The dual-continua model of mental health in daily life: momentary associations between distress and wellbeing in clinical and non-clinical populations

Background: The dual-continua model suggests that psychological distress and mental wellbeing are related, yet distinct constructs. Previous studies have supported the model in general populations, though they have relied almost entirely on retrospective trait measures. No studies have contrasted clinical and non-clinical populations to investigate the association between distress and wellbeing as momentary experiences in daily life. Methods: This study used ecological momentary assessment (42 reports over 7 days) and multilevel structural equation modelling to analyse the strength of the momentary associations between distress and wellbeing (hedonic and eudaimonic) in participants with and without a clinical disorder (N = 345). We hypothesised that clinical diagnostic status (any diagnosis, anxiety diagnosis, or depression diagnosis) would predict a stronger negative within-person association between distress and wellbeing. Results: The momentary association between distress and wellbeing was strong and negative for hedonic wellbeing, and moderate and negative for eudaimonic wellbeing. Contrary to hypotheses, only depression diagnosis predicted the strength of the momentary distress-wellbeing association, wherein participants with depression tended to have a weaker negative association of distress with both types of wellbeing. Conclusion: Distress and wellbeing appear to be related but distinct momentary experiences in daily life regardless of one's clinical diagnostic status, suggesting that each is important to consider in clinical settings.