Effect of worry, depressed affect, and sensitivity to environmental stress owing to neurotic personality on MRI markers of cerebral small vessel disease: A univariable and multivariable Mendelian randomization study.

OBJECTIVE: Neuroticism was found to be associated with cerebral small vessel disease (CSVD) in observational studies. We aimed to explore the causal relationship between distinct components of neuroticism and CSVD. METHODS: Two-sample mendelian randomization (MR) study was conducted to explore the bidirectional causal relationships between three genetically distinct subclusters of neuroticism (depressed affect, worry, and sensitivity to environmental stress and adversity [SESA]) and MRI markers of CSVD using publicly available genome-wide association studies (GWAS) data. Inverse variance weighted (IVW) method was used for the primary causal estimates. Alternative MR approaches and extensive sensitivity analyses were conducted to ensure the robustness of the findings. Multivariable MR (MVMR) analysis was used to estimate the direct causal effects with adjustment of other known risk factors for CSVD. RESULTS: Genetically determined SESA was significantly associated with reduced fractional anisotropy (FA) (beta: -1.94, 95%CI: -3.04 to -0.84, p=5.29e-4), and associated with increased mean diffusivity (MD) (beta=1.55, 95%CI: 0.29 to 2.81, p=0.016) and white matter hyperintensities (WMH) (beta=0.25, 95% CI: 0.03 to 0.47, p=0.029) at the nominally significant level. MVMR analysis suggested the significant associations remained significant after accounting for body mass index (BMI), smoking, alcohol drinking, type 2 diabetes (T2D), hypertension, and depression. The other two neuroticism subclusters (depressed affect and worry) didn't have significant causal effects on the MRI markers. In the reverse MR analysis with the MRI markers as exposures, no significant associations were found. CONCLUSION: This study supported the casual role of SESA in the development of CSVD. Further research to explore the underlying mechanism are warranted.

The Association Between Personality Traits and Health-Related Quality of Life and the Mediating Role of Smoking: Nationwide Cross-Sectional Study.

Background: There are positive and negative correlations in different directions between smoking, personality traits, and health-related quality of life (HRQOL), where smoking may mask the pathway between personality traits and HRQOL. Understanding the masking pathway of smoking between personality traits and HRQOL can elucidate the mechanisms of smoking's psychosocial effects and provide new ideas for developing tobacco control strategies. Objective: The purpose of this study was to investigate the correlation between Big Five personality traits and HRQOL and whether smoking mediates the relationship between them. Methods: This was a cross-sectional study using data from 21,916 respondents from the 2022 Psychology and Behavior Investigation of Chinese Residents survey. Linear regression models were used to analyze the correlations between smoking, Big Five personality traits, and HRQOL while controlling for potential confounders. The mediating role of smoking on the association between Big Five Personality traits and HRQOL was analyzed using the Sobel-Goodman mediation test. Results: Extraversion (ß=.001; P=.04), agreeableness (ß=.003; P<.001), and neuroticism (ß=.003; P<.001) were positively correlated with HRQOL, whereas openness was negatively correlated with HRQOL (ß=-.001; P=.003). Smoking was associated with a decrease in HRQOL and mediated the positive effect of HRQOL on extraversion (z=-2.482; P=.004), agreeableness (z=-2.264; P=.02), and neuroticism (z=-3.230; P=.001). Subgroup analyses further showed that smoking mediated the effect of neuroticism on HRQOL in the population with chronic illnesses (z=-2.724; P=.006), and in the population without chronic illnesses, smoking contributed to the effect of HRQOL on extraversion (z=-2.299; P=.02), agreeableness (z=-2.382; P=.02), and neuroticism (z=-2.213; P=.03). Conclusions: This study provided evidence that there is a correlation between personality traits and HRQOL. It also found that smoking plays a role in mediating the connection between personality traits and HRQOL. The development of future tobacco control strategies should consider the unique traits of each individual's personality, highlighting the significance of extraversion, agreeableness, and neuroticism.

Causal relationship between neuroticism and frailty: A bidirectional Mendelian randomization study.

