High Neuroticism and Propensity of Major Depressive Disorder and

Generalized Anxiety Disorder

Yuhan Hu

Brandeis University, Waltham, 02453, U.S.A.

Keywords: Neuroticism, Major Depressive Disorder, Generalized Anxiety Disorder.

Abstract: Neuroticism is one of the Big Five personality traits. The features of high neuroticism level have several

similarities with symptoms of major depressive disorder and generalized anxiety disorder, which are two

major forms of depressive disorders and anxiety disorders. Because of the overlaps, it is proposed that high

neuroticism is positively correlated with the diagnosis of major depressive disorder and generalized anxiety

disorder. Multiple previous correlational studies proved such correlation through their measures of

participants’ self-reports and statistical analysis. This indicates that neuroticism level could be a predictor for

depression and anxiety. This means earlier and more efficient prevention and intervention of experiencing

mental disorders could be enforced through daily assessment of Big Five personality factors. This discovery

has a crucial impact on public health. It provides social institutions such as schools and workplaces with

accessible and practical methods to assess the mental health issues of their students and staff timely and

effectively.

1 INTRODUCTION

Mental health issues have become a growing concern

and priority for society in recent years. Life pressures,

personal experiences, and competition in society can

all lead to stress, sadness, depression, and even

mental illness. As a result, people have an increasing

awareness and concerns of their own mental problems

and also the mental health of people around them.

Among various prevalent psychology theories, Big

Five personality traits are a widely accepted

personality model in psychology. It divides

personality traits into five main dimensions -

openness to experience, conscientiousness,

extraversion, agreeableness, and neuroticism. Each of

which represents a core personality tendency, and

neuroticism is one of these dimensions that would be

the main focus of this article. Noticeably, high

neuroticism have several symptoms that overlap with

the symptoms of depressive disorders and anxiety

disorder, two of the most important and prevalent

mental disorders. Thus, this essay proposes that there

is a propensity of people with high levels of

neuroticism to have depressive disorders and/or

anxiety disorders, proving through the lens of

previous research and experiments in the field of

psychopathology. It is hoped that this study will raise

awareness of mental health issues, and expresses the

idea that early detection and prevention of depression

can be enhanced by testing for neuroticism.

2 INTRODUCTION TO THE KEY

CONCEPTS

In order to explore in depth the potential relationship

between high neuroticism and mental illness, and

whether neuroticism level can serve as a predictor of

mental illness, it is necessary to clarify the three main

psychological terms in detail. Neuroticism was

proved to be able to predict people’s potential

academic or life outcomes (Mata et al., 2018). People

with low level of neuroticism are tend to feel calm,

emotional stable, secure, and confident about

themselves. By contrast, people with high levels of

neuroticism are more likely to feel worried, fear,

insecure, and self-doubting (Lim, 2023). They are

likely to have difficulty in sleeping, feel upset

frequently, and experience heart palpitations. This

means they would feel pounding or racing heart beat.

They would have stronger and more negative

reactions to negative events, easier to get stressed out,

greater difficulty picking up social cues, and less

supportive social networks. These symptoms have

424

Hu, Y.

High Neuroticism and Propensity of Major Depressive Disorder and Generalized Anxiety Disorder.

DOI: 10.5220/0014118000004942

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 2nd International Conference on Applied Psychology and Marketing Management (APMM 2025), pages 424-429

ISBN: 978-989-758-791-7

several singularities with the symptoms of depressive

disorders and anxiety disorders.

Depressive disorders included different types of

depression such as major depressive disorder,

dysthymia, premenstrual dysphoric disorder, and

anhedonia. Among them, major depressive disorder

is the most common and famous type of depressive

disorders. It is characterized by symptoms such as

low self-esteem, decreased interests, and feeling

anxious about daily tasks. People with depressive

disorders would have persistent anxious and sad

mood, suicidal ideas, frustration and irritability, and

sleep disturbances such as insomnia (Bains &

Abdijadid, 2023). Major depressive disorder can be

caused by many different aspects such as

environmental factors, biological factors, personal

experiences, and social factors. The main personal

experience or psychological factors can include

traumatic childhood experiences, parenting styles,

high social expectations, and stressful or harsh

upbringing environment.

