Why do People Worry and Ruminate? Investigating Factors that Maintain Repetitive Negative Thought

Abstract

The overarching aim of this research was to understand factors implicated in the maintenance of rumination and worry, conceptualised as a transdiagnostic process of repetitive negative thought (RNT), through the use of cross-sectional, prospective, and experimental research designs. Rumination and worry have been repeatedly implicated in the development and maintenance of various forms of psychopathology, in particular, depression and anxiety disorders. Given the negative outcomes for mood and psychopathology, there is a need for a better understanding of vulnerability factors that maintain this unconstructive thinking. Based on a review of the literature, an integrative theoretical model was developed and tested using structural equation modelling. Using cross-sectional data, the model was tested in a large sample of adults (n = 506). Of the broad range of proximal and distal vulnerability factors examined, only neuroticism and beliefs about the function of repetitive thought remained significantly associated with RNT once current symptoms were statistically controlled. Emotional abuse and abstract processing were indirectly associated with RNT. Following on from this, a prospective study examined which of these vulnerability factors prospectively predicted change in RNT over six to eight weeks. Only neuroticism and the specific belief that repetitive thought aids instrumental understanding predicted change in RNT, after controlling for depression and anxiety symptoms. Next, two experimental studies were conducted to explore the causal relationship between RNT and the belief that RNT aids insight and understanding, by experimentally manipulating this appraisal and measuring the impact on state RNT. Whilst methodological issues with the first experimental study precluded clear conclusions being drawn about the nature of the relationship, the second experimental study demonstrated that participants manipulated to believe that RNT is helpful for increasing insight and understanding had greater levels of state RNT after exposure to a stressor, relative to participants manipulated to believe that RNT is unhelpful. Finally, in order to see whether rumination has any consequences that may potentially reinforce its further use, an experimental study was conducted to manipulate processing mode (abstract rumination versus concrete thinking) and examine the effect on a range of outcomes relating to insightfulness and avoidance. Whilst rumination did not lead to increased insight, it did afford more justification for avoidance, relative to concrete thinking. The clinical and theoretical implications of these findings are discussed with respect to existing theories of repetitive negative thought.