BACKGROUND: Observational studies have shown that neuroticism is associated with frailty, but the causal relationship between them remains unclear. METHODS: A two-sample Mendelian randomization (MR) study was conducted to explore the bidirectional causal relationship between neuroticism (n = 380,506 for the primary analysis, n = 79,004 for the validation) and frailty (n = 175,226) using publicly available genome-wide association study data. The inverse variance weighted (IVW), weighted median, and MR-Egger were used to obtain the causal estimates. Findings were verified through extensive sensitivity analyses and validated using another dataset. Multivariable MR (MVMR) analysis was performed to estimate the direct causal effects with adjustment of potential confounders. Two-step MR technique was then conducted to explore the mediators in the causal effects of neuroticism on frailty. RESULTS: Genetically-predicted higher neuroticism score was significantly correlated with higher frailty index (IVW beta: 0.53, 95%CI: 0.48 to 0.59, P = 9.3E-83), and genetically-determined higher frailty index was significantly associated with higher neuroticism score (IVW beta: 0.28, 95%CI: 0.21 to 0.35, P = 1.3E-16). These results remained robust across sensitivity analyses and were reproducible using another dataset. The MVMR analysis indicated that the causal relationships remained significant after adjusting for the potential confounding factors. Mediation analysis revealed that depression, years of schooling, and smoking were significantly mediated the causal effects of neuroticism on frailty. CONCLUSIONS: A bidirectional causal relationship existed between neuroticism and frailty. Our findings suggested that early intervention and behavioral changes might be helpful to reduce the neuroticism levels and prevent the development of frailty.

Dissecting the causal relationship between neuroticism and osteoarthritis: a univariable and multivariable Mendelian randomization study.

Background: Mental health has been found to be associated with risk of osteoarthritis (OA), but the causal relationship was not fully clarified. Methods: Two-sample Mendelian randomization (MR) study was conducted to investigate the causal relationship between neuroticism (n = 329,821) and the two most frequently affected parts of osteoarthritis (OA) (knee OA: case/control =24,955/378,169; hip OA: case/control = 15,704/378,169) using large scale summary genome-wide association study (GWAS) data. Inverse variance weighted (IVW), weighted median, and MR-Egger were used to estimate the causal effects. Multiple sensitivity analyses were conducted to examine the robustness of the causal estimates. Multivariable MR analysis was used to estimate the direct effects of neuroticism on OA after accounting for the other OA risk factors. Two-step MR approach was employed to explore the potential mediators of the causal relationship. Results: Univariable MR analysis indicated that 1-SD increase in genetically predicted neuroticism score was associated with an increased risk of knee OA (IVW: OR, 1.17; 95% CI, 1.087-1.26; p = 2.72E-05) but not with hip OA. The causal effects remained significant after accounting for the effects of BMI, alcohol drinking, and vigorous physical activity but were attenuated with adjustment of smoking. Further mediation analysis revealed that smoking initiation mediated a significant proportion of the causal effects of neuroticism on knee OA (proportion of mediation effects in total effects: 22.3%; 95% CI, 5.9%-38.6%; p = 7.60E-03). Conclusions: Neuroticism has significant causal effects on knee OA risk. Smoking might partly mediate the causal relationship. Further studies were warranted to explore the underlying mechanisms and potential use of neuroticism management for OA treatment.

Personality and Risk of Arthritis in Six Longitudinal Samples.

OBJECTIVES: Personality traits are broadly related to medical conditions, but there is limited research on the association with the risk of arthritis. This multicohort study examines the concurrent and prospective associations between personality traits and arthritis risk. METHODS: Participants (N > 45,000) were mostly middle-aged and older adults from 6 established longitudinal cohorts. Baseline assessments of personality traits, covariates (age, sex, education, race, ethnicity, depressive symptoms, body mass index, and smoking), and arthritis diagnosis were obtained in each sample. Arthritis incidence was assessed over 8-20 years of follow-up. RESULTS: The meta-analyses identified an association between higher neuroticism and an increased risk of concurrent (odds ratio = 1.20, 95% confidence interval [CI] = 1.16-1.24; p < .001, I2 = 40.27) and incident (hazard ratio = 1.11, 95% CI = 1.08-1.14; p < .001, I2 = 0) arthritis and between higher conscientiousness and a decreased risk of concurrent (odds ratio = 0.88, 95% CI = 0.86-0.90; p < .001, I2 = 0) and incident (hazard ratio = 0.95, 95% CI = 0.92-0.98; p = .002, I2 = 41.27) arthritis. Higher extraversion was linked to lower risk of concurrent (odds ratio = 0.92, 95% CI = 0.88-0.96; p < .001, I2 = 76.09) and incident (hazard ratio = 0.97, 95% CI = 0.95-0.99; p = .018, I2 = 0) arthritis, and openness was related to lower risk of concurrent arthritis (odds ratio = 0.96, 95% CI = 0.93-0.99; p = .006, I2 = 35.86). Agreeableness was unrelated to arthritis. These associations were partially accounted for by depressive symptoms, body mass index, and smoking. There was no consistent evidence of moderation by age or sex. DISCUSSION: Findings from 6 samples point to low neuroticism and higher conscientiousness as factors that reduce the risk of arthritis.