Anxiety disorders include generalized anxiety

disorder, panic disorder, separation anxiety disorder,

social anxiety disorder, and specific phobias. The

main focus of this article is generalized anxiety

disorder, which has symptoms such as excessive

worries about at least two domains such as health,

natural disasters, family members, and school, and

the patients cannot control such worries. They would

also experience sleeping problems, increased heart

rate, restlessness, irritability, headache, and fatigue

(DeMartini et al., 2019). Separation anxiety disorder

refers to the symptoms of excessive distress when the

patients are separate from their attachment figures.

They would have excessive worry about possible

harm to attachment figure, or to themselves during the

separation. Thus, patients with separation anxiety

disorder are commonly children or adolescents rather

than adults. Physical symptoms such as headaches

and fatigue also accompany their anxiety (Clinic,

2024). Social anxiety disorder’s symptoms are

patients’ excessive anxiety toward social situations.

They exhibit avoidance of these situations which may

involve fear of judgment or humiliation.

3 RELATIONSHIP BETWEEN

NEUROTICISM AND MAJOR

DEPRESSIVE DISORDER

Scholars in the field of psychopathology noticed the

overlapping symptoms of high neuroticism and major

depressive disorder, such as persistent sad mood and

sleep problems. They proposed that neuroticism

levels have profound significance in predicting public

health (Lahey, 2009). Such significance is mainly

because features of neuroticism provide the

vulnerability required for the diagnosis of multiple

mental illnesses, including depressive disorders and

anxiety disorders (Widiger & Oltmanns, 2017). This

indicate that there might be a correlation between

neuroticism level and the diagnosis of major

depressive disorder. In such way, assessment of

neuroticism can be used as a predictor for depression

level, and more timely intervention and prevention of

mental illnesses could be implemented.

One previous study demonstrated the correlation

between neuroticism and the degree of depression.

This study measured and analyzed the factors through

two large population-based cohorts - Generation

Scotland: Scottish Family Health Study (GS:SFHS)

and UK Biobank. The GS:SFHS included 19,200

participants from Scotland, aged 18-98 years. The UK

Biobank included 90,529 participants, aged 40-69

years. From the two cohorts, the researchers selected

individuals with complete data for analysis.

Participants completed questionnaires during both

clinical assessments. They provided the information

of their mental health, cognitive ability and

demographic conditions. During this process, the

Eysenck Personality Questionnaire Short Form-

Revised (EPQ-SF) was used to measure participants'

neuroticism levels. Neuroticism in the Eysenck

personality is not exactly the same as neuroticism in

the Big Five personality, but the basic characteristics

are the same. In the questionnaire, participants rated

their feelings. Those who received higher scores on

the questionnaire had higher levels of neuroticism. At

the same time, the Patient Health Questionnaire-9

(PHQ-9) and the General Health Questionnaire

(GHQ-28) were used to assess their levels of

psychological distress and depressive symptoms.

Higher scores indicate more severe depression levels.

The researchers also recorded the their intelligence

level (g) through standardized cognitive tests such as

the Wechsler Digit Symbol Substitution Task and the

Mill Hill Vocabulary Test (Navrady et al., 2017).

Researchers then calculated and compared the

data using statistical methods such as the

MCMCglmm package and generalized linear

regression analyses. The results showed that there

was a significant positive correlation between high

neuroticism levels and depressive symptoms.

Participants with high levels of neuroticism are more

likely to experience depression and psychological

distress. This proves the correlation between high

neuroticism and major depressive disorder. Another

High Neuroticism and Propensity of Major Depressive Disorder and Generalized Anxiety Disorder

425

focus of this research study was intelligence, it also

found that intelligence seemed to decrease the

association between neuroticism and self-reported

depression levels. This suggests that intelligence may

be able to alleviate the psychological stress associated

with high neuroticism (Navrady et al., 2017). The

study did not control whether or not the participants

engaged in psychotherapy. Therefore, individuals

with higher intelligence may be less depressed

because they were more likely to seek out relevant

treatment, and thus have fewer depressive symptoms.

The association between high neuroticism and

depressive symptoms was also found in a study

conducted on Chinese college students. 1,238

undergraduate students from a university in Harbin,

China, served as the study's subjects. 1,233

participants remained after those who did not fit the

age limit were eliminated. By asking participants to

complete questionnaires, the researchers investigated

the connections between neuroticism, anxiety,

depression, and life satisfaction. The Big Five

Inventory-2 (BFI-2) questionnaire was used to gauge

their degree of neuroticism and the Big Five

personality traits, while the Self-Rating Depression

Scale (SDS) was utilized to gauge their depression.

