Exploring the nature, development and effects of complex emotions in Sheffield and Plymouth, UK: a longitudinal mixed methods study protocol
18 affiliations
- 1SCHARR, The University of Sheffield, Sheffield, South Yorkshire, UK
- 2Complex Emotions Lived Experience Advisory Panel, Sheffield, UK
- 3Division of Population Health, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- 4Psychiatry, University of Oxford, Oxford, UK
- 5Academic Unit of Primary Medical Care, University of Sheffield, Sheffield, UK
- 6Centre for Clinical Trials and Health Research, University of Plymouth, Plymouth, UK
- 7Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Sheffield, South Yorkshire, UK
- 8The McPin Foundation, London, UK
- 9Sheffield Health Partnership University NHS Foundation Trust, Sheffield, UK
- 10University of Cambridge, Cambridge, UK
- 11SHHS, University of Huddersfield, Huddersfield, UK
- 12Medical School, University of Exeter, Exeter, UK
- 13The University of Sheffield, Sheffield, UK
- 14Mental Health, NHS England, Redditch, UK
- 15University of Sheffield, The University of Sheffield, Sheffield, UK
- 16Queen Mary University of London, London, UK
- 17McPin Foundation, London, UK
- 18University of Exeter, Exeter, UK
Abstract
Introduction: Complex emotions include difficulties with emotional regulation, impulsivity, identity, relationships and functioning. These experiences are often construed as borderline personality disorder, a highly stigmatised diagnosis. We will use a transdiagnostic approach to investigate the nature, course and lived experience of complex emotions, with lived experience involvement embedded throughout the programme.
We aim to (1) model symptom and functional trajectories to identify subgroups with distinct needs; (2) elucidate mechanisms underlying outcomes, including interactions with social, cultural and environmental factors; (3) investigate associations between complex emotions and physiological and behavioural measures; and (4) integrate findings to inform interventions and service delivery.
Methods and analysis: We will undertake a mixed methods longitudinal study co-developed with our Lived Experience Advisory Panel (LEAP) and informed by evidence synthesis. We aim to recruit 300 participants who self-identify as experiencing complex emotions through health services, third-sector organisations and probation services, with baseline assessments and 6 monthly follow-up. Two nested substudies will comprise (1) longitudinal biographical interviews and (2) ecological momentary assessment (EMA) of experiential, physiological and behavioural data. Quantitative data will be analysed using multivariate and longitudinal trajectory modelling methods to identify underlying dimensions and phenotypic subgroups. Qualitative data will undergo reflexive thematic and narrative approaches to identify shared experiences, coping strategies and meaning-making. EMA data will be analysed using network and time-series approaches to examine within-person and between-person associations and temporal instability. Findings will be integrated to develop an overall understanding of the nature, trajectories and mechanisms of complex emotions.
Ethics and dissemination: The cohort and qualitative studies were approved by the East Midlands (Derby) National Health Service (NHS) Research Ethics Committee (REC) and the Health Research Authority (HRA) (IRAS 353789, REC 25/EM/0128; 4 July 2025). The EMA substudy was approved by Cambridge East NHS REC and HRA (IRAS 364085, REC 26/EE/0171; 11 August 2026). Dissemination strategies will be co-developed by researchers, LEAP members and lived experience co-investigators. All partners will contribute to peer-reviewed publications, conference presentations and accessible outputs. The anticipated date of study completion is 31 March 2029.
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BibTeX
@article{ohlsen2026exploring,
title = {{Exploring the nature, development and effects of complex emotions in Sheffield and Plymouth, UK: a longitudinal mixed methods study protocol}},
author = {Sally Ohlsen and Dion Anderson and Anastasios Bastounis and Kamaldeep Bhui and Andrew Booth and Christopher D Burton and Richard Byng and Timothy James Chico and Lisa Couperthwaite and Helen Crimlisk and Tim Dalgleish and Michael Doyle and Saffron Gravestock and Rebecca Hardwick and Michelle Horspool and Katie Hullock and Tim Kendall and Joanna Leaviss and Tiffany Markwick and Venet Osmani and Vanessa Pinfold and Molly Robinson and Georgia Jean Sullivan and Anthea Sutton and Felicity Thomas and Elissa Rosina Thompson and Evette Wilson and Scott Weich},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-117088},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117088},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exploring the nature, development and effects of complex emotions in Sheffield and Plymouth, UK: a longitudinal mixed methods study protocol
AU - Sally Ohlsen
AU - Dion Anderson
AU - Anastasios Bastounis
AU - Kamaldeep Bhui
AU - Andrew Booth
AU - Christopher D Burton
AU - Richard Byng
AU - Timothy James Chico
AU - Lisa Couperthwaite
AU - Helen Crimlisk
AU - Tim Dalgleish
AU - Michael Doyle
AU - Saffron Gravestock
AU - Rebecca Hardwick
AU - Michelle Horspool
AU - Katie Hullock
AU - Tim Kendall
AU - Joanna Leaviss
AU - Tiffany Markwick
AU - Venet Osmani
AU - Vanessa Pinfold
AU - Molly Robinson
AU - Georgia Jean Sullivan
AU - Anthea Sutton
AU - Felicity Thomas
AU - Elissa Rosina Thompson
AU - Evette Wilson
AU - Scott Weich
PY - 2026
DA - 2026/10/26
JO - BMJ Open
DO - 10.1136/bmjopen-2026-117088
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117088
AB - Introduction: Complex emotions include difficulties with emotional regulation, impulsivity, identity, relationships and functioning. These experiences are often construed as borderline personality disorder, a highly stigmatised diagnosis. We will use a transdiagnostic approach to investigate the nature, course and lived experience of complex emotions, with lived experience involvement embedded throughout the programme. We aim to (1) model symptom and functional trajectories to identify subgroups with distinct needs; (2) elucidate mechanisms underlying outcomes, including interactions with social, cultural and environmental factors; (3) investigate associations between complex emotions and physiological and behavioural measures; and (4) integrate findings to inform interventions and service delivery. Methods and analysis: We will undertake a mixed methods longitudinal study co-developed with our Lived Experience Advisory Panel (LEAP) and informed by evidence synthesis. We aim to recruit 300 participants who self-identify as experiencing complex emotions through health services, third-sector organisations and probation services, with baseline assessments and 6 monthly follow-up. Two nested substudies will comprise (1) longitudinal biographical interviews and (2) ecological momentary assessment (EMA) of experiential, physiological and behavioural data. Quantitative data will be analysed using multivariate and longitudinal trajectory modelling methods to identify underlying dimensions and phenotypic subgroups. Qualitative data will undergo reflexive thematic and narrative approaches to identify shared experiences, coping strategies and meaning-making. EMA data will be analysed using network and time-series approaches to examine within-person and between-person associations and temporal instability. Findings will be integrated to develop an overall understanding of the nature, trajectories and mechanisms of complex emotions. Ethics and dissemination: The cohort and qualitative studies were approved by the East Midlands (Derby) National Health Service (NHS) Research Ethics Committee (REC) and the Health Research Authority (HRA) (IRAS 353789, REC 25/EM/0128; 4 July 2025). The EMA substudy was approved by Cambridge East NHS REC and HRA (IRAS 364085, REC 26/EE/0171; 11 August 2026). Dissemination strategies will be co-developed by researchers, LEAP members and lived experience co-investigators. All partners will contribute to peer-reviewed publications, conference presentations and accessible outputs. The anticipated date of study completion is 31 March 2029.
SN - 2044-6055
SN - 2044-6055
ER -