Rumination as a transdiagnostic factor in depression and anxiety.
The high rate of comorbidity among mental disorders has driven a search for factors associated with the development of multiple types of psychopathology, referred to as transdiagnostic factors. Rumination is involved in the etiology and maintenance of major depression, and recent evidence implicates rumination in the development of anxiety. The extent to which rumination is a transdiagnostic factor that accounts for the co-occurrence of symptoms of depression and anxiety, however, has not previously been examined. We investigated whether rumination explained the concurrent and prospective associations between symptoms of depression and anxiety in two longitudinal studies: one of adolescents (N=1065) and one of adults (N=1317). Rumination was a full mediator of the concurrent association between symptoms of depression and anxiety in adolescents (z=6.7, p< .001) and was a partial mediator of this association in adults (z=5.6, p< .001). In prospective analyses in the adolescent sample, baseline depressive symptoms predicted increases in anxiety, and rumination fully mediated this association (z=5.26, p< .001). In adults, baseline depression predicted increases in anxiety and baseline anxiety predicted increases in depression; rumination fully mediated both of these associations (z=2.35, p= .019 and z=5.10, p< .001, respectively). These findings highlight the importance of targeting rumination in transdiagnostic treatment approaches for emotional disorders.
Department of Health Care Policy, Harvard Medical School, 180A Longwood Avenue, Boston, MA 02115, USA. katie_mclaughlin@hms.harvard.edu
Katie A
KA
McLaughlin
Susan
S
Nolen-Hoeksema
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013850:Thinking
Behav Res Ther. 2002 Jul;40(7):753-72
12074371
Arch Gen Psychiatry. 1998 Jan;55(1):56-64
9435761
Behav Res Ther. 2002 Oct;40(10):1179-89
12375726
Arch Gen Psychiatry. 2003 Oct;60(10):993-1000
14557144
J Abnorm Psychol. 1993 Feb;102(1):20-8
8436695
J Pers Soc Psychol. 1994 Jul;67(1):92-104
8046585
J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-62
14399272
Behav Ther. 2007 Mar;38(1):23-38
17292692
J Consult Clin Psychol. 1979 Apr;47(2):223-33
469068
Arch Gen Psychiatry. 2007 Jun;64(6):651-60
17548747
Arch Gen Psychiatry. 1999 Oct;56(10):921-6
10530634
J Abnorm Psychol. 1997 May;106(2):221-9
9131842
Psychiatr Serv. 2007 Sep;58(9):1205-11
17766567
Psychosom Med. 2006 May-Jun;68(3):454-62
16738079
J Child Psychol Psychiatry. 1999 Jan;40(1):57-87
10102726
Psychol Bull. 2008 Mar;134(2):163-206
18298268
Arch Gen Psychiatry. 2004 Aug;61(8):807-16
15289279
Pers Soc Psychol Bull. 2003 Jan;29(1):96-107
15272963
J Abnorm Psychol. 2001 Nov;110(4):585-99
11727948
J Pers Soc Psychol. 1993 Aug;65(2):339-49
8366423
J Abnorm Psychol. 2000 Aug;109(3):504-11
11016119
J Consult Clin Psychol. 1998 Jun;66(3):451-60
9642883
J Abnorm Psychol. 2007 Feb;116(1):198-207
17324030
Psychol Med. 2004 Oct;34(7):1309-18
15697057
Arch Gen Psychiatry. 2005 Jun;62(6):617-27
15939839
J Consult Clin Psychol. 1995 Jun;63(3):408-18
7608353
Behav Res Ther. 2000 Mar;38(3):243-57
10665158
J Am Acad Child Adolesc Psychiatry. 2001 Jan;40(1):106-14
11195551
Emotion. 2005 Sep;5(3):319-28
16187867
J Pers Soc Psychol. 1995 Jul;69(1):176-90
7643299
J Pers Soc Psychol. 1999 Oct;77(4):801-14
10531672
Postgrad Med. 1972 Dec;52(6):81-5
4635613
J Pers Soc Psychol. 1991 Jul;61(1):115-21
1890582
Annu Rev Clin Psychol. 2006;2:111-33
17716066
J Am Acad Child Adolesc Psychiatry. 1997 Apr;36(4):554-65
9100431
Psychol Bull. 1984 Nov;96(3):465-90
6393179
Br J Clin Psychol. 1999 Sep;38(3):251-65
10532147
Psychol Methods. 2002 Mar;7(1):83-104
11928892
J Abnorm Psychol. 2006 Nov;115(4):639-57
17100523
Arch Gen Psychiatry. 2003 Aug;60(8):837-44
12912767
Behav Res Ther. 2007 Sep;45(9):2144-54
17367751
Perspect Psychol Sci. 2008 Sep;3(5):400-24
26158958
J Abnorm Child Psychol. 2002 Oct;30(5):515-27
12403154
Behav Ther. 2016 Nov;47(6):838-853
27993336
J Abnorm Psychol. 2005 Nov;114(4):522-36
16351375
Behav Res Ther. 2002 Jun;40(6):665-75
12051485
J Consult Clin Psychol. 2004 Feb;72(1):62-71
14756615