The participants were split into two groups according

to the neuroticism test mean score of 32.38.

Participants in the high neuroticism group had scores

higher than the mean, while those in the low

neuroticism group had scores lower than the mean.

The data was then compiled into graphs and charts to

compare the two groups' degrees of depression. The

t-test results showed substantial differences in

depressive symptoms between the two groups. The

mean scores for the majority of symptoms associated

with depression were greater in the group with high

neuroticism. Thus, this study also confirmed the

finding that major depressive disorder experience is

positively correlated with high neuroticism (Tang et

al., 2023).

These studies highlight some important

takeaways for public health and clinical practice. By

showing a clear link between neuroticism and major

depressive disorder, researchers point out the value of

early assessment and intervention. Screening for

neuroticism could be a practical way to identify and

predict individuals at high risk for major depressive

disorder at an early time. Thus, it enables these

individuals to take timely prevention and actions to

reduce the propensity before symptoms get worse.

On top of that, the findings also show how

personality traits, cognitive abilities, and mental

health can all interact in complex ways. For example,

the first study of intelligence, neuroticism, and

depression proved the correlation between high

neuroticism and depressive symptoms, and also

mentioned that intelligence might reduce the impact

of neuroticism on depression. This could offer a new

angle for preventing mental health issues by focusing

on neuroticism. This suggests that improving

intelligent skills could diminish the psychological

stress related to high neuroticism, and help reduce the

intensity of depressive symptoms. Although the clear

association between intelligence and mental illnesses

is still unclear and needs further studies, this could be

a helpful insight for the treatment of major depressive

disorder.

4 RELATIONSHIP BETWEEN

NEUROTICISM AND

GENERALIZED ANXIETY

DISORDER

High neuroticism also has overlapping symptoms

with generalized anxiety disorder, such as persistent

worries, sleep disturbances, and heart problems. One

previous twin study demonstrated the existing

association between high neuroticism and

generalized anxiety disorders. The researchers

wanted to determine whether neuroticism is a risk

factor for internalizing disorders including

generalized anxiety disorder. The use of a twin design

effectively separated genetic and environmental

influences. A large number of twin pairs were

included in the study to ensure a diverse sample. The

twins were asked to do assessments, where they used

self-reported Eysenck Personality Questionnaire to

measure their neuroticism levels and a diagnostic

interview to identify internalizing disorders. Finally,

the researchers used multivariate genetic analysis, the

software package Mx, and independent pathway

models to calculate the results. The study concludes

that neuroticism is indeed an important risk factor for

the development of internalizing disorders including

generalized anxiety disorder. The results of the twin

study also suggest a significant genetic component to

both neuroticism and internalizing disorders

(Hettema et al., 2006).

A study done at UCLA and Northwestern

University also showed that young people with high

levels of neuroticism were more likely to have a

predisposition to anxiety disorders. Researchers

suggest that people with high neuroticism tend to

show more negative emotions such as anxious, sad,

and stressful, as well as higher vulnerability and

sensitivity to negative events. The study selected 547

APMM 2025 - International Conference on Applied Psychology and Marketing Management

426

senior students from two high schools in Chicago and

Los Angeles. Participants were also asked to take

questionnaires. The results of the study showed a

positive correlation between neuroticism and

generalized anxiety disorder. Therefore, the

researchers state that neuroticism may be useful to

predict internalizing disorders such as generalized

anxiety disorder and major depressive disorder

(Anyaso, 2016).

In 2020, another research project investigated

interpretative bias and neuroticism levels as warning

signs for internalizing diseases such as generalized

anxiety disorder. The researchers hoped to understand

how neuroticism affects interpretive bias, and how

this bias influences mental health outcomes over

time. The study involved a group of college students.

Initially, 1,269 students were invited to participate,

focusing on those who were likely to develop mood

and anxiety disorders based on neuroticism scores.

Ultimately, 668 students agreed to participate, 627 of

them completed the baseline assessment. The

research study utilized a longitudinal design. The task

for assessing participants’ interpretive bias was

implemented approximately six years after the

baseline assessment. Their interpretive-bias was

assessed through their answers to 20 scenarios, which

included filler tasks and ranking questions of social

and nonsocial situations. In the study, the Mood and

Anxiety Symptoms Questionnaire was used to assess

their level of anxiety disorders symptoms. Multiple

self-reported measures were used to construct

participants’ hierarchical neuroticism model, such as

the International Personality Item Pool-NEO-PI-R,

The Behavioral Inhibition Scale, and the Big Five

Mini-Markers Scale (Vinograd et al., 2020).

