Neuroticism

Neuroticism
Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the combination of high negative affectivity or neuroticism with marked social inhibition or introversion, also called Type D personality (Denollet, 2000), may compose a risk factor for PTSD. There is no research available that examined pretrauma Type D personality in relation to PTSD. The present study examined the predictive validity of the Type D personality construct in a sample of Dutch soldiers. Data were collected prior to and 6 months after military deployment to Afghanistan. Separate multiple regression analyses were performed to examine the predictive validity of Type D personality. First, Type D personality was defined as the interaction between negative affect and social inhibition (Na × Si). A second analysis showed that Type D personality (dichotomous) did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, and prior psychological symptoms. Therefore, Type D personality appears to be of limited value to explain development of combat-related PTSD symptoms. (PsycINFO Database Record (c) 2011 APA, all rights reserved)

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In studies on the connection between preexisting personality factors and PTSD, the most frequently mentioned personality factors are neuroticism and antisocial behavior or impulsivity (Breslau, Davis, & Andreski, 1995; Williams, 1999).

When one compares Freud’s description of the actual neurosis with the description of PTSD in the //DSM–IV,// a number of similarities immediately appear. First, for both actual neurosis and PTSD, the central clinical phenomenon is //anxiety//. That is why PTSD is classified under the heading of the anxiety disorders in the //DSM–IV//. The nature of this anxiety is quite typical: There is no psychical processing of this anxiety. The fear, helplessness, or horror described in the //DSM–IV// criteria of PTSD closely resembles the anxiety of the anxiety neurosis and the panic attacks in Freud. As a matter of fact, the //DSM–IV// description of panic disorder is almost exactly the same as Freud’s description of anxiety neurosis (American Psychiatric Association, 1994; Freud, 1895/1962b, pp. 92–97; Verhaeghe, 2004). (Freud, 1895/1962b, 1896/ 1962d, 1985).

In nearly all cases of PTSD, one finds phenomena of //somatization// (Lee & Young, 2001, p. 152) For Freud, somatization was also a typical characteristic of actual neurosis. He regarded these somatic symptoms as equivalents of anxiety and distinguished them from conversion symptoms. The latter imply a psychical elaboration of an underlying conflict concerning sexual desire.

The very high comorbidity of PTSD with toxicomania points in the same direction: The patients try to “treat” their problem by making an immediate impact on their body (Jacobsen, Southwick, & Kosten, 2001; Perkonigg, Kessler, Stortz, & Wittchen, 2000). Moreover, in a large number of patients, toxicomania can be considered as an actual neurosis as well (Loose, 2002).

In search of an explanation of this phenomenon, researchers have found another important aspect, namely, that the personality factor //alexithymia// is a crucial factor underlying medically unexplained symptoms. //Alexithymia//, literally meaning “no words for feelings,” is defined as a deficit in the cognitive processing and regulation of emotions (Bagby, Taylor, & Parker, 1994). In the context of somatization, research into the Toronto Alexithymia Scale (Bagby et al., 1994), the most validated instrument for alexithymia, found a significant and stable correlation between the number of medically unexplained symptoms mentioned and “difficulty identifying feelings,” one of the four dimensions of alexithymia (De Gucht, 2001). These findings clearly confirm the existence of a stable subjective position characterized by an absence of psychical elaboration of bodily arousal.

On these grounds, we believe there is sufficient evidence to confirm our first hypothesis: PTSD occurs in those victims who, prior to the traumatic incident, //already had an actual-neurotic structure//. It is precisely because of this structure that they are unable to process the trauma in a psychical, representational way and, as a consequence, develop PTSD.

Failure to fulfill its critical task of mediating—that is, representing and mirroring—the regulation of the drive. This is also why separation anxiety, which can find expression in antisocial behavior (Breslau et al., 1995; Williams, 1999) or social phobias (Perkonigg et al., 2000, p. 53), remains so predominant in these patients (Fonagy et al., 2002).