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Neuroticism, Emotions, and Your Health

According to new research, there’s a reason neuroticism can affect your health.

The relationship between personality and health is well-established. A considerable body of research has established that if you have a certain set of personality traits, you may be more prone to developing cardiovascular disease, or if you have a different constellation of traits, less likely to be able to recover from a heart attack. Personality can also relate to people’s patterns of risky behavior, including substance use and abuse. In the Five Factor Model of personality, which describes a set of fundamental personality traits, the trait of neuroticism stands out as one that can play an important role in both physical and mental health. People high on neuroticism, who are prone to worrying, feeling tense, and just generally being “nervous,” are, as you might imagine, particularly at risk. However, until now, much of the research has been correlational and the mechanisms through which neuroticism could affect health haven’t been specified. Indeed, if you think about the people you know you would describe as high on neuroticism, it might strike you that their gloomy outlook on the world could help explain some of the constant health problems they seem to have.

In a newly-published study, National University of Singapore’s Vincent Oh and colleagues (2020) examined neuroticism’s relationship to health by taking advantage of the extensive data in the U.S. study on midlife development known as MIDUS. The Oh et al. investigation focused on the subset of the 2,022 adult participants who took part in the MIDUS Daily Stress Project across a 7-year period. The key data consisted of daily diary ratings about the emotions participants experienced across 8 consecutive days. Prior to the diary component of the study, participants had provided demographic data and completed measures of neuroticism and health, both objective (number of chronic conditions) and subjective (perceived). They were then retested with the original demographic and personality tests given at the first test occasion.

The University of Singapore team believed that the connection between neuroticism and health involves what they call “negative emotion differentiation,” or the ability to tell whether you’re sad, angry, or fearful. There should be benefits, they argued, to being able to sort out these negative feelings. If you know the source of your bad mood, so the thinking goes, you can then figure out how to bring yourself back to a more harmonious inner state. This ability to regulate your emotions should help protect you from the harmful effects of negative feelings on your health. Otherwise, you will continue to stew in an unproductive manner, allowing those feelings to permeate your daily life and raise your blood pressure. In the words of the authors, “negative emotion differentiation allows detailed emotional representation, such that one’s negative emotions would either be effectively downregulated or utilized to facilitate adaptive strivings toward positive behaviors and outcomes." Your coping will be more effective, and you’ll bring your levels of stress down to manageable proportions.

How, then, does neuroticism fit into this picture? As Oh et al. note, people high in neuroticism experience many negative emotions and do so on a chronic basis. With such a torrent of negativity penetrating their emotional life, perhaps they become overwhelmed by the challenge of sorting out the cause of their feelings. Thus, rather than separate one bad feeling from the other, the authors propose that a “differentiation threshold” may operate, and once this is passed, highly neurotic individuals just give up and try to avoid confronting their feelings altogether. With their high negativity threshold, then, highly neurotic people may not show benefits to their health of being able to separate out the exact nature of their disturbing feelings because they prefer to resort to an unhealthy type of avoidance.

The questions in the MIDUS stress survey that tapped emotion differentiation asked participants to indicate how much of the time during the day they felt these specific feelings: “so sad no one could cheer you up, nervous, restless, everything was an effort, hopeless, worthless, lonely, afraid, jittery, irritable, ashamed, upset, angry, and frustrated.” The authors defined poor emotion differentiation as occurring when people’s ratings on these states were highly intercorrelated. Using this differentiation score as a predictor, the researchers then were able to track its impact, over that 7-year period of the study, on both objective and subject health.

The findings indicated that, overall, negative emotion differentiation had no effect on either measure of health. However, the picture became altered when neuroticism was factored into the equation. For individuals low in neuroticism, the ability to discriminate negative emotions did predict better health status at the follow-up time of testing. Those individuals high in neuroticism failed to show the negative emotion differentiation benefit on their long-term health outcomes.

Taking a look at what these findings mean for your health, they suggest that if you would consider yourself low in neuroticism (i.e. you don’t tend to worry that much), then it’s advantageous for you to take stock of the exact situation that’s leading you to feel bad at the moment. This “in-depth emotional information,” the authors conclude, “enables more effective regulation strategies for managing negative affect." Going even further, the authors maintain that “for a significant portion of the population, the association between negative emotion differentiation and later health is likely to be sizable, substantive, and comparable to key demographic variables such as age and income."

However, for those high in neuroticism, the findings caution against a “one-size-fits-all” approach. The highly neurotic individual may be unable to engage in the fine-grained emotion processing more easily used by the individual with less of a chronic tendency to worry. Instead, it may be more beneficial to help those high in neuroticism overcome their natural inclination to engage in emotional avoidance. They could benefit from more generally acknowledging that, in a particularly distressing moment, their levels of stress are indeed high. It’s not as important for them to figure out where the bad feelings are coming from; instead, they can gain from just acknowledging that they exist. Simply labeling their emotions as negative, in other words, may serve ironically to alleviate the stress of trying to separate out their source. Otherwise, people high in neuroticism may just avoid the negative feelings altogether and it’s this suppression that can harm their health.

To sum up, your personality seems to be intimately associated with your ability to understand and regulate your emotions. Figuring out where you stand on the neuroticism dimension may help guide you to the best strategy for promoting your own long-term health and fulfillment.


Oh, V. Y. S., & Tong, E. M. W. (2020). Negative emotion differentiation and long-term physical health—The moderating role of neuroticism. Health Psychology, 39(2), 127–136. doi:10.1037/hea0000809.supp (Supplemental)

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