Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

Repetitive Thought and Self-Reported Sleep Disturbance

Repetitive thought has been focused upon as a transdiagnostic risk factor for depression, anxiety, and poor physical health. Among the forms of repetitive thought, rumination and worry are considered to play important roles in the onset and maintenance of insomnia. However, there have been few attempts to clarify the similarities, differences, and interaction between the functions of rumination and worry in sleep problems. Furthermore, no study has investigated the prospective relationships between these two forms of repetitive thought and sleep disturbance. In the present study, we examined the prospective associations between repetitive thought and subjective sleep quality, measured by a self-report questionnaire. A total of 208 undergraduates participated in a 2-wave longitudinal survey with an interval of 3 weeks between assessments. Hierarchical multiple regression analyses showed that baseline rumination predicted reduction in the follow-up assessment of subjective sleep quality, controlling for levels of depressive and anxious symptoms. This main effect of rumination was qualified by the levels of worry; for individuals with higher levels of worry, rumination was associated with greater reduction in subjective sleep quality. These results suggest that both rumination and worry have unique associations with sleep and that their interaction is especially important in sleep problems.     

The Role of Repetitive Negative Thoughts in the Vulnerability for Emotional Problems in Non-Clinical Children

The current study examined the role of repetitive negative thoughts in the vulnerability for emotional problems in non-clinical children aged 8–13 years (N = 158). Children completed self-report questionnaires for assessing (1) neuroticism and behavioral inhibition as indicators of general vulnerability (2) worry and rumination which are two important manifestations of repetitive negative thoughts, and (3) emotional problems (i.e., anxiety, depression, and sleep difficulties). Results demonstrated that there were positive correlations between measures of general vulnerability, repetitive negative thoughts, and emotional problems. Further, support was found for a model in which worry and rumination acted as partial mediators in the relation between neuroticism and symptoms of anxiety and depression. In the case of sleep difficulties, no evidence was obtained for such a mediation model. In fact, data suggested that sleeping difficulties are better conceived as an epiphenomenon of high symptom levels of anxiety and depression or as a risk factor for the development of other types of psychopathology. Finally, besides neuroticism, the temperamental trait of behavioral inhibition appeared to play a unique direct role in the model predicting anxiety symptoms but not in the models predicting depressive symptoms or sleep difficulties. To conclude, the current findings seem to indicate that worry and rumination contribute to children’s vulnerability for anxiety and depression.     

The effects of worry and rumination on affect states and cognitive activity

The effects of worry and rumination on affective states and mentation type were examined in an unselected undergraduate sample in Study 1 and in a sample of individuals with high trait worry and rumination, high rumination, and low worry/rumination in Study 2. Participants engaged in worry and rumination inductions, counterbalanced in order across participants to assess main and interactive effects of these types of negative thinking. During mentation periods, the thought vs. imaginal nature and the temporal orientation of mentations were assessed 5 times. Following mentation periods, negative and positive affect, relaxation, anxiety, and depression were assessed. Both worry and rumination produced increases in negative affect and decreases in positive affect. Worry tended to generate greater anxiety, and rumination tended to generate greater depression. Interactive effects were also found indicating that worry may lessen the anxiety experienced during subsequent rumination. Moreover, worry lessened the depressing effects of rumination. Worry was associated with significantly greater thought than imagery, compared to rumination. Rumination involved a progression from mentation about the past to mentation about the future over time. Implications for understanding the generation of negative affect and comorbid anxiety and depression are discussed.     

Procrastination and Depression from a Cognitive Perspective: An Exploration of the Associations Among Procrastinatory Automatic Thoughts,Rumination, and Mindfulness

Extensive research indicates that procrastination is associated with many maladaptive outcomes including diminished performance and greater psychological distress, but the specific factors and mechanisms associated with the vulnerability of procrastinators still need to be identified. The current study examined the associations among procrastination, ruminative brooding, mindfulness, and self-compassion. Procrastination was measured in terms of academic procrastination as well as a cognitive measure of procrastination examining the frequency of procrastination-related automatic thoughts. In addition to the main focus on the vulnerability of procrastinators, the question of whether students with multiple vulnerabilities would be particularly at risk for depression was also assessed. A sample of 214 undergraduate students completed measures of academic procrastination, procrastination-related automatic thoughts, rumination, mindfulness, self-compassion, and depression. Correlational analyses showed that both procrastination measures were associated with ruminative brooding as well as reduced mindfulness and self-compassion. Moderator-effect tests yielded no significant interactions. Overall, our findings highlight the relevance of cognitive factors in explaining procrastination and depression. Elevated levels on measures tapping cognitive risk factors (ruminative brooding and procrastination-related automatic thoughts) or a low level of protective, self-relevant cognitive factors associated with resilience (mindfulness and self-compassion) were related to a high level of procrastination and depression. These results imply that procrastinators might be vulnerable to depression due to the joint presence of these cognitive risk and resilience factors.     

