The role of neuroticism in self-harm and suicidal ideation: results from two UK population-based cohorts

Abstract

BackgroundSelf-harm is common, debilitating and associated with completed suicide and increased all-cause mortality, but there is uncertainty about its causal risk factors, limiting risk assessment and effective management. Neuroticism is a stable personality trait associated with self-harm and suicidal ideation, and correlated with coping styles, but its value as an independent predictor of these outcomes is disputed.MethodsPrior history of hospital-treated self-harm was obtained by record-linkage to administrative health data in Generation Scotland:Scottish Family Health Study (N = 15,798; self-harm cases = 339) and by a self-report variable in UK Biobank (N = 35,227; self-harm cases = 772). Neuroticism in both cohorts was measured using the Eysenck Personality Questionnaire-Short Form. Associations of neuroticism with self-harm were tested using multivariable regression following adjustment for age, sex, cognitive ability, educational attainment, socioeconomic deprivation, and relationship status. A subset of GS:SFHS was followed-up with suicidal ideation elicited by self-report (n = 3342, suicidal ideation cases = 158) and coping styles measured by the Coping Inventory for Stressful Situations. The relationship of neuroticism to suicidal ideation, and the role of coping style, was then investigated using multivariable logistic regression.ResultsNeuroticism was positively associated with hospital-associated self-harm in GS:SFHS (per EPQ-SF unit odds ratio 1.2 95% credible interval 1.1–1.2, pFDR 0.0003) and UKB (per EPQ-SF unit odds ratio 1.1 95% confidence interval 1.1–1.2, pFDR 9.8 × 10−17). Neuroticism, and the neuroticism-correlated coping style, emotion-oriented coping (EoC), were also associated with suicidal ideation in multivariable models.ConclusionsNeuroticism is an independent predictor of hospital-treated self-harm risk. Neuroticism and emotion-orientated coping styles are also predictive of suicidal ideation.Electronic supplementary materialThe online version of this article (10.1007/s00127-019-01725-7) contains supplementary material, which is available to authorized users.

Investigating the phenotypic and genetic associations between personality traits and suicidal behavior across major mental health diagnoses

“…An association of neuroticism with increased suicidal behavior risk has already been described in population-based cohorts [14,28,29] and studies on individuals with personality [30] or affective disorders [31][32][33]; our secondary analyses confirmed these findings in patients with MDD (the largest diagnostic group in our study) and showed similar effects for BD and SCZ, suggesting that neuroticism may represent a transdiagnostic risk factor for SI [34].…”

Personality, affect and coping style in severe personality disorder

“…The results confirm that internalizers exhibit a greater negative affect than externalizers and report a greater symptoms disturbance, in line with the results of research linking neuroticism with NA (Gómez et al, 2002;Gross et al, 1998;Meyer and Shack, 1989;Uziel, 2006) and with psychopathology (Lahey, 2009;Hafferty et al, 2019;Ormel et al, 2013). Griffith et al (2010) came to find an almost perfect correlation between internalization and neuroticism.…”

“…On the other hand, if neuroticism is a relatively stable trait for years (which makes it possible to predict vulnerability to adversity), task-focused learning of coping strategies is an important protective factor that should be strengthened (Hafferty et al, 2019). This introduces us to the comment on the finding that we consider most relevant in this work: the use of favourable coping strategies (rational and detached styles) could alleviate the effect that personality (directly and through affective disposition) exerts on distress and pathology.…”

Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study

“…The association between the immune system and mental health may be different in females and in males [13,56,57], although the reasons for this are still unclear, leading to a question whether gender differences may exist in the effect of infections on suicidality. As transmission of CMV requires intimate contact with other people, one could speculate whether persons seronegative for CMV have personality factors that predispose to suicidality as well, such as neuroticism [58] or social isolation. However, HSV-1 and EBV have similar modes of person-to-person transmission as CMV, and our result was specific to CMV.…”