The association of interpersonal distress with negative mental health outcomes in people with a diagnosed anxiety disorder: a meta-analytic review

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.