Associations between transdiagnostic psychological processes and global symptom severity among outpatients with various mental disorders: A cross-sectional study

Objective: Knowledge about transdiagnostic factors associated with global symptom severity among patients diagnosed with various mental disorders remains limited. This study examined the cross-sectional associations between transdiagnostic psychological processes (emotional regulation, emotional intelligence, sleep quality, perceived stress, fear of the coronavirus, repetitive negative thinking), amount of physical activity, and sedentary behavior with global symptom severity, while controlling for sociodemographic data (age, gender, employment status, relationship status, educational level). Methods: Data from 401 outpatients, aged 42.08 years on average (SD = 13.26; 71.3% female), diagnosed with depressive disorders, non-organic primary insomnia, agoraphobia, panic disorder, and/or posttraumatic stress disorder were analyzed. Data was collected from 10 different study sites between March 2021 and May 2022 for cross-sectional analysis. The influence of predictors of global symptom severity was determined using multiple regression. Global symptom severity was measured using the Global Severity Index, derived from the Brief Symptom Inventory-18. Predictors were measured using validated scales and physical activity was additionally assessed via accelerometer-based sensors. Results: The proposed model explained 40.3% of variance on the Global Severity Index. Higher levels of repetitive negative thinking, fear of coronavirus, perceived stress, worse sleep quality as well as greater difficulties with emotional regulation and emotional intelligence were significantly associated with higher global symptom severity in our clinical outpatient sample; however, no associations were found for physical activity, and sedentary behavior. Conclusion: Transdiagnostic psychological processes were significantly associated with global symptom severity. Additional prospective longitudinal studies with transdiagnostic samples are necessary to explore possible causal relationships. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial DRKS00024152 ### Funding Statement This study was funded by the German Innovation Fund of the Federal Joint Committee (grant number: 01NVF19022). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The ethics committee for medical research at the University of Tuebingen gave ethical approval for this work(ID: 888/2020B01, 02/11/2020). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced are available online at https://osf.io/5rcuz/files/osfstorage.