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Mindfulness and Emotion Dysregulation across Internalizing Disorders: A trans-diagnostic comparison of MDD, OCD, and comorbidity

R. Ghorbani, N. Vahidi, Sh. Tamannaeifar, S. Marmazi

Clinical Psychology and Special Education September 30, 2026 DOI: 10.17759/cpse.2026150303 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational comparative study Peer reviewed
Sample size 419
Population Adults in Iran: 101 with major depressive disorder, 36 with obsessive-compulsive disorder, 150 with OCD who developed depressive symptoms, and 132 healthy controls
Measures Beck Depression Inventory – Second Edition (BDI-II), Yale-Brown Obsessive-Compulsive Scale, Difficulties in Emotion Regulation Scale (DERS), Five Facet Mindfulness Questionnaire (FFMQ)
Topics Depression Meditation
Key findings The group with comorbid OCD and depressive symptoms reported the most severe impairments in emotion regulation and mindfulness compared with the MDD, OCD-only, and healthy control groups. People with OCD alone scored better on emotion regulation and mindfulness than those with MDD, except on the non-reactivity facet, where the MDD group performed better. Healthy controls scored highest on all components.

Abstract

Context and relevance. Emotion regulation and mindfulness are trans-diagnostic mechanisms underlying internalizing disorders such as Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD), having a significant influence on symptoms intensity and therapeutic effectiveness. Given the biological and phenomenological intersections as well as the high comorbidity between OCD and MDD, along with the rising number of such cases in Iran, a comprehensive understanding of the aspects of mindfulness and emotion regulation in these populations is essential. Objective. The present study focused on comparing mean scores of emotion regulation and mindfulness dimensions among four groups: Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), OCD patients who developed symptoms of depression (Comorbidity of OCD and MDD), and healthy controls. A total of 419 participants, including 101 individuals diagnosed with MDD, 36 individuals diagnosed with OCD, 150 individuals diagnosed with OCD who subsequently developed depressive symptoms (comorbidity), and 132 healthy controls were selected. Hypothesis. The combination of OCD and MDD was predicted to cause more difficulties in managing emotions and being mindful. Methods and materials. Participants were evaluated using the Beck Depression Inventory – Second Edition (BDI-II), the Yale-Brown Obsessive-Compulsive Scale, the Difficulties in Emotion Regulation Scale (DERS), and the Five Facet Mindfulness Questionnaire (FFMQ). Results. The results of the analysis of covariance indicated that the comorbidity group reported more severe impairments in both emotion regulation and mindfulness components in comparison to the three other groups. Moreover, individuals with an OCD diagnosis demonstrated better outcomes in the components of mindfulness and emotion regulation than the MDD group except for non-reactivity on which individuals with MDD performed better. The control group reported higher scores in all components. Conclusions. The combination of OCD and MDD was predicted to cause more difficulties in managing emotions and being mindful.

Comparable studies

Other observational and cohort studies on depression, most cited first.

Study Year Design Participants
Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Residually depressed patients and nondepressed controls; recovered depressed patients 2002 Observational cohort with intervention components
Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Patients with treatment-resistant depression 2017 Observational cohort n = 19
Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report Patients with a depressive disorder 2015 Observational study
Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder 2012 Observational cohort n = 30
Altered peripheral immune profiles in treatment-resistant depression: response to ketamine and prediction of treatment outcome Healthy controls and actively depressed patients with treatment-resistant depression... 2017 Observational cohort n = 59

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