The structure and health correlates of trait repetitive thought in older adults

The Future-oriented Repetitive Thought (FoRT) scale: Validation in Chinese samples and application in the schizophrenia spectrum

BACKGROUND

Repetitive thoughts are usually associated with psychopathology. The Future-oriented Repetitive Thought (FoRT) Scale is a measure designed to capture frequency of repetitive thought about positive and negative future events. However, the validity of the scale in Chinese population and its application in the schizophrenia spectrum have not been examined.

METHODS

The current study aimed to examine the psychometric properties of the Chinese version of the FoRT scale and to apply it to the schizophrenia spectrum. In Study 1, three samples (total N = 1875) of university students were recruited for exploratory factor analysis, confirmatory factor analysis, and validity test, respectively. In Study 2, we identified subsamples with high schizotypal traits (N = 89) and low schizotypal traits (N = 89), and recruited 36 inpatients with schizophrenia and 41 matched healthy controls.

RESULTS

The three-factor (pessimistic repetitive future thinking, repetitive thinking about future goals, and positive indulging about the future) structure of the FoRT scale with one item deleted, fitted the Chinese samples. And the scale could distinguish patients with schizophrenia and individuals with high schizotypal traits from controls.

CONCLUSION

These findings support that the Chinese version of the FoRT scale is a valid tool and provide evidence for the potential applications in the schizophrenia spectrum.

Repetitive thought, cognition, and systemic inflammation in the midlife in the United States study

OBJECTIVE

Poor cognition increases risk for negative health outcomes, and this may be explained by associations with systemic inflammation. Previously, amount of repetitive thought (Total RT) interacted with IQ to predict interleukin-6 (IL-6) in older adults. This study continued the investigation of repetitive thought (RT) as an element involved in the effect of cognition on inflammation.

DESIGN

Participants (N = 164) came from the Midlife in the United States Refresher project (Mage = 45.33, SD = 11.51, ranges = 25-74; 48.2% female; 85% Caucasian). Cognition was assessed via telephone, inflammatory biomarkers (IL-6, C-reactive protein (CRP), and tumour-necrosis factor-alpha (TNF- α)) analysed after blood draw, and RT derived from daily diary data.

RESULTS

Cognition significantly interacted with RT valence (p = .009) to explain CRP after covariate adjustment. Better cognition and more negative RT valence was associated with lower CRP (β = -0.190 [-.387, .008]). Worse cognition and more negative RT valence was associated with higher CRP (β = 0.133 [-.031, .297]). No significant effects were found for IL-6 or TNF-α.

CONCLUSION

RT may interact with cognition to affect different inflammatory biomarkers. Those with worse cognition may benefit more from skills related to regulating thought than those with better cognition.

Rumination in dementia and its relationship with depression, anxiety, and attentional biases

Rumination (self-referential and repetitive thinking), attentional biases (AB), and impaired cognitive control are theorized as being integral factors in depression and anxiety. Yet, research examining the relationship between rumination, mood, and AB for populations with reduced cognitive control, e.g., people living with dementia (PwD), is lacking. To explore whether literature-based relationships are demonstrated in dementia, PwD (n = 64) and healthy controls (HC) (n = 75) completed an online self-report survey measuring rumination and mood (twice), and a telephone cognitive status interview (once). Rumination was measured as an emotion-regulation style, thinking style, and response to depression. We examined the test-retest reliability of PwD's (n = 50) ruminative-scale responses, ruminative-scale internal consistency, and correlations between rumination, age, cognitive ability, and mood scores. Also, nine participants (PwD = 6, HC = 3) completed an AB measure via eye-tracking. Participants fixated on a cross, naturally viewed pairs of facial images conveying sad, angry, happy, and neutral emotions, and then fixated on a dot. Exploratory analyses of emotional-face dwell-times versus rumination and mood scores were conducted. Except for the HC group's reflective response to depression measure, rumination measures were reliable, and correlation strengths between rumination and mood scores (.29 to .79) were in line with literature for both groups. For the AB measure subgroup, ruminative thinking style scores and angry-face metrics were negatively correlated. The results of this study show that literature-based relationships between rumination, depression, and anxiety are demonstrated in dementia, but the relationship between rumination and AB requires further investigation.

