Impaired Emotional Clarity and Psychopathology: A Transdiagnostic Deficit with Symptom-Specific Pathways through Emotion Regulation

Abstract

Deficits in emotional clarity, or difficulties identifying which emotions one feels, are increasingly associated with multiple forms of psychopathology. We addressed two fundamental, unresolved issues regarding the transdiagnostic nature of this dysfunction. First, we examined the relationship of deficits in emotional clarity to seven symptom types, accounting for possible confounding effects of overlapping symptoms. We found that deficits in emotional clarity were associated with symptoms of depression, social anxiety, borderline personality, binge eating, and alcohol use, but not anxious arousal or restrictive eating. Second, we tested whether deficits in emotional clarity would relate to psychopathology by way of impaired emotion regulation. Notably, the relationship between deficits in emotional clarity and each symptom type was mediated by a distinct, disorderspecific pattern of emotion regulation deficits. Findings suggest that deficits in emotional clarity can be conceptualized as a transdiagnostic process with diverging mechanisms involving emotion regulation difficulties that vary from disorder to disorder. We discuss these findings within a contextual approach to delineating transdiagnostic processes.