Difficulties in emotion regulation, repetitive negative thinking, and sexual and psychological distress: a two-wave longitudinal mediation study using a transdiagnostic approach.

Background: Sexual distress is a critical element in diagnosing sexual dysfunction. Recent research using a cross-sectional design has supported the adequacy of a transdiagnostic approach for its understanding.

Aim: This exploratory study aimed to investigate the mediating role of repetitive negative thinking between difficulties in emotional regulation and sexual and psychological distress in a community sample.

Methods: We used a quantitative longitudinal design with measures including a sociodemographic questionnaire, the Difficulties in Emotion Regulation Scale-Short Form, the Persistent and Intrusive Negative Thoughts Scale, the Sexual Distress Scale-Revised, and the Kessler Psychological Distress Scale.

Outcomes: Data were collected from 64 partnered individuals (85.9% women; age: M = 31.20, SD = 6.46).

Results: Correlational analysis across time revealed significant associations among difficulties in emotion regulation (T1 r = 0.37, T2 r = 0.32), repetitive negative thinking (T1 r = 0.30, T2 r = 0.27), psychological distress (T1 r = 0.37, T2 r = 0.55), and sexual distress (all at P < .01)​. The total effect of difficulties in emotion regulation on sexual distress was found to be positive (β = 0.20, P = .008) after controlling for frequency of sexual activity (r = -0.25, P < .05). Longitudinal mediation analysis indicated a significant negative indirect effect from difficulties in emotion regulation on sexual distress via repetitive negative thinking (β = -0.04, 95% CI [-0.008, -0.001]), suggesting a buffering effect over time on sexual distress.

Clinical implications: These results highlight the significance of recognizing difficulties in emotion regulation and repetitive negative thinking as coping strategies when examining sexual distress, emphasizing the need to explore the putative efficacy of therapeutic interventions focused on addressing these cognitive processes to decrease adverse sexual-related outcomes.

Strengths and limitations: These findings highlight the importance of acknowledging difficulties in emotion regulation and repetitive negative thinking as coping strategies in the study of sexual distress. However, the small sample size and the predominance of women participants limit generalizability. Further research with clinical samples and more diverse populations is needed to better understand the relevance of these aspects in assessment and therapy.

Conclusions: The findings imply that repetitive negative thinking may have potentially adaptive effects, indicating a nuanced role in coping strategies within the context of the study.