Is rumination associated with psychological distress after a cancer diagnosis? A systematic review

Objective: The aim of this work was to review evidence on the association between psychological rumination and distress in those diagnosed with cancer. Methods: Six databases were searched for studies exploring rumination alongside overall assessments of psychological distress, depression, anxiety, or stress. Results: Sixteen studies were identified. Rumination was associated with distress cross-sectionally and longitudinally. However, once baseline depression was controlled for, the association was no longer seen. The emotional valence of ruminative thoughts and the style in which they were processed, rather than their topic, was associated with distress. Brooding and intrusive rumination were associated with increased distress, deliberate rumination had no association, and reflection/instrumentality had mixed findings. Conclusions: This review highlights that it is not necessarily the topic of content, but the style and valence of rumination that is important when considering its association with distress. The style of rumination should be the target of clinical intervention, including brooding and intrusion.

Are All Anxieties Created Equal? Stress-related Networks and Anxiety Phenotypes in Old Age

OBJECTIVE

The dysregulation of stress-related networks due to chronic symptoms such as severe worry and/or rumination is one of the putative pathways linking anxiety in late-life with cognitive decline and increased cardiovascular burden. Symptoms such as severe worry or rumination respond poorly to standard treatment and drive the morbidity associated with anxiety in older adults. We assessed if any of the neural networks anchored in the stress-related regions of interest (ROIs) are associated with distinct anxiety phenotypes (worry, rumination and global anxiety).

METHODS

We recruited older participants (over 50 years of age) with varying levels of worry (N = 91) to undergo resting state fMRI. We computed seed-based connectivity for each ROI: the bed nucleus of the stria terminalis, the paraventricular nucleus of the hypothalamus, habenula, and amygdala. We limited our connectivity analyses to extracted regions for each seeded ROI-based network based on their canonical networks in 1,000 participants (Neurosynth). Using connectivity and clinical factors, we fit cross-validated elastic net models to predict scores on Penn State Worry Questionnaire, Rumination Subscale Questionnaire, Hamilton Anxiety Rating Scale, and Perceived Stress Scale.

RESULTS

We identified several distinct connectivity patterns that predict anxiety phenotypes' severity. Greater worry was associated with greater paraventricular nucleus of the hypothalamus -subgenual anterior cingulate cortex, parahippocampal, and olfactory and amygdala-PHC connectivity. Greater global anxiety was associated with lower amygdala-superior temporal gyrus connectivity. Greater perceived stress was associated with lower amygdala-inferior temporal gyrus and amygdala-fusiform gyrus connectivity.

CONCLUSION

Our study suggests that various late-life anxiety phenotypes (worry, global anxiety, rumination) may be associated with varying functional connectivity related to stress and emotion regulation. This may aid in the development of future targeted interventions.

Links between Savoring, Rumination, and Sleep-Related Experiences across Adulthood: Implications for Older Adults

OBJECTIVES

Sleep problems are pervasive, particularly in older adults. Much work examines psychological factors that adversely affect sleep; fewer studies examine those with a positive effect. Savoring is a form of positive repetitive thought that is linked to several aspects of health but has been understudied in relation to sleep. We examined cross-sectional associations of both savoring and rumination with subjective sleep experiences, and assessed if these associations vary by age.

METHODS

Adults and older adults (N = 216) ranging from 20-80 years in age (M = 44.9 ± 15.6 years) completed an online survey of validated measures of savoring, rumination, sleep disturbance, and sleep-related impairment.

RESULTS

Higher levels of savoring were significantly associated with lower levels of sleep-related impairment but not sleep disturbance in regression analyses. Higher levels of rumination were significantly associated with higher levels of sleep disturbance and sleep-related impairment. Associations of savoring and rumination with sleep-related experiences did not vary by age.

CONCLUSIONS

Savoring and rumination are relevant to sleep-related experiences in adults ranging from younger to older. Further investigation of the potential positive impact of savoring on sleep-related experiences is needed.

CLINICAL IMPLICATIONS

Engagement in savoring and rumination should be considered when assessing sleep and sleep-related impairment in adults.