Psychological Distress and Meniere's Disease: A Bidirectional Two-Sample Mendelian Randomization Study.

OBJECTIVE: This study is aim to explore the causal relationship between anxiety, depression, neuroticism, and Meniere's disease (MD). STUDY DESIGN: Two-sample bidirectional Mendelian randomization (MR) analyses. SETTING: IEU, FinnGen, CTG, and UKB databases. METHODS: The genome-wide association studies data for anxiety, depression, neuroticism, and MD involved over 357,957 participants. MR was performed to explore relationships between anxiety, depression, neuroticism, and MD. Sensitivity analyses were performed to assess the robustness of the MR results. Reverse MR was used to exclude the possibility of reverse causality. Finally, multivariate MR was performed to explore the collinear relationships between neuroticism subclusters. RESULTS: MR results showed that anxiety and depression are not causes of MD, nor does MD cause anxiety and depression. Elevated neuroticism sum score is a cause of anxiety, depression, and MD, but MD does not lead to an increase in the level of neuroticism sum score. Further analysis showed that the 5 subclusters of neuroticism often feel lonely, mood often goes up and down, often feel fed-up, feelings easily hurt, and sensitivity to environmental stress and adversity are causes of MD. Multivariate MR analysis results suggested that the 5 neuroticism subclusters have a collinear relationship. CONCLUSION: Anxiety and depression are not causative factors of MD, and vice versa. Elevated neuroticism levels serve as a shared causative factor for anxiety, depression, and MD. Identification and effective management of neuroticism is a potential target for preventing and treating MD.

Higher purpose in life and education were associated with better cognition among older adults / Maior propósito de vida e escolaridade se associaram a melhor cognição entre pessoas idosas

Abstract Background With aging, some cognitive abilities change because of neurobiological processes. Cognition may also be influenced by psychosocial aspects. Objective To describe the relationship between a measure of neuroticism, depression symptoms, purpose in life, and cognitive performance in community-dwelling older adults. Methods This was a cross-sectional analysis based on the data from the second wave of the Frailty in Brazilian Older Adults (FIBRA) study, carried out between 2016 and 2017. The sample consisted of 419 older people (≥ 72 years old) cognitively unimpaired and mostly with low education. The variables of interest were sociodemographic, Neuroticism domain from the NEO-PI-R, Geriatric Depression Scale (GDS), Purpose in Life (PiL) scale, and a cognitive composite score which included the Mini-Mental State Examination (MMSE), and the scores for the sub-items of the Mini-Addenbrooke's Cognitive Examination (M-ACE), namely, Verbal Fluency (VF) - Animal, Clock Drawing Test (CDT), Episodic Memory (name and address). Results There was a greater number of women (70%), with older age (median = 80 years, IQR = 77-82), and low education (median = 4 years, IQR = 2-5). In the bivariate correlations, years of education (ρ = 0.415; p < 0.001) and PiL (ρ = 0.220; p < 0.001) were positively associated with cognition. Neuroticism (ρ = -0.175; p < 0.001) and depression symptoms (ρ = -0.185; p < 0.001) were negatively associated with cognition. In the logistic regression, after including confounding variables, the associations between cognition and PiL (OR = 2.04; p = 0.007) and education (OR = 1.32; p < 0.001) remained significant. Conclusion Low PiL and low education levels were associated with worse cognition among older adults. Such results may be of relevance in programs that aim to improve cognition among older adults.

