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Tsuchiyagaito A, Aoki S, Cochran G, Kawanori Y, Horiuchi S. Hard to let it go: repetitive negative thinking and hoarding in later life in Japan. Aging Ment Health 2024; 28:542-550. [PMID: 37178150 DOI: 10.1080/13607863.2023.2209774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
Objectives: Hoarding in older adults can have a detrimental effect on daily life. Repetitive negative thinking (RNT) could result in a greater avoidance of discarding and increased saving behaviors; yet, the unique role of RNT on hoarding in older adults remains understudied. This study aimed to investigate whether the intensity of RNT contributes to hoarding in older adults. Methods: Two hundred and sixty-four older adults in Japan (ages 65-86 years, 132 males and 132 females) participated in an online survey. Hierarchical regression analyses were conducted to examine whether RNT could significantly explain the variance of hoarding after controlling for age, sex, years of education, self-reported cognitive impairment, and depression. Results: As we expected, RNT was significantly associated with greater hoarding behaviors, such as excessive acquisition (β = .27, p = .005) and difficulty in discarding (β = .27, p = .003). On the other hand, reflection, repetitive thinking without negative emotional valence, was significantly associated with higher scores on clutter (β = .36 p < .001). Conclusion: Our findings highlight the importance of addressing RNT in the prevention and treatment of hoarding symptoms among older adults, potentially leading to more effective interventions and improved outcomes in managing hoarding behaviors in this population.
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Affiliation(s)
- Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Shuntaro Aoki
- Center for Medical Education and Career Development, Fukushima Medical University, Fukushima, Japan
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, Japan
| | - Gabe Cochran
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Satoshi Horiuchi
- Department of Social and Clinical Psychology, Hijiyama University, Hiroshima, Japan
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Pryor DW, Hughes MR, Langdon JJ. Agents of Socialization, Anxiety, College Women, and Fear of Rape. Violence Against Women 2024; 30:691-721. [PMID: 37194265 DOI: 10.1177/10778012231172703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This paper examines the impact of messages about sexual danger women receive from parents, peers, media, school officials, and past victimization on fear of stranger and acquaintance rape. Analyzing survey data for 630 undergraduate women, we find that parental warnings, internalized mean world view, university crime alerts, and being more prone to anxiety are significant predictors of fear of rape across models, while effects of media and victimization are limited. When high and low proneness to anxiety subgroups are considered separately, numerous differences emerge. Results suggest the need to include formal measures of anxiety in future fear of crime research.
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Affiliation(s)
- Douglas W Pryor
- Department of Sociology, Anthropology & Criminal Justice, Towson University, Towson, MD, USA
| | - Marion R Hughes
- Department of Sociology, Anthropology & Criminal Justice, Towson University, Towson, MD, USA
| | - Jennifer J Langdon
- Department of Sociology, Anthropology & Criminal Justice, Towson University, Towson, MD, USA
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Almeida TC, Ifrim IC. Psychometric Properties of the Positive Thinking Skills Scale (PTSS) among Portuguese Adults. Behav Sci (Basel) 2023; 13:bs13050357. [PMID: 37232594 DOI: 10.3390/bs13050357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Positive thinking is a cognitive attitude that focuses on optimism and aims for positive results. Positive thinking leads to positive emotions, more adaptive behaviors, and better problem solving. Positive thoughts can inspire individuals and have been linked to increased psychological health. On the other hand, negative thoughts are related to unsatisfactory mental health. OBJECTIVES This study aimed to analyze the factor structure and psychometric properties of the Portuguese version of the Positive Thinking Skills Scale (PTSS) and to verify the correlations between positive thinking, resilience, and repetitive negative thinking. PARTICIPANTS The sample comprised 220 Portuguese participants between 18 and 62 years of age (M = 24.9, SD = 6.58), and the majority were women (80.5%). METHOD Participants responded to an online sociodemographic questionnaire, the PTSS, the Persistent and Intrusive Negative Thoughts Scale (PINTS), and the Resilience Scale-10 (RS-10). RESULTS Confirmatory factor analysis results indicated that the original one-factor structure of the PTSS obtained good fits. An excellent value of internal consistency was found. The results also revealed convergent and discriminant validity. CONCLUSION The PTSS is a brief and reliable instrument for assessing positive thinking skills, and its use in research is recommended.
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Affiliation(s)
- Telma Catarina Almeida
- Egas Moniz School of Health and Science, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
- CiiEM-Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
- LabPSI-Laboratório de Psicologia Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
| | - Ionela Catalina Ifrim
- Egas Moniz School of Health and Science, Instituto Universitário Egas Moniz (IUEM), 2829-511 Caparica, Portugal
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Actigraphic Wake after Sleep Onset and Symptom Severity Correspond with Rumination in Trauma-Exposed Individuals. Brain Sci 2023; 13:brainsci13010139. [PMID: 36672120 PMCID: PMC9856627 DOI: 10.3390/brainsci13010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Rumination and worry are forms of repetitive negative thinking (RNT) commonly associated with internalizing psychopathologies, although less is known about RNT in trauma-exposed individuals with internalizing psychopathologies. Separate lines of research show RNT also plays a role in problematic sleep, which is frequently experienced after trauma exposure. To address gaps in the literature, the current study examines the impact of sleep and symptoms on RNT in trauma-exposed participants. A transdiagnostic sample of 46 unmedicated treatment-seeking trauma-exposed participants completed standard measures of rumination and worry, as well as clinical measures that assessed posttraumatic stress, depression, and anxiety severity. Actigraphic sleep variables were sleep duration, wake after sleep onset (WASO), and sleep efficiency. Sleep and clinical measures were submitted to multiple regression analyses with rumination and worry as dependent variables. The regression results showed that rumination was significantly explained by WASO and posttraumatic stress symptom (PTSS) severity, and the omnibus test was significant. Depression, anxiety, and other estimates of sleep were not significant. No significant results emerged for worry. Preliminary findings suggest that PTSS and WASO, an index of fragmented sleep, may contribute to rumination, but not worry, in trauma-exposed individuals. Longitudinal studies are needed to determine potential causal relationships.
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Peixoto MM, Ribeiro V. Repetitive Negative Thinking and Sexual Functioning in Portuguese Men and Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:567-576. [PMID: 38596387 PMCID: PMC10903578 DOI: 10.1080/19317611.2022.2084201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/17/2022] [Accepted: 05/22/2022] [Indexed: 04/11/2024]
Abstract
Objective: Repetitive negative thinking (RNT) is a transdiagnostic process involved in the development and maintenance of emotional disorders that negatively affect sexual functioning. However, empirical evidence for the role of RNT on sexual functioning is still lacking. The current study aimed to investigate the role of RNT on sexual functioning in men and women by examining differences in RNT between men and women and between individuals with and without subclinical sexual difficulties. It also aimed to investigate the predictive role of RNT on sexual function indices in men and women. Methods: A total of 424 participants (270 women) completed online a sociodemographic questionnaire and Portuguese versions of the Persistent and Intrusive Negative Thoughts Scale, the Female Sexual Functioning Index, and the International Index of Erectile Function. Results: The main findings showed that women scored significantly higher than men on the RNT. Similarly, individuals with subclinical sexual difficulties scored significantly higher on the RNT compared with individuals without sexual difficulties. RNT was a statistically significant and negative predictor of sexual functioning in women and men. The role of RNT on sexual functioning in women and men was found, with men and women with subclinical sexual difficulties more likely to express persistent and intrusive negative thoughts compared with men and women without sexual difficulties. Conclusions: In summary, RNT appears to be a negative predictor of sexual functioning in both women and men, suggesting that individuals with more intrusive and negative persistent thoughts also have more difficulty in their sexual response.
