Think again: Adaptive repetitive thought as a transdiagnostic treatment for individuals predisposed to repetitive thinking styles.

Abstract

Maladaptive repetitive thought (RT) is a transdiagnostic construct associated with several psychopathological disorders, including major depressive disorder and anxiety disorders. However, not all forms of RT are maladaptive. Adaptive RT is characterized by primarily positive and concrete thought content, is usually focused on the present rather than the past or future, and frequently from a self-distanced perspective. From a behavioral therapy perspective, interventions that promote adaptive RT may interrupt or decrease engagement in maladaptive RT. In this review, we explore the distinction between adaptive and maladaptive RT and examine the utility of various forms of adaptive RT. Empirical evidence for several examples of adaptive RT (e.g., savoring, reminiscing, compassion, gratitude, mantra-based intervention) are provided, with demonstrated efficacy in the treatment of psychopathology or as components of empirically supported psychotherapies. Using adaptive RT therapeutically may be beneficial for those who are already predisposed to RT, either as an individual difference (e.g., neural default mode connectivity) or in response to a stressful life event. Recommendations for future research into adaptive RT and its potential utility in addressing maladaptive RT in vulnerable populations are discussed.

Stress, repetitive negative thinking, and mental health in Chilean university students: an ecological momentary assessment study

“…Repetitive negative thinking is a cognitive process characterized by recurrent thoughts and self-focused attention in the face of negative events, whose effects can be adaptive or maladaptive ( Cova et al, 2019 ; Lawrence et al, 2021 ); the most well-known repetitive thinking is the maladaptive one, usually referred to as RNT, that includes negative rumination, and worry, while on the adaptive side is reflection ( Nolen-Hoeksema and Watkins, 2011 ; Cova et al, 2019 ; Lawrence et al, 2021 ). Although repetitive negative thinking is employed as a strategy for self-regulation and modulating own affective experiences, it may be counterproductive, and it has been associated with affective disorders ( Ferrer et al, 2018 ; Spinhoven et al, 2018 ), eating disorders ( Palmieri et al, 2021 ), increased vulnerability to stress-related disorders in those exposed to childhood adversities ( Mansueto et al, 2021 ), difficulties in emotion regulation ( Mansueto et al, 2022 , 2024 ; Palmieri et al, 2023 ), perfectionism ( Kummer et al, 2024 ; Palmieri et al, 2024 ) and shyness ( Palmieri et al, 2018 ).…”

“…Reflection or adaptive rumination has less empirical support to date ( Cova et al, 2019 ; Lawrence et al, 2021 ). One element that has been debated is whether it operates as a protective factor against stress since, although it is associated with fewer symptoms in cross-sectional studies, it is usually related to brooding at follow-ups ( Cova et al, 2009 , 2019 ).…”

“…One element that has been debated is whether it operates as a protective factor against stress since, although it is associated with fewer symptoms in cross-sectional studies, it is usually related to brooding at follow-ups ( Cova et al, 2009 , 2019 ). Some characteristics proposed to consider reflection as adaptive are the attributes of being deliberate, controllable, concrete, and self-distancing, although several of these elements have little research ( Cova et al, 2019 ; Lawrence et al, 2021 ).…”

“…In the last decade, the field of study of RNT has expanded the focus of determining what type or content of negative repetitive thought-ruminating or worrying is associated with which disorders to know which RNT processes make it maladaptive. Among the attributes proposed for the study are intrusiveness, lack of control, duration, and self-immersive or first-person perspective ( Cova et al, 2019 ; Rosenkranz et al, 2020 ; Lawrence et al, 2021 ); elements that are usually assessed with Perseverative Thinking Questionnaire (PTQ). Studies show cross-sectional associations between process RNT and social anxiety and depression in adolescents ( Klemanski et al, 2017 ).…”