Associations Among in-The-Moment Emotional Clarity, Emotion Regulation, and Psychopathology in Obsessive-Compulsive Disorder

Abstract

Past research showed that lower emotional clarity (EC) was associated with more maladaptive emotion regulation (ER) and psychopathology, such as obsessive-compulsive (OC) disorder (OCD). However, most of these studies used single time-point, retrospective self-reports. Next to high risk for recall biases and low ecological validity, this assessment method is only able to capture between-person differences (i.e., individuals generally high vs. low in EC). It therefore neglects temporal variations in EC and resulting within-person differences (i.e., moments with higher-than-usual vs. lower-than-usual EC within one individual). To address this gap, our study uses intensive longitudinal data based on a 6-day ecological momentary assessment (EMA) design with up to six measurements daily. In total, N = 72 individuals diagnosed with OCD and N = 54 mentally healthy controls (HCs) reported on EC, ER behavior, and OC symptoms. Our results confirm that EC was significantly lower in individuals with OCD, even when controlling for baseline depression. Furthermore, lower within-person EC was associated with a higher number of used avoidance-oriented ER strategies, a lower number of engagement-oriented ER strategies and lower ER effectiveness. Surprisingly, these associations were more pronounced in the control (vs. OCD) group. In individuals with OCD, results indicated a negative concurrent (but not subsequent) association between EC and OC symptoms. Explanations for nonsignificant findings and possible implications for the role of EC in OCD are discussed.