Resumo Antecedentes Com o envelhecimento, algumas habilidades cognitivas mudam devido a processos neurobiológicos. A cognição também pode ser influenciada por aspectos psicossociais. Objetivo Descrever as relações entre uma medida de neuroticismo, sintomas depressivos, propósito de vida e o desempenho cognitivo em pessoas idosas residentes na comunidade. Métodos Trata-se de uma análise transversal com base nos dados da segunda onda do estudo de Fragilidade em Idosos Brasileiros (FIBRA), realizado entre 2016 e 2017. A amostra foi composta por 419 pessoas idosas (≥ 72 anos) cognitivamente saudáveis e em maior parte com baixa escolaridade. As variáveis de interesse foram as sociodemográficas, domínio Neuroticismo do NEO-PI-R, Escala de Depressão Geriátrica (EDG) e Escala de Propósito de Vida (PV) e um escore cognitivo composto que incluiu o Miniexame de Estado Mental (MEEM) e as pontuações dos subitens do Miniexame Cognitivo de Addenbrooke (M-ACE), a saber, Fluência Verbal (FV) Animal, Teste do Desenho do Relógio (TDR) e Memória Episódica (nome e endereço). Resultados Houve um maior número de mulheres (70%), com idade elevada (mediana = 80 anos, IIQ = 77-82) e baixa escolaridade (mediana = 4 anos, IIQ = 2-5). Nas correlações bivariadas, anos de escolaridade (ρ = 0,415; p < 0,001) e PV (ρ = 0,220; p < 0,001) foram positivamente associadas à cognição. Neuroticismo (ρ = -0,175; p < 0,001) e sintomas depressivos (ρ = -0,185; p < 0,001) foram negativamente associados à cognição. Na regressão logística, após a inclusão de variáveis de confusão, as associações entre cognição e PV (OR = 2,04; p = 0,007) e escolaridade (OR = 1,32; p < 0,001) permaneceram significativas. Conclusão Baixo PV e baixa escolaridade foram associados à pior cognição em idosos. Tais resultados podem ser relevantes em programas que visam a melhorar a cognição entre pessoas idosas.

Analysis of relationships between personality factors and the risk of Eating Disorders

Introduction: Regarding the origin of Eating Disorders, different psychological variables such as the personality, have been identified as risk factors for the onset and subsequent development of these pathologies. This study aimed to analyse the relationships between personality and different risk variables for the development of ED in the population of female students without disorders. Method: Participants included 627 women, Spanish university students, who completed the Eating Disorder Inventory-3 (EDI-3) and the Five-Factor Inventory (NEO-FFI). Correlation and regression analyses were conducted in order to observe patterns of common variation among the variables, and to determine the contribution of the personality traits in the explanation of the variables. Results: Neuroticism correlated significantly with all scales and is the main predictor of the risk scales (drive for thinness, bulimia and body dissatisfaction), and the seven psychological scales. The remaining factors showed negative correlations with all of the scales. Extraversion was the main predictor variable in the explained variance of interpersonal insecurity and interpersonal alienation. In addition, conscientiousness and agreeableness demonstrated an effect on different scales in combination with other factors. Conclusion: The study sustained the importance of personality in the risk of developing ED. Neuroticism is the factor that is most closely related to the risk variables and psychological constructs which are conceptually relevant in the development and maintenance of these disorders. The study of personality should help in identifying at-risk populations, and will enable adopting solutions aimed at the prevention of ED.

Introducción: En el origen de los trastornos alimentarios han sido identificadas diferentes variables psicológicas como factores de riesgo, como la personalidad, para el inicio y posterior desarrollo de estas patologías. El objetivo del estudio fue analizar las relaciones entre la personalidad y diferentes variables de riesgo para el desarrollo de trastornos alimentarios, en la población de mujeres universitarias sin trastornos. Método: Las participantes fueron 627 mujeres, estudiantes universitarias españolas, que completaron el Eating Disorder Inventory-3 (EDI-3) y el Five-Factor Inventory (NEO-FFI). Se realizaron análisis de correlación y regresión para observar los patrones de variación común entre las variables y para determinar la contribución de los rasgos de personalidad en la explicación de las variables. Resultados: El neuroticismo correlacionó significativamente con todas las escalas, y fue la principal variable predictiva en la varianza explicada de las escalas de riesgo (obsesión por la delgadez, bulimia e insatisfacción corporal), y siete escalas psicológicas. Los rasgos de personalidad restantes mostraron correlaciones negativas con todas las escalas. Extraversión fue la principal variable predictora de la varianza explicada de inseguridad interpersonal y alienación personal. Además, responsabilidad y amabilidad mostraron efecto en combinación con otros factores en diferentes variables. Conclusión: El estudio apoyó la importancia de la personalidad en el riesgo de desarrollar trastornos alimentarios. El neuroticismo es el factor que más se relaciona con las variables de riesgo y constructos psicológicos conceptualmente relevantes en el desarrollo y mantenimiento de estos trastornos. El estudio de la personalidad debería ayudar a identificar a las poblaciones de riesgo y adoptar soluciones dirigidas a la prevención.

The influence of personality on patient-reported outcomes in women undergoing implant-based breast reconstruction.

