The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct
The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct
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DOI：
10.1016/j.jad.2013.06.014
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发表时间：
2013-10-01
影响因子：
6.6
通讯作者：
Nathan, Paula
中科院分区：
文献类型：
--
作者：
McEvoy, Peter M.;Watson, Hunna;Nathan, Paula
背景：重复消极思维（RNT）会增加罹患多种焦虑症和抑郁症的可能性，并且作为一种常见的危险因素，RNT 升高可能是情绪障碍之间观察到的高水平合并症的原因。本研究的目的是 (a) 比较非共存焦虑症或抑郁症患者的两种常见 RNT 形式（忧虑和沉思），以及 (b) 检查 RNT 与共存疾病之间的关系。 方法：通过在社区心理健康中心就诊的焦虑症或抑郁症患者 (N = 513) 的大量临床样本，完成结构化诊断访谈和沉思、忧虑、焦虑和抑郁的测量 临床结果：没有（n = 212）和有（n = 301）合并症诊断的患者在主要诊断组（抑郁症、广泛性焦虑症、社交焦虑症、恐慌症）中的担忧或沉思方面通常没有差异。正如预测的那样，合并症与较高水平的 RNT 相关。局限性：横断面设计排除了因果结论，研究结果可能无法推广到排除的焦虑症。结论：与跨诊断假设一致，RNT 与一系列焦虑症和抑郁症以及原发性抑郁症患者的合并症相关，支持最近的证据表明 RNT 是一种跨诊断障碍 过程。无论诊断情况如何，都应评估和治疗 RNT 的存在，特别是担忧和沉思。未来的研究可能表明，单纯的和共病的抑郁或焦虑患者都可以从为治疗传统上与单独疾病相关的 RNT 核心病理过程而开发的跨诊断方案中获得增量益处。 (C) 2013 Elsevier B.V. 保留所有权利。
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. (C) 2013 Elsevier B.V. All rights reserved.