After collecting the data, the researcher conducted

a regression analysis. The result indicated that

neuroticism significantly predicted a general distress

dimension. It also showed that neuroticism was a

helpful predictor of negative interpretations in social

situations. The study concluded that neuroticism

could reflect an increased risk for anxiety disorders,

but interpretive bias did not serve as a mediator of this

relationship. This study fills the gap in understanding

the longitudinal relationship between neuroticism

levels and internalizing problems, and indicates the

complexity of how neuroticism may contribute to

mental health problems (Vinograd et al., 2020).

These previous studies and their evidence

revealed the positive association between neuroticism

and generalized anxiety disorder. This highlights the

importance of treating neuroticism as a predictor for

intervention of mental illnesses. As the twins study

revealed that neuroticism has a genetic component, it

conveys the importance of future research of

biological mechanisms behind this trait. For example,

exploring specific genes or neural pathways

associated with neuroticism and generalized anxiety

disorder may provide new evidence of why

individuals with higher neuroticism are more likely to

experience anxiety disorders. These explorations

could lead to more innovative and effective

treatments for intervening mental illnesses, through

the testing of neuroticism levels. The important

influence of shared and non-shared environmental

factors also suggests that regulations of stressors in

daily life may help reduce the risk of developing

generalized anxiety disorder in individuals with high

neuroticism. Furthermore, the study of high school

students focused on a younger demographic - the

approximate age range of American high school

senior students is between 17-19 years old. This focus

on a younger group proves that the relationship

between neuroticism and anxiety disorders is not only

in adults, but also in the adolescence. This

demonstrates the age generalization of this

correlation.

5 DISCUSSION AND

SUGGESTION

This article aims to examine the relationship between

neuroticism and depression and anxiety. People with

high neuroticism are characterized by high sensitivity

and vulnerability to negative stimulus and emotional

distress, which may make them more susceptible to

developing depressive symptoms. Overlapping

features between neuroticism and depression, such as

persistent worry, emotional instability, and sleep

disturbances, provide a basis and motivation for

proposing the hypothesis and conducting the

researches.

These previous studies are very similar in their

approaches. First of all, they all took participants

from a specific population, such as adults in Scotland

and UK, high school seniors in Chicago and Los

Angeles, and twins. Also, the methods for these

studies were all through self-reported questionnaires.

Different questionnaires were used to assess

participants' levels of neuroticism, depression, and

anxiety. Moreover, the researches are also similar that

the data were all collected and analyzed through

statistical methods such as regression calculations

and the production of graphs and charts. The

conclusions they came up with were similar that high

High Neuroticism and Propensity of Major Depressive Disorder and Generalized Anxiety Disorder

427

levels of neuroticism were positively correlated with

depression and anxiety.

Such similarities contribute to several limitations

of these studies. Because of these studies’ similar

correlational choices of research methods, the

conclusions they draw can only be about correlation,

but could not a direct cause-and-effect relationship

between high neuroticism and the diagnoses of

mental illnesses. Thus, these studies cannot tell if

neuroticism causes major depressive disorder and

generalized anxiety disorder or if there is a

bidirectional relationship between neuroticism and

the two mental illnesses. Also, these studies relied on

self-report measures, which may introduce response

bias in the answers. For example, participants may

answer base on social desirability or inaccurate self-

assessment. For instance, some of them may think

that they do not want to be associated with high level

of depression or anxiety, since this does not align with

the social expectation they received from their

families. Therefore, they may disguise their real

feelings and rate themselves lower in depression and

anxiety levels. They might also anticipate the goals of

the researches and choose the answers more align

with the goals, such as choosing answers that indicate

higher level of depression, although they might not

actually feel that depressed.

