{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:06:06Z","timestamp":1788998766994,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>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\u2013F48). 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), Fagerstr\u00f6m 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.<\/jats:p>","DOI":"10.3390\/ejihpe16030035","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:01:07Z","timestamp":1772636467000},"page":"35","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Personality Traits, Affective Distress, and Addictive Behaviors in Patients with Neurotic Disorders: A Mediation Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0893-7805","authenticated-orcid":false,"given":"Marin","family":"Mami\u0107","sequence":"first","affiliation":[{"name":"General County Hospital Po\u017eega, Osje\u010dka 107, 34000 Po\u017eega, Croatia"},{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goranka","family":"Radmilovi\u0107","sequence":"additional","affiliation":[{"name":"General County Hospital Po\u017eega, Osje\u010dka 107, 34000 Po\u017eega, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakov","family":"Ivkovi\u0107","sequence":"additional","affiliation":[{"name":"Naftalan Special Hospital for Medical Rehabilitation, Omladinska 21, 10310 Ivani\u0107-Grad, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Dokozi\u0107","sequence":"additional","affiliation":[{"name":"General County Hospital Po\u017eega, Osje\u010dka 107, 34000 Po\u017eega, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danijel","family":"Mikuli\u0107","sequence":"additional","affiliation":[{"name":"University Hospital Center Sestre Milosrdnice, Vinogradska cesta 29, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Mami\u0107","sequence":"additional","affiliation":[{"name":"General County Hospital Po\u017eega, Osje\u010dka 107, 34000 Po\u017eega, Croatia"},{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Matijevi\u0107","sequence":"additional","affiliation":[{"name":"University Hospital Center Sestre Milosrdnice, Vinogradska cesta 29, 10000 Zagreb, Croatia"},{"name":"School of Medicine, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Vukoja","sequence":"additional","affiliation":[{"name":"General County Hospital Po\u017eega, Osje\u010dka 107, 34000 Po\u017eega, Croatia"},{"name":"Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. 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