Preoccupation as psychopathological process and symptom in adjustment disorder: A scoping review

In the ICD‐11 diagnostic guidelines, preoccupation has been introduced as the new core symptom of adjustment disorder. Despite this essential innovation, preoccupation has so far largely been defined as rumination and worry and does not feature a distinct character as an independent symptom. In order to investigate the nature of preoccupation, various cognitive approaches are evaluated and linked to preoccupation. Furthermore, the aim of this review is to define preoccupation more precisely and to distinguish it from other symptoms in psychopathology. The evaluation of key features of cognitive dissonance theory, attention bias theory, memory theories, and other cognitive paradigms indicates that preoccupation is constituted by a complex interaction of cognitive–emotional mechanisms. In addition, this review implies that preoccupation in AjD can be defined as stressor‐related factual thinking, which is time‐consuming and often associated with negative emotions. It is assumed that rumination and dysfunctional worry serve as reactive processes to cope with preoccupation. For further distinction, this review presents similarities and differences of preoccupation and other symptoms, including negative automatic thoughts, flashbacks, and yearning. Finally, implications and suggestions for future research on preoccupation are offered. Overall, it is plausible that preoccupation is not only associated with adjustment disorder but also possesses a transdiagnostic character.

Aging faster: worry and rumination in late life are associated with greater brain age

Older adults with anxiety have lower gray matter brain volume-a component of accelerated aging. We have previously validated a machine learning model to predict brain age, an estimate of an individual's age based on voxel-wise gray matter images. We investigated associations between brain age and anxiety, depression, stress, and emotion regulation. We recruited 78 participants (≥50 years) along a wide range of worry severity. We collected imaging data and computed voxel-wise gray matter images, which were input into an existing machine learning model to estimate brain age. We conducted a multivariable linear regression between brain age and age, sex, race, education, worry, anxiety, depression, rumination, neuroticism, stress, reappraisal, and suppression. We found that greater brain age was significantly associated with greater age, male sex, greater worry, greater rumination, and lower suppression. Male sex, worry, and rumination are associated with accelerated aging in late life and expressive suppression may have a protective effect. These results provide evidence for the transdiagnostic model of negative repetitive thoughts, which are associated with cognitive decline, amyloid, and tau.

Emotional approach coping in older adults as predictor of physical and mental health

Emotional approach coping involves active attempts at emotional expression and processing in response to stressful circumstances. This study tested whether dispositional emotional approach coping processes predict changes in physical and mental health in community-dwelling older adults, particularly within the context of higher perceived stress. To test this, older adults (N = 150) completed assessments of emotional expression and emotional processing at study entry. They also completed measures of perceived stress, depressive symptoms, and ill-health (a composite of subjective and objective physical health indicators, which included blood draw for collection of biomarkers), every 6 months over 4.5 years. Emotional processing and emotional expression were not related significantly to ill-health at study entry. However, emotional processing (but not emotional expression) significantly predicted changes in ill-health. At higher levels of emotional processing, ill-health remained low and stable; at lower levels of emotional processing, ill-health increased over time. However, when perceived stress was high, higher emotional processing and emotional expression were related to lower depressive symptoms at study entry, but higher emotional processing was associated with increasing depressive symptoms over time. Emotional approach coping processes evidence prospective relations with health outcomes, which are partially conditioned by stress perceptions. Emotional processing appears to have a protective impact against declining physical health. Predictive relationships for depressive symptoms are more complex. Older adults with chronically high perceived stress might benefit from interventions that target emotion-regulating coping processes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Structure of Self-Regulation and Its Psychological and Physical Health Correlates in Older Adults

Self-regulation refers to effortful control over one's thoughts, emotions, choices, impulses, and behaviors, and has implications for older adults' health. Executive function, physiological, and subjective indices have all been proposed to reflect self-regulation. Pairwise associations among these indices have been previously examined; however, a self-regulation constellation encompassing all of these indices has never been tested in older adults. The present study described the relationships among indices of self-regulation and tested their between- and within-person associations with upstream personality factors (conscientiousness) and downstream psychological and physical health in 149 older adults aged 60-93 years, assessed semi-annually for five years (up to 10 waves). Indices of self-regulation were only modestly correlated with each other but were each associated with health. Better executive function was associated with better psychological and physical health between and within people, whereas higher heart rate variability was associated with psychological health within people. Better subjective self-regulation had the most between- and within-person associations with better psychological and physical health. Conscientiousness was associated with subjective self-regulation and better psychological and physical health. These findings support the non-unitary nature of self-regulation in older adults and the health relevance of each of its indices between and within older adults. The aging process may change how the indices relate to each other, and older adults may draw more on certain self-regulatory components over others, given limited resources. Subjective self-regulation may be an important final common pathway to psychological and physical health in older adults.

