Background. Most research has indicated that neuroticism (or trait anxiety) is associated with only negative outcomes. Such a common, heritable and variable trait is expected to have beneficial as well as detrimental effects. We tested the hypothesis that trait anxiety in childhood reduces the risk of dying from accidental causes in early adult life.

Method. A longitudinal, population-based, birth cohort study of 4070 men and women born in the UK in 1946. Trait anxiety as judged by teachers when the participants were 13 and 15 years old, and the neuroticism scale of a Maudsley Personality Inventory (MPI) when the participants were 16 years old. Outcomes were deaths, deaths from accidents, non-fatal accidents, and non-fatal accidents requiring medical intervention.

Results. Adolescents with low trait anxiety had higher rates of accident mortality to age 25 [low anxiety at 13, hazard ratio (HR) 5·9, low anxiety at 15, HR 1·8]. Low trait anxiety in adolescence was associated with decreased non-accidental mortality after age 25 (low anxiety at 13, HR 0; low anxiety at 15, HR 0·7; low neuroticism at 16, HR 0·7).

Conclusions. High trait anxiety measured in adolescence is associated with reduced accidents and accidental death in early adulthood but higher rates of non-accidental mortality in later life.