Reciprocal Relations of Worry,Rumination, and Psychopathology Symptoms After Loss: A Prospective Cohort Study

Bereavement can precipitate symptoms of depression, prolonged grief disorder, and posttraumatic stress disorder. Targeting repetitive negative thought (i.e., worry, rumination) in treatment may help reduce post-loss psychopathology. Yet, evidence on longitudinal associations of depressive rumination and worry with post-loss psychopathology symptoms has been mixed and the directions of effects are still unclear. Recently bereaved adults (78% female) completed questionnaires assessing depressive rumination (brooding), worry, and depression, prolonged grief and posttraumatic stress symptoms 11 times in 1.5 month intervals. We applied random-intercept cross-lagged panel models (RICLPMs) to examine reciprocal within-person associations between worry and psychopathology symptoms, between rumination and these symptoms, and between worry and rumination. Main findings were that worry showed reciprocal relationships with psychopathology symptoms (although worry did not consistently predict prolonged grief symptoms). Depressive rumination was predicted by psychopathology symptoms, but not vice versa. Worry showed reciprocal relations with depressive rumination. Findings suggest that worry may be part of a downward spiral, enhancing psychopathology symptoms following loss, whereas depressive rumination is solely a consequence of such symptoms.     

Perfectionism and negative repetitive thoughts: Examining a multiple mediator model in relation to mindfulness

Perfectionism is known to be associated with various maladaptive outcomes, yet little research has examined mechanisms underlying perfectionism or potential protective factors. This study investigated worry and rumination as mediators between perfectionism and psychological distress in university students (N = 213), and related the multiple mediator model to a five-facet conceptualization of mindfulness. Socially prescribed perfectionism was related to higher levels of distress, including negative affect, depression, anxiety, and stress, while self-oriented perfectionism and other-oriented perfectionism appeared unrelated to distress. Mindfulness facets of acting with awareness, non-judging of inner experience, and to a lesser extent non-reactivity to inner experience, were the strongest independent contributors to perfectionism, negative repetitive thoughts, and distress. Worry and rumination mediated the relationship between socially prescribed perfectionism and negative affect; however, the mediating effect of rumination was absent in those high in mindfulness. These findings suggest that a mindfulness disposition may mitigate distress related to socially prescribed perfectionism by removing the mediating effect of ruminative thought. Future research might explore a mindfulness-training program to target negative repetitive thoughts underlying socially prescribed perfectionism.     

Repetitive Negative Thinking Predicts Depressed Mood at 3-Year Follow-up in Students

Repetitive negative thinking (RNT; e.g., rumination and worry) is a key-factor involved in the maintenance of emotional problems like depression and anxiety. Recently, the Perseverative Thinking Questionnaire (PTQ) was developed as a content-independent measure of RNT. The current study investigated the validity of this new measure in predicting depressive symptoms prospectively. Eighty-one students completed measures of depressive symptoms, depressive rumination and repetitive negative thinking. Depressive symptoms were re-assessed 3?years later (40?months follow-up). Results showed that repetitive negative thinking as measured by the PTQ predicts depressive symptoms at follow-up, even when taking into account baseline depressive symptoms and rumination. The results suggest that the PTQ has good (prospective) predictive validity for depressed mood and reconfirm RNT’s role in the course of emotional complaints.     

Intelligence and emotional disorders: Is the worrying and ruminating mind a more intelligent mind?

