Major depression is characterised by ruminative thinking whilst worry is considered central in generalised anxiety disorder (GAD). However, not only do these two forms of repetitive negative thinking regularly co-occur in the same individual but similarities between worry and rumination are apparent. Adapting a methodology developed by Langlois et al. (Behav. Res. Therapy 38 (2000) 157–173), this study directly compared worry and rumination in a non-clinical population across a series of variables drawn from current models (appraisal, general descriptors and emotional reactions). Each of 149 female volunteers, with a wide range of age and backgrounds, identified a ruminative thought and a different worry and subsequently evaluated them using the Cognitive Intrusion Questionnaire. Significant within-subject differences were revealed on seven variables: chronicity, unpleasantness, reality of problem, future orientation, past orientation, feelings of worry and insecurity. There were no differences found between worry and rumination on appraisals and strategies, consistent with accounts that propose that worry and rumination share the same processes but involve different content (Cognitive Ther. Res. 24 (2000) 671–688).
Both worry (Borkovec, Ray, & Stober, 1998) and depressive rumination (Nolen–Hoeksema, 1991) are elevated in psychiatric populations, associated with adverse mood and involve negative recurrent thinking. Worry is considered to be a primary attribute of generalized anxiety disorder (GAD) (APA, 1994). Rumination is characteristic of major depression, predicting its onset and duration (Nolen–Hoeksema, 2000; Spasojevic & Alloy, 2001). Anxiety symptoms and anxiety disorders are highly co-morbid with depressive symptoms and depressive disorders (e.g. Clark & Watson, 1991), with especially high rates of co-morbidity between GAD and depression (Brawman-Mintzer et al., 1993). Thus, there are clearly common aspects between worry and rumination. However the extent to which worry shares the same processes, mechanisms and content with rumination, and the extent to which worry has specific unique differences from rumination remain unresolved.
Clarifying the similarities and differences between worry and rumination is important, not only to develop more accurate cognitive models of recurrent negative thinking, but also in the development of more systematic clinical interventions. Better understanding of the relationship between worry and rumination would indicate whether particular treatment approaches developed for GAD might be relevant for depression, and vice versa, and, potentially, might highlight effective points of intervention for co-morbid anxiety and depression symptoms. The present study aims to specify the differences between worry and ruminative thought in a non-clinical population across a series of variables, including form and content (general descriptors), appraisals, strategies and emotional reactions.
Although there is a general consensus that worry and rumination share some degree of overlap, there are differences in the views of how similar worry and rumination are. Borkovec et al. (1998, p. 569) suggested that “depressive rumination (which) may be similar in process and content to the worrisome thinking studied in GAD”. Depressive rumination has been found to be significantly correlated with worry on self-report measures in students (Fresco, Frankel, Mennin, Turk, & Heimberg, 2002; Segerstrom, Tsao, Alden, & Craske, 2000) and patients (Segerstrom et al., 2000). Furthermore, Segerstrom et al. (2000) found that both worry and rumination significantly correlated with a measure of repetitive thinking, leading them to propose that whilst thought content and goal orientation could discriminate between anxious worry and depressive rumination, thought process might not discriminate between them.
In contrast, Papageorgiou, & Wells (1999) and Papageorgiou, & Wells (2001) proposed that whilst depressive rumination and anxious worry share a number of similarities, there are also important differences in process and meta-cognitive dimensions, concluding that “worrying is a process that overlaps with but differs from rumination” (Papageorgiou & Wells, 2001, p. 15). In a non-clinical sample, Papageorgiou and Wells (1999) found that depressive thoughts were associated with less verbal content, lower effort and lower confidence for problem solving, and more past orientation than anxious thoughts. Papageorgiou and Wells (2001) hypothesized that these differences reflect process differences between worry and rumination, as rumination and worry are characteristic of depressive and anxious thinking, respectively. An important aspect of this study was that it measured form, process and meta-cognitive dimensions for each thought. However, it used a relatively small sample (n=54)(n=54), and did not directly examine worry and rumination.
None of the previous studies comparing measures of worry and rumination have examined both the form and content of worry and rumination, and the emotions, appraisals and strategies associated with worry and rumination, as Langlois, Freeston, and Ladouceur (2000) did when comparing worry and obsessions. A detailed evaluation of form, emotions, appraisals and strategies would help in determining similarities and differences in content and process between worry and rumination. Thus, the aim of this study is to use Langlois et al. (2000) approach to compare any similarities and differences that might exist between ruminative and worrisome thoughts. There was a particular emphasis on testing whether the process differences hypothesized by Papageorgiou and Wells (2001) would be found when worry and rumination were directly compared.
