Negative affectivity showed the strongest associations across diagnosis-specific symptom scores and may serve as a particularly informative transdiagnostic indicator of overall symptom burden in primary care, while emotion regulation mechanisms showed limited incremental value beyond negative affectivity.
Key Findings
Results
All transdiagnostic factors were correlated with depressive, anxiety, and somatic symptom scores in primary care patients.
The sample consisted of n=87 patients in a primary care setting.
Transdiagnostic factors examined included emotion beliefs, cognitive reappraisal, emotion suppression, experiential avoidance, and negative affectivity.
Symptom domains assessed were depressive, anxiety, and somatic symptoms.
This was a secondary analysis of a randomised controlled pilot study using cross-sectional data.
Results
Negative affectivity showed the strongest associations across all diagnosis-specific symptom scores compared to other transdiagnostic factors.
Negative affectivity was compared against emotion regulation mechanisms including emotion beliefs, cognitive reappraisal, emotion suppression, and experiential avoidance.
Small to moderate correlation estimates were observed for the emotion regulation mechanisms.
Negative affectivity remained the most consistent contributor to symptom variance in multiple regression analyses.
Negative affectivity most closely reflected symptom gradients across respective severity levels of depression, anxiety, and somatic symptom scores.
Results
Emotion regulation mechanisms showed limited incremental value in explaining symptom variance beyond what was already accounted for by negative affectivity.
Multiple regression analyses were used to assess incremental value of emotion regulation mechanisms over negative affectivity.
The study examined whether emotion regulation mechanisms explain variance in symptom severity not accounted for by negative affectivity alone.
No incremental relevance of emotion regulation mechanisms beyond negative affectivity was supported by the analyses.
The four emotion regulation mechanisms examined were emotion beliefs, cognitive reappraisal, emotion suppression, and experiential avoidance.
Discussion
Negative affectivity may serve as a particularly informative transdiagnostic indicator of overall symptom burden in primary care.
This conclusion is based on cross-sectional findings from a secondary analysis of a pilot RCT.
Negative affectivity most closely reflected symptom gradients across severity levels of depression, anxiety, and somatic symptoms.
The authors suggest negative affectivity has potential screening relevance in the primary care setting.
The findings are described as cross-sectional, limiting causal interpretation.
Conclusions
The authors identified future research directions for emotion regulation mechanisms, particularly regarding mechanism-based interventions and symptom trajectories.
Despite limited incremental value in cross-sectional analyses, emotion regulation mechanisms were noted for their potential in guiding mechanism-based interventions.
The authors call for future research examining the relation of emotion regulation mechanisms to symptom trajectories over time.
The pilot study was registered with the German Clinical Trials Register on 18th of March 2024 (DRKS00033386).
The cross-sectional nature of the findings was cited as a key limitation.
What This Means
This research suggests that among several psychological factors thought to cut across different mental health diagnoses, a person's general tendency to experience negative emotions — called 'negative affectivity' — is the most strongly linked to the severity of depression, anxiety, and physical (somatic) symptoms in patients seen in primary care. The study analyzed data from 87 primary care patients and looked at how well negative affectivity and various emotion regulation strategies (such as suppressing emotions, avoiding difficult feelings, and beliefs about emotions) could predict how severely patients were experiencing mental health symptoms. Negative affectivity consistently outperformed the other factors in explaining symptom burden across all three symptom types.
The study also tested whether the emotion regulation strategies added useful information on top of what negative affectivity already told us about symptom severity, but found that they contributed little additional explanatory power. This suggests that, at least in a single snapshot in time, negative affectivity alone captures much of what is relevant about a patient's overall mental health symptom burden in primary care.
This research suggests that measuring negative affectivity could be a practical and efficient way to screen for mental health problems across different diagnoses in primary care settings, rather than using multiple separate disorder-specific tools. However, because the study only looked at one point in time and involved a relatively small pilot sample, the authors caution that future research should examine how emotion regulation strategies might still matter for treatment approaches and for predicting how symptoms change over time.
Ebert C, Peris-Baquero &, Junker L, Ehring T, Gensichen J, Osma J. (2026). Exploring transdiagnostic factors for mental health screening in primary care: a secondary analysis of a randomised controlled pilot study.. BMC research notes. https://doi.org/10.1186/s13104-026-07885-5