Previous research has shown that anxiety and depression symptoms are negatively associated with measures of intelligence. However, this research has often not taken state distress and test anxiety into account, and recent findings indicate possible positive relationships between generalized anxiety disorder (GAD), worry, and intelligence. The present study examined the relationships between GAD, depression, and social anxiety symptoms, as well as their underlying cognitive processes of worry, rumination, and post-event processing, with verbal and non-verbal intelligence in an undergraduate sample (N = 126). While the results indicate that verbal intelligence has positive relationships with GAD and depression symptoms when test anxiety and state negative affect were taken into account, these relationships became non-significant when overlapping variance was controlled for. However, verbal intelligence was a unique positive predictor of worry and rumination severity. Non-verbal intelligence was a unique negative predictor of post-event processing. The possible connections between intelligence and the cognitive processes that underlie emotional disorders are discussed.     

Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The current study sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N = 198). All patients completed a battery of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety. Results showed that in subsequent analyses, rumination and worrying both mediated the relation between neuroticism and depression and anxiety. When rumination and worrying were simultaneously entered in the mediation analysis, only rumination was found to mediate the relation between neuroticism and symptoms of anxiety and depression. Two components of rumination (i.e., brooding and reflection) were also analyzed in the mediational analysis. Both reflection and brooding were significant mediators with respect to depressive symptoms, whereas brooding was the only significant mediator in relation to anxiety symptoms. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and suggestions for future research are provided.     

Repetitive Thought and Health Anxiety: Tests of Specificity

Researchers suggest that worry, rumination, and unwanted intrusive thoughts are forms of repetitive thought (RT) important to health anxiety. To better understand RT-health anxiety interrelations, four tests of specificity between these three forms of RT and health anxiety were completed in the present research using a large community sample of medically healthy adults (N = 410). Results were that worry and rumination shared particularly strong zero-order correlations with health anxiety. In addition, worry, rumination, and unwanted intrusive thoughts each shared statistically stronger zero-order correlations with health anxiety than did another form of RT (i.e., reflection). Moreover, worry, rumination, and unwanted intrusive thoughts each shared unique relations with health anxiety after accounting for negative affect. Finally, these three forms of RT each evidenced incremental validity beyond one another as they relate to health anxiety. The pattern of relations was replicated across three commonly used measures of health anxiety. Implications for the conceptualization, assessment, and treatment of health anxiety are discussed.     

Psychometric Qualities of Turkish Version of Perseverative Thinking Questionnaire (PTQ)

Repetitive negative thinking (RNT) is an umbrella term that refers to an individual’s tendency to have negative thoughts in an uncontrollable and repetitive manner regardless of their content and temporal focus. RNT is suggested to be a transdiagnostic factor that may be associated with vulnerability for many different psychological disorders. The aim of the present study is to examine the psychometric qualities of Perseverative Thinking Questionnaire (PTQ), which is a scale that assesses non-disorder-specific form of RNT. The data was gathered from 446 Turkish individuals between the ages of 18 and 58 years through a web based data collection method. In addition to PTQ, the participants also completed questionnaires that measure worry, rumination, anxiety, depression, and thought suppression. Two models were tested, and CFA revealed a better fit for the 3-factor model. Results indicated that the scale has satisfactory levels of internal consistency, split-half reliability, and test–retest reliability. Further, correlation analyses showed moderate correlations with measures of worry, rumination, anxiety, and depression; which is indicative of satisfactory levels of both convergent and concurrent validity. In sum, Turkish version of PTQ is a psychometrically sound measure that researchers can utilize in research focusing on transdiagnostic processes.     

Relation of Repetitive Thinking Styles with Anxiety and Depression in Patients with Inflammatory Bowel Disease

In this study, we aimed to evaluate the relationship between the repetitive thinking styles and anxiety and depression in patients with inflammatory bowel disease (IBD). One hundred IBD outpatients (39 active and 61 remission) attending the gastroenterology clinic and 100 healthy controls were included.The rumination and worry scores of IBD patients, particularly in their active period, were significantly higher than controls. Additionally, the correlation of rumination and worry with anxiety and depression was statistically significant. Our results suggest that psychological interventions targeting repetitive thinking would alleviate depression and anxiety as well as GI symptoms in people with IBD which should be confirmed by further studies.

