The study, published in BMC Public Health by Ruixin He of Shanghai Jiao Tong University School of Medicine and colleagues at the University of Oxford and Peking University, took advantage of the second resurvey of the China Kadoorie Biobank, conducted in 2013 and 2014. Participants were drawn from five urban and five rural regions of China, an unusually broad geographic and social spread for personality research. Neuroticism was measured with the 23-item Eysenck Personality Questionnaire, a classic psychometric instrument in which respondents answer yes-or-no questions about mood, worry and emotional reactivity. Answers were converted into a neuroticism score, or N-score, ranging from 0 to 23, with higher values indicating a stronger tendency toward anxiety, irritability and emotional instability.

The average N-score in the cohort was 2.52, a comparatively low figure that the authors interpret in light of cultural and response-style differences. Yet the patterning across the population was anything but flat. Women scored higher than men on average, and urban residents scored higher than their rural counterparts. Perhaps most intriguingly, the trait showed a pronounced downward trend with age: older participants reported consistently fewer neurotic symptoms than younger ones. This age gradient echoes findings from Western cohorts and supports the idea of a maturational curve in emotional stability, in which people tend to become calmer and more resilient as they move through adulthood, though longitudinal data would be needed to confirm that individuals actually decline in neuroticism rather than the pattern reflecting generational differences.

Socioeconomic circumstances left an equally strong fingerprint on the trait. Higher N-scores were strongly associated with social disadvantage: participants who were not married and those from households with lower incomes scored significantly higher than their wealthier, married peers. The relationship between neuroticism and deprivation is almost certainly bidirectional. Chronic financial stress and social isolation can heighten emotional reactivity, while a temperament prone to worry and distress can undermine relationships, job performance and economic advancement. Disentangling cause from consequence in such data is notoriously difficult, but the consistency of the association across a cohort of this size strengthens the case that personality and social position are deeply intertwined.

The cross-sectional health findings were dramatic. Compared with participants who scored zero on the neuroticism scale, those with an N-score of 4 or higher showed substantially higher prevalence of mental health problems and poor self-rated general health, with adjusted risk ratios ranging from 1.52 to 41.01 depending on the condition examined. The upper end of that range reflects the near-universal co-occurrence of very high neuroticism scores with certain psychological conditions, which is expected given that the trait itself measures emotional distress. Even the more conservative end of the range, however, indicates a meaningful excess burden of psychological suffering among people with elevated scores, reinforcing the trait’s status as one of the most robust psychological predictors of mental ill health.

What elevates the study above a simple snapshot is its prospective component. By linking participants to electronic health registries, the researchers tracked who went on to develop major diseases after the personality assessment. Using Cox regression models that adjusted for confounding factors, they found that people in the highest neuroticism category had significantly higher risks of several serious conditions than those in the lowest category, with hazard ratios between 1.17 and 1.81. The list of affected outcomes is strikingly broad: ischaemic heart disease, stroke, mental and behavioural disorders, and diseases of the nervous system and digestive system all appeared at elevated rates among highly neurotic participants.

The cardiovascular findings deserve particular attention because they speak to a long-standing debate in psychosomatic medicine. Proposed mechanisms run along several plausible pathways. Chronically heightened emotional reactivity is associated with sustained activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, which can raise blood pressure, promote inflammation and disturb metabolic regulation. People high in neuroticism are also more likely to smoke, sleep poorly, remain sedentary and neglect medical care, behaviours that mediate part of the observed risk. The digestive system association is similarly biologically credible, given the dense neural communication between the gut and the brain and the established role of stress in functional gastrointestinal disorders.

The authors are careful to frame their results as associations rather than proof of causation. Reverse causation remains a possibility, since subclinical disease may itself heighten emotional distress, and residual confounding by unmeasured lifestyle or environmental factors cannot be excluded. Nevertheless, the sheer scale and diversity of the China Kadoorie Biobank, combined with registry-based outcome ascertainment, give the findings a weight that smaller clinic-based studies cannot match. The work also fills a conspicuous gap: most large-scale personality epidemiology has been conducted in Europe and North America, and it was genuinely uncertain whether the trait’s health correlates would replicate in a population with very different cultural norms around expressing emotion and answering questionnaire items.

