Background: Despite interest in transdiagnostic dimensional approaches to psychopathology, little is known about the dynamic interplay of affecting and internalizing symptoms that cut across diverse mental health disorders. We examined within-person reciprocal effects of negative and positive affect (NA, PA) and symptoms (depression and anxiety), and their between-person associations with affective dynamics (i.e., affect inertia).

Methods: Individuals currently receiving treatment for psychological disorders (N = 776) completed daily assessments of affect and symptoms across 14 treatment days (average). We used dynamic structural equation modeling to examine daily affect-symptom dynamics.

Results: Within-person results indicated NA-symptom reciprocal effects; PA only predicted subsequent depression symptoms. After accounting for changes in mean symptoms and affect over time, NA-anxiety and PA-depression relations remained particularly robust. Between-person correlations indicated NA inertia was positively associated with NA-symptom effects; PA inertia was negatively associated with PA-symptoms effects.

Conclusions: Results suggest that transdiagnostic affective treatment approaches may be more useful for reducing internalizing symptoms by decreasing NA compared to increasing PA. Individual differences in resistance to shifting out of affective states (i.e., high NA vs. PA inertia) may be a useful marker for developing tailored interventions.

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