     

自我决定动机对考试焦虑的影响：拖延行为的不同中介作用

我国约有一半的大学生经受着考试焦虑的困扰。结合国内外已有研究成果,本研究以624名大学生为被试,考察了自我决定动机的3种类型和拖延行为的2种类型对考试焦虑的忧虑性、情绪性的影响。结果发现：(1) 无动机对考试焦虑的2种类型都有正向的直接影响。(2) 唤起性拖延仅对情绪性有正向直接影响,而回避性拖延仅对忧虑性有正向直接影响。(3) 唤起性拖延在无动机影响考试焦虑的情绪性中起了重要的部分中介作用,而回避性拖延在无动机影响考试焦虑的忧虑性中起了重要的部分中介作用。     

Worry and Rumination in Generalized Anxiety Disorder and Obsessive Compulsive Disorder

Ample work has already been conducted on worry and rumination as negative thought processes involved in the etiology of most of the anxiety and mood related disorders. However, minimal effort has been exerted to investigate whether one type of negative thought process can make way for another type of negative thought process, and if so, how it subsequently results in experiencing a host of symptoms reflective of one or the other type of psychological distress. Therefore, the present study was taken up to investigate whether rumination mediates the relationship between worry and generalized anxiety disorder (GAD), and between worry and obsessive compulsive disorder (OCD) in two clinical groups. Self-report questionnaires tapping worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) were administered to a clinical sample of 60 patients aged 30–40. Worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) correlated substantially with each other, however, rumination did not mediate the relationship between worry and generalized anxiety disorder (GAD) and between worry and obsessive compulsive disorder (OCD). We also analyzed differences of outcome variables within two clinical groups. These results showed that worry and rumination were significantly different between GAD and OCD groups.     

Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.     

大学生早期适应不良图式、焦虑与拖延的关系

为探讨大学生早期适应不良图式、焦虑与拖延的关系, 并考察焦虑在早期适应不良图式与拖延之间的中介效应, 采用一般拖延量表、Young图式问卷—简版、状态—特质焦虑问卷和自编一般人口学情况调查表, 对广东一高校559名大学生进行调查研究。研究结果发现:(1)"分离和拒绝"、"自主性和能力不足"、"缺乏自控/自律不足"图式均能显著正向预测焦虑和拖延;(2)特质焦虑能显著正向预测拖延, 而状态焦虑对拖延无显著预测作用;(3)特质焦虑在"分离和拒绝"、"自主性和能力不足"、"缺乏自控/自律不足"图式与拖延之间起部分中介作用。     

Academic Hardiness as a Moderator between Evaluative Concerns Perfectionism and Academic Procrastination in Students

Abstract

Academic procrastination is a common phenomenon in students that can have a negative impact on effective learning, academic achievement, self-esteem, and quality of life. This study examined the associations among the two dimensions of perfectionism (personal standards perfectionism and evaluative concerns perfectionism), academic hardiness, and academic procrastination, as well as the moderating role of academic hardiness in the relationship between the two dimensions of perfectionism and academic procrastination. Participants of this study included 410 high school students in grades 9 to 12 from six schools in Tehran, Iran who completed the Almost Perfect Scale-Revised, the Academic Hardiness Scale, and the Procrastination Assessment Scale. The results indicated that personal standards perfectionism and academic hardiness had negative relationships with academic procrastination, whereas evaluative concerns perfectionism had a positive relationship with academic procrastination. Interaction-moderation analysis demonstrated that academic hardiness only played a buffering role in the relationship between evaluative concerns perfectionism and academic procrastination. The results of this study elucidate the experience of academic procrastination in students and highlight the role of academic hardiness and personal standards perfectionism. Implications for educators and psychologists are discussed.     

Worry and rumination: differential associations with anxious and depressive symptoms and coping behavior

Worry and rumination are closely allied cognitive processes that impact on the experience of anxious and depressive symptoms. Using a prospective design, this study examined overlapping and distinct features of worry and rumination in relation to symptoms and coping behavior in a nonclinical sample of Singaporean college students. Worry and rumination were highly correlated, but they retained distinct components that predicted anxious and depressive symptoms differentially within and across time. Specifically, worry was uniquely associated with anxious and depressive symptoms whereas rumination was uniquely related to depression. In comparison to rumination, worry emerged as the dominant cognitive vulnerability factor that predicted increments in symptoms over time. With regards to coping behavior, low perceived coping effectiveness partially mediated the relation between worry and increases in anxiety and depression. Conversely, rumination uniquely predicted higher disengagement from problems, which resulted in further exacerbation of depressive mood. These results demonstrated not only the distinct features of worry and rumination on coping behavior, but also the different coping pathways by which they differentially impact on subsequent symptoms.