came from the Finnish Twin Cohort. Neuroticism data were collected in 1975 and 1981 and SLEs data in 1981 (n = 21 085). By entering baseline neuroticism as a predictor for neuroticism at follow–up, the outcome measure was change in neuroticism. Changes in neuroticism were predicted from SLE indices or their interaction with baseline neuroticism. Timing of SLEs was taken into account by distinguishing recent from distant SLEs. To control for confounding by shared genes and environments, both within–twin pair and between–twin pair effects were tested for monozygotic and dizygotic twin pairs separately. Neuroticisms six–year stability was high (r = .58, p < .001). Exposure to SLEs modestly increased neuroticism (βs > .55, ps < .001), unconfounded by shared genes. This effect was not moderated by high baseline neuroticism. Recent SLEs (.09 < βs < .15) had more impact than distant SLEs (.03 < βs < .11; ps < .01). In conclusion, the findings strongly supported a model of environmentally driven SLEs causing dynamic fluctuations around a persons set point of neuroticism. Copyright

Why Not Everyone Gets Their Fair Share of Stress: Adolescent's Perceived Relationship Affection Mediates Associations Between Temperament and Subsequent Stressful Social Events

Temperamental differences are associated with subsequent stressful life events, a phenomenon that has in part been attributed to evocation. However, we remain ignorant about the mechanisms that mediate this process. In the current paper, we test whether differences in ‘perceived relationship affection’ accounted for part of the prospective association between temperament and stressful social event evocation in three social domains, viz. parents, peers and romantic partners. Data were derived from the Tracking Adolescents’ Individual Lives Survey, a large population cohort of Dutch adolescents (n = 1158). Parent–reported adolescent temperament and adolescents perceived affection were assessed at age 11 years. Stressful social events that occurred between age 11 and 16 years were captured using the event history calendar. Results indicate that adolescents evoke subsequent stressful social events based on their temperament, and that this association is partially mediated by perceived affection. Importantly, we found evidence for both generic and domain–specific associations, which indicates that social domains are related yet distinct. Taken together, the findings suggest that a search for mediating variables may be a promising way to increase our understanding of the mechanisms that underlie the social stress selection principle, and that perceived relationship affection is one of the candidates. Copyright

Temporal dynamics of health and well-being: A crowdsourcing approach to momentary assessments and automated generation of personalized feedback

Objective Recent developments in research and mobile health enable a quantitative idiographic approach in health research. The present study investigates the potential of an electronic diary crowdsourcing study in the Netherlands for (1) large-scale automated self-assessment for individual-based health promotion and (2) enabling research at both the between-persons and within-persons level. To illustrate the latter, we examined between-persons and within-persons associations between somatic symptoms and quality of life. Methods A website provided the general Dutch population access to a 30-day (3 times a day) diary study assessing 43 items related to health and well-being, which gave participants personalized feedback. Associations between somatic symptoms and quality of life were examined with a linear mixed model. Results A total of 629 participants completed 28,430 assessments, with a mean (SD) of 45 (32) assessments per participant. Most participants (n = 517 [82%]) were women and 531 (84%) had high education. Almost 40% of the participants (n = 247) completed enough assessments (t = 68) to generate personalized feedback including temporal dynamics between well-being, health behavior, and emotions. Substantial between-person variability was found in the within-person association between somatic symptoms and quality of life. Conclusions We successfully built an application for automated diary assessments and personalized feedback. The application was used by a sample of mainly highly educated women, which suggests that the potential of our intensive diary assessment method for large-scale health promotion is limited. However, a rich data set was collected that allows for group-level and idiographic analyses that can shed light on etiological processes and may contribute to the development of empirical-based health promotion solutions.

A primrose path? Moderating effects of age and gender in the association between green space and mental health

This paper explored whether the association between green space and mental health is moderated by age and gender. Questionnaires on psychopathology and quality of life were filled out by 4924 individuals from the general Dutch population and regressed on greenness levels. Green space was associated with better mental health, but only in specific age and gender groups, and only in a 3 km, not a 1 km buffer. The moderating effects of age and gender may be explained by whether or not people have the opportunity to make use of their green living environment.

Why Personality and Psychopathology Are Correlated: A Developmental Perspective Is a First Step but More Is Needed

Durbin and Hicks offered a provocative critique of current research linking personality traits with psychopathology. We had a generally positive response to their article despite reservations about classifying an entire field as stagnant. We describe our reservations and suggest that their developmental approach represents an important opportunity to create synergy across a number of sub-disciplines within psychology. We then underscore their point about the importance of process when attempting to understand the dynamic connections between personality traits and psychopathology. Copyright

Preserving Subjective Wellbeing in the Face of Psychopathology: Buffering Effects of Personal Strengths and Resources

Background Many studies on resilience have shown that people can succeed in preserving mental health after a traumatic event. Less is known about whether and how people can preserve subjective wellbeing in the presence of psychopathology. We examined to what extent psychopathology can co-exist with acceptable levels of subjective wellbeing and which personal strengths and resources moderate the association between psychopathology and wellbeing. Methods Questionnaire data on wellbeing (Manchester Short Assessment of Quality of Life/Happiness Index), psychological symptoms (Depression Anxiety Stress Scales), and personal strengths and resources (humor, Humor Style questionnaire; empathy, Empathy Quotient questionnaire; social company; religion; daytime activities, Living situation questionnaire) were collected in a population-based internet study (HowNutsAreTheDutch; N = 12,503). Data of the subset of participants who completed the above questionnaires (n = 2411) were used for the present study. Regression analyses were performed to predict wellbeing from symptoms, resources, and their interactions. Results Satisfactory levels of wellbeing (happiness score 6 or higher) were found in a substantial proportion of the participants with psychological symptoms (58% and 30% of those with moderate and severe symptom levels, respectively). The association between symptoms and wellbeing was large and negative (-0.67, P < .001), but less so in persons with high levels of self-defeating humor and in those with a partner and/or pet. Several of the personal strengths and resources had a positive main effect on wellbeing, especially self-enhancing humor, having a partner, and daytime activities. Conclusions Cultivating personal strengths and resources, like humor, social/animal company, and daily occupations, may help people preserve acceptable levels of wellbeing despite the presence of symptoms of depression, anxiety, and stress.