Are Different Forms of Repetitive Negative Thinking Associated With Interpretation Bias in Generalized Anxiety Disorder and Depression?

Abstract

Worry and rumination, two forms of repetitive negative thinking (RNT), are prevalent in generalized anxiety disorder (GAD) and depression. Cognitive processing biases, especially the tendency to draw negative conclusions from ambiguous information (interpretation bias), may maintain worry and rumination. Yet the relationship between interpretation bias and both forms of RNT has not been explored in clinical versus nonclinical samples. In this cross-sectional study, participants with GAD ( n = 72), depression ( n = 79), or neither disorder ( n = 71) completed two tasks assessing interpretation bias, measures of worry and rumination, and reported negative thought intrusions during a behavioral task. Interpretation bias was associated with higher levels of worry, rumination, and negative thought intrusions. Both clinical groups generated significantly more negative interpretations than healthy comparison participants. These findings link interpretation bias to worry and rumination and establish the need for research investigating the causal role of interpretation bias in maintaining RNT.

Rumination as a mechanism of the association between interpretation bias and depression symptoms: A longitudinal investigation

“…If you have a negative interpretation bias, you might mistakenly imagine the audience is harboring harsh criticisms of your work and you must have done a poor job. Dysphoric individuals exhibit patterns of evaluating and assigning emotionally relevant meaning to ambiguous information in a manner that is decidedly negative (Lee et al, 2016) and do so to a higher degree than non-dysphoric persons (Everaert, Podina, et al, 2017; Krahe et al, 2019). It should be noted that these negative interpretation biases appear most pronounced when situations are directly relevant to oneself (Cowden Hindash & Rottenberg, 2017; Wisco, 2009; Wisco & Nolen-Hoeksema, 2010).…”

“…In fact, others have proposed this very idea and supporting evidence has been found. Rumination is significantly associated with negative cognitive styles (Krahé et al, 2019;Spasojevic & Alloy, 2001), and negative cognitive styles moderate the association between rumination and depression symptoms, such that this association is stronger as negative cognitive styles increase. Additionally, predictable changes in depressive symptoms have been observed via the processing of negative cognitive biases through rumination (Ciesla & Roberts, 2007).…”

Approaching Cognitive Behavior Therapy For Generalized Anxiety Disorder From A Cognitive Process Perspective

“…The groups did not differ in their rejection of threatening but impossible interpretations (foils), thus ruling out the effects of a general threat-based response bias. Using the same task, Krahé et al (48) further demonstrated that worry was associated with negative interpretation bias across the general population, and that participants with GAD were biased towards negative interpretations, while community volunteers were biased towards benign (i.e. neutral or positive) interpretations.…”

Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment.

“…In a cognitive model of pathological worry, proposed that worry arises in GAD due to a combination of factors, such as an automatic cognitive bias in which emotionally ambiguous events are interpreted as threatening. Supporting this hypothesis, Krahé et al (2019) demonstrated that worry is associated with a more negative interpretation bias, and evidence of a causal role for interpretation bias in the maintenance of worry and anxiety has been found in experiments using Cognitive Bias Modification (CBM). CBM for interpretation, pioneered by Grey and Mathews (2000) and Mathews and Mackintosh (2000), adapts paradigms designed to assess interpretation bias to train a certain -usually benign -interpretive style.…”