Neuroticism: the personality risk factor for stress and impaired health and well-being

This chapter reviews the literature on the Big Five and physical and mental health, focussing on neuroticism as the personality risk factor for stress and impaired health and well-being. Although neuroticism is often associated with excessive or unfounded symptom and illness reporting, studies of objective health outcomes, such as longevity or mortality, have confirmed that the trait does indeed play a genuine role in objective health status. With regard to mental health, neuroticism is associated with a range of conditions, and recent work has linked the trait with DSM-IV personality disorders. In addition, neuroticism is a strong and consistent predictor of both subjective (hedonic) and psychological (eudaimonic) dimensions of well-being. This chapter presents an overarching process model, describing the effect of neuroticism on various intermediate mechanisms that tie situational stressors to negative health and well-being outcomes. Evidence is reviewed linking neuroticism with stressor exposure and emotional reactivity, negative cognitive appraisal, maladaptive and ineffective coping, and risky health behavior. The combined/interactive effect of neuroticism and other traits on vulnerability is also considered. The chapter examines biological and psychological mechanisms underlying the toxic effect of neuroticism, and concludes with a discussion of possible intervention strategies