The replication appears to have succeeded, and that has practical implications. If neuroticism reliably flags elevated risk for cardiometabolic and psychiatric disease in Chinese adults, it could in principle be incorporated into risk stratification tools, helping clinicians identify patients who might benefit from closer monitoring, stress-management interventions or earlier mental health support. The sociodemographic patterning adds another layer: because elevated scores cluster among people who are unmarried, poorer and, in some respects, already vulnerable, the trait may serve as a marker for compounded disadvantage, concentrating both psychological and physical health burdens in specific segments of the population.

For a trait once dismissed as a mere questionnaire curiosity, neuroticism is emerging as a genuine public health variable. The China Kadoorie Biobank analysis suggests that the emotional temperament of a population is not evenly distributed, that it tracks social circumstances closely, and that it foreshadows disease outcomes ranging from heart attacks to digestive disorders. As biobanks worldwide continue to link psychological measurements to long-term health records, the question is shifting from whether personality matters for health to how best to translate that knowledge into prevention. For the tens of millions of people worldwide who sit at the anxious end of the neuroticism spectrum, the new evidence offers both a warning and, potentially, an early opportunity for intervention.

Subject of Research: Sociodemographic patterns and disease associations of neuroticism in Chinese adults

Article Title: Patterns and health relevance of neuroticism in Chinese men and women: evidence from the China Kadoorie Biobank

Article References: He, R., Du, H., Clarke, J., Wang, B., Yang, L., Pei, P., Sun, D., Lv, J., Yu, C., Yang, X., Sun, X., Chen, J., Li, L., Chen, Z., Chen, Y., for the China Kadoorie Biobank Collaborative Group, Clarke, R., Collins, R., Peto, R., … Qu, C. (2026). Patterns and health relevance of neuroticism in Chinese men and women: evidence from the China Kadoorie Biobank. BMC Public Health. https://doi.org/10.1186/s12889-026-29670-6

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29670-6

Keywords: neuroticism, China Kadoorie Biobank, personality, mental health, ischaemic heart disease, stroke, Eysenck Personality Questionnaire, epidemiology, public health, socioeconomic status, cohort study, psychometrics

The intellectual starting point for the study is a rejection of one of the oldest assumptions in finance: that individual investors behave as rational actors whose choices flow purely from financial calculation. Decades of research in behavioral finance have dismantled that picture, showing that emotions, cognitive shortcuts, and stable personality dispositions all shape how people allocate their money. The authors focus on the Big Five personality traits, the dominant framework in contemporary personality psychology, which describes human temperament along five broad dimensions: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Originally formalized by Paul Costa and Robert McCrae in the early 1990s, the five-factor model has been shown to predict everything from job performance to coping styles, and a growing body of work suggests it also colors how investors gather information, tolerate risk, and react to gains and losses.

The ostrich effect itself was given its canonical definition by economists Nir Karlsson, George Loewenstein, and Duane Seppi in a 2009 paper in the Journal of Risk and Uncertainty. Studying how investors track their portfolios, they found that people are more likely to check on their investments when markets are rising than when they are falling. In other words, attention to financial information is selective: pleasant news draws the gaze, while threatening news triggers avoidance. Earlier work by Dan Galai and Orly Sade in 2006 had already shown a related pattern in the pricing of financial assets, finding that investors demand a premium for securities whose values are harder to monitor, effectively paying to avoid the discomfort of watching losses accumulate. The effect has since been detected in fixed-income markets, in natural experiments comparing disposition behavior, and in studies of financial attention frequency and trading activity.

