title: Neuroticism and common mental disorders: meaning and utility of a complex relationship.
abstract: Neuroticism's 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 neuroticism's 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.
authors.affiliation: Department of Psychiatry Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.affiliation: Department of Psychiatry Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Bertus F
authors.initials: BF
authors.lastname: Jeronimus
authors.affiliation: Department of Psychiatry, Stony Brook University, NY, USA.
authors.forename: Roman
authors.initials: R
authors.lastname: Kotov
authors.affiliation: Department of Psychiatry Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.|Department of Epidemiology Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Harriëtte
authors.initials: H
authors.lastname: Riese
authors.affiliation: Department of Psychiatry Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Bos
authors.affiliation: Department of Psychology, University of Denver, CO, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hankin
authors.affiliation: Department of Psychiatry Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Judith G M
authors.initials: JGM
authors.lastname: Rosmalen
authors.affiliation: Department of Psychiatry Interdisciplinary Center Psychopathology and Emotion regulation (ICPE) University of Groningen University Medical Center Groningen P.O.Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: Albertine J
authors.initials: AJ
authors.lastname: Oldehinkel
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008960:Models, Psychological; D000075384:Neuroticism; D010551:Personality