Sleep in the anxiety-related disorders: A meta-analysis of subjective and objective research

Although sleep disturbance is implicated in psychopathology, its role in anxiety-related disorders remains unclear. The present meta-analysis characterizes sleep disturbance in anxiety-related disorders collectively and individually. Subjective measures of total sleep time and sleep continuity were included with objective measures. Results indicate a large effect for increased subjective sleep disturbance (g = 2.16), medium effects for decreased total sleep time (g = -.40) and sleep continuity (g = -.49), and a small effect for decreased sleep depth (g = -.20) in anxiety-related disorders compared to healthy controls. Each anxiety-related disorder exhibited a distinct sleep disturbance pattern, suggesting that sleep may facilitate identification of unique biopsychological underpinnings. Effects were not moderated by comorbid depression and were similar in magnitude to those found for depression. Sleep disturbances, particularly decreased sleep continuity, may be a key pathology in the anxiety-related disorders that could highlight novel etiological mechanisms and intervention targets.

Between the Error Bars: How Modern Theory, Design, and Methodology Enrich the Personality-Health Tradition

The study of relationships between personality traits and health has a long history in psychosomatic research. However, personality science has evolved from an understanding of personality as fixed traits to one that acknowledges that personality is dynamic. Dynamic approaches to conceptualizing and measuring personality and individual differences can enrich personality-health research. In this Presidential Address (American Psychosomatic Society, 2018), I consider how different formulations of personality-stable traits, stable signals in a noisy or variable measure, within-person changes, and intraindividual variability-can be implemented to better understand how personality is related to health and particularly to immune function. These approaches recognize and, in some cases, capitalize on the fact that personality factors can display variability as well as stability over time. They also require repeated measurement and therefore greater methodological sophistication that considers reliability and generalizability, Simpson's paradox, and the difference between variability and flexibility. Dynamic qualities of personality and individual differences potentially influence health, and designs and methodology that incorporate them can illuminate the important processes that occur inside the error bars.

Coping Flexibility and Health-Related Quality of Life Among Older Adults: The Compensatory Effect of Co-rumination

Background: Coping flexibility, defined as a wide range of coping strategies, may be a promising construct in determining coping effectiveness, especially in conjunction with a person-centered approach. However, no studies have focused on these issues. The study aimed to identify the distinct, multidimensional patterns of strategies for coping with chronic health conditions and their association with changes in physical and psychological health-related quality of life (HRQoL) among older adults over a one month period.

Methods: Coping strategies (brooding, reflection, co-rumination, and positive reappraisal) and HRQoL psychological and physical domains were assessed twice (at the baseline and one month later) among 210 older adults (age 76.12 ± 9.09 years, 66% women).

Findings: The parallel process analysis demonstrated the sample heterogeneity regarding coping. In multidimensional latent class growth analysis (MLCGA), four coping classes of overall strategies were identified: consistently low (46%), medium and decreasing (18%), medium and increasing (20%), and consistently high (16%). The last two can be considered the coping flexibility. Participants in the medium and increasing subgroup reported enhancement in HRQoL psychological domain, whereas members of the consistently high subgroup indicated its decrease. The favorable effects were related to an increase in co-rumination.

Discussion: The findings shed light on the longitudinal patterns of coping in older adults, showing that coping flexibility is more adaptive when it relies on modifying coping efforts rather than coping complexity. Co-rumination played a key role, compensated by the effect of maladaptive strategies.

Imbalance between abstract and concrete repetitive thinking modes in schizophrenia

OBJECTIVE

Repetitive thoughts can be divided in two modes: abstract/analytic (decontextualized and dysfunctional) and concrete/experiential (problem-focused and adaptive). They constitute a transdiagnostic process involved in many psychopathological states but have received little attention in schizophrenia, as earlier studies only indexed increased ruminations (related to dysfunctional repetitive thoughts) without jointly exploring both modes. This study explored the two repetitive thinking modes, beyond ruminations, to determine their imbalance in schizophrenia.

