The role of psychological distress in the relationship between lifestyle and compulsivity: An analysis of independent, bi-national samples

Mary Ellen E. Brierley, Lucy Albertella, Kristian Rotaru, Louise Destree, Emma M. Thompson, Chang Liu, Erynn Christensen, Amelia Lowe, Rebecca A. Segrave, Karyn E. Richardson, Edouard Kayayan, Samuel R. Chamberlain, Jon E. Grant, Rico S.C. Lee, Sam Hughes, Murat Yücel, Leonardo F. Fontenelle

Research output: Contribution to journalArticleResearchpeer-review


BackgroundPoor mental health is a state of psychological distress that is influenced by lifestyle factors such as sleep, diet, and physical activity. Compulsivity is a transdiagnostic phenotype cutting across a range of mental illnesses including obsessive-compulsive disorder, substance-related and addictive disorders, and is also influenced by lifestyle. Yet, how lifestyle relates to compulsivity is presently unknown, but important to understand to gain insights into individual differences in mental health. We assessed (a) the relationships between compulsivity and diet quality, sleep quality, and physical activity, and (b) whether psychological distress statistically contributes to these relationships.MethodsWe collected harmonized data on compulsivity, psychological distress, and lifestyle from two independent samples (Australian n = 880 and US n = 829). We used mediation analyses to investigate bidirectional relationships between compulsivity and lifestyle factors, and the role of psychological distress.ResultsHigher compulsivity was significantly related to poorer diet and sleep. Psychological distress statistically mediated the relationship between poorer sleep quality and higher compulsivity, and partially statistically mediated the relationship between poorer diet and higher compulsivity.ConclusionsLifestyle interventions in compulsivity may target psychological distress in the first instance, followed by sleep and diet quality. As psychological distress links aspects of lifestyle and compulsivity, focusing on mitigating and managing distress may offer a useful therapeutic approach to improve physical and mental health. Future research may focus on the specific sleep and diet patterns which may alter compulsivity over time to inform lifestyle targets for prevention and treatment of functionally impairing compulsive behaviors.

Original languageEnglish
Pages (from-to)164-173
Number of pages10
JournalCNS Spectrums
Issue number2
Publication statusPublished - Apr 2023


  • compulsivity
  • diet
  • lifestyle
  • obsessive-compulsive
  • Psychological distress
  • sleep

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