Neuroticism Predicts Who Suffers Lasting Mental Distress in a Crisis, USC Study Finds

When a crisis strikes an entire society, the psychological fallout is never distributed evenly. Some people absorb the shock, adapt, and recover, while others carry the weight of uncertainty for months or even years after the immediate danger has passed. A new study led by researchers at the University of Southern California suggests that one of the strongest clues to who will suffer most may lie not in their circumstances alone, but in something far more fundamental to who they are: their personality. The research, published in PLOS ONE on October 7, 2026, found that adults scoring higher in neuroticism experienced larger and more persistent increases in anxiety and depression symptoms during the COVID-19 pandemic than those scoring lower on the same trait.

The study was led by Marco Angrisani, senior economist at the USC Center for Economic and Social Research and associate professor (research) of economics at the USC Dornsife College of Letters, Arts and Sciences. Angrisani and his colleagues set out to answer a question that has troubled mental health researchers for decades: why do responses to large-scale societal stressors vary so dramatically from one person to the next? Their answer, drawn from one of the most extensive longitudinal datasets available, points to personality as a meaningful and measurable factor in shaping that heterogeneity. “There is a wide variety of mental health responses to large-scale societal stressors,” Angrisani said. “Our study shows that personality traits, and neuroticism in particular, play a role in shaping heterogeneous responses in a major crisis across individuals and could therefore inform better targeted interventions.”

The evidence base for these conclusions is unusually robust. The researchers followed 4,030 U.S. adults using data from the Understanding America Study, a nationally representative internet panel managed by the USC Center for Economic and Social Research. The analysis drew on more than 100,000 survey responses collected from 2019 through early 2024, a window that allowed the team to compare mental health before, during, and after the pandemic. That temporal span matters enormously. Cross-sectional studies conducted at a single point in time can show that distress was high during the pandemic, but they cannot reveal whether it rose, fell, or lingered afterward. By anchoring their measurements in pre-pandemic baselines and extending them well into the recovery period, the researchers could distinguish acute, transient distress from the kind of prolonged suffering that signals genuine vulnerability.

At the heart of the analysis were the so-called Big Five personality traits, the dominant framework in contemporary personality psychology. Neuroticism describes a tendency to experience worry, emotional sensitivity, and stronger reactions to stress or uncertainty. Extraversion captures the tendency to be outgoing, energetic, and motivated by social interaction. Openness reflects curiosity about new ideas and experiences and a willingness to consider change. Agreeableness denotes a tendency to be cooperative, trusting, and concerned about social harmony, while conscientiousness describes people who are organized, dependable, self-disciplined, and goal-oriented. Crucially, these characteristics exist on a continuum. Everyone possesses some degree of each trait, and a high or low score on any dimension does not constitute a disorder. The Big Five model is valued by researchers precisely because it reduces the enormous complexity of human temperament to five stable, measurable dimensions that can be tracked over time and correlated with real-world outcomes.

Mental distress in the study was measured with the PHQ-4, a brief validated questionnaire that assesses symptoms of anxiety and depression. A score of six or higher on the PHQ-4 indicates moderate-to-severe symptoms, although the instrument is a screening tool rather than a clinical diagnosis. Using this threshold, the researchers quantified how the probability of moderate or severe distress shifted across the pandemic for people at different points on the personality spectrum. The results were striking. Increases in the probability of moderate or severe distress were approximately 11 to 20 percentage points greater among participants who scored in the highest 25 percent for neuroticism compared with those in the lowest quarter. In practical terms, this means that highly neurotic individuals were dramatically more likely to cross the threshold into clinically significant distress as the crisis unfolded.

Just as important as the size of the effect was its persistence. The association between neuroticism and elevated distress held across young, middle-aged, and older adults, and it remained evident into the post-pandemic observation period. This durability is what distinguishes the finding from earlier work documenting short-lived spikes in anxiety during lockdowns. The pandemic has largely receded as an acute threat, yet the psychological shadow it cast appears to have lingered far longer for people high in neuroticism than for their more emotionally stable counterparts. For health systems still grappling with elevated demand for mental health services, that pattern suggests the pandemic’s toll was not merely an episode but, for a vulnerable segment of the population, a lasting shift.

The study also uncovered behavioral differences that may help explain the mechanism. Participants higher in neuroticism perceived greater health and financial risks during the crisis, adopted more protective behaviors, and reported exercising and relaxing less frequently while consuming more alcohol. These patterns sketch a coherent picture: people who react strongly to uncertainty tend to perceive danger more acutely, respond with heightened caution, and simultaneously withdraw from the very activities, such as exercise, relaxation, and moderate drinking habits, that buffer against psychological distress. Measurements of extraversion, openness, and agreeableness showed weaker or inconsistent associations with distress trajectories, while conscientiousness appeared modestly protective, particularly among adults aged 60 and older. That last finding hints that the self-discipline and structure characteristic of conscientious individuals may function as a psychological resource in older adults facing prolonged disruption.

The practical implications extend well beyond pandemic planning. The findings could help clinicians and emergency planners recognize who may need closer follow-up after disasters, public-health emergencies, or other prolonged disruptions. Public information campaigns could also be tested to ensure they inform people without unnecessarily increasing distress among those who are more vulnerable to it. Angrisani was careful to emphasize, however, that personality should be just one part of a broader risk assessment, considered alongside current symptoms, previous mental health conditions, and social circumstances, rather than serving as a label or an automatic trigger for treatment. Neuroticism is a risk factor, not a diagnosis, and it does not determine any individual’s mental health destiny. In the paper, the authors advocate for monitoring and stepped care: following people over time and offering treatments such as cognitive behavioral therapy or emotion-regulation training when significant, persistent symptoms emerge, rather than treating people solely because of a personality score.

Like all observational research, the study has limits that the authors acknowledge. It identifies associations and cannot prove that personality, especially neuroticism, caused the distress patterns observed. All personality and mental distress measures were self-reported, which introduces the possibility of reporting bias, and the findings may not generalize beyond the United States. Even so, the scale and duration of the dataset give the results considerable weight, and they point toward a concrete strategy for the future: crisis communication that emphasizes practical, controllable actions, combined with accessible mental health support, could help protect psychologically vulnerable groups when the next major disruption arrives. As climate events, geopolitical instability, and future pandemics test societies around the world, the USC-led study offers a deceptively simple insight with far-reaching consequences. The question of who will suffer most in a crisis may be partly answerable in advance, and answering it could mean the difference between reactive care and genuinely preventive support for the millions of people whose minds bear the longest scars of collective trauma.

Subject of Research: The influence of personality traits, particularly neuroticism, on the persistence of mental distress during and after the COVID-19 pandemic

Article Title: Personality traits influence level of lasting distress during a crisis, USC-led study finds

Article References: Personality traits influence level of lasting distress during a crisis, USC-led study finds. (n.d.). Original publication

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Keywords: neuroticism, personality traits, Big Five, mental distress, COVID-19 pandemic, anxiety, depression, PHQ-4, Understanding America Study, stepped care, observational study, USC