What remained missing, the researchers argue, was a validated measurement tool. Previous studies had inferred the ostrich effect from observable behavior, such as login frequencies on investment accounts, but no psychometric scale existed to capture the underlying psychological tendency directly. Building such an instrument is a demanding process. Following established guidance on scale development, including the widely cited ten-step framework published by Stephen Carpenter in Communication Methods and Measures, the team generated an initial pool of items designed to tap the core of the construct: the deliberate avoidance of potentially negative financial information. The items then passed through the standard gauntlet of psychometric testing, in which statistical procedures refine the item pool, check that the items hang together as a coherent dimension, and confirm that the resulting scale behaves as theory says it should.

With the new scale in hand, the researchers turned to their central question: does personality shape the ostrich effect, and does the ostrich effect in turn shape investment decisions? To answer it, they collected survey data from individual investors and subjected the hypothesized relationships to structural equation modeling, a family of statistical techniques that can estimate networks of direct and indirect effects among latent variables, meaning constructs like personality traits that cannot be observed directly but are inferred from questionnaire responses. The authors employed the partial least squares variant of the method, following the reporting standards laid out by Joseph Hair and colleagues, and took precautions against common method bias, the distortion that can arise when all data come from self-reports gathered at a single time.

The results paint a nuanced portrait of which personalities bury their heads in the sand. Three of the five traits showed a positive influence on the ostrich effect: conscientiousness, extraversion, and openness to experience. The conscientiousness finding may appear counterintuitive at first glance, since conscientious people are typically organized and deliberate, but the authors suggest that the trait’s association with goal protection and discomfort with negative feedback may drive avoidance of information that threatens financial self-image. Extraverted investors, who are socially engaged and optimistic, may similarly prefer not to dwell on losses, while open investors’ attention patterns may interact with information seeking in complex ways. Whatever the precise mechanisms, the study establishes that these three traits predict a stronger tendency to look away from unwelcome financial news.

The remaining two traits moved in the opposite direction. Agreeableness and neuroticism both showed a negative influence on the ostrich effect, meaning that investors high in these characteristics were less prone to information avoidance. The neuroticism result is particularly striking because it inverts a common expectation. Neurotic individuals experience anxiety and emotional volatility, and one might assume they would flee from distressing portfolio information most eagerly. Yet the study’s data indicate the reverse: heightened sensitivity to threat may actually keep anxious investors vigilant, compelling them to monitor their investments rather than ignore them. This interpretation aligns with earlier research on personality and information behavior, including Jannica Heinstrom’s work on how different temperaments approach seeking and avoiding information, and with studies linking neuroticism to heightened attention to negative stimuli.

Perhaps the study’s most consequential finding concerns mediation. In statistical terms, a mediator is a variable that transmits the influence of one factor onto another, explaining how or why an effect occurs. The analysis showed that the ostrich effect serves as a mediator in the relationship between the Big Five traits and investment decisions. Personality, in other words, does not only influence investment behavior directly; part of its power flows through the psychological habit of avoiding negative financial information. An investor’s disposition shapes whether she watches or looks away, and that watching or looking away then feeds into the choices she ultimately makes about her money. This pathway gives the ostrich effect a central position in the architecture of investor psychology, elevating it from a curiosity of market data to a mechanism that helps explain how personality becomes destiny in financial life.

The practical implications extend well beyond the laboratory. For investment firms, financial advisors, and regulators, the findings suggest that client profiling should account not only for risk tolerance and financial literacy but also for information-avoidance tendencies, which the new scale now makes measurable. An advisor who knows that a client scores high on the ostrich effect can design communication strategies that counteract avoidance, ensuring that critical portfolio information actually reaches the investor. The study also speaks to the Indian context in which it was conducted, where surveys by the Securities and Exchange Board of India have documented a rapidly expanding but still maturing base of individual investors who may be especially vulnerable to behavioral pitfalls. Understanding which personality profiles are most susceptible to selective attention could inform investor education programs that teach people to confront, rather than evade, uncomfortable financial realities.

