Repetitive Thought (Rumination and Worry)

Disorders That Are Associated with Rumination and Worry

• generalized anxiety disorder (GAD)
• depression
• social anxiety
• post-traumatic stress disorder (PTSD)
• pain
• eating disorders
• insomnia
• psychosis

Helpful Questions for Assessing Rumination and Worry

• How often do you find yourself ruminating or dwelling on your problems?
• When do you tend to do most of your worrying or ruminating?
• What are the consequences of ruminating and worrying for you? How does it make you feel?
• Are there any particular feelings that are warning signs that you might worry?
• What tends to stop your ruminating?

Treatment Approaches That Target Rumination and Worry

A variety of treatment approaches have been identified that target rumination and worry. These include:

• approaching uncomfortable thoughts and feelings rather than avoiding them;
• imaginal exposure to a ‘worry script’ or ‘worry story’;
• problem-solving training;
• processing information at a more concrete and less abstract level;
• identifying and challenging positive and negative metacognitive beliefs that may contribute to repetitive thinking.

References

Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press.

Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. New York: Guilford Press.