Associations and Interactions Between Neuroticism, Adverse Life Events and Health Anxiety: Results From a Large Representative Cohort

Abstract

[Purpose] Adverse life events and neuroticism have been shown to be associated with health anxiety (HA), but their interaction has not been studied. This study aimed to examine the separate associations as well as the possible interaction effect of neuroticism and adverse life events with HA. [Method] Cross-sectional self-report data originated from a representative Danish population cohort (DanFunD) (N = 7,493, 18-72 years, 53% females). Primary measures were HA (Whiteley Index 6 revised), neuroticism (NEO personality Inventory Revised short form), and adverse life events (Cumulative Lifetime Adversity Measure, CLAM). The CLAM was split into illness/death related life events (IDE) and other adverse life events (OAE) to test the specificity of IDEs. [Results] Adjusted ordinal logistic regression models showed positive associations with HA for IDEs (OR = 1.05, CI [1.03, 1.08]), OAEs (OR = 1.05, CI [1.03, 1.07]) and neuroticism (OR = 1.08, CI [1.07, 1.09]). A Wald's test revealed no difference in association with HA for IDEs and OAEs (p = .82). Adjusted models showed an interaction effect for neuroticism*IDEs (OR = 1.002, CI [1.000, 1.004]), but not for neuroticism*OAEs (OR = 0.999, CI [0.996, 1.002]). [Conclusion] Associations with HA were found for both adverse life events and neuroticism. Size of association did not differ for IDEs and OAEs. Only IDEs interacted with neuroticism.

Keywords

• health anxiety
• neuroticism
• adversity
• diathesis stress model
• cohort study
• effect moderation