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In this paper we examine two aspects of neuroticism (N): its status as a personality descriptor and its role in the personality dynamics of abnormal states. We first suggest that high N is such a universal accompaniment of abnormal functioning (both psychological and biological) that by itself it has little descriptive or explanatory value. Then, acknowledging that N has more utility when used alongside other personality variables, we argue that here the most informative are disorder-specific characteristics that have unique variance, while also correlating with N. We propose that N's role in aetiology is that of a moderator variable, influencing the expression of these disorder-specific characteristics to produce (or not) the clinical conditions to which they relate. By way of illustration, examples are taken from our joint studies of the eating disorders and of schizotypy and schizophrenia.