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Affiliation(s)
- Maria Manuela Peixoto
- Centro de Investigação em Psicologia para o Desenvolvimento Positivo, Instituto de Psicologia e Ciências da Educação, Universidade Lusíada do Porto, Porto, Portugal
| | - Vera Ribeiro
- Instituto de Psicologia e Ciências da Educação, Universidade Lusíada do Porto, Porto, Portugal
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Castro AA, Hur J, Berenbaum H. A bifactor approach to modeling the structure of repetitive thinking: Replication and extension. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Prevalence, predictors and types of unpleasant and adverse effects of meditation in regular meditators: international cross-sectional study. BJPsych Open 2021. [PMCID: PMC8693904 DOI: 10.1192/bjo.2021.1066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Meditation is commonly implemented in psychological therapies since the ‘third wave’ of cognitive–behavioural therapy has increased the focus on mindfulness-based interventions. Although extensive research literature demonstrates its benefits, little is known about potential adverse effects. Aims The aim of this study is to report the prevalence, type and severity of particularly unpleasant meditation-related experiences in the largest cross-sectional study on this topic to date, with 1370 regular meditators. Method The participants were asked whether they ever encountered particularly unpleasant experiences as a result of their meditation experience. For the first time, the type and severity of those experiences were assessed and the association with several predictors, such as pre-existing mental disorders, were explored via logistic and linear regression. Results Similar to previous studies, 22% of participants (95% CI 20–24) reported having encountered unpleasant meditation-related experiences, and 13% of participants (95% CI 3–5) reported experiences that were categorised as adverse. Those were mostly of affective, somatic and cognitive nature. Unpleasant meditation-related experiences were more likely to occur in participants with pre-existing mental illnesses (P = 0.000, 95% CI 1.25–2.12). Conclusions This study demonstrates that unpleasant meditation-related experiences are prevalent among meditators and, to a relevant extent, severe enough to warrant further scientific inquiry. Longitudinal studies are needed to examine whether the unpleasant meditation-related experiences are merely negative and thus should be avoided, or are an inherent part of the contemplative path.
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Constantin K, Penney AM, Pope CJ, Miedema VC, Tett RP, Mazmanian D. Negative repetitive thoughts clarify the link between trait emotional intelligence and emotional distress. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-00497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peixoto MM, Cunha O. Translation and Validation for the Portuguese Adult Population of the Persistent and Intrusive Negative Thoughts Scale: Assessing Measurement Invariance. Int J Cogn Ther 2021. [DOI: 10.1007/s41811-021-00120-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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10
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Kovács LN, Kocsel N, Galambos A, Magi A, Demetrovics Z, Kökönyei G. Validating the bifactor structure of the Ruminative Thought Style Questionnaire-A psychometric study. PLoS One 2021; 16:e0254986. [PMID: 34310621 PMCID: PMC8312922 DOI: 10.1371/journal.pone.0254986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/07/2021] [Indexed: 11/19/2022] Open
Abstract
The Ruminative Thought Style Questionnaire (RTSQ) is a self-report measure that aims to capture rumination globally, unbiased by depressive symptoms. We explored its psychometric properties among university students (N = 1123), as the existing models about the factor structure of the RTSQ have been inconclusive. In a second study (N = 320) we tested its convergent validity compared to the Ruminative Response Scale (RRS) and its construct validity compared to the Zung Self-rating Depression Scale (ZSDS). The results of Study 1 suggest that the factor structure of the RTSQ is best described with a 19-item bifactor Exploratory Structural Equation Modelling (ESEM), where most of the variance is explained by the general factor. The model was found to be invariant across genders. The correlations in Study 2 demonstrated that the RTSQ is congruent with the RRS, and that rumination captured by the RTSQ is rather maladaptive, as it was more strongly associated with the brooding subscale of the RRS than with reflective pondering. Significant positive associations were found with depressive symptoms, reaffirming the validity of the RTSQ due to the well-known association between rumination and depressive symptoms. Our results support that RTSQ assesses rumination globally, and it is a valid measure of ruminative thinking style that is rather negatively valenced but does not solely focus on depressive mood and symptoms.
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Affiliation(s)
- Lilla Nóra Kovács
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Natália Kocsel
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Attila Galambos
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Anna Magi
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
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Higher Order Repetitive Negative Thinking Is More Robustly Related to Depression, Anxiety, and Mania Than Measures of Rumination or Worry. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10235-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Feurer C, Jimmy J, Chang F, Langenecker SA, Phan KL, Ajilore O, Klumpp H. Resting state functional connectivity correlates of rumination and worry in internalizing psychopathologies. Depress Anxiety 2021; 38:488-497. [PMID: 33621397 PMCID: PMC8085064 DOI: 10.1002/da.23142] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/29/2021] [Accepted: 02/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Rumination and worry are repetitive negative thinking (RNT) tendencies that contribute to the development and maintenance of internalizing psychopathologies. Accruing data suggest rumination and worry represent overlapping and unique transdiagnostic cognitive processes. Yet, prior neuroimaging research has mostly focused on rumination in depression, which points to involvement of resting-state brain activity in default mode, executive, salience, and/or affective networks. METHODS The current study examined relations between brain activity during rest and RNT in a transdiagnostic sample. Resting-state fMRI data was analyzed in 80 unmedicated patients with internalizing conditions. Regression analysis, controlling for anxiety and depression symptoms, was performed with seed regions implicated in default mode, executive, salience, and affective networks. Rumination and worry were assessed with standard self-report measures. RESULTS Whole-brain regression results showed more rumination and worry jointly corresponded with greater positive resting-state functional connectivity (rsFC) between the amygdala and prefrontal regions (i.e., middle frontal gyrus, inferior frontal gyrus). Conversely, more worry (controlling for rumination) corresponded with greater negative rsFC between amygdala and precuneus. No significant results were observed for rumination alone (controlling for worry). CONCLUSIONS Findings indicate the affective network plays a role in RNT, and distinct patterns of connectivity between amygdala and regions implicated in the executive and default mode networks were observed across patients with internalizing conditions. Results suggest different mechanisms contribute to RNT as a unitary construct and worry as a unique construct.
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Affiliation(s)
- Cope Feurer
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Jagan Jimmy
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Fini Chang
- University of Illinois at Chicago, Departments of Psychiatry and Psychology, Chicago, IL, USA
| | | | - K. Luan Phan
- The Ohio State University, Department of Psychiatry and Behavioral Health, Columbus, OH, USA
| | - Olusola Ajilore
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Heide Klumpp
- University of Illinois at Chicago, Departments of Psychiatry and Psychology, Chicago, IL, USA
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The association of changes in repetitive negative thinking with changes in depression and anxiety. J Affect Disord 2020; 275:157-164. [PMID: 32734902 DOI: 10.1016/j.jad.2020.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 05/26/2020] [Accepted: 07/04/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a common feature of different mental disorders in the affective spectrum. Most measures of RNT are disorder-specific and measure e.g. rumination in depression or worry in anxiety. METHODS In the Netherlands Study of Depression and Anxiety (NESDA), 1820 adults completed the Perseverative Thinking Questionnaire to assess content-independent RNT over a 3-year follow-up period. We investigated the relative stability of content-independent RNT (Perseverative Thinking Questionnaire), over time as well as the association between changes in RNT and changes in affective disorder status (Composite International Diagnostic Interview) and depressive and anxiety severity (Inventory of Depressive Symptomatology, Beck Anxiety Inventory, Fear Questionnaire). RESULTS In the total group, baseline RNT was strongly related to RNT three years later, while the difference between the scores at baseline and three years later was negligible. Increases and decreases in RNT were associated with the occurrence and recovery of affective disorders, respectively. Furthermore, changes in RNT between baseline and three years later were associated with corresponding changes in depression, anxiety, and avoidance symptom severity. These associations were small or negligible. LIMITATIONS Our findings may not be representative of all affective disorders as individuals with an obsessive-compulsive disorder or bipolar disorder were excluded from our sample. CONCLUSIONS The findings suggest that RNT is not primarily an index of disorder status or epiphenomenon of symptom severity and may constitute a relatively stable transdiagnostic person characteristic.
