Benjamin B. Lahey, University of Chicago

Student Leadership Presentation by Travis J. Pashak

Presentation Overview

What IS neuroticism? Association with disorders Genetic and Environmental influences Causal links to adverse outcomes Prevention Future research

What is neuroticism?

What is neuroticism?

“Relatively stable tendencies to respond with negative emotions to threat, frustration, or loss.” – Lahey, B. B.

“An enduring tendency to experience negative emotional states” – Wikipedia

Characteristics of Neuroticism Levels peak in late adolescence

Moderate decline through adulthood

Across rank-order individuals, stable

Somewhat higher in low SES groups

Slightly higher in females

Association with Mental Disorders

Neuroticism is strongly associated with: Somatoform disorders Eating disorders Schizophrenia Substance use disorders Depression

and more…

Association with Mental Disorders

Associated AND Predictive

Higher neuroticism predicts a 90%-100% greater likelihood of developing major depression in the next 12 months

High neuroticism scores at age 16 predicted 93% greater likelihood of developing schizophrenia

Suicide risk between ages 15-21 was 225% greater for 14 year-olds in the highest neuroticism quartile vs. the lowest

Association with Physical Health

Neuroticism is associated with: Unfounded somatic complaints Cardiovascular disease Atopic eczema Asthma Irritable Bowel Syndrome

Associated AND Predictive Neuroticism significantly predicts longevity in

normative samples.

Neuroticism predicts morbidity in individuals with chronic diseases and cancer.

Neuroticism predicts health deterioration in individuals with Type I Diabetes and those with cardiac disease.

Neuroticism and Quality of LifeNeuroticism is inversely related to: Marital satisfaction Occupational success Overall quality of life

All things considered, higher neuroticism “predicts shorter, less happy, less healthy, and less successful lives to a meaningful extent.” - Lahey

What causes neuroticism?

Evidence exists for both genetic influences on neuroticism and environmental influences.

Although we know that nature and nurture’s effects are intertwined, let’s explore their roots separately.

Genetic Influences

Neuroticism is largely heritable, peaking in early adolescence and early adulthood

During that period there are little sex differences, but with age women have more heritability than men

Genetic Influences A polymorphism of the

serotonin transporter has been shown to play a part in neuroticism development.

Called “5-HTTLPR,” this polymorphism is of special interest because:It indirectly influences serotonin

transportersIt could be a target for medication

since we’ve seen progress using SSRI’s

Genetic Influences

Neuroticism scores are slightly but significantly higher in persons with at least one short 5-HTTLPR allele

fMRI has shown variations in 5-HTTLPR are linked to differences in amygdala activation in reaction to threats

However, Genome-wide linkage studies have been inconsistent

(see link at end for more on GWAS)

Environmental Influences Some correlations between neuroticism

scores in adults and retrospective recall of their upbringing include:Being abused as a childLack of religiosity in the familyLow parental involvement

This area is in definite need of prospective longitudinal research

Causal Links to Adverse Outcomes Currently there are three working models of the

causal links between neuroticism and mental disorders.

First, let’s briefly review some models from class:

1) 2)

3) 4)

Causal Link Models#1 Overlapping Genetic Influences This model explains the correlation between

mental disorders and neuroticism by showing that they are influenced by the same genes.

*Multiformity *Mediator

Causal Link Models

#2 Neuroticism, stressful events, and social support This model explains the link between neuroticism

and mental disorders by pointing to an indirect relationship of life events and social support

Causal Link Models#3 Neuroticism and Emotional Reactivity to

Stressful Life Events This model is probably the most fundamental

of the three, stating that persons with high neuroticism respond more negatively to stimuli which then affects their mental health.

Neuroticism and Physical Health Evidence is growing that neuroticism

moderates the magnitude of physiological responses to stressors.

Other plausible examples? White board!

Neuroticism and Prevention

Ultimately, knowledge about neuroticism isn’t helpful to public health unless we can use it to prevent or treat problems.

Lahey suggests three potential prevention plans, but first can we think of any of our own?

Neuroticism and Prevention

#1 Neuroticism Screenings Those with high scores could be advised to seek

further individual check-ups for both medical and mental issues which are commonly associated

However, the risks must be assessed including:Money spent vs. positive impact on public healthFalse-positives leading to stigma or unnecessary worryPeople largely already aware of their associated

symptoms

Neuroticism and Prevention#2 Reduce population levels of neuroticism to

indirectly reduce associated problems To date, no interventions specifically for

neuroticism have been developed but they seem feasible.

Implemented in group settings, could be very cost-effective

Neuroticism and Prevention

#3 Routinely Assess for Neuroticism in Persons Already Showing the Associated Conditions

For those who appear to deteriorate more quickly when with high neuroticism, could improve longevity

-Diabetes

-Cardiovascular Disease

Where to Start Searching?

If we aim to identify populations with high levels of neuroticism and provide treatment & prevention of associated conditions, where do we start?

Geography and Personality: Regional Differences

Future Directions for Research Further testing of the causal models Combine evidence to construct

comprehensive multimodal perspectives Invest in a greater understanding of

genetic and environmental influences Create working models for each disorder

of the multifaceted causal pathways

Helpful Online Resources

Neuroticism 5-HTTLPR Longevity Regional Differences Genome-Wide Association Study

THANK YOU FOR YOUR ATTENTION AND PARTICIPATION!