BACKGROUND: Despite the lack of hard evidence for causality, some women attribute their systemic complaints to their silicone breast implants. Personality and psychological distress are associated with the development of medically unexplained symptoms. It could be hypothesized that these psychological factors are related to the development of breast implant illness (BII). In a previous study, we found a relationship between personality traits and BII-related complaints in patients with cosmetic breast implants. This association may also exist in patients with implant-based breast reconstruction. OBJECTIVES: This cross-sectional study evaluated the association between personality, self-reported health complaints, and health- and breast-related quality of life (QoL) in women with implant-based breast reconstruction. METHODS: Women who underwent breast reconstruction between January 2015 and December 2018 in either the Maastricht University Medical Center or Zuyderland Medical Center were invited to participate in this study. Participants were asked to complete a physical complaint score form and the BREAST-Q, SF-36, and EPQ-RSS questionnaires through an online survey. The association between outcomes was analyzed with multivariate linear regression. RESULTS: A total of 118 women completed the questionnaires. Social desirability and extroversion were predominant personality traits. Neuroticism levels were comparable with normative data. Neuroticism correlated significantly with health status and breast-related QoL. Health-related QoL had the strongest correlation with neuroticism (ß = -2.93, ß = -3.41, p < 0.001). CONCLUSION: This study suggests that personality, and neuroticism in particular, may contribute to the development of medically unexplained complaints in women with implant-based reconstruction. The influence of personality on BII needs to be further investigated in large prospective studies.

The Impact of Psychotrauma and Emotional Stress Vulnerability on Physical and Mental Functioning of Patients with Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) is a chronic health condition thought to be influenced by personal life experiences and emotional stress sensitivity (neuroticism). In the present study, we examined the impact of cumulative trauma experiences and trait neuroticism (as a measure for emotional stress vulnerability) on physical and mental functioning of n = 211 patients diagnosed with IBD (112 Crohn's disease, 99 ulcerative colitis). All patients were assessed for self-reported trauma histories, emotional stress vulnerability, clinical disease activity, functional gastrointestinal (GI) symptoms, and quality of life. Results showed that patients with severe IBD activity have endured significantly more interpersonal trauma and victimization than those with quiescent IBD. Moreover, cumulative trauma was found to exert an indirect (neuroticism-mediated) effect on patients' symptom complexity, with trauma and neuroticism conjointly explaining 16-21% of the variance in gastrointestinal and 35% of the variance in mental symptoms. Upon correction for condition (using a small group of available controls, n = 51), the predictive capacity of trauma and neuroticism increased further, with both predictors now explaining 31% of the somatic-and almost 50% of the mental symptom heterogeneity. In terms of trauma type, victimization (domestic violence and intimate abuse) proved the best predictor of cross-sample symptom variability and the only trauma profile with a consistent direct and indirect (neuroticism-mediated) effect on patients' mental (QoL) and physical fitness. Results are consistent with the growing body of evidence linking experiential vulnerability factors (trauma and neuroticism) and associated feelings of personal ineffectiveness, helplessness, and uncontrollability to interindividual differences in (GI) disease activity and quality of life.

Distinct dyadic quality of life profiles among patient-caregiver dyads with advanced lung cancer: a latent profile analysis.

PURPOSE: This study aimed to identify the heterogeneity of dyadic quality of life (QoL) profiles, determine whether these profiles differ in terms of demographic and medical factors, neuroticism, resilience, and family functioning, and explore the combined effect of patient and caregiver neuroticism, resilience, and family functioning on dyadic QoL profiles. METHODS: A cross-sectional study was conducted with 304 advanced lung cancer patient-caregiver dyads. Self-report questionnaires were administered to patient-caregiver dyads to assess demographic and medical characteristics, neuroticism, resilience, family functioning, and QoL. RESULTS: The latent profile analysis identified four subgroups of dyadic QoL: patient-low-caregiver-high profile (38.82%), patient-high-caregiver-high profile (22.37%), patient-high-caregiver-low profile (19.74%), and patient-low-caregiver-low profile (19.08%). Additionally, when both patients and their caregivers had a high level of neuroticism or low level of resilience and low family functioning, compared with only member having them, there was a higher risk of poorer dyadic QoL. CONCLUSIONS: Our study identified the four heterogeneities of dyadic QoL profiles among advanced lung cancer patient-caregiver dyads. Future dyadic interventions should consider the heterogeneity of dyadic QoL in this population and prioritize patient-caregiver dyads at risk of poor dyadic QoL. Furthermore, when high neuroticism, low resilience, or family functioning coexist between patients and their caregivers, both parties exhibit much lower dyadic QoL.

Neuroticism as a moderator of symptom-related distress and depression in 4 noncancer end-of-life populations.