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Martínez R, Senra C, Fernández-Rey J, Merino H. Sociotropy, Autonomy and Emotional Symptoms in Patients with Major Depression or Generalized Anxiety: The Mediating Role of Rumination and Immature Defenses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165716. [PMID: 32784694 PMCID: PMC7459840 DOI: 10.3390/ijerph17165716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
The relationships between dimensions of personality (sociotropy and autonomy), coping strategies (rumination: brooding and reflection subtypes, and immature defenses) and symptoms of depression and anxiety were explored in patients with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). A total of 279 patients completed questionnaires including measures of personality dimensions, rumination, immature defenses, depression and anxiety. Our findings suggested that sociotropy and autonomy may be associated with both depressive and anxious symptoms in patients with MDD and with GAD. Multiple mediation analyses indicated that brooding always acted as a mediating link between personality vulnerabilities (sociotropy and autonomy) and depressive and anxiety symptoms, independently of the patient group. In addition, in patients with MDD and those with GAD, brooding and immature defenses functioned together by linking sociotropy and autonomy, respectively, with depressive symptoms. Our results also showed that, in patients with GAD, both types of rumination explained the relationship between sociotropy and autonomy and anxiety symptoms. Overall, our findings provided evidence of the transdiagnostic role of the brooding, linking the vulnerability of personality dimensions and emotional symptoms. They also indicated that reflection and immature defenses can operate in conjunction with brooding, depending on the type of vulnerability and emotional context.
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Affiliation(s)
- Ruth Martínez
- Child and Youth Mental Health Unit, Álvaro Cunqueiro Hospital, 36213 Vigo, Spain;
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (J.F.-R.); (H.M.)
| | - José Fernández-Rey
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (J.F.-R.); (H.M.)
| | - Hipólito Merino
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (J.F.-R.); (H.M.)
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Memory-Related Emotion Regulation and its Relation to Internalizing Symptoms. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10137-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Kalmbach DA, Buysse DJ, Cheng P, Roth T, Yang A, Drake CL. Nocturnal cognitive arousal is associated with objective sleep disturbance and indicators of physiologic hyperarousal in good sleepers and individuals with insomnia disorder. Sleep Med 2020; 71:151-160. [PMID: 32247571 PMCID: PMC8212183 DOI: 10.1016/j.sleep.2019.11.1184] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/01/2019] [Accepted: 11/02/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cognitive arousal is central to models of sleep disturbance and insomnia, but findings remain mixed regarding whether cognitive arousal is associated with objective sleep disturbance and physiologic hyperarousal. This study explored associations of objective nocturnal wakefulness and indicators of physiologic hyperarousal with cognitive arousal in healthy sleepers and individuals with insomnia. METHODS In sum, 52 adults (51.9% women; 18 with insomnia disorder, 34 healthy sleepers) underwent two overnight polysomnography (PSG) studies (adaptation + baseline nights) and a multiple sleep latency test (MSLT). Baseline depression was assessed and presleep cognitive arousal and somatic arousal were recorded for each night. Multivariate regression was used to evaluate associations of PSG sleep parameters with insomnia, cognitive arousal, and somatic arousal. RESULTS Analyses showed that high levels of nocturnal cognitive arousal were associated with prolonged sleep latency, lower sleep efficiency, and shorter total sleep time by PSG on both nights. An association between nocturnal cognitive arousal and wake after sleep onset was observed on night one only. Moreover, greater nocturnal cognitive arousal was associated with greater likelihood of obtaining short sleep and with longer MSLT sleep latencies. Insomnia diagnosis, depression, and somatic arousal were not associated with PSG sleep parameters or MSLT latency. CONCLUSIONS Heightened cognitive arousal at night is linked to objective sleep disturbances and indicators of physiologic hyperarousal at night and during the day. For patients with insomnia, cognitive arousal may contribute to the 24-hr physiologic hyperarousal. Cognitive arousal may be a critical therapeutic target for severe or treatment-resistant sleep disturbance.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Daniel J Buysse
- Center for Sleep and Circadian Science, Departments of Psychiatry and Clinical and Translational Science, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Alexander Yang
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
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Psychological well-being and distress in patients with generalized anxiety disorder: The roles of positive and negative functioning. PLoS One 2019; 14:e0225646. [PMID: 31774860 PMCID: PMC6881031 DOI: 10.1371/journal.pone.0225646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 11/09/2019] [Indexed: 12/02/2022] Open
Abstract
Background Whether mindfulness and emotional intelligence may counteract psychological symptoms and whether brooding and worry may be linked to decreased psychological well-being (PWB) in individuals with generalized anxiety disorder (GAD) is still an issue. Methods The study used a cross-sectional design on a sample of 66 consecutive individuals with a diagnosis of GAD. Two hierarchical multiple regressions were conducted to determine whether PWB and anxiety symptoms were accounted for by mindfulness and emotional intelligence skills, brooding, and worry. Results Worry was negatively related to PWB and showed a tendency to be positively associated with anxiety symptoms after controlling for the other variables. Brooding was uniquely and positively related to anxiety symptoms. Different mindfulness (i.e., describing and nonjudging) and emotional intelligence (i.e., attention and repair) skills were particularly important for PWB. Repair was also negatively related to anxiety symptoms. Conclusions Repair was the variable that played a key role in the association with both PWB and GAD symptoms. Worry was the second most important variable, although it approached significance in the relationship with anxiety symptoms. Brooding was more strongly positively associated with anxiety than worry. In sum, the results suggest that an integrated and balanced focus on both positive and negative functioning will be useful in future clinical psychology research to predict, understand, and treat anxiety as well as to examine the antecedents and characteristics of positivity in individuals with GAD and promote their PWB.
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Pössel P, Mitchell AM, Harbison B, Fernandez-Botran GR. Repetitive Negative Thinking, Depressive Symptoms, and Cortisol in Cancer Caregivers and Noncaregivers. Oncol Nurs Forum 2019; 46:E202-E210. [PMID: 31626616 DOI: 10.1188/19.onf.e202-e210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the effect of informal cancer caregiving and repetitive negative thinking (RNT) on depressive symptoms and salivary cortisol levels. SAMPLE & SETTING The sample was recruited from a hospital bone marrow unit and caregiver support organizations. It included 60 informal cancer caregivers (52% partners) of individuals with cancer who provided care for a median of 27.5 hours per week for 12 months, and 46 noncaregiver participants. METHODS & VARIABLES In this cross-sectional study, participants completed questionnaires assessing RNT and depressive symptoms and provided saliva samples to measure cortisol levels. RESULTS Cancer caregiving and RNT, but not the interaction, were associated with more depressive symptoms. RNT, but not cancer caregiving, was associated with salivary cortisol. A disordinal interaction effect suggests that cancer caregiving was associated with lower cortisol levels, and RNT in noncaregivers was associated with higher cortisol levels. IMPLICATIONS FOR NURSING Given that RNT is related to depressive symptoms and cortisol, connecting cancer caregivers who experience RNT to resources and the development and evaluation of brief nurse-led interventions to reduce RNT in informal cancer caregivers seems warranted.
