Gorrell Sasha, Divers Ross, Boxley Laura, Fournier Jay C
Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA.
Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, USA.
J Clin Exp Neuropsychol. 2025 Jul 1:1-14. doi: 10.1080/13803395.2025.2526650.
Rumination (repetitive negative thinking; RNT) and anhedonia are hallmark features of depression and other psychiatric disorders known for their association with executive functioning. However, limited work has directly evaluated associations between these indices and their potential contribution to impairments in social and occupational function. This study investigated cross-sectional and longitudinal associations between RNT and anhedonia with functional outcomes at 6- and 12-months among individuals with elevated depression or anxiety symptoms.
Participants ( = 92, AgeM[SD] = 22[2.9], 72% female) completed Hamilton Depression and Anxiety Rating Scales, Perseverative Thinking Questionnaire (RNT), Snaith-Hamilton Pleasure Scale, Social Adjustment Scale (SAS-SR), and Health and Work Performance Questionnaire (HPQ). Participants also completed 7-day daily-diaries capturing social and occupational function; SAS-SR, HPQ, and daily-diaries were repeated at 6- and 12-months. General linear models evaluated baseline associations and linear mixed models tested longitudinal effects of baseline RNT and anhedonia on functional outcomes. Depression, anxiety, age, and sex-at-birth were covaried.
At baseline, RNT and anhedonia were associated with lower global and social function, and greater work impairment (ps ≤ .03). Daily diaries showed baseline associations between anhedonia and lower social satisfaction ( = .04) and RNT and greater work impairment ( = .01). Function generally improved over time (ps ≤ .03), and baseline associations with anhedonia tended to diminish (ps < .001). By contrast, baseline RNT continued to impact global, social, and work function and absenteeism (ps ≤ .01) at 12-months. Per daily diaries, baseline RNT predicted reduced social satisfaction ( = .01) and elevated work impairment 12 months later ( = .04).
There were independent clinically significant associations for both anhedonia and RNT with multiple aspects of functioning. Some functional improvements occurred over time, accompanied by attenuated relationships with anhedonia. In contrast, RNT to functioning relationships persisted over 12 months.
反刍思维(重复性消极思维;RNT)和快感缺乏是抑郁症及其他精神障碍的标志性特征,这些障碍因与执行功能相关而为人所知。然而,直接评估这些指标之间的关联及其对社会和职业功能损害的潜在影响的研究工作有限。本研究调查了抑郁症或焦虑症状加重的个体中,RNT与快感缺乏在6个月和12个月时与功能结局的横断面和纵向关联。
参与者(n = 92,年龄中位数[标准差]=22[2.9],72%为女性)完成了汉密尔顿抑郁和焦虑评定量表、反刍思维问卷(RNT)、斯奈斯-汉密尔顿快感量表、社会适应量表(SAS-SR)以及健康和工作绩效问卷(HPQ)。参与者还完成了记录社会和职业功能的7天日常日记;SAS-SR、HPQ和日常日记在6个月和12个月时重复填写。一般线性模型评估基线关联,线性混合模型测试基线RNT和快感缺乏对功能结局的纵向影响。对抑郁、焦虑、年龄和出生时性别进行了协变量调整。
在基线时,RNT和快感缺乏与较低的整体和社会功能以及更大的工作障碍相关(p值≤0.03)。日常日记显示,快感缺乏与较低的社会满意度(p = 0.04)以及RNT与更大的工作障碍(p = 0.01)之间存在基线关联。功能总体上随时间有所改善(p值≤0.03),与快感缺乏的基线关联趋于减弱(p值<0.001)。相比之下,基线RNT在12个月时继续影响整体、社会和工作功能以及缺勤情况(p值≤0.01)。根据日常日记,基线RNT预测12个月后社会满意度降低(p = 0.01)以及工作障碍增加(p = 0.04)。
快感缺乏和RNT在功能的多个方面均存在独立的具有临床意义的关联。随着时间推移出现了一些功能改善,同时与快感缺乏的关系减弱。相比之下,RNT与功能的关系在12个月内持续存在。