OBJECTIVES: Neuroticism is a significant predictor of adverse psychological outcomes in patients with cancer. Less is known about how this relationship manifests in those with noncancer illness at the end-of-life (EOL). The objective of this study was to examine the impact of neuroticism as a moderator of physical symptoms and development of depression in patients with amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), end-stage renal disease (ESRD), and frailty in the last 6 months of life. METHODS: We met this objective using secondary data collected in the Dignity and Distress across End-of-Life Populations study. The data included N = 404 patients with ALS (N = 101), COPD (N = 100), ESRD (N = 101), and frailty (N = 102) in the estimated last 6 months of life, with a range of illness-related symptoms, assessed longitudinally at 2 time points. We examined neuroticism as a moderator of illness-related symptoms at Time 1 (∼6 months before death) and depression at Time 2 (∼3 months before death) using ordinary least squares regression. RESULTS: Results revealed that neuroticism significantly moderated the relationship between the following symptoms and depression measured 3 months later: drowsiness, fatigue, shortness of breath, wellbeing (ALS); drowsiness, trouble sleeping, will to live, activity (COPD); constipation (ESRD); and weakness and will to live (frailty). SIGNIFICANCE OF RESULTS: These findings suggest that neuroticism represents a vulnerability factor that either attenuates or amplifies the relationship of specific illness and depressive symptoms in these noncancer illness groups at the EOL. Identifying those high in neuroticism may provide insight into patient populations that require special care at the EOL.

Association Between Big Five Personality Traits and Hypertension in Saudi Patients: A Case Control Study.

Background: The association between personality traits and hypertension is complex and has so far not been studied in depth. Objective: The present study aims to explore the connection between the Big Five personality traits and hypertension. Methods: This case control study includes 310 participants, and the relationship between personality traits and hypertension was investigated in normotensive and hypertensive patients by the Big Five Inventory-10. We examined the association of each of the Big Five personality traits in hypertensive patients and a control group using binary logistic regression analysis. Results: The findings of the study revealed that amongst the Big Five personality factors, low conscientiousness (OR: 1.09, 95% CI: 0.92-1.29, P<0.005) and high neuroticism (OR: 0.54, 95% CI: 0.45-0.66, P<0.001) were related with high risk of hypertension. Male, older people, and physically inactive individuals have been found to be at a higher risk of hypertension. No significant relationship was found between hypertension and marital status, education, or smoking habits. Conclusion: These results suggested that a low score in conscientiousness trait and a high neuroticism score may be an additional risk factor of hypertension. Thus, it may be worthy to investigate further in order to identify patients at risk and develop a more individual treatment strategy. Cognitive behavioral therapy and pharmacological options can be used preemptively in high-risk patients.

High neuroticism is associated with common late adverse effects in a nationwide sample of long-term breast cancer survivors.

PURPOSE: Neuroticism is a basic personality trait characterized by negative emotions triggered by stress such as a breast cancer diagnosis and its treatment. Due to lack of relevant research, the purpose of this study was to examine if high neuroticism is associated with seven common late adverse effects (LAEs) in long-term (≥ 5 years) breast cancer survivors (BCSs). METHODS: All female Norwegian BCSs aged 20-65 years when diagnosed with stage I-III breast cancer in 2011 or 2012 were invited to a questionnaire study in 2019 (N = 2803), of whom 48% participated (N = 1355). Neuroticism was self-rated using the abridged version of the Eysenck Personality Questionnaire, and scores dichotomized into high and low neuroticism. LAEs were defined by categorization of ratings on the EORTC QLQ-C30 (cognitive function, pain, and sleep problems) and QLQ-BR23 (arm problems) questionnaires, and categorizations of scale scores on mental distress, fatigue, and neuropathy. Associations between high neuroticism and LAEs were explored using multivariate logistic regression analyses. RESULTS: High neuroticism was found in 40% (95%CI 37-42%) of BCSs. All LAEs were significantly more common among BCSs with high compared to low neuroticism. In multivariable analyses, high neuroticism was positively associated with all LAEs except neuropathy. Systemic treatment, somatic comorbidity, and not being in paid work were also significantly associated with all LAEs. CONCLUSIONS: High neuroticism is prevalent and associated with increased risks of LAEs among BCSs. Identification of high neuroticism could improve the follow-up care of BCSs as effective interventions for the condition exist.

Personality factors in patients with myasthenia gravis: A prospective study.