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Wahl K, Ehring T, Kley H, Lieb R, Meyer A, Kordon A, Heinzel CV, Mazanec M, Schönfeld S. Is repetitive negative thinking a transdiagnostic process? A comparison of key processes of RNT in depression, generalized anxiety disorder, obsessive-compulsive disorder, and community controls. J Behav Ther Exp Psychiatry 2019; 64:45-53. [PMID: 30851652 DOI: 10.1016/j.jbtep.2019.02.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 02/06/2019] [Accepted: 02/17/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES The transdiagnostic view of repetitive negative thinking (RNT) claims that different forms of RNT are characterized by identical processes that are applied to disorder-specific content. The purpose of the study was to test whether the processes of RNT differ across major depression disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). METHODS Forty-two individuals diagnosed with MDD, 35 individuals with GAD, 41 individuals with OCD, and 35 community controls were asked to think of a typical RNT episode and to rate its processes (core processes; use of mental capacity, unproductivity, abstractness, verbal quality, duration). Ratings were compared across groups using planned contrasts and analysis of variance. RESULTS All individuals with a clinical diagnosis rated the key processes of RNT and avoidance function of RNT as higher than healthy controls. There were no differences between individuals diagnosed with MDD, GAD or OCD on key processes and avoidance function of RNT. LIMITATIONS Results are based on retrospective self-reports, which might restrict validity of the measurements. CONCLUSIONS Data support the transdiagnostic hypothesis of RNT. Transdiagnostic prevention and intervention techniques seem highly recommendable given these findings.
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Affiliation(s)
- Karina Wahl
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland.
| | - Thomas Ehring
- LMU Munich, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Leopoldstr. 13, 80802, Munich, Germany
| | - Hanna Kley
- Bielefeld University, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Psychotherapy Clinic of the University Bielefeld, Morgenbreede 2-4, 33615, Bielefeld, Germany
| | - Roselind Lieb
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Andrea Meyer
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Andreas Kordon
- Oberbergklinik Hornberg, Oberberg 1, 79132, Hornberg, Germany
| | - Carlotta V Heinzel
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Martin Mazanec
- University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Missionsstr. 62a, 4055, Basel, Switzerland
| | - Sabine Schönfeld
- Institut für Allgemeine Psychologie, Biopsychologie und Methoden der Psychologie; Professur Differentielle und Persönlichkeitspsychologie; TU Dresden, 01062, Dresden, Germany
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20
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Kim JH, Piao Y, Kim WS, Park JJ, Kang NI, Lee KH, Chung YC. The Development of the Brooding Scale. Psychiatry Investig 2019; 16:443-449. [PMID: 31247703 PMCID: PMC6603696 DOI: 10.30773/pi.2019.04.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/25/2019] [Accepted: 04/16/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purpose of this study was to develop a Brooding Scale (BS) and to confirm its psychometric properties. METHODS A preliminary questionnaire was developed based on a literature review and face-to-face interviews with healthy subjects. To evaluate reliability and construct validity, a 15-item BS was administered to 124 healthy subjects. Convergent validity was tested by assessing the relationship between the BS and the Ruminative Response Scale (RRS). Discriminant validity was confirmed in 58 patients with schizophrenia. RESULTS The internal consistency for the BS was excellent. An exploratory factor analysis yielded two factors: the emotional (six items) and cognitive (five items) domains, which explained 33.83% and 23.69% of the variance, respectively. The BS total score and scores for factors 1 and 2 showed significant positive correlations with the RRS. The total score and sub-factor scores of the BS were significantly higher in patients with schizophrenia than in healthy subjects. CONCLUSION The BS can be used as a reliable and valid tool to assess brooding in healthy adults. In addition, it had good discriminant validity for patients with schizophrenia.
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Affiliation(s)
- Ji-Hyun Kim
- Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Yanhong Piao
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Woo-Sung Kim
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Medical Science, Chonbuk National University, Jeonju, Republic of Korea
| | - Jeong-Jae Park
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Nam-In Kang
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Republic of Korea
| | - Keon-Hak Lee
- Department of Psychiatry, Maeumsarang Hospital, Wanju, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
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21
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Mitchell AM, Christian LM. Repetitive negative thinking, meaning in life, and serum cytokine levels in pregnant women: varying associations by socioeconomic status. J Behav Med 2019; 42:960-972. [PMID: 30848417 DOI: 10.1007/s10865-019-00023-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 02/20/2019] [Indexed: 12/22/2022]
Abstract
Elevated proinflammatory cytokines and decreased antiinflammatory cytokines are important in the context of perinatal health, and immune dysregulation has been found among perinatal women with low socioeconomic status (SES). Data examining psychological factors that may contribute to cytokines in pregnancy are lacking. Of importance, these associations may be most evident among women with low SES. This study examined the moderating role of SES on associations among presence of meaning in life and repetitive negative thinking with cytokine levels among 67 pregnant women. A cumulative SES index was calculated using income, education, perceived social class, and receipt of governmental support. Measures included the Perseverative Thinking Questionnaire, Meaning in Life Questionnaire, and serum interleukin (IL)-6 as well as IL-4. Using PROCESS, moderation analyses showed significant interactions between psychological factors and SES in predicting serum cytokines. In the context of high SES only, greater repetitive negative thinking was associated with higher levels of the proinflammatory cytokine IL-6 (p = 0.056) while greater meaning in life was associated with higher levels of the antiinflammatory cytokine IL-4 (p = 0.02). Findings from this study suggest that the benefits of these psychological factors on cytokine levels may be most readily observable among women with greater economic stability. Identifying psychological factors that positively contribute to biological functioning in women experiencing heightened economic distress will be crucial in addressing SES-related disparities in perinatal health.
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Affiliation(s)
- Amanda M Mitchell
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Woodford and Harriett Porter Building, 1905 South 1st Street, Louisville, KY, 40292, USA.
