From neuroticism to anxiety: Examining unique contributions of three transdiagnostic vulnerability factors

Neuroticism has been implicated in many forms of psychopathology. Additional transdiagnostic factors such as shame, psychological inflexibility, and emotion dysregulation may explain the association between neuroticism and anxiety. While past work has, to some degree, evaluated these factors that cut across diagnostic categories, no study has evaluated them jointly to examine unique explanatory value over and above shared variance and/or general distress. The indirect effects of neuroticism via three transdiagnostic factors (shame, psychological inflexibility, and emotion dysregulation) on anxiety symptoms were evaluated among 97 inpatient adolescents (63.9% female; Mage 15.23; SD = 1.43) using three separate measures of anxiety (two self-report and one diagnostic symptom count) as well as a composite anxiety severity outcome variable comprised of all three measures. As expected, neuroticism was significantly associated with anxiety symptoms and all three transdiagnostic factors. Neuroticism via shame was the only significant indirect effect and was present in all models. The indirect effects were of medium size. Competing models testing alternative pathways were rejected, adding confidence to the significant findings of neuroticism via shame. Data were cross-sectional. For adolescent anxiety, shame may be particularly important. Future intervention work can examine effects of targeting shame among adolescents with high neuroticism and/or anxiety.