INTRODUCTION: In myasthenia gravis (MG), depression and anxiety have frequently been reported as comorbidities. However, little is known about personality characteristics in MG patients. We aimed to characterise personality traits in MG and to correlate them with disease severity and disease course. METHODS: The Big Five Inventory data questionnaire was used to investigate personality traits in 44 MG patients and 45 healthy controls similar in age and gender. In 28 MG patients, a caregiver was also available for patient assessments to limit bias associated with social desirability in patients' responses. Patients were assessed with regard to premorbid personality (before manifestation of MG) and to present condition. In addition, anxiety and depression scales (Hospital Anxiety and Depression Scale and Beck Anxiety Inventory) were applied. RESULTS: Compared to controls, MG patients showed significantly higher levels of neuroticism, whereas openness and extraversion were significantly lower. Agreeableness and conscientiousness did not differ between groups. Neuroticism was influenced by disease severity such as generalization of weakness, presence of thymoma, and bulbar involvement as well as disease duration. Neuroticism correlated with premorbid level of neuroticism but also with depression and anxiety scores. CONCLUSION: A personality profile of increased neuroticism and lower openness and extraversion in MG patients may contribute considerably to the perception of disease severity. It may also be related to frequent comorbidities such as anxiety and depression. Although premorbid levels of neuroticism were increased, this characteristic may also increase considerably during the course of the disease. The data indicate that muscle weakness in MG is accompanied or even complicated by psychological aspects. Therefore, a psychological and behavioral intervention in addition to the specific pharmacological therapy might be of particular value.

Neuroticism personality traits are linked to adverse cardiovascular phenotypes in the UK Biobank.

AIMS: To evaluate the relationship between neuroticism personality traits and cardiovascular magnetic resonance (CMR) measures of cardiac morphology and function, considering potential differential associations in men and women. METHODS AND RESULTS: The analysis includes 36 309 UK Biobank participants (average age = 63.9 ± 7.7 years; 47.8% men) with CMR available and neuroticism score assessed by the 12-item Eysenck Personality Questionnaire-Revised Short Form. CMR scans were performed on 1.5 Tesla scanners (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany) according to pre-defined protocols and analysed using automated pipelines. We considered measures of left ventricular (LV) and right ventricular (RV) structure and function, and indicators of arterial compliance. Multivariable linear regression was used to estimate association of neuroticism score with individual CMR metrics, with adjustment for age, sex, obesity, deprivation, smoking, diabetes, hypertension, hypercholesterolaemia, alcohol use, exercise, and education. Higher neuroticism scores were associated with smaller LV and RV end-diastolic volumes, lower LV mass, greater concentricity (higher LV mass to volume ratio), and higher native T1. Greater neuroticism was also linked to poorer LV and RV function (lower stroke volumes) and greater arterial stiffness. In sex-stratified analyses, the relationships between neuroticism and LV stroke volume, concentricity, and arterial stiffness were attenuated in women. In men, association (with exception of native T1) remained robust. CONCLUSION: Greater tendency towards neuroticism personality traits is linked to smaller, poorer functioning ventricles with lower LV mass, higher myocardial fibrosis, and higher arterial stiffness. These relationships are independent of traditional vascular risk factors and are more robust in men than women.

Neuroticism and white matter hyperintensities.

Neuroticism is a major risk factor for neurodegenerative disorders, such as Alzheimer's disease and related dementias. This study investigates whether neuroticism is associated with white matter hyperintensities and whether this measure of brain integrity is a mediator between neuroticism and cognitive function. Middle-aged and older adults from the UK Biobank (N = 40,602; aged 45-82 years, M = 63.97, SD = 7.66) provided information on demographic and health covariates, completed measures of neuroticism and cognition, and underwent magnetic resonance imaging from which the volume of white matter hyperintensities was derived. Regression analyses that included age and sex as covariates found that participants who scored higher on neuroticism had more white matter hyperintensities (ß = 0.024, 95% CI 0.015 to 0.032; p < .001), an association that was consistent across peri-ventricular and deep brain regions. The association was reduced by about 40% when accounting for vascular risk factors (smoking, obesity, diabetes, high blood pressure, heart attack, angina, and stroke). The association was not moderated by age, sex, college education, deprivation index, or APOE e4 genotype, and remained unchanged in sensitivity analyses that excluded individuals with dementia or those younger than 65. The mediation analysis revealed that white matter hyperintensities partly mediated the association between neuroticism and cognitive function. These findings identify white matter integrity as a potential neurobiological pathway that accounts for a small proportion of the association between neuroticism and cognitive health.

Genetic architecture of DCC and influence on psychological, psychiatric and cardiometabolic traits in multiple ancestry groups in UK Biobank.