For the research community, the study offers both a tool and a template. The validated ostrich effect scale opens the door to replication across cultures, asset classes, and market conditions, allowing researchers to test whether the personality pathways identified here hold in other populations. It also invites longitudinal work that could establish whether information avoidance causes poorer investment outcomes over time, a question the present cross-sectional design cannot fully settle. What the study makes unmistakably clear, however, is that the rational investor of classical economic theory never existed in the wild. Real investors are bundles of temperament, emotion, and attention, and sometimes the most important financial decision they make is not what to buy or sell, but simply whether to look.

Subject of Research: The role of the ostrich effect, a psychological bias of avoiding negative financial information, in linking Big Five personality traits to individual investors' investment decisions

Article Title: Ostrich effect: scale development and unveiling its role in investment decision

Article References: Tiwari, P., Asma, A., & Singh, B. K. (2026). Ostrich effect: scale development and unveiling its role in investment decision. International Review of Economics, 73(2), Article 37. https://doi.org/10.1007/s12232-026-00551-z

Image Credits: AI Generated

DOI: 10.1007/s12232-026-00551-z

Keywords: ostrich effect, behavioral finance, Big Five personality traits, investment decisions, scale development, structural equation modeling, information avoidance, financial attention, individual investors, psychometrics, neuroticism, economic psychology

Functional gastrointestinal disorders are among the most common diagnoses in paediatric medicine, encompassing conditions such as functional abdominal pain, irritable bowel syndrome, and functional constipation, defined clinically by the Rome IV criteria. Because no structural, biochemical, or inflammatory abnormality explains the symptoms, these disorders have long sat at the intersection of gastroenterology and psychology. Within the biopsychosocial framework that now dominates thinking about FGIDs, the family environment is recognised as a powerful modulator of how a child experiences and expresses symptoms. Yet most previous research compared families of affected children only with healthy families, making it impossible to tell whether elevated parental distress reflected something specific to functional illness or merely the universal stress of raising a child with a chronic gastrointestinal condition.

The Basel team, led by Anna Geser and Sebastian Weber of the Faculty of Medicine at the University of Basel, together with senior authors Margarete Bolten and Eva Unternaehrer, set out to disentangle these possibilities. Between February 2024 and February 2025, they recruited 65 parents of children aged two to twelve years whose FGIDs had been diagnosed according to Rome IV criteria. Two comparison groups were assembled at the same hospital: 62 parents of children with organic gastrointestinal diseases, in which a structural or biological cause had been identified, and 90 parents of healthy children. By including an organic disease control group, the design could separate the specific psychosocial signature of functional illness from the broader caregiving burden of chronic paediatric disease.

Each parent completed three well-validated psychometric instruments. Psychological distress was measured with the four-item Patient Health Questionnaire (PHQ-4), which screens jointly for anxiety and depression. Somatic symptom burden — the tendency to experience and report physical symptoms such as pain, fatigue, or gastrointestinal complaints — was assessed with the eight-item Somatic Symptom Scale (SSS-8). Personality traits were captured with the ten-item Big Five Inventory (BFI-10), from which the researchers extracted neuroticism, the disposition toward emotional instability and negative affect. Because the score distributions were skewed, the team applied non-parametric Kruskal–Wallis tests for initial group comparisons and then refined their estimates using covariate-adjusted negative binomial regression models, reporting incidence rate ratios with appropriate confidence intervals and checking model assumptions with variance inflation factors and Akaike information criteria.

The results were unambiguous. Parents of children with FGIDs scored significantly higher than both comparison groups on all three measures, with differences reaching statistical significance at p < 0.01. In the adjusted regression models, both the organic disease group and the healthy group showed consistently lower scores relative to the FGID group, with incidence rate ratios ranging from 0.31 to 0.77 — a substantial gap that survived correction for demographic and clinical covariates. In practical terms, parental anxiety and depression screening, based on the two subscales of the PHQ-4, yielded the highest positive rates in the FGID group, at roughly 17 percent for anxiety and about 25 percent for depression, well above the levels observed among parents of children with identifiable organic disease.