Thus, future research studies can aim to explore a

more direct and causal relationship between

neuroticism and the two mental illnesses. This could

provide more convincing evidence for neuroticism as

a predictor of depressive disorders and anxiety

disorders. For example, future researches can develop

effective methods for constructing experimental

designs to assess individuals’ neuroticism levels and

their depression and anxiety symptoms. Designing

experiments for studying the hypothesized

relationship could be difficult, since unbiased and

valid experiments require blinded studies, disguise to

the participants, and the elimination of confounding

variables. These requirements may be difficult to

practice in real life. However, the success in

constructing such experiments could be a crucial

progress in demonstrating the more direct and causal

relationship between neuroticism and mental

illnesses. Also, if experimental studies are difficult to

carry out, longitudinal studies that track the changes

of variables over time could be helpful in providing

more evidence of causality. This could be helpful for

institutions to provide timely interventions and

prevention regarding people’s mental health issues,

and raise the overall awareness about mental health

problems among the public.

6 CONCLUSION

In conclusion, the characteristics of high neuroticism

overlap with several symptoms of major depressive

disorder and generalized anxiety disorder. Thus, the

hypothesis that highly neurotic people have a

tendency to also experience psychological disorders

was proposed. Adequate correlational studies have

successfully demonstrated a positive correlation

between high neuroticism and the two mental

illnesses. While more future research is essential,

these evidence is still significant. They suggest that

neuroticism can be used as an effective screening tool

to identify people at risk for major depressive

disorder and generalized anxiety disorder. By

evaluating an individual's neuroticism level, those

who may have the propensity for mental illnesses can

be identified earlier, so that earlier preventative

strategies can be developed more timely. This could

increase social institutions’ awareness of assessing

people’s mental health and provide them with

accessible way to do it through Big Five personality

inventories. This deepens the understanding of how

personality traits reflect the propensity of mental

illnesses, and highlights the importance of early

detection and intervention.

REFERENCES

R. Mata, R. Frey, D. Richter, J. Schupp, R. Hertwig, Risk

Preference: A View from Psychology. J. Econ.

Perspect. 32, 155-172 (2018)

A. G. Y. Lim, Big Five Personality Traits | Simply

Psychology. (2023)

https://www.simplypsychology.org/big-five-

personality.html#neuroticism

N. Bains and S. Abdijadid, Major Depressive Disorder,

(StatPearls Publishing, 2023).

J. DeMartini, G. Patel, T. L. Fancher, Generalized Anxiety

Disorder. Ann. Intern. Med. 170, 7 (2019)

C. Clinic, Separation Anxiety Disorder: What It Is,

Symptoms & Treatment. Cleveland Clinic (2024).

https://my.clevelandclinic.org/health/diseases/separati

on-anxiety-disorder

B. B. Lahey, Public health significance of neuroticism. Am.

Psychol. 64, 241-256 (2009)

T. A. Widiger, J. R. Oltmanns, Neuroticism is a

fundamental domain of personality with enormous

public health implications. World Psychiatry 16, 144-

145 (2017)

L. B. Navrady, S. J. Ritchie, S. W. Y. Chan, D. M. Kerr, M.

J. Adams, E. H. Hawkins, A. M. McIntosh, Intelligence

and neuroticism in relation to depression and

psychological distress: Evidence from two large

population cohorts. Eur. Psychiatry 43, 58-65 (2017)

APMM 2025 - International Conference on Applied Psychology and Marketing Management

428

Q. Tang, X. He, L. Zhang, X. Liu, Y. Tao, G. Liu, Effects

of Neuroticism on Differences in Symptom Structure of

Life Satisfaction and Depression-Anxiety among

College Students: A Network Analysis. Behav. Sci. 13,

641 (2023)

J. M. Hettema, M. C. Neale, J. M. Myers, C. A. Prescott, K.

S. Kendler, A population-based twin study of the

relationship between neuroticism and internalizing

disorders. Am. J. Psychiatry 163, 857-864 (2006)

H. H. Anyaso, Neuroticism Predicts Anxiety and

Depression Disorders. Northwestern University (2016)

https://news.northwestern.edu/stories/2016/01/neurotic

ism-predicts-anxiety-depression-disorders

M. Vinograd, A. Williams, M. Sun, L. Bobova, K. B.

Wolitzky-Taylor, S. Vrshek-Schallhorn, S. Mineka, R.

E. Zinbarg, M. G. Craske, Neuroticism and Interpretive

Bias as Risk Factors for Anxiety and Depression. Clin.

Psychol. Sci. 8, 641-656 (2020)

High Neuroticism and Propensity of Major Depressive Disorder and Generalized Anxiety Disorder

429