METHODS

Thirty stabilized patients with schizophrenia and 30 matched controls completed the Repetitive Response Scale and the Mini Cambridge-Exeter Repetitive Thought Scale, both measuring repetitive thinking modes. Complementary measures related to schizophrenic symptomatology, depression and anxiety were also conducted.

RESULTS

Compared to controls, patients with schizophrenia presented an imbalance between repetitive thinking modes, with increased abstract/analytic and reduced concrete/experiential thoughts, even after controlling for comorbidities. Schizophrenia is associated with stronger dysfunctional repetitive thoughts (i.e. abstract thinking) and impaired ability to efficiently use repetitive thinking for current problem-solving (i.e. concrete thinking).

CONCLUSION

This imbalance confirms the double-faced nature of repetitive thinking modes, whose influence on schizophrenia's symptomatology should be further investigated. The present results also claim for evaluating these processes in clinical settings and for rehabilitating the balance between opposite repetitive thinking modes.

Intelligence and Interleukin-6 in Older Adults: The Role of Repetitive Thought

OBJECTIVE

Higher intelligence quotient (IQ) correlates with lower systemic inflammation, consistent with an association between lower IQ and disease risk. The present study examined the role of repetitive thought (RT) in the relationship between IQ and interleukin (IL)-6. RT is thinking attentively, repeatedly, and frequently about oneself and one's world and is characterized by valence (positive-negative), purpose (searching-solving), and total quantity (much-little).

METHODS

Estimated IQ and RT dimension scores were assessed at baseline in a sample of older adults (N = 120, mean age = 74 years), who thereafter had blood drawn up to 10 times semiannually (n = 799). Models were adjusted for body mass index, chronological age, and statin medication.

RESULTS

Higher IQ was associated with lower IL-6 (γ = -0.225, SE = 0.111, p = .045). Of the RT dimensions, only more total RT predicted lower IL-6 (γ = -0.037, SE = 0.011, p = .001), an effect that was not moderated by valence or purpose. More total RT accounted for part of the effect of IQ on IL-6 (indirect effect = -0.06 [confidence interval = -0.14 to -0.002]). There was also a significant interaction between IQ and total RT (F(1,119) = 6.97, p = .009), in which more total RT was more strongly associated with lower IL-6 for people with lower IQ.

CONCLUSIONS

Although some forms of RT such as worry may have negative health correlates for older adults, engaging in RT per se can be healthy insofar as it also encompasses planning, processing, and coping. Older adults with higher IQ were more likely to engage in RT, but those with average IQ benefitted the most with regard to a marker of systemic inflammation.

Communication and Stress: Effects of Hope Evocation and Rumination Messages on Heart Rate, Anxiety, and Emotions After a Stressor

How we cope with the many stressors that we encounter throughout our lives has implications for our well-being. By affecting how individuals appraise stressful events, communication can prolong or ameliorate physiological and emotional responses to stress. This study investigated the short-term effects of hope-inducing and rumination-inducing messages on heart rate, state anxiety, and emotions after a standardized, social-evaluative stressor. Continuous heart rate was monitored for 127 college students (64 female, 63 male) throughout an experiment that included a performance stressor and messages designed to (a) cause feelings of hope, (b) evoke rumination, or (c) be a distraction (control). Heart rate varied by message, such that heart rate was lowest in the hope evocation condition. State anxiety was lower in the hope evocation and distraction control conditions than in the rumination condition. The rumination condition led to greater anger, greater guilt, and less happiness than did the other conditions. This study advances our knowledge about potential ways that communication messages can counter the psychological and biological effects of stressful life events. Overall, the study provides preliminary evidence that hope evocation messages may be a form of supportive communication and can ameliorate stress.

Age differences in rumination and autobiographical retrieval

OBJECTIVES

Higher well-being in older adults compared to young adults is a well-known phenomenon. However, the variables associated with this effect are still uncertain. Negative repetitive thinking (rumination) is a transdiagnostic variable related to psychopathology. It is strongly associated with depression and a lack of specificity in autobiographical retrieval. This research explores age differences in the association of rumination with mood, autobiographical memories and working memory.

METHOD

Two groups of participants (older adults versus young adults), recruited through a public announcement, were compared in a cross-sectional study.

