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2026: Online Advance Publication
The association of interpersonal distress with negative mental health outcomes in people with a diagnosed anxiety disorder: a meta-analytic review
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 1 July 2026
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Empirical research has suggested the association between interpersonal dysfunctions and anxiety disorders. However, no previous meta-analysis has estimated the extent to which these relational issues are related to negative mental health in anxiety disorders. This study aimed to conduct a systematic review and meta-analysis to evaluate the correlation between interpersonal distress and negative mental health outcomes in people with a diagnosed anxiety disorder. We performed a systematic search in PsycINFO and PubMed, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, including studies reporting estimates of the associations between interpersonal distress and negative (non-relational) mental health outcomes in people with diagnosed anxiety disorders. Using multilevel meta-analytic models, we estimated a pooled correlational (r) effect size, accounting for variability at the within-effect-size, between-effect-size, and between-study level. We identified 18 eligible articles, reporting 43 effect sizes from 2,998 subjects. The multilevel models showed a significant association between interpersonal distress and mental health in people with a diagnosed anxiety disorder (r=0.37, 95% confidence interval [CI] [0.28, 0.52], d=0.84). We found significant heterogeneity around the estimations (Q(42)=463.29, p<.001) but failed to find significant moderators of the association. Interpersonal distress has a moderate-to-large correlation with non-relational mental health outcomes in people with diagnosed anxiety disorders. More research would be necessary to determine putative moderators of this association.
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The association of interpersonal distress with negative mental health outcomes in people with a diagnosed anxiety disorder: a meta-analytic review. (2026). Research in Psychotherapy: Psychopathology, Process and Outcome. https://doi.org/10.4081/ripppo.2026.894
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