Associations between emotion regulation, symptom severity, and affect in obsessive-compulsive disorder

Previous cross-sectional, retrospective studies have shown associations between dysfunctional emotion regulation (ER) and obsessive-compulsive (OC) symptoms. No studies to date have, however, used intensive longitudinal designs to assess the theoretically proposed, yet empirically understudied dynamic relations between momentary OC symptoms, affect, and ER. Up to six times a day across six days, n = 68 individuals with OCD and n = 43 mentally healthy controls reported engagement-oriented and avoidance-oriented ER strategies, self-perceived ER effectiveness, negative and positive affect, and OC symptoms. We investigated associations between ER behavior and current outcomes (i.e., affect or symptoms in the moment) as well as subsequent outcomes (i.e., 1–2 h later). Results showed that higher-than-usual self-perceived ER effectiveness was associated with higher current positive affect and lower current negative affect and OC symptoms. Use of avoidance-oriented ER strategies was also partly associated with less beneficial outcomes. Effects for engagement-oriented ER strategies were mostly non-significant, except from a negative association with subsequent OC symptoms. All other associations with subsequent outcomes did not reach statistical significance. One possible explanation may be the overall low endorsement of ER strategies across groups. Future studies with varying study designs are needed. Constraints on generality and possible clinical implications are also discussed. • Associating emotion regulation, affect, and symptoms with EMA design. • Higher self-perceived effectiveness was associated with more positive affect. • Higher self-perceived effectiveness related to less negative affect and OC symptoms. • Use of avoidance-oriented strategies was partly associated with emotional benefits. • Mostly non-significant results for engagement-oriented strategies.