REAL-WORLD EMOTION DYNAMICS ARE ASSOCIATED WITH CURRENT AND FUTURE INTERNALIZING SYMPTOMS

Abstract

Most studies of internalizing disorders have emphasized the role of emotional traits in the development of internalizing disorders, however more proximal pathology-promoting processes like momentary emotional experiences remain underexplored. Given that the current treatments for these debilitating illnesses are far from curative, understanding proximal processes is critical to optimize interventions and alleviate suffering. Here, we utilized smart-phone ecological momentary assessment (EMA) to identify the relevance of real-world emotional dynamics in internalizing symptomatology and change over a 2.5-year follow-up period. Results demonstrate that one’s event-independent (tonic) level of affect are predictive of broadband (Dysphoria) and narrow-band (Panic and Well-being) internalizing symptoms, whereas positive and negative event exposure is not. Notably, increased emotional reactivity to negative events predicts greater concurrent and future Dysphoria symptoms but not its trajectory. Whereas tonic levels of negative affect lose predictive value for future Dysphoria when controlling for baseline symptoms, elevated tonic positive affect uniquely predicts healthier Well-being trajectories. These findings advance our understanding of real-world emotional dynamics in internalizing illnesses and lay the groundwork for improved research paradigms and targeted interventions.