ارزیابی و استراتژی های مرتبط با نشخوار فکری و نگرانی
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|31330||2004||16 صفحه PDF||سفارش دهید||محاسبه نشده|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Personality and Individual Differences, Volume 37, Issue 4, September 2004, Pages 679–694
Rumination (Nolen-Hoeksema, 1991) and worry (Borkovec, Ray, & Stober, 1998) are forms of recurrent negative thinking that are implicated in the maintenance of, respectively, depression and generalized anxiety disorder. However, despite their clinical significance, the mechanisms underlying rumination and worry are not well understood. This study aimed to test recent suggestions that particular appraisals and strategies in response to intrusive thoughts may be associated with increased tendency to ruminate and worry. 148 volunteers reported appraisals and strategies to worry and rumination-related intrusions (as measured with the Cognitive Intrusion Questionnaire) and the tendency to ruminate and tendency to worry, as measured by the Response Styles Questionnaire and the Penn State Worry Questionnaire, respectively. Increased tendency to ruminate was associated with a greater need to understand a situation, increased personal importance of the situation and the strategies of analysing a situation and dwelling on the causes and meanings of situations. Increased tendency to worry was associated with greater disapproval of worry-related intrusions, and with the strategy of replacing a worrisome intrusion with another unpleasant thought. These correlational findings are consistent with meta-cognitive (Watkins & Baracaia, 2001) and goal-discrepancy accounts (Martin & Tesser, 1996) of rumination, and with a cognitive avoidance account of worry (Borkovec et al., 1998).
Rumination, that is, repetitive and recurrent self-focused thinking about failure and depressed mood (Martin & Tesser, 1996; Nolen-Hoeksema, 1991; Teasdale, 1999), has been increasingly recognised as an important component of depression. Longitudinal studies indicate that rumination can predict the onset (Just & Alloy, 1997; Spasojevic & Alloy, 2001) and maintenance of major depression (Kuehner & Weber, 1999; Nolen-Hoeksema, 2000, although not replicated by Lara, Klein, & Kasch, 2000). Relative to distraction, for participants in a dysphoric mood, rumination exacerbates depressed mood (Morrow & Nolen-Hoeksema, 1990; Nolen-Hoeksema & Morrow, 1993) and negative thinking (Lyubomirsky & Nolen-Hoeksema, 1995). Worry, another form of recurrent negative thinking, is a central and defining characteristic of Generalized Anxiety Disorder (GAD) (APA, 1994). Worry has been defined as “a chain of thoughts and images, negatively affect-laden and relatively uncontrollable” (Borkovec, Robinson, Pruzinsky, & DePree, 1983), typically focused on possible negative consequences (“What if this happened?”). Despite the clinical importance of worry and rumination, the mechanisms of worry and rumination are not well understood. In particular, there is the question of why some people ruminate or worry more frequently and for longer than other people. After all, everyone worries and ruminates some of the time, particularly when faced with difficult situations. However, not everyone dwells on upsetting thoughts in an excessive, uncontrollable or chronic way. What makes some people more prone to rumination or worry? An important difference between normal and pathological thinking may be the response to intrusive thoughts. For both worry and rumination, the sequence of recurrent thinking on a negative theme is often initiated by intrusive thoughts that come unbidden into peoples’ minds (Langlois et al., 2000a and Langlois et al., 2000b; Martin & Tesser, 1996). However, intrusive thoughts are a common and normal phenomenon (e.g. Rachman & de Silva, 1978; Wells & Morrison, 1994), such that the occurrence of an intrusive thought cannot solely account for pathological worry or pathological rumination. Rather, it has been suggested that particular appraisals and strategies in response to intrusions will lead to recurrent negative thinking such as worry and rumination (Langlois et al., 2000a; Wells, 1995). Thus, worry, in the form of a sequence of elaborated verbal thoughts, may be initiated in response to intrusive catastrophic images as a form of cognitive avoidance (Borkovec et al., 1998). Likewise, rumination has been proposed to be a persistent mental attempt at resolving unattained goals, which is initiated by an intrusive concern indicating a discrepancy between current state and ideal outcome (Martin & Tesser, 1996). However, the relationship between appraisals and strategies in response to particular intrusive thoughts and the overall tendency to ruminate or to worry has not been directly examined. The aim of this study was to examine the relationship between appraisals and strategies to specific intrusions and tendency towards rumination (using Response Styles Questionnaire, RSQ, Nolen-Hoeksema & Morrow, 1993) and tendency to worry (using Penn State Worry Questionnaire, PSWQ, Meyer, Miller, Metzger, & Borkovec, 1990). The study first examined the relationship between appraisals/strategies, worry and rumination by looking at the correlations between tendency to ruminate, tendency to worry and specific items reflecting appraisals and strategies in response to intrusions. Furthermore, because this approach does not control for the possible inter-relationships between each appraisal and strategy response, principal components factor analyses were also used to derive factors for appraisals and strategies in response to intrusions. This analysis reduced the data to fewer structural factors, whilst controlling for inter-relationships between appraisal and strategy items. These structural factors were then correlated with tendency to ruminate or tendency to worry. Recent accounts of worry and rumination suggested various predictions to examine within this study. First, rumination is hypothesised to be initiated by discrepancies in progress towards goals