Transdiagnostic mechanisms in depression and anxiety: The role of rumination and attentional control

Abstract

Background Deficits in attentional control have been hypothesized to cause rumination, suggesting that the relationships between attentional control and clinical symptoms may be mediated in part by rumination. However, to date, no clinical study has examined these constructs transdiagnostically in a path analysis model. Methods Fifty-one adults presenting for treatment completed measures of self-reported attentional control, rumination, and depression and anxiety symptoms. A bias-corrected path analysis-based approach was employed to test whether indirect (i.e., mediating) effects of rumination were significantly associated with the direct effects of attentional control on depression and anxiety symptoms. Separate models for depression and anxiety symptoms were tested along with reverse models using attentional control as a proposed mediator. Results The relationship between attentional control and clinical symptomatology (i.e., both depression and anxiety symptoms) was mediated by rumination. Poor attentional control was associated with more rumination and consequently more severe symptoms of depression and anxiety. The reverse relationship (i.e., attentional control mediating the relationship between rumination and depression or anxiety symptoms) was not significant. Limitations Study design did not allow testing of temporal precedence for the mediation models. All constructs were assessed via self-report. Conclusions Attentional control appears to impact depression and anxiety symptoms through rumination. The pathway between poor attentional control and emotion dysregulation via rumination suggests that interventions targeting attentional control may decrease maladaptive ruminative processes, leading to improved emotion regulation and reduced clinical symptomatology. Future studies should examine the stability of this mediational relationship over time (and in the face of targeted interventions).

A Comparison of the Facets of Mindfulness Among Patients With Major Depression, Social Anxiety Disorder and Healthy Individuals

“…These relationships are consistent with previous reports stating that acting with awareness is negatively related to anxiety and depression (Bohlmeijer et al, 2010), and it has also been found to be inversely associated with worry and rumination (de Bruin, 2012) which are associated with both social anxiety and depression (Hsu et al, 2015). Being aware of one's present activity may compete for attentional resources required for processing of negative repetitive thoughts (Raphiphatthana et al, 2016).…”

“…worry, rumination) (e.g. Hsu et al, 2015). Thus, we hypothesized that there are significant differences between the levels of describing, nonjudging, acting with awareness and non-reacting facets in the three groups, particularly groups with SAD and MDD show lower levels of these facets as compared to the healthy group.…”

“…In addition, theoretically, the concept of non-judging appears to be the opposite of negative self-cognitions and self-criticism (Raphiphatthana et al, 2016), which are shared characteristics of MDD and SAD (Cox, Fleet, & Stein, 2004). Acting with awareness has been found to be inversely associated with worry and rumination (de Bruin et al, 2012) which are associated with both social anxiety and depression (Hsu et al, 2015). Finally, the process of permitting feelings and thoughts to pass through awareness without reacting to or controlling them may be particularly beneficial for reducing negative and repetitive thought processes which are common to both social anxiety and depression (i.e.…”

Transdiagnostic psychiatry: a systematic review

“…The exact definition of the transdiagnostic construct per study is provided in Table . Only a minority of constructs (36%) involved multiple processes. Most studies (81%) were descriptive in nature.…”

Cognitive Attentional Syndrome and Metacognitive Beliefs in Male Sexual Dysfunction: An Exploratory Study

“…Seven participants with PE stated that they had based their evaluation of goal attainment on duration (unspecified) of sexual activity, six participants (three with ED and three with PE) took their partner's orgasm as an indication of success, four participants with ED rated success in terms of a bodily sensation of erection, while four participants with ED could not specify what they had based their judgment on. Table 2 summarizes participants' positive and negative metacognitive beliefs in light of four specific selfreported cognitive-attentional responses: rumination, distraction, worry, and self-imposition (Hsu et al, 2015). Eighteen participants identified positive metacognitive beliefs about the usefulness of their cognitive-attentional response in: (a) enhancing sexual performance (five participants with ED, eight with PE), (b) controlling negative thoughts and emotions (three participants with ED, two participants with PE), and (c) understanding the causes of their sexual problem (three participants with ED).…”