The Protective Effect of Decentering on the Links Between Internalising Symptoms, Functional Impairment and Wellbeing

There is a lack of longitudinal research examining the relationships between internalising symptoms and well-being via functional impairment. Decentering is a malleable and clinically relevant characteristic that may disrupt the links among these constructs over time, but this is yet to be explored. A community sample (N = 386) completed monthly self-report surveys for 12 months, assessing internalising symptoms (depression, generalised anxiety, social anxiety, panic), impairment, well-being and decentering. Multilevel structural equation modelling was conducted to analyse the within-person association between symptoms and well-being mediated by impairment (in the same month and subsequent months), as well as a moderated-mediation model with decentering as the moderator (in the same month and as individual differences). Further, the mediation model was tested over time bidirectionally. Within a given month, higher levels of symptoms significantly predicted lower well-being via impairment, and prospective analyses revealed that these effects were bidirectional. Decentering significantly reduced the impact of one's symptoms on impairment on a given month and throughout the study, but not the impact of impairment on well-being. Thus, decentering was supported as a protective factor that reduces the link between symptoms and impairment. Further research is needed to uncover different ways to protect well-being, particularly because low well-being also predicted elevated symptoms over time. These novel findings indicate that the inverse cycle between symptoms and well-being may be maintained by impairment, but the short-term and cumulative effects of symptoms on impairment could be reduced by decentering. As such, impairment and decentering may be important therapeutic targets when aiming to promote well-being in the context of symptoms.