The neuroticism finding is particularly striking because personality traits are typically considered stable dispositions rather than situational responses. Elevated neuroticism among parents of children with FGIDs cannot plausibly be explained as the transient stress of hospital visits, since parents of children with equally chronic organic gastrointestinal disease did not show the same elevation. One plausible interpretation, consistent with the biopsychosocial model, is that neuroticism and functional illness cluster within families: the same dispositional sensitivity to negative emotion that shapes a parent’s own experience may influence how symptoms are perceived, interpreted, and amplified in the child. Previous research on familial aggregation of pain and somatic complaints has repeatedly suggested that children of parents with high somatic symptom reports tend to report more symptoms themselves, a pattern of modelling and reinforcement that could be especially relevant when the child’s symptoms are, by definition, not explained by observable pathology.

The somatic symptom data add an important mechanistic nuance. In the initial comparisons, parents of children with FGIDs reported a markedly higher somatic symptom burden than either control group. However, when the researchers added psychological distress as an additional covariate, the differences in somatic symptom scores were attenuated. This statistical pattern suggests that the elevated physical symptom reporting among these parents is substantially intertwined with — and possibly mediated by — their anxiety and depressive symptoms. In other words, the parents’ bodily complaints and emotional distress may represent two faces of the same underlying vulnerability, a coupling that mirrors the gut–brain interaction hypothesised to drive the children’s own functional symptoms.

The clinical implications are considerable. If parents of children with FGIDs carry a distinct psychosocial risk profile, then treating the child in isolation may miss a critical lever for recovery. The authors argue that their findings highlight the importance of family-centred approaches to paediatric FGID care, in which parental distress, somatic symptom awareness, and maladaptive illness behaviour are assessed and addressed alongside the child’s symptoms. Screening instruments as brief as the PHQ-4 could feasibly be administered during a routine paediatric gastroenterology visit, identifying families who might benefit from psychological support, psychoeducation about the gut–brain axis, or targeted interventions that reduce parental anxiety about the child’s unexplained symptoms. Such measures could interrupt the feedback loops in which parental concern heightens child symptom focus, which in turn intensifies parental distress.

The study’s cross-sectional design imposes limits on interpretation: elevated parental neuroticism, distress, and somatic symptoms could contribute to the child’s disorder, arise in response to it, or, most likely, reflect bidirectional influences over time. The modest sample sizes — 65, 62, and 90 parents — while adequate for the statistical models employed, leave room for uncertainty in subgroup estimates, and all data derive from self-report questionnaires at a single Swiss tertiary centre. Longitudinal and genetically informed designs will be needed to establish causal direction. Nevertheless, by showing that the parental psychosocial burden in paediatric FGIDs exceeds that seen in organic gastrointestinal disease of comparable chronicity, the Basel team has strengthened the case that functional disorders are genuinely systemic family phenomena. For clinicians confronting a child’s debilitating abdominal pain with no biological explanation, the message is that the family context is not background noise but an active ingredient in the illness — one that rigorous, empathetic assessment can begin to address.

Subject of Research: Parental psychological distress, somatic symptoms and neuroticism in paediatric functional gastrointestinal disorders

Article Title: Parental psychological distress, somatic symptoms and neuroticism in paediatric functional gastrointestinal disorders: comparison with organic and healthy controls

Article References: Geser, A., Weber, S., Légeret, C., Furlano, R., Bolten, M., & Unternaehrer, E. (2026). Parental psychological distress, somatic symptoms and neuroticism in paediatric functional gastrointestinal disorders: comparison with organic and healthy controls. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07681-x

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07681-x

Keywords: functional gastrointestinal disorders, gut-brain interaction, parental distress, somatic symptoms, neuroticism, paediatrics, Rome IV criteria, anxiety, depression, biopsychosocial model, Parental, psychological