| | - Lisa M Christian
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.,Department of Psychology, The Ohio State University, Columbus, OH, USA.,Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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22
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Kalmbach DA, Cheng P, Arnedt JT, Anderson JR, Roth T, Fellman-Couture C, Williams RA, Drake CL. Treating insomnia improves depression, maladaptive thinking, and hyperarousal in postmenopausal women: comparing cognitive-behavioral therapy for insomnia (CBTI), sleep restriction therapy, and sleep hygiene education. Sleep Med 2018; 55:124-134. [PMID: 30785053 DOI: 10.1016/j.sleep.2018.11.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/19/2018] [Accepted: 11/28/2018] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Depression increases during menopause, and subclinical depressive symptoms increase risk for major depression. Insomnia is common among postmenopausal women and increases depression-risk in this already-vulnerable population. Recent evidence supports the efficacy of cognitive-behavioral therapy for insomnia (CBTI) to treat menopausal insomnia, but it remains unclear whether treating insomnia also alleviates co-occurring depressive symptoms and depressogenic features. This trial tested whether CBTI improves depressive symptoms, maladaptive thinking, and somatic hyperarousal in postmenopausal women with insomnia; as well as whether sleep restriction therapy (SRT)-a single component of CBTI-is equally efficacious. MATERIALS AND METHODS Single-site, randomized controlled trial. 117 postmenopausal women (56.34 ± 5.41 years) with peri-or-postmenopausal onset of chronic insomnia were randomized to three treatment conditions: sleep hygiene education control (SHE), SRT, and CBTI. Blinded assessments were performed at baseline, posttreatment, and six-month follow-up. RESULTS CBTI produced moderate-to-large reductions in depressive symptoms, whereas SRT produced moderate reductions but not until six months posttreatment. Treatment effects on maladaptive thinking were mixed. CBTI and SRT both produced large improvements in dysfunctional beliefs about sleep, but weaker influences on presleep cognitive arousal, rumination, and worry. Presleep somatic arousal greatly improved in the CBTI group and moderately improved in the SRT group. Improvements in depression, maladaptive thinking, and hyperarousal were linked to improved sleep. SHE produced no durable treatment effects. CONCLUSIONS CBTI and SRT reduce depressive symptoms, dysfunctional beliefs about sleep, and presleep somatic hyperarousal in postmenopausal women, with CBTI producing superior results. Despite its cognitive emphasis, cognitive arousal did not respond strongly or durably to CBTI. NAME: Behavioral Treatment of Menopausal Insomnia: Sleep and Daytime Outcomes. URL: clinicaltrials.gov. REGISTRATION NCT01933295.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | - J Todd Arnedt
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jason R Anderson
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA
| | | | - Reg A Williams
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, USA.
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Arditte Hall KA, Quinn ME, Vanderlind WM, Joormann J. Comparing cognitive styles in social anxiety and major depressive disorders: An examination of rumination, worry, and reappraisal. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 58:231-244. [PMID: 30484868 DOI: 10.1111/bjc.12210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/31/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Social anxiety disorder (SAD) and major depressive disorder (MDD) are commonly occurring and frequently comorbid disorders. Though individuals with SAD and MDD are more likely to engage in rumination and worry, relatively few studies have compared individuals with SAD, MDD, or both disorders on their use of these cognitive styles. Similarly, the extent to which the disorders differ in their use of reappraisal remains unclear. Thus, the current study sought to systematically examine rumination, worry, and reappraisal in individuals with and without SAD, MDD, or both disorders. METHODS The study comprised 330 participants recruited from the community (n = 54 with SAD, n = 61 with MDD, n = 69 with comorbid SAD/MDD, and n = 146 healthy controls). Following confirmation of diagnostic status via clinical interview, participants completed measures of rumination, worry, and reappraisal. RESULTS Healthy controls reported less use of rumination (i.e., brooding and reflection) and worry than individuals with a psychiatric diagnosis. Individuals with SAD or MDD did not differ from each other, but participants in both groups reported less rumination, particularly brooding, than individuals with comorbid SAD/MDD. Diagnostic group differences in reappraisal only emerged when reappraisal was considered alongside other cognitive styles. Further, moderation analyses indicated that reappraisal was only associated with SAD or MDD when participants also reported high levels of rumination and worry. CONCLUSIONS Results support transdiagnostic conceptualizations of rumination and worry. They also suggest that reappraisal is only useful when it is used by people who experience frequent and habitual negative cognitions. PRACTITIONER POINTS Individuals with SAD or MDD report more rumination and worry than healthy controls, but do not differ from each other in their reliance on these cognitive styles. Individuals with comorbid SAD/MDD endorse more rumination than individuals with SAD or MDD alone, even after adjusting for differences in symptom severity. Reappraisal may only predict diagnostic group status when considered alongside other cognitive styles. In particular, high reappraisal may be associated with reduced risk of psychiatric disorder, but only when rumination and worry are also high. LIMITATIONS The study was limited by its cross-sectional design and reliance on self-report measures. Participants were diagnosed using DSM-IV-TR criteria for SAD and MDD.
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Affiliation(s)
- Kimberly A Arditte Hall
- VA National Center for PTSD at VA Boston Healthcare System, Massachusetts, USA.,Boston University School of Medicine, Massachusetts, USA
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24
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Gustavson DE, du Pont A, Whisman MA, Miyake A. Evidence for Transdiagnostic Repetitive Negative Thinking and Its Association with Rumination, Worry, and Depression and Anxiety Symptoms: A Commonality Analysis. COLLABRA-PSYCHOLOGY 2018; 4. [PMID: 30761388 DOI: 10.1525/collabra.128] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent theoretical advances have emphasized the commonality between rumination and worry, often referred to as repetitive negative thinking. Although not studied extensively, repetitive negative thinking may not only account for a substantial overlap between depression and anxiety symptoms but also encapsulate other constructs including one's tendency to experience unwanted intrusive thoughts or have low levels of mindfulness. In this study, 643 college students completed self-report questionnaire measures of repetitive negative thinking (the Habit Index of Negative Thinking) and other relevant constructs including rumination, worry, depression and anxiety symptoms, intrusive thoughts, and mindfulness. To analyze the data, we conducted systematic commonality analyses, which algebraically decomposed shared variances among these measures into various unique components. Results in Study 1 indicated that individual differences in repetitive negative thinking were explained largely by the overlap between rumination and worry, but also by some rumination-specific and worry-specific variance. Moreover, the shared variation in rumination and worry explained the frequencies of depression and anxiety symptoms and their overlap. We also found in Study 2 that repetitive negative thinking was positively related to intrusive thoughts and negatively related to mindfulness. These associations were mostly explained by shared variance with rumination and worry, but there was also some mindfulness-specific variance. These results suggest that repetitive negative thinking may indeed lie at the core of the comorbidity between depression and anxiety symptoms, but that it is also a broader construct that encompasses intrusive thoughts and low levels of mindfulness.
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Affiliation(s)
- Daniel E Gustavson
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California, San Diego; La Jolla, CA, USA
| | - Alta du Pont
- Institute for Behavioral Genetics and Department of Psychology and Neuroscience, University of Colorado Boulder; Boulder, CO, USA
| | - Mark A Whisman
- Department of Psychology and Neuroscience, University of Colorado Boulder; Boulder, CO, USA
| | - Akira Miyake
- Department of Psychology and Neuroscience, University of Colorado Boulder; Boulder, CO, USA
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25
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McEvoy PM, Hyett MP, Ehring T, Johnson SL, Samtani S, Anderson R, Moulds ML. Transdiagnostic assessment of repetitive negative thinking and responses to positive affect: Structure and predictive utility for depression, anxiety, and mania symptoms. J Affect Disord 2018; 232:375-384. [PMID: 29510356 DOI: 10.1016/j.jad.2018.02.072] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 01/22/2018] [Accepted: 02/25/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a cognitive process that is repetitive, passive, relatively uncontrollable, and focused on negative content, and is elevated in emotional disorders including depression and anxiety disorders. Repetitive positive thinking is associated with bipolar disorder symptoms. The unique contributions of positive versus negative repetitive thinking to emotional symptoms are unknown. The first aim of this study was to use confirmatory factor analyses to evaluate the psychometrics of two transdiagnostic measures of RNT, the Repetitive Thinking Questionnaire (RTQ-10) and Perseverative Thinking Questionnaire (PTQ), and a measure of repetitive positive thinking, the Responses to Positive Affect (RPA) Questionnaire. The second aim was to determine incremental predictive utility of these measures. METHOD All measures were administered to a sample of 2088 undergraduate students from the Netherlands (n = 992), Australia (n = 698), and America (n = 398). RESULTS Unidimensional, bifactor, and three-factor models were supported for the RTQ-10, PTQ, and RPA, respectively. A common factor measured by all PTQ items explained most variance in PTQ scores suggesting that this measure is essentially unidimensional. The RNT factor of the RTQ-10 demonstrated the strongest predictive utility, although the PTQ was also uniquely although weakly associated with anxiety, depression, and mania symptoms. The RPA dampening factor uniquely predicted anxiety and depression symptoms, suggesting that this scale is a separable process to RNT as measured by the RTQ-10 and PTQ. LIMITATIONS Findings were cross-sectional and need to be replicated in clinical samples. CONCLUSIONS Transdiagnostic measures of RNT are essentially unidimensional, whereas RPA is multidimensional. RNT and RPA have unique predictive utility.