BACKGROUND: People with severe mental illness have a higher risk of cardiometabolic disease than the general population. Traditionally attributed to sociodemographic, behavioural factors and medication effects, recent genetic studies have provided evidence of shared biological mechanisms underlying mental illness and cardiometabolic disease. We aimed to determine whether signals in the DCC locus, implicated in psychiatric and cardiometabolic traits, were shared or distinct. METHODS: In UK Biobank, we systematically assessed genetic variation in the DCC locus for association with metabolic, cardiovascular and psychiatric-related traits in unrelated "white British" participants (N = 402,837). Logistic or linear regression were applied assuming an additive genetic model and adjusting for age, sex, genotyping chip and population structure. Bonferroni correction for the number of independent variants was applied. Conditional analyses (including lead variants as covariates) and trans-ancestry analyses were used to investigate linkage disequilibrium between signals. RESULTS: Significant associations were observed between DCC variants and smoking, anhedonia, body mass index (BMI), neuroticism and mood instability. Conditional analyses and linkage disequilibrium structure suggested signals for smoking and BMI were distinct from each other and the mood traits, whilst individual mood traits were inter-related in a complex manner. LIMITATIONS: Restricting analyses in non-"white British" individuals to the phenotypes significant in the "white British" sample is not ideal, but the smaller samples sizes restricted the phenotypes possible to analyse. CONCLUSIONS: Genetic variation in the DCC locus had distinct effects on BMI, smoking and mood traits, and therefore is unlikely to contribute to shared mechanisms underpinning mental and cardiometabolic traits.

Distribution of Psychological Instability Among Surgeons.

BACKGROUND: High emotional instability (i.e., neuroticism) is associated with poor mental health. Conversely, traumatic experiences may increase neuroticism. Stressful experiences such as complications are common in the surgical profession, with neurosurgeons being particularly affected. We compared the personality trait neuroticism between physicians in a prospective cross-sectional study. METHODS: We used an online survey using the Ten-Item Personality Inventory, an internationally validated measure of the 5-factor model of personality dimensions. It was distributed to board-certified physicians, residents, and medical students in several European countries and Canada (n = 5148). Multivariate linear regression was used to model differences between surgeons, nonsurgeons, and specialties with occasional surgical interventions with respect to neuroticism, adjusting for sex, age, age squared, and their interactions, then testing equality of parameters of adjusted predictions separately and jointly using Wald tests. RESULTS: With an expected variability within disciplines, average levels of neuroticism are lower in surgeons than nonsurgeons, especially in the first part of their career. However, the course of neuroticism across age follows a quadratic pattern, that is, an increase after the initial decrease. The acceleration of neuroticism with age is specifically significant in surgeons. Levels of neuroticism are lowest towards mid-career, but exhibit a strong secondary increase towards the end of the surgeon's career. This pattern seems driven by neurosurgeons. CONCLUSIONS: Despite initially lower levels of neuroticism, surgeons suffer a stronger increase of neuroticism together with age. Because, beyond well-being, neuroticism influences professional performance and health care systems costs, explanatory studies are mandatory to enlighten causes of this burden.

Parent personality traits and problem behavior in adolescence: The mediating role of adolescent personality.

INTRODUCTION: Parental personality traits are predicted to influence offspring outcomes through parenting behavior and offspring personality traits. This study explored whether mother and father personality traits relate to offspring behavior problems in mid-late adolescence METHOD: In total, 3089 Australian adolescents (1576 boys, 1513 girls; Mage = 16.46 ± 0.50 years) and their parents completed questionnaires assessing personality, conduct problems, emotional and social functioning, antisocial and criminal behavior, cigarette smoking and drug use, at a single time-point. RESULTS: After controlling for sociodemographic factors, results showed that problem behaviors in adolescence were most consistently related to mothers' scores on neuroticism and conscientiousness, and fathers' scores on neuroticism. Father personality traits were most important for antisocial and criminal behavior, whereas mother personality traits were most important for social and emotional functioning. Moderation analysis showed that associations between fathers' personality traits and some adolescent outcomes (cigarette smoking and drug use) were stronger for adolescent boys than for adolescent girls. Mediation models further demonstrated that adolescent personality traits mediated associations between parent personality and adolescent outcomes in almost all cases. Indirect effects expressed as a percentage showed that between 1.4% and 33.3% of the variance in the association between parent personality and adolescent outcomes was shared with the corresponding adolescent personality trait. CONCLUSIONS: Overall, the findings of this study provide evidence that traits inherited (directly or indirectly) from parents might have an important role in shaping problem behavior in adolescence.