RESULTS

Older adults ruminated less than young participants. Rumination was positively associated with depression scores but not with working memory scores in both samples. More importantly, the interaction between brooding rumination and negative autobiographical memories was the only significant variable to explain the variance of mood scores in young participants. However, in older participants, the interaction between brooding and positive autobiographical memories significantly explained the variance of mood scores. Digit span forward and the interaction of brooding by negative autobiographical memories also significantly explained mood scores in older adults.

CONCLUSION

These results suggest that a different interaction between brooding rumination and the valence of autobiographical memories may be a relevant variable associated with mood differences by age.

Beliefs about savoring in older adulthood: Aging and perceived health affect temporal components of perceived savoring ability

The ability to savor positive life events is associated with higher emotional well-being; however, few studies have examined savoring ability in older adults. The present study used a longitudinal design to examine changes in perceived savoring abilities and associations with perceived health in older adulthood. Older adults (N=131) reported on beliefs about savoring and perceived health at baseline and 2½ years later. Perceived anticipation (savoring the future) and reminiscing (savoring the past) abilities declined from baseline to follow-up. Better perceived health at baseline predicted greater perceived reminiscing and anticipation abilities at follow-up. Greater perceived ability to savor the present moment at baseline predicted better perceived health at follow-up. Aging and poorer health focus older adults' thoughts on present-moment pleasures, which may benefit health, but may also lead to reductions in perceived anticipation and reminiscing abilities.

Age and Gender Differences in Emotion Regulation Strategies: Autobiographical Memory, Rumination, Problem Solving and Distraction

Our study tested the hypothesis that older adults and men use more adaptive emotion regulatory strategies but fewer negative emotion regulatory strategies than younger adults and women. In addition, we tested the hypothesis that rumination acts as a mediator variable for the effect of age and gender on depression scores. Differences in rumination, problem solving, distraction, autobiographical recall and depression were assessed in a group of young adults (18-29 years) compared to a group of older adults (50-76 years). The older group used more problem solving and distraction strategies when in a depressed state than their younger counterparts (ps .06). Ordinary least squares regression analyses with bootstrapping showed that rumination mediated the association between age, gender and depression scores. These results suggest that older adults and men select more adaptive strategies to regulate emotions than young adults and women with rumination acting as a significant mediator variable in the association between age, gender, and depression.

Social Daydreaming and Adjustment: An Experience-Sampling Study of Socio-Emotional Adaptation During a Life Transition

Estimates suggest that up to half of waking life is spent daydreaming; that is, engaged in thought that is independent of, and unrelated to, one’s current task. Emerging research indicates that daydreams are predominately social suggesting that daydreams may serve socio-emotional functions. Here we explore the functional role of social daydreaming for socio-emotional adjustment during an important and stressful life transition (the transition to university) using experience-sampling with 103 participants over 28 days. Over time, social daydreams increased in their positive characteristics and positive emotional outcomes; specifically, participants reported that their daydreams made them feel more socially connected and less lonely, and that the content of their daydreams became less fanciful and involved higher quality relationships. These characteristics then predicted less loneliness at the end of the study, which, in turn was associated with greater social adaptation to university. Feelings of connection resulting from social daydreams were also associated with less emotional inertia in participants who reported being less socially adapted to university. Findings indicate that social daydreaming is functional for promoting socio-emotional adjustment to an important life event. We highlight the need to consider the social content of stimulus-independent cognitions, their characteristics, and patterns of change, to specify how social thoughts enable socio-emotional adaptation.

A systematic review of sleep disturbance in anxiety and related disorders

Recent research suggests that sleep disturbance may be a transdiagnostic process, and there is increasing interest in examining how sleep disturbance may contribute to anxiety and related disorders. The current review summarizes and synthesizes the extant research assessing sleep in anxiety and related disorders. The findings suggest that sleep disturbance exacerbates symptom severity in the majority of anxiety and related disorders. However, the nature of sleep disturbance often varies as a function of objective versus subjective assessment. Although sleep disturbance is a correlate of most anxiety and related disorders, a causal role for sleep disturbance is less clear. A model of potential mechanisms by which sleep disturbance may confer risk for the development of anxiety and related disorders is discussed. Future research integrating findings from basic sleep research with current knowledge of anxiety and related disorders may facilitate the development of novel treatments for comorbid sleep disturbance and clinical anxiety.

