The author reviews research showing that repetitive thought (RT) can have constructive or unconstructive consequences. The main unconstructive consequences of RT are (a) depression, (b) anxiety, and (c) difficulties in physical health. The main constructive consequences of RT are (a) recovery from upsetting and traumatic events, (b) adaptive preparation and anticipatory planning, (c) recovery from depression, and (d) uptake of health-promoting behaviors. Several potential principles accounting for these distinct consequences of RT are identified within this review: (a) the valence of thought content, (b) the intrapersonal and situational context in which RT occurs, and (c) the level of construal (abstract vs. concrete processing) adopted during RT. Of the existing models of RT, it is proposed that an elaborated version of the control theory account provides the best theoretical framework to account for its distinct

/pdf/constructive-and-unconstructive-repetitive-thought-1cx5otpxi0.pdf

Constructive and Unconstructive Repetitive Thought.

Sexual minorities are at increased risk for multiple mental health burdens compared with heterosexuals. The field has identified 2 distinct determinants of this risk, including group-specific minority stressors and general psychological processes that are common across sexual orientations. The goal of the present article is to develop a theoretical framework that integrates the important insights from these literatures. The framework postulates that (a) sexual minorities confront increased stress exposure resulting from stigma; (b) this stigma-related stress creates elevations in general emotion dysregulation, social/interpersonal problems, and cognitive processes conferring risk for psychopathology; and (c) these processes in turn mediate the relationship between stigma-related stress and psychopathology. It is argued that this framework can, theoretically, illuminate how stigma adversely affects mental health and, practically, inform clinical interventions. Evidence for the predictive validity of this framework is reviewed, with particular attention paid to illustrative examples from research on depression, anxiety, and alcohol-use disorders.

How does sexual minority stigma “get under the skin”? A psychological mediation framework.

The current paper provides an updated review of repetitive negative thinking as a transdiagnostic process. It is shown that elevated levels of repetitive negative thinking are present across a large range of Axis I disorders and appear to be causally involved in the maintenance of emotional problems. As direct comparisons of repetitive negative thinking between different disorders (e.g., GAD–type worry and depressive rumination) have generally revealed more similarities than differences, it is argued that repetitive negative thinking is characterized by the same process across disorders, which is applied to a disorder–specific content. On the other hand, there is some evidence that—within given disorders—repetitive negative thinking can be reliably distinguished from other forms of recurrent cognitions, such as obsessions, intrusive memories or functional forms of repeated thinking. An agenda for future research on repetitive negative thinking from a transdiagnostic perspective is presented.

Repetitive negative thinking as a transdiagnostic process

This review addresses three questions regarding the relationships among gender, emotion regulation, and psychopathology: (a) are there gender differences in emotion regulation strategies, (b) are emotion regulation strategies similarly related to psychopathology in men and women, and (c) do gender differences in emotion regulation strategies account for gender differences in psychopathology? Women report using most emotion regulation strategies more than men do, and emotion regulation strategies are similarly related to psychopathology in women and men. More rumination in women compared to men partially accounts for greater depression and anxiety in women compared to men, while a greater tendency to use alcohol to cope partially accounts for more alcohol misuse in men compared to women. The literature on emotion regulation is likely missing vital information on how men regulate their emotions. I discuss lessons learned and questions raised about the relationships between gender differences in emotion regu...

Emotion Regulation and Psychopathology: The Role of Gender

Specificity of cognitive emotion regulation strategies: A transdiagnostic examination

Rumination-focused cognitive behaviour therapy for residual depression: a case series.

Background 

About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive-behavioural therapy (CBT).

Aims 

To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression.

Method 

Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered ([ISRCTN22782150][1]).

Results 

Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination.

Conclusions 

This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v . non-specific therapy effects.

 [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN22782150

/pdf/rumination-focused-cognitive-behavioural-therapy-for-2b2wj6zsla.pdf

Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial

failed to find any acute benefit of addingCBT to pharmacotherapy in treating residual depression. Thesecondary aim was to test the hypothesis that rumination-focusedCBTreduces rumination significantly more than TAU, i.e. acts onits intended target. The third aim was to test whether change inrumination mediates any treatment effect of rumination-focusedCBT.MethodThe study was approved by the UK National Health Service SouthLondon and Maudsley Research Ethics Committee and wasconducted in community mental health teams and psychologicaltreatment services in South East London and Devon, UK.Consecutive referrals to out-patient services for depression andon the waiting list for psychological therapies were approachedand those who met inclusion criteria and gave written informedconsent to participate were randomly allocated to TAU alone orto TAU plus rumination-focused CBT. Randomisation wasperformed by an off-site researcher using computer-generatedrandom numbers, and stratified according to gender and theduration of the index episode of major depression (5 v.51 year).All participants were assessed by research staff masked to treat-ment allocation at intake baseline assessment (Time 1 (T

Neil Bathurst

Papers

Rumination-focused cognitive behaviour therapy for residual depression: a case series.

Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial

depression: phase II randomised controlled trial Rumination-focused cognitive-behavioural therapy for residual