that are appraised as personally important (Carver & Scheier, 1990; Martin and Tesser, 1989 and Martin and Tesser, 1996; McIntosh & Martin, 1992; Pyszczynski & Greenberg, 1987), predicting that appraisal of an intrusive thought as personally important would be associated with tendency to ruminate. This account further proposes that pathological rumination involves attempts at problem solving, which persist even when the goal is unattainable. This account therefore predicts that increased tendency to ruminate should be positively correlated with greater effort at problem solving. Conversely, Papageorgiou and Wells (2001) hypothesised that rumination is maintained by poor confidence and poor effort in problem solving, which causes people to repeatedly reinitiate thinking about problems, predicting a negative correlation between effort and confidence in problem solving and rumination. Second, recent accounts propose that meta-cognitive beliefs and appraisals, that is, judgements about the function and meaning of thinking itself, play a role in maintaining recurrent negative thinking (Papageorgiou & Wells, 2001; Watkins & Baracaia, 2001; Wells, 1995). Positive beliefs, for example that rumination is helpful for understanding the self and the world (Lyubomirsky & Nolen-Hoeksema, 1993; Papageorgiou & Wells, 2001; Watkins & Baracaia, 2001), and that worry helps to prevent or minimise future difficulties (Wells, 1995) have been hypothesised to maintain, respectively, rumination and worry. These accounts also suggest that beliefs about the importance of understanding oneself and the world exacerbate rumination (Watkins & Baracaia, 2001; Watkins & Mason, 2002), leading to the prediction that appraisals of needing to understand situations will be associated with greater tendency to ruminate. Likewise, positive meta-cognitive accounts of worry (Wells, 1995) predict that appraisals of needing to prevent the situation described in an intrusive thought will be associated with tendency to worry. Negative meta-cognitive beliefs have also been suggested to play a role in the development of worry. For example, thinking that intrusive thoughts are uncontrollable and inappropriate has been argued to lead to further worry (Wells, 1995), in the form of “worry about worry”. Negative interpretations of rumination-related intrusions (e.g. perceived uncontrollability, disapproval) might further exacerbate rumination. These negative meta-cognitive accounts predict that tendency to worry and ruminate will be associated with perceived uncontrollability and disapproval of intrusions. Third, there is accumulating evidence that thought suppression (Wenzlaff & Wegner, 2000) leads to a resurgence of unwanted thoughts, which suggests that using a thought suppression strategy in response to intrusive thoughts may be one factor which differentiates people more and less prone to worry and rumination. For example, one might predict that the effort to remove a thought would be associated with tendency to ruminate and worry. Fourth, Borkovec et al. (1998) suggested that worry acted as a form of cognitive avoidance to reduce the negative emotion associated with intrusive catastrophic images. Within this account, Borkovec and Roemer (1995) hypothesised that people might worry about superficial things in order to distract themselves from a real problem or intrusive thought, thus, extending the sequence of worry, without resolving the underlying concern. This account would predict that tendency to worry would be associated with the strategy of replacing an intrusive thought with another negative thought. Finally, this study examined the use of particular strategies in response to intrusions in order to check that the intrusions reported were relevant to rumination and worry. Because Nolen-Hoeksema (1991) defined rumination as thinking about the causes and consequences of depressed mood, if the intrusions were relevant to rumination, then one would expect the strategy of dwelling on the causes and meanings of the situation described in the intrusions to be associated with tendency to depressive rumination. Likewise, given that worry is concerned with future negative consequences, the strategy of dwelling on the consequences of intrusive thoughts was expected to be associated with tendency to worry. Given previous findings that worry and rumination overlap (Fresco, Frankel, Mennin, Turk, & Heimberg, 2002; Segerstrom, Tsao, Alden, & Craske, 2000), rumination and worry were expected to be positively correlated. For this reason, all appraisals and strategies were examined for their relationship to both worry and rumination, even if the specific hypotheses were originally formulated with only worry or rumination in mind. The appraisals and strategies were examined by use of the Cognitive Intrusions Questionnaire (CIQ; Freeston, Ladouceur, Thibodeau, & Gagnon, 1992), which includes the aforementioned appraisals and strategies, plus a number of other responses not mentioned above. These other items provided a comparison group of responses where no relationship was expected, in order to conceal the study’s specific hypotheses from participants and to check that there was not a general bias to endorse all responses. For example, no relationship was expected between worry/rumination and appraisals of the intrusion as correct or a real problem, or between worry/rumination and the strategies of neutralizing the thought or doing nothing in response to the intrusion (the set of CIQ items, both those hypothesised to be associated with worry/rumination in the text above and the comparison items are reported in Table 1). Since anxiety, depression, worry and rumination are positively correlated (Segerstrom et al., 2000), anxiety and depression were partialled out, in order to check that any relationship between worry or rumination and responses to intrusive thoughts was not secondary to depression or anxiety. By further partialling out the other form of recurrent thinking, the responses uniquely related to worry or rumination were examined.