744 vII. APPLICATIONS  AND  IMPLICATIONS
tive and has produced cross-  sectional asso -
ciations between specific personality traits 
and disorders or disorder categories or di -
mensions. Although such associations do 
not offer direct information about cause or 
process, the sheer magnitude of work exam -
ining these associations offers a robust esti -
mate of overall trait–  disorder relations. Be -
fore discussing questions of cause, process, 
and function, we first highlight the now 
largely established pattern of personality– 
psychopathology associations. In general, 
we use the Big Five domains (John, Chapter 
2, this volume) to describe personality–  trait 
associations, with the understanding that 
different measures of each domain map onto 
one another and reflect shared trait variance 
(Markon, Krueger, & Watson, 2005).
Internalizing disorders, which are char -
acterized by problems with anxiety and de -
pression, typically show strong associations 
with the higher-  order trait of neuroticism 
(Brandes & Tackett, 2019; Kotov, Gamez, 
Schmidt, & Watson, 2010; Kushner, Tack -
ett, & Bagby, 2012; Tackett, Lahey, et al., 
2013; Tackett, Quilty, Sellbom, Rector, & 
Bagby, 2008). Internalizing disorders can be 
further split into distress (e.g., depression) 
and fear (e.g., panic) categories, with some 
indication that distress may be slightly more 
strongly related to neuroticism (Kotov et al., 
2010), although this may also be account -ed for primarily by distress–  fear comorbid 
cases (Tackett, Quilty, et al., 2008). Internal -
izing disorders also show associations with 
low extraversion and low conscientiousness, 
with somewhat mixed findings for agree -
ableness and openness to experience (Kotov 
et al., 2010; Naragon-  Gainey, Watson, & 
Markon, 2009; Tackett, Quilty, et al., 2008; 
Watson, Stanton, Khoo, Ellickson-  Larew, & 
Stasik-  O’Brien, 2019).
Externalizing disorders, which are char -
acterized by problems with disinhibited be -
havior, including aggression, substance use, 
and gambling, also show associations with 
higher levels of neuroticism (Kotov et al., 
2010; J. Miller et al., 2013; Mullins-  Sweatt, 
DeShong, Lengel, Helle, & Krueger, 2019; 
Tackett, Daoud, De Bolle, & Burt, 2013; 
Tackett, Herzhoff, Reardon, De Clercq, & 
Sharp, 2014). Indeed, neuroticism accounts 
for substantial variance in internalizing– 
externalizing disorder comorbidity (or 
above-  chance co-  occurrence; Brandes & 
Tackett, 2019; Tackett, Lahey et al., 2013), 
positioning neuroticism as a potential “gen -
eral” personality liability for psychopathol -
ogy of any type. Beyond neuroticism, the 
strongest personality associations for ex -
ternalizing disorders are typically with low 
agreeableness and low conscientiousness 
(Eisenberg et al., 2009; Kotov et al., 2010; 
Lahey & Waldman, 2003; J. Miller, Zeich -05,00010,00015,00020,00025,00030,000
2001 2003 2005 2007 2009 2011 2013 2015
FIGURE 35.1. Citation counts for “personality” and “psychopathology” over the last 15 years, as in -
dexed by Google Scholar.