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Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, Perth, Western Australia, Australia; School of Psychology, Curtin University, Perth, Western Australia, Australia.
| | - Matthew P Hyett
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | | | - Sheri L Johnson
- Department of Psychology, University of California Berkeley, Berkeley, CA, USA
| | - Suraj Samtani
- School of Psychology, The University of New South Wales, UNSW Sydney, New South Wales, Australia
| | - Rebecca Anderson
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW Sydney, New South Wales, Australia
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Chan KKS, Lam CB, Law NCW, Cheung RYM. From child autistic symptoms to parental affective symptoms: A family process model. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 75:22-31. [PMID: 29455076 DOI: 10.1016/j.ridd.2018.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/23/2017] [Accepted: 02/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Depression and anxiety are prevalent among parents of children with autism spectrum disorder (ASD), but limited research has investigated why parenting a child with ASD is associated with elevated distress and increased risks of mental health problems. We responded to this gap in the literature by examining the associations between child autistic symptoms and parental affective symptoms, as well as the potential underlying mechanisms. Guided by a family process theory, we hypothesized that child autistic symptoms would be positively associated with parental depressive and anxiety symptoms, and that these associations would be mediated by parents' concerns about their children's characteristics (future-related worry), parental roles (parenting stress), marital relationships (marital conflicts), and family conditions (family economic pressure). METHODS Cross-sectional questionnaire data were collected from 375 parents of children with ASD residing in Hong Kong, China. The hypotheses were tested using structural equation modeling. RESULTS Child autistic symptoms were positively associated with parental depressive and anxiety symptoms. These associations were mediated by future-related worry, parenting stress, marital conflicts, and family economic pressure. CONCLUSIONS Our findings revealed the potential pathways through which child autism symptomatology may adversely affect parental mental health. Our findings also highlighted the importance of designing multipronged intervention programs for families raising children with ASD in order to improve relevant family processes and reduce parental affective symptoms.
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Affiliation(s)
- Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Hong Kong; Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong.
| | - Chun Bun Lam
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong; Centre for Child and Family Science, The Education University of Hong Kong, Hong Kong
| | - Naska Chung Wa Law
- Department of Childcare, Elderly and Community Services, Hong Kong Institute of Vocational Education, Hong Kong
| | - Ryan Yat Ming Cheung
- Society for the Welfare of the Autistic Persons, Hong Kong; Educational Psychology Service, Social Services Department, Po Leung Kuk, Hong Kong
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Wang SB, Borders A. The unique effects of angry and depressive rumination on eating-disorder psychopathology and the mediating role of impulsivity. Eat Behav 2018; 29:41-47. [PMID: 29477016 DOI: 10.1016/j.eatbeh.2018.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 02/02/2018] [Accepted: 02/13/2018] [Indexed: 11/16/2022]
Abstract
Negative affect and maladaptive emotion regulation strategies are associated with eating-disorder (ED) psychopathology. Depressive rumination is a maladaptive cognitive style associated with the onset, maintenance, and severity of ED psychopathology among both clinical and nonclinical samples. However, although anger is also strongly associated with ED behaviors, the associations between angry rumination and ED psychopathology, as well as mechanisms of the relationships between rumination and ED psychopathology, remain largely unknown. The current study sought to examine the unique influences of trait depressive and angry rumination on ED psychopathology and whether trait negative urgency (i.e., responding rashly to negative affect) mediated these relationships. Study 1 sampled undergraduate students (N = 119) cross-sectionally and longitudinally (five months), and Study 2 sampled patients with eating disorders (N = 85). All participants completed questionnaires assessing angry rumination, depressive rumination, ED psychopathology, and negative urgency. Angry rumination had consistent indirect effects on ED psychopathology via negative urgency among both clinical and nonclinical samples. However, there was mixed support for the influence of depressive rumination: whereas depressive rumination showed total and indirect effects on ED psychopathology in Study 1 cross-sectional analyses, no total or indirect effects emerged in Study 1 longitudinal analyses or in Study 2. Associations between depressive rumination and ED psychopathology may reflect the strong overlap between angry and depressive rumination. Interventions targeting angry rumination and negative urgency may enhance prevention and treatment of disordered eating across eating disorder diagnosis and severity.
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Affiliation(s)
- Shirley B Wang
- Department of Psychology, The College of New Jersey, 2000 Pennington Road, Ewing, NJ 08618, United States; Center for Eating Disorders Care, University Medical Center of Princeton at Plainsboro, 1 Plainsboro Road, Plainsboro, NJ 08536, United States.
| | - Ashley Borders
- Department of Psychology, The College of New Jersey, 2000 Pennington Road, Ewing, NJ 08618, United States
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28
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Nota JA, Coles ME. Shorter sleep duration and longer sleep onset latency are related to difficulty disengaging attention from negative emotional images in individuals with elevated transdiagnostic repetitive negative thinking. J Behav Ther Exp Psychiatry 2018; 58:114-122. [PMID: 29111422 DOI: 10.1016/j.jbtep.2017.10.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Repetitive negative thinking (RNT) is often associated with disruptions in sleep and circadian rhythms. Disruptions in sleep and circadian rhythms may deal a "second hit" to attentional control deficits. This study evaluated whether sleep and circadian rhythm disruptions are related to the top-down control of attention to negative stimuli in individuals with heightened repetitive negative thinking. METHODS Fifty-two community adults with high levels of transdiagnostic RNT and varying habitual sleep durations and bedtimes participated in a hybrid free-viewing and directed attention task using pairs of emotionally-evocative and neutral images while eye-tracking data were collected. Self-report and clinician-administered interviews regarding sleep were also collected. RESULTS Shorter habitual sleep duration was associated with more time looking at emotionally negative compared to neutral images during a free-viewing attention task and more difficulty disengaging attention from negative compared to neutral images during a directed attention task. In addition, longer sleep onset latencies were also associated with difficulty disengaging attention from negative stimuli. The relations between sleep and attention for positive images were not statistically significant. LIMITATIONS A causal link between sleep and attentional control cannot be inferred from these cross-sectional data. The lack of a healthy control sample means that the relations between sleep disruption, attention, and emotional reactivity may not be unique to individuals with RNT. CONCLUSIONS These findings suggest that sleep disruption may be associated with a specific impact on cognitive resources that are necessary for the top-down inhibitory control of attention to emotionally negative information.
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Affiliation(s)
- Jacob A Nota
- Binghamton University, Department of Psychology, United States.
