Who pays the price for high neuroticism? Moderators of longitudinal risks for depression and anxiety.

BACKGROUND High neuroticism is a well-established risk for present and future depression and anxiety, as well as an emerging target for treatment and prevention. The current analyses tested the hypothesis that physical, social and socio-economic disadvantages each amplify risks from high neuroticism for longitudinal increases in depression and anxiety symptoms. METHOD A national sample of adults (n = 7108) provided structured interview and questionnaire data in the Midlife Development in the United States Survey. Subsamples were reassessed roughly 9 and 18 years later. Time-lagged multilevel models predicted changes in depression and anxiety symptom intensity across survey waves. RESULTS High neuroticism predicted increases in a depression/anxiety symptom composite across retest intervals. Three disadvantage dimensions - physical limitations (e.g. chronic illness, impaired functioning), social problems (e.g. less social support, more social strain) and low socio-economic status (e.g. less education, lower income) - each moderated risks from high neuroticism for increases in depression and anxiety symptoms. Collectively, high scores on the three disadvantage dimensions amplified symptom increases attributable to high neuroticism by 0.67 standard deviations. In contrast, neuroticism was not a significant risk for increases in symptoms among participants with few physical limitations, few social problems or high socio-economic status. CONCLUSIONS Risks from high neuroticism are not shared equally among adults in the USA. Interventions preventing or treating depression or anxiety via neuroticism could be targeted toward vulnerable subpopulations with physical, social or socio-economic disadvantages. Moreover, decreasing these disadvantages may reduce mental health risks from neuroticism.