The Bidirectional Effects of Obsessive-Compulsive Symptoms and Difficulties in Emotion Regulation in Chinese Adults During the COVID-19 Pandemic: A Dynamic Structural Equation Model

Abstract

Background: With the accumulation of negative emotions bought by COVID-19-related dysfunctional beliefs, individuals adopted obsessive-compulsive (OC) symptoms (e.g., over-checking the wearing of masks) and formed difficulties in emotion regulation (DER). Both OC symptoms and DER had a devastating impact on the individual's mental health. This study focused on the temporal dynamics of the bidirectional relation between OC symptoms and DER. As an extension, we further explored whether OC and DER and their relationship affect sleep problems (SP).Methods: In February 2020, a 14-day (twice a day) online questionnaire survey was conducted on 122 Chinese adults (aged 18 to 55 years; 63 females). In addition, this research applied a dynamic structural equation model with a cross-lagged relationship and a time series. Health anxiety, anxiety, and depression were controlled as covariates.Results: Both OC symptoms and DER had a significant autoregressive and cross-lagged effect. Comparatively speaking, DER was a stronger predictor of OC symptom than OC’s prediction of DER. Besides, both higher levels of OC symptoms and DER were related to the severity of SP.Conclusions: More guidance on identifying intervening OC symptoms and emotion regulation should be added to reduce the external crisis's negative impact on public mental health.