# Personality Traits, Affective Distress, and Addictive Behaviors in Patients with Neurotic Disorders: A Mediation Analysis

## TL;DR

This study shows how personality traits like neuroticism influence addiction severity through anxiety and depression in patients with neurotic disorders.

## Contribution

The study identifies specific mediation pathways linking personality traits to addiction severity in psychiatric patients.

## Key findings

- Neuroticism influences alcohol dependence through anxiety and nicotine dependence through depression.
- Extraversion and agreeableness have both direct and indirect effects on addiction severity.
- Personality-driven addiction is mediated by clinical symptoms, suggesting targeted therapeutic approaches.

## Abstract

This study investigated an integrative mediation model examining whether anxiety and depression mediate the relationship between the Big Five personality traits and the severity of alcohol and nicotine dependence among psychiatric patients with neurotic disorders (ICD-10 codes F40–F48). A cross-sectional design was conducted on a clinical sample of 232 patients (57.3 female; mean age = 48.58, SD = 10.77) using standardized instruments: Big Five Inventory (BFI-44), Fagerström Test for Nicotine Dependence (FTND), Michigan Alcoholism Screening Test (MAST), and Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed using MLR mediation modeling. The model explained 32.6 of the variance in nicotine dependence and 27.1 in alcohol dependence. Results revealed a pattern of complete mediation: neuroticism had no direct effect on addiction but influenced alcohol dependence exclusively through anxiety (p = 0.001) and nicotine dependence through depressive symptoms (p = 0.012). Extraversion and agreeableness showed a dual role, exerting significant direct positive paths toward addiction severity (p = 0.005) while simultaneously reducing it through negative indirect effects on affective distress. Overall, neuroticism was confirmed as a universal risk factor for mental health issues. These findings suggest that personality-driven addiction in neurotic patients is operationalized through specific clinical symptoms, highlighting the necessity for therapeutic interventions focused on targeted affect regulation and social assertiveness to mitigate substance use in this population.