The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct
MetadataShow full item record
NOTICE: This is the author’s version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Affective Disorders, Vol. 151, Issue 1. (2013). doi: 10.1016/j.jad.2013.06.014
Background: Repetitive negative thinking (RNT) increases vulnerability to multiple anxiety and depressive disorders and, as a common risk factor, elevated RNT may account for the high levels of comorbidity observed between emotional disorders. The aims of this study were to (a) compare two common forms of RNT (worry and rumination) across individuals with non-comorbid anxiety or depressive disorders, and (b) to examine the relationship between RNT and comorbidity.Methods: A structured diagnostic interview and measures of rumination, worry, anxiety, and depression were completed by a large clinical sample with an anxiety disorder or depression (N=513) presenting at a community mental health clinic.Results: Patients without (n=212) and with (n=301) comorbid diagnoses did not generally differ across the principal diagnosis groups (depression, generalised anxiety disorder, social anxiety disorder, panic disorder) on worry or rumination. As predicted, comorbidity was associated with a higher level of RNT.Limitations: Cross-sectional design precluded causal conclusions and findings may not generalize to excluded anxiety disorders.Conclusions: Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.
Showing items related by title, author, creator and subject.
McEvoy, Peter; Tribodeau, M.; Asmundson, G. (2014)Repetitive negative thinking (RNT) is an established transdiagnostic process associated with multiple emotional disorders. Brief transdiagnostic measures of RNT uncontaminated with diagnosis-specific symptoms, terminology, ...
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?Mansell, W.; McEvoy, Peter (2016)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. ...
Are worry, rumination, and post-event processing one and the same? Development of the repetitive thinking questionnaireMcEvoy, Peter; Mahoney, A.; Moulds, M. (2010)Accumulating evidence suggests that repetitive negative thinking (RNT) is a transdiagnostic phenomenon. However, various forms of RNT such as worry, rumination, and post-event processing havebeen assessed using separate ...