No evidence of "healthy neuroticism" in the Hawaii personality and health cohort
Sara J Weston, Patrick L Hill, Grant W Edmonds, Daniel K Mroczek, Sarah E Hampson
*Annals of Behavioral Medicine*
Abstract
Background. Heterogeneity in the effects of trait neuroticism on mortality has inspired recent theories of "healthy neuroticism," or the possibility that neuroticism can lead people down either healthy or unhealthy behavioral pathways. The logical extension of this theory is that some construct, perhaps another trait, financial resource or health-relevant situation, changes the relationship between neuroticism and health. The other possibility is that different components of neuroticism lead to different health behaviors, and therefore different outcomes. Purpose. The current study systematically examines the relationship between child and adult neuroticism and various health indicators including perceptions of health, behaviors, health outcomes and biomarkers of health. Finally, we examine both potential moderators of the associations with neuroticism and examine its facet-structure. Methods. The current study utilizes data from the Hawaii Longitudinal Study of Personality and Health, which includes both adult (IPIP-NEO) and childhood (teacher-reported) measures of personality and SES, as well as a variety of health outcomes, from self-reported health and health behavior to biological markers, such as cholesterol and blood glucose levels. Sample sizes range from 299 to 518. Results. The relationship between neuroticism and health was not consistently moderated by any other variable, nor were facets of neuroticism differentially related to health. Conclusions. Despite a systematic investigation of the potential "paths" which may differentiate the relationship of neuroticism to health, no evidence of healthy neuroticism was found.
Why we asked
Studies of neuroticism and mortality disagree. Some find that neuroticism is harmful, some find nothing, and a few find that it is protective. One explanation is “healthy neuroticism”: the idea that neuroticism leads some people toward protective behavior, perhaps because they are also conscientious, because they are ill and worried about it, or because they have the money to act on their worries. Another explanation is that different pieces of neuroticism, such as anxiety and depression, pull health in different directions. We wanted to test every one of these routes in the same dataset.
What we did
We used the Hawaii Personality and Health Cohort, in which teachers rated children’s personality in the 1960s and the same people, now adults, completed questionnaires and a clinic exam. That gave us neuroticism at about age 10 and in adulthood, and health measured as self-rated health, smoking, drinking, exercise, chronic disease, and biomarkers such as cholesterol and blood pressure. We asked whether conscientiousness, socioeconomic status, or having a chronic disease changed the link between neuroticism and health, and whether the facets of neuroticism worked in opposite directions.
What we found
Adult neuroticism was associated with worse health, for example worse self-rated health (r = −.37) and more chronic diseases (r = .15). Childhood neuroticism was not associated with any health measure. Across the moderator tests, only a handful of interactions were statistically significant. Several ran opposite to the healthy neuroticism prediction, and others had p-values between .04 and .05. With that many tests, we do not think they are real effects, so we did not interpret them. No facet of neuroticism was tied to better health.
What it means
Statistical analyses cannot disprove a theory, and our sample was smaller than in the mortality studies that motivated it. Still, the search came up empty, and we suspect the earlier heterogeneity may be noise. We recommend that future work look at other pathways, such as state-level processes that rise and fall from day to day.
The PDF here is our author preprint. The published version is available through the DOI.