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29
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A longitudinal investigation of perfectionism and repetitive negative thinking in perinatal depression. Behav Res Ther 2017; 97:26-32. [DOI: 10.1016/j.brat.2017.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 05/31/2017] [Accepted: 06/26/2017] [Indexed: 11/17/2022]
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Fernandes S, Arriaga P, Carvalho H, Esteves F. Psychometric Assessment of the Child Surgery Worries Questionnaire Among Portuguese Children. J Clin Psychol Med Settings 2017; 24:289-301. [PMID: 28752271 DOI: 10.1007/s10880-017-9503-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Worries are common in surgical patients, especially in children. The present study analyzed the factor structure and the psychometric properties of a Portuguese version of the Child Surgery Worries Questionnaire (CSWQ-P) in a Portuguese sample of 490 children. Exploratory factor analysis, conducted via principal axis factoring with oblimin rotation, provided evidence for a four-factor structure of the 21 item questionnaire. A confirmatory factor analysis was also conducted, showing the good fit of this solution. The CSWQ-P proved to have one more subscale than the original Spanish version CSWQ. Correlations with the children's trait anxiety provided evidence of convergent validity for the CSWQ-P. Females also scored higher on worries than males on all subscales. Psychometric properties of this revised version of the CSWQ provided support for use with young children, and indicate the CSWQ-P has value for use in healthcare practice and in clinical research.
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Affiliation(s)
- Sara Fernandes
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Av. das Forças Armadas, 1649-026, Lisbon, Portugal.
| | - Patrícia Arriaga
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Helena Carvalho
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
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Mansell W, McEvoy PM. A test of the core process account of psychopathology in a heterogenous clinical sample of anxiety and depression: A case of the blind men and the elephant? J Anxiety Disord 2017; 46:4-10. [PMID: 27400661 DOI: 10.1016/j.janxdis.2016.06.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/11/2016] [Accepted: 06/23/2016] [Indexed: 11/26/2022]
Abstract
Many cognitive and behavioral processes, such as selective attention to threat, self-focused attention, safety-seeking behaviors, worry and thought suppression, have their foundations in research on anxiety disorders. Yet, they are now known to be transdiagnostic, i.e. shared across a wide range of psychological disorders. A more pertinent clinical and theoretical question is whether these processes are themselves distinct, or whether they reflect a shared 'core' process that maintains psychopathology. The current study utilized a treatment-seeking clinical adult sample of 313 individuals with a range of anxiety disorders and/or depression who had completed self-report measures of widely ranging processes: affect control, rumination, worry, escape/avoidance, and safety-seeking behaviors. We found that only the first factor extracted from a principal components analysis of the items of these measures was associated with symptoms of anxiety and depression. Our findings supported the 'core process' account that had its origins in the field of anxiety disorders, and we discuss the implications for theory, clinical practice and future research across psychological disorders.
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Affiliation(s)
- Warren Mansell
- School of Psychological Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.
| | - Peter M McEvoy
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia; Centre for Clinical Interventions, Perth, Australia
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Rabner J, Mian ND, Langer DA, Comer JS, Pincus D. The Relationship Between Worry and Dimensions of Anxiety Symptoms in Children and Adolescents. Behav Cogn Psychother 2017; 45:124-138. [PMID: 27852349 PMCID: PMC5405454 DOI: 10.1017/s1352465816000448] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Worry is a common feature across many anxiety disorders. It is important to understand how and when worry presents from childhood to adolescence to prevent long-term negative outcomes. However, most of the existing studies that examine the relationship between worry and anxiety disorders utilize adult samples. AIMS The present study aimed to assess the level of worry in children and adolescents and how relationships between worry and symptoms of separation anxiety disorder (SAD) and social anxiety disorder (Soc) may present differently at different ages. METHOD 127 children (age 8-12 years) and adolescents (age 13-18 years), diagnosed with any anxiety disorder, presenting at a child anxiety out-patient clinic, completed measures of worry, anxiety and depression. RESULTS Worry scores did not differ by age group. Soc symptoms were significantly correlated with worry in both age groups; however, SAD symptoms were only significantly correlated with worry in younger participants. After the inclusion of covariates, SAD symptoms but not Soc symptoms remained significant in the regression model with younger children, and Soc symptoms remained significant in the regression model with older children. CONCLUSIONS The finding that worry was comparable in both groups lends support for worry as a stable construct associated with anxiety disorders throughout late childhood and early adolescence.
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Affiliation(s)
- Jonathan Rabner
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Nicholas D. Mian
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
- University of New Hampshire, Manchester, NH
| | - David A. Langer
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - Jonathan S. Comer
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
- Department of Psychology, Florida International University, Miami, Florida
| | - Donna Pincus
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
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Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. Behav Res Ther 2017; 90:123-136. [DOI: 10.1016/j.brat.2016.12.015] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 09/16/2016] [Accepted: 12/20/2016] [Indexed: 11/23/2022]
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McEvoy PM, Salmon K, Hyett MP, Jose PE, Gutenbrunner C, Bryson K, Dewhirst M. Repetitive Negative Thinking as a Transdiagnostic Predictor of Depression and Anxiety Symptoms in Adolescents. Assessment 2017; 26:324-335. [PMID: 29214855 DOI: 10.1177/1073191117693923] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic process associated with numerous emotional disorders. Most measures of RNT are disorder-specific, limiting utility in comorbid populations. Transdiagnostic measures of RNT have been developed in adults and are associated with anxiety and depression. However, a transdiagnostic measure is needed to assess RNT in adolescents as a potential vulnerability factor for emotional disorders. This study validates a transdiagnostic measure of RNT-Repetitive Thinking Questionnaire-10 (RTQ-10)-in adolescents ( N = 840, Mage = 15.7 years). Exploratory and confirmatory factor analyses supported a unidimensional structure. The RTQ-10 manifested good internal consistency and measurement invariance across genders and age. RNT was equally associated with anxiety and depression symptoms irrespective of gender or age. Convergent validity was demonstrated by correlations with disorder-specific measures of RNT. These findings support the RTQ-10 as a reliable and valid transdiagnostic measure of RNT in adolescents.
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Affiliation(s)
- Peter M McEvoy
- 1 Curtin University, Perth, Western Australia, Australia.,2 Centre for Clinical Interventions, Perth, Western Australia, Australia
| | - Karen Salmon
- 3 Victoria University of Wellington, Wellington, New Zealand
| | - Matthew P Hyett
- 2 Centre for Clinical Interventions, Perth, Western Australia, Australia
| | - Paul E Jose
- 3 Victoria University of Wellington, Wellington, New Zealand
| | | | - Kate Bryson
- 3 Victoria University of Wellington, Wellington, New Zealand
| | - Mary Dewhirst
- 3 Victoria University of Wellington, Wellington, New Zealand
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McEvoy PM, Erceg-Hurn DM. The search for universal transdiagnostic and trans-therapy change processes: Evidence for intolerance of uncertainty. J Anxiety Disord 2016; 41:96-107. [PMID: 26898177 DOI: 10.1016/j.janxdis.2016.02.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 01/29/2016] [Accepted: 02/02/2016] [Indexed: 11/20/2022]
Abstract
The search for universal processes associated with symptom change across emotional disorders and different forms of psychotherapy offers hope of increased theoretical parsimony and treatment efficiencies. This study investigated whether intolerance of uncertainty (IU) is a universal process by examining whether changes in IU were associated with changes in symptoms across three different cognitive behavior therapy protocols for depression (n=106), social anxiety disorder (n=88), or generalized anxiety disorder (n=62) in a community mental health clinic. IU was associated with reductions in repetitive negative thinking in all treatments, which is consistent with IU being a transdiagnostic and 'trans-therapy' process of change. Changes in IU were also associated with symptom relief in the social anxiety disorder and generalized anxiety disorder groups, but not in the depression group. Implications of these findings are discussed within the broader literature of transdiagnostic approaches to emotional disorders.
