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Abstract
Rumination has often been investigated in relation to the etiology and maintenance of major depression. Evidence now suggests that rumination is also associated with anxiety disorders. However, there are relatively few studies that examine ruminative response in clinical samples such as generalized anxiety disorder (GAD) or social phobia (SP). The goal of this article is to provide a comprehensive review of the studies analyzing the relations between rumination, generalized anxiety disorder and social phobia. A comprehensive search of the literature identified 37 studies that were included in this review. We searched the PsycArticles, PubMed, Sciencedirect and Web of Science databases, beginning with January 2000.We conclude that investigating the potential role of rumination in social phobia and generalized anxiety has implications for current cognitive models as well as in clinical practice.
Keywords
rumination, generalized anxiety disorder, social phobia, systematic review
Theoretical Perspectives on Rumination
Rumination is defined as ''behavior and thoughts that focus one's attention on one's depressive symptoms and on the implications of these symptoms'' (Nolen-Hoeksema, 1991). According to Response Style Theory (NolenHoeksema, 1991) rumination is a cognitive process hallmarked by repetitive thinking and negative automatic thoughts. Theories of rumination
The Response style theory (Nolen-Hoeksema, 1991) defines rumination as repetitive and passive thinking about one's symptoms of distress and the possible causes and consequences of these symptoms. Usually, people who are involved in this process repeatedly ask themselves why they can't get going or what's wrong with them. Ruminators frequently feel that they cannot ever get over some situations. They do not actively solve the problem, but instead remain fixed on their problems and feelings, without taking any action. Usually they are caught in a vicious circle. The response style theory (NolenHoeksema, 1991) maintains that rumination exacerbates and prolongs distress, specifically depression, through particular mechanisms. The first mechanism refers to the enhancement of the effects of depressed mood on thinking. The second one refers to rumination interfering with effective problem solving, which makes people think in a more pessimistic and fatalistic ways. The third mechanism is related to rumination interfering with instrumental behavior.
In their model of social phobia, Clark and Wells (1995) conceptualize rumination as a post-event process that follows a social or performance event such as public speaking or social interactions....