Rumination, worry, cognitive avoidance, and behavioral avoidance: examination of temporal effects

Behav Ther. 2012 Sep;43(3):629-40. doi: 10.1016/j.beth.2011.11.002. Epub 2011 Dec 2.

Abstract

Recently, cross-sectional research has demonstrated that depressive rumination is significantly associated with the tendency to engage in cognitive and behavioral avoidance. This evidence suggests that rumination may be the result of attempts to avoid personally threatening thoughts, in a manner suggested by multiple contemporary theories of worry. This investigation examined the temporal relationship among daily levels of cognitive avoidance, behavioral avoidance, rumination, worry, and negative affect. Seventy-eight adolescents completed baseline questionnaires and then electronically completed daily measures of rumination, worry, behavioral avoidance, and cognitive avoidance, as well as sad and anxious affect for 7 days. Lagged-effect multilevel models indicated that increases in daily sadness were predicted by greater daily rumination and cognitive avoidance. Increases in daily anxiety were predicted by greater daily rumination, worry, and both cognitive and behavioral avoidance. Further, both daily rumination and worry were positively predicted by daily cognitive, but not behavioral, avoidance. Mediation analyses suggested that rumination mediated the effect of cognitive avoidance on both sadness and anxiety. Also, worry mediated the effect of cognitive avoidance on anxiety. Implications for models of avoidance, rumination, and worry are discussed.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Anxiety / complications
  • Anxiety / psychology*
  • Avoidance Learning*
  • Cognition*
  • Depression / complications
  • Depression / psychology*
  • Female
  • Humans
  • Male
  • Models, Psychological
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Surveys and Questionnaires
  • Thinking*
  • Time Factors