Exploring transdiagnostic factors for mental health screening in primary care: a secondary analysis of a randomised controlled pilot study

OBJECTIVE: This secondary analysis of a randomised controlled pilot study (n = 87 patients) examined how transdiagnostic factors-including emotion regulation mechanisms (emotion beliefs, cognitive reappraisal, emotion suppression and experiential avoidance) and negative affectivity-relate to depressive, anxiety and somatic symptoms in the primary care setting, and whether emotion regulation mechanisms provide potential screening relevance beyond negative affectivity, i.e., by explaining variance in symptom severity that is not accounted for by negative affectivity alone. RESULTS: All transdiagnostic factors were correlated with depressive, anxiety and somatic symptom scores. Negative affectivity showed the strongest associations across diagnosis-specific symptom scores, while small to moderate correlation estimates were observed for the emotion regulation mechanisms. In multiple regression analyses, negative affectivity remained the most consistent contributor to symptom variance; emotion regulation mechanisms showed limited incremental value. Lastly, across the respective symptom severity levels of depression, anxiety and somatic symptom scores, negative affectivity most closely reflected symptom gradients. These cross-sectional findings suggest that negative affectivity may serve as a particularly informative transdiagnostic indicator of overall symptom burden in primary care. While no incremental relevance of emotion-regulation mechanisms beyond negative affectivity was supported, their potential for guiding mechanism-based interventions and relation to symptom trajectories should be examined by future research. TRIAL REGISTRATION: of March 2024, https://drks.de/search/en/trial/DRKS00033386.