VA National Center for PTSD at VA Boston Healthcare System, Massachusetts, USA.
Boston University School of Medicine, Massachusetts, USA.
Br J Clin Psychol. 2019 Jun;58(2):231-244. doi: 10.1111/bjc.12210. Epub 2018 Nov 28.
Social anxiety disorder (SAD) and major depressive disorder (MDD) are commonly occurring and frequently comorbid disorders. Though individuals with SAD and MDD are more likely to engage in rumination and worry, relatively few studies have compared individuals with SAD, MDD, or both disorders on their use of these cognitive styles. Similarly, the extent to which the disorders differ in their use of reappraisal remains unclear. Thus, the current study sought to systematically examine rumination, worry, and reappraisal in individuals with and without SAD, MDD, or both disorders.
The study comprised 330 participants recruited from the community (n = 54 with SAD, n = 61 with MDD, n = 69 with comorbid SAD/MDD, and n = 146 healthy controls). Following confirmation of diagnostic status via clinical interview, participants completed measures of rumination, worry, and reappraisal.
Healthy controls reported less use of rumination (i.e., brooding and reflection) and worry than individuals with a psychiatric diagnosis. Individuals with SAD or MDD did not differ from each other, but participants in both groups reported less rumination, particularly brooding, than individuals with comorbid SAD/MDD. Diagnostic group differences in reappraisal only emerged when reappraisal was considered alongside other cognitive styles. Further, moderation analyses indicated that reappraisal was only associated with SAD or MDD when participants also reported high levels of rumination and worry.
Results support transdiagnostic conceptualizations of rumination and worry. They also suggest that reappraisal is only useful when it is used by people who experience frequent and habitual negative cognitions.
Individuals with SAD or MDD report more rumination and worry than healthy controls, but do not differ from each other in their reliance on these cognitive styles. Individuals with comorbid SAD/MDD endorse more rumination than individuals with SAD or MDD alone, even after adjusting for differences in symptom severity. Reappraisal may only predict diagnostic group status when considered alongside other cognitive styles. In particular, high reappraisal may be associated with reduced risk of psychiatric disorder, but only when rumination and worry are also high.
The study was limited by its cross-sectional design and reliance on self-report measures. Participants were diagnosed using DSM-IV-TR criteria for SAD and MDD.
社交焦虑障碍（SAD）和重性抑郁障碍（MDD）是常见且常共病的障碍。尽管患有 SAD 和 MDD 的个体更可能进行反刍和担忧，但相对较少的研究比较了患有 SAD、MDD 或两种障碍的个体在使用这些认知风格上的差异。同样，这些障碍在使用再评价方面的差异程度尚不清楚。因此，本研究旨在系统地检查患有 SAD、MDD 或两种障碍的个体与无 SAD、MDD 或两种障碍的个体在反刍、担忧和再评价方面的差异。
该研究包括从社区招募的 330 名参与者（n=54 名患有 SAD，n=61 名患有 MDD，n=69 名患有 SAD/MDD 共病，n=146 名健康对照）。通过临床访谈确认诊断后，参与者完成了反刍、担忧和再评价的测量。
健康对照组报告的反刍（即沉思和反思）和担忧少于有精神科诊断的个体。患有 SAD 或 MDD 的个体彼此之间没有差异，但两组参与者的反刍，尤其是沉思，都少于患有 SAD/MDD 共病的个体。只有当考虑到其他认知风格时，诊断组在再评价方面的差异才会出现。此外，调节分析表明，只有当参与者报告高水平的反刍和担忧时，再评价才与 SAD 或 MDD 相关。
研究结果支持反刍和担忧的跨诊断概念化。它们还表明，只有当经常习惯性地出现负面认知时，再评价才是有用的。
患有 SAD 或 MDD 的个体报告的反刍和担忧多于健康对照组，但在依赖这些认知风格方面彼此之间没有差异。患有 SAD/MDD 共病的个体比单独患有 SAD 或 MDD 的个体更认可反刍，即使在调整了症状严重程度的差异后也是如此。只有当考虑到其他认知风格时，再评价才可以预测诊断组的状态。特别是，当反刍和担忧也很高时，高再评价可能与降低患精神障碍的风险相关。
该研究受到其横断面设计和依赖自我报告测量的限制。参与者的 SAD 和 MDD 诊断是根据 DSM-IV-TR 标准进行的。