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Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
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36
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Psychometric Properties of the Spanish Adaptation of the Anger Rumination Scale: Evidence of Reliability and Validity in the General Population. SPANISH JOURNAL OF PSYCHOLOGY 2016; 19:E17. [PMID: 27103336 DOI: 10.1017/sjp.2016.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The key role of rumination and perseveration processes in anger experience has been empirically supported. The tendency to ruminate has been demonstrated to be crucial in understanding pathological and adaptive behaviours. The Anger Rumination Scale (ARS) was developed to assess anger rumination frequency when people are angry, showing adequate levels of reliability and validity. However, although it has been adapted to several languages, the development of the Spanish version was still pending. The aim of this study, therefore, was to develop the Spanish adaptation of the ARS and to validate it in a general population sample (N = 388). Participants were asked to complete the ARS as well as other measures of anger (STAXI-2), anxiety (STAI-T), depression (BDI-II short form), rumination (PSWQ), and thought self-regulation (TCQ). A confirmatory factor analysis replicated the four-factor structure obtained with the original version (S-B χ2(145) = 323.26, p < .00005; CFI = .92; TLI = .90; RMSEA = .06; SRMR = .05). The resulting subscales (i.e., Angry Afterthoughts, Angry Memories, Thoughts of Revenge, and Understanding of Causes) met psychometric criteria of reliability (α = .89) and validity. In conclusion, a psychometrically sound Spanish adaptation of the ARS is now available.
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Arditte KA, Shaw AM, Timpano KR. Repetitive Negative Thinking: A Transdiagnostic Correlate of Affective Disorders. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2016. [DOI: 10.1521/jscp.2016.35.3.181] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Spinhoven P, Drost J, van Hemert B, Penninx BW. Common rather than unique aspects of repetitive negative thinking are related to depressive and anxiety disorders and symptoms. J Anxiety Disord 2015; 33:45-52. [PMID: 26004746 DOI: 10.1016/j.janxdis.2015.05.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022]
Abstract
Repetitive Negative Thinking (RNT) is assumed to be a transdiagnostic factor in depressive and anxiety disorders. We hypothesized that an underlying common dimension of RNT will be more strongly associated with each of the anxiety and depressive disorders, with comorbidity among disorders and with symptom severity than unique aspects of rumination and worry. In a cross-sectional study, 2143 adults diagnosed according to DSM-IV criteria completed questionnaires for content-independent RNT, rumination and worry. 84% of the shared variance of worry and rumination overlapped with content-independent RNT. The common dimension of RNT was significantly associated with each of the depressive and anxiety disorders, comorbidity among emotional disorders and the common core of depressive, anxiety and avoidance symptoms. The unique portion of rumination showed a significant relationship with Major Depressive Disorder and depressive comorbidity and the unique portion of worry with Generalized Anxiety Disorder. These findings are particularly relevant for clinical practice as generic interventions to reduce RNT are currently being tested.
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Affiliation(s)
- Philip Spinhoven
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands; Leiden University Medical Center, Department of Psychiatry, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Jolijn Drost
- Leiden University, Institute of Psychology, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - Bert van Hemert
- Leiden University Medical Center, Department of Psychiatry, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - Brenda W Penninx
- Leiden University Medical Center, Department of Psychiatry, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; VU University Medical Center, Department of Psychiatry, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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McEvoy PM, Erceg-Hurn DM, Anderson RA, Campbell BNC, Swan A, Saulsman LM, Summers M, Nathan PR. Group metacognitive therapy for repetitive negative thinking in primary and non-primary generalized anxiety disorder: an effectiveness trial. J Affect Disord 2015; 175:124-32. [PMID: 25601312 DOI: 10.1016/j.jad.2014.12.046] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a common and highly comorbid anxiety disorder characterized by repetitive negative thinking (RNT). Treatment trials tend to exclude individuals with non-primary GAD, despite this being a common presentation in real world clinics. RNT is also associated with multiple emotional disorders, suggesting that it should be targeted regardless of the primary disorder. This study evaluated the acceptability and effectiveness of brief group metacognitive therapy (MCT) for primary or non-primary GAD within a community clinic. METHODS Patients referred to a specialist community clinic attended six, two-hour weekly sessions plus a one-month follow-up (N=52). Measures of metacognitive beliefs, RNT, symptoms, positive and negative affect, and quality of life were completed at the first, last, and follow-up sessions. RESULTS Attrition was low and large intent-to-treat effects were observed on most outcomes, particularly for negative metacognitive beliefs and RNT. Treatment gains increased further to follow-up. Benchmarking comparisons demonstrated that outcomes compared favorably to longer disorder-specific protocols for primary GAD. LIMITATIONS No control group or independent assessment of protocol adherence. CONCLUSIONS Brief metacognitive therapy is an acceptable and powerful treatment for patients with primary or non-primary GAD.
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Affiliation(s)
- Peter M McEvoy
- Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - David M Erceg-Hurn
- Centre for Clinical Interventions, Perth, Australia; University of Western Australia, Perth, Australia
| | - Rebecca A Anderson
- Centre for Clinical Interventions, Perth, Australia; School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | | | - Amanda Swan
- Centre for Clinical Interventions, Perth, Australia
| | | | - Mark Summers
- Centre for Clinical Interventions, Perth, Australia
| | - Paula R Nathan
- Centre for Clinical Interventions, Perth, Australia; University of Western Australia, Perth, Australia
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Nota JA, Coles ME. Duration and Timing of Sleep are Associated with Repetitive Negative Thinking. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9651-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Orue I, Calvete E, Padilla P. Brooding rumination as a mediator in the relation between early maladaptive schemas and symptoms of depression and social anxiety in adolescents. J Adolesc 2014; 37:1281-91. [DOI: 10.1016/j.adolescence.2014.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 09/09/2014] [Accepted: 09/14/2014] [Indexed: 02/02/2023]
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Rosen CC, Hochwarter WA. Looking back and falling further behind: The moderating role of rumination on the relationship between organizational politics and employee attitudes, well-being, and performance. ORGANIZATIONAL BEHAVIOR AND HUMAN DECISION PROCESSES 2014. [DOI: 10.1016/j.obhdp.2014.03.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Intolerance of uncertainty and negative metacognitive beliefs as transdiagnostic mediators of repetitive negative thinking in a clinical sample with anxiety disorders. J Anxiety Disord 2013; 27:216-24. [PMID: 23474912 DOI: 10.1016/j.janxdis.2013.01.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 01/21/2013] [Accepted: 01/22/2013] [Indexed: 11/20/2022]
Abstract
This study aimed to replicate and extend a hierarchical model of vulnerability to worry, with neuroticism and extraversion as higher-order factors and negative metacognitions and intolerance of uncertainty as second-order factors. The model also included a transdiagnostic measure of repetitive negative thinking (RNT) and depression symptoms as outcome variables to determine whether relationships would extend beyond worry, which has traditionally been studied within the context of generalized anxiety disorder (GAD). Participants (N=99) were referrals to a specialist anxiety disorders clinic with a principal anxiety disorder who completed a battery of self-report questionnaires assessing neuroticism, extraversion, metacognitions, intolerance of uncertainty, worry, RNT, and depression symptoms. Mediational analyses using bootstrapping provided support for transdiagnostic and diagnosis-specific mediation effects. Negative metacognitions fully mediated the relationship between neuroticism and RNT for the whole sample and for subsamples with and without GAD. Intolerance of uncertainty mediated the relationship between neuroticism and worry (for the whole sample and for those with GAD) and between neuroticism and RNT (for those with GAD). Implications for theory, treatment, and nosology are discussed.
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