Engaging in life as a potential key transdiagnostic mechanism in emotional disorders

The high disease burden of emotional disorders underscores a need to identify efficient transdiagnostic mechanisms to improve mental health interventions. While maladaptive cognitions and emotion dysregulation are widely recognized, the role of engaging in life has been largely overlooked. Clinically, promoting engagement in everyday activities represents a highly practical, accessible and broadly implementable therapeutic pathway that requires comparatively less professional expertise. Given the significant clinical implications of engaging in life as a potential transdiagnostic mechanism, we conducted a scoping review, guided by Kazdin's criteria for mechanism evaluation, to systematically map the current research status of this construct as it relates to emotional disorders. This review analyzed 89 empirical studies to map its conceptual boundaries (aggregating definitions into five categories) and investigate the association between variables related to engaging in life and various mental health outcomes, including depression, anxiety, and overall well-being. Although critical appraisal revealed prevalent risks of methodological bias and our mechanistic evaluation highlighted a gap in definitive experimental causal evidence, consistent observational data suggest that greater engaging in life is associated with improved mental health, while reduced engagement correlates with elevated psychopathological symptoms. Future research should prioritize rigorous trial designs and adopt process-based methodologies to rigorously evaluate the real-time dynamics of targeting engaging in life and investigate whether it can function as an operational transdiagnostic mechanistic variable. Importantly, while this broad behavioral topography shows macroscopic statistical promise as a mechanism of change, future studies must disentangle the highly diverse and heterogeneous functional processes operating beneath it. This line of inquiry holds promise for developing accessible, efficient interventions to prevent and manage emotional disorders, ultimately contributing to improved global mental health and well-being.