The many faces of anxiety-neurobiological correlates of anxiety phenotypes

Anxiety is an all-inclusive concept incorporating somatic symptoms (palpitations, dizziness, dyspnea), emotional and cognitive elements (negative affect, fear, worry, rumination) and behavioral components (e.g., avoidance). The aim of this study was to examine the specific neural correlates associated with anxiety phenotypes (worry, rumination, somatic anxiety) and negative affect (neuroticism). Twenty-nine anxious participants and 30 healthy controls were included in the study. We analyzed seed-based intrinsic connectivity and used correlation maps in a multivariable regression model to describe the specific effect of each anxiety phenotype independently of the effects of age and the other measures of anxiety. Worry severity was uniquely correlated with increased intrinsic connectivity between right anterior insula (RAI) and the precuneus. Global and somatic anxiety were associated with the limbic and paralimbic structures (increased connectivity between the amygdala, PVN, and hippocampus), while neuroticism was correlated with increased connectivity between limbic and prefrontal structures. Rumination severity did not correlate significantly with any measures of functional connectivity once we controlled for other clinical measures of anxiety. Measures of worry, global anxiety, somatic anxiety, and neuroticism have distinct 'neural signatures'. These results advocate for a fine-grain approach when analyzing the neural substrates of clinical samples with various anxiety disorders.

Briefly Assessing Repetitive Thought Dimensions: Valence, Purpose, and Total

Discrete forms of repetitive thought (RT), such as worry and reflection, can be characterized along basic dimensions of valence (positive vs. negative) and purpose (searching vs. solving). In addition, people can be characterized as high or low in their tendency to engage in RT. This dimensional model has been demanding to assess, and a smaller number of items that could stand in for a large battery would make measurement more accessible. Using four samples (N = 1,588), eight items that assess RT valence, purpose, and total in a circumplex model were identified. Across these and other samples, the dimensions were adequately reliable and valid with regard to assessment via large RT battery, other measures of RT, and depressive symptoms. The accessibility of dimensional assessment of RT using this smaller number of items should facilitate work on questions about the qualities of RT that predict mental and physical health.

Ovarian hormones and borderline personality disorder features: Preliminary evidence for interactive effects of estradiol and progesterone

Cyclical fluctuations in the ovarian hormones 17β-estradiol (E2; estrogen) and progesterone (P4) predict emotions, cognitive processes, and behaviors relevant to Borderline Personality Disorder (BPD); however, there are individual differences in sensitivity to normal hormone shifts. This study examined associations of naturally occurring hormonal changes with concurrent BPD feature expression. Forty women sampled for a flat distribution of the PAI-BOR (n=10 where T<50, n=10 where 50<T<60, n=10 where 60<T<70, and n=10 where T>70) provided four weekly saliva samples and psychological assessments. Across most outcomes (e.g., BPD features, felt rejection, anger rumination, negative urgency) P4 deviation (from one's person mean) moderated the effect of current E2 deviation (from one's person mean) among women high (+1 SD) in trait BPD features such that E2 deviation was negatively associated with symptoms only when P4 was higher-than-usual. Cyclical hormone changes (e.g., higher P4 in the luteal phase; E2 fluctuations at ovulation and in the luteal phase) may impact BPD feature expression among at-risk women.

Repetitive thought dimensions, psychological well-being, and perceived growth in older adults: a multilevel, prospective study

BACKGROUND AND OBJECTIVES

Forms of repetitive thought (RT) such as worry are clearly related to states such as anxiety and depression. However, the presence of other forms such as reminiscing suggests that RT could also relate to eudaimonic well-being (EWB). Furthermore, a largely overlooked characteristic, total tendency to engage in RT, may associate with a particular kind of EWB, namely, perceived growth (PG).

DESIGN

Older adults (N=150) were interviewed semi-annually for up to 10 waves.

METHODS

Participants completed a battery of RT measures at baseline and annual assessments of psychological well-being (PWB) and PG. Multilevel models tested the prospective, between-person relationships between baseline RT and future PWB and PG.

RESULTS

RT qualities prospectively predicted both PWB and PG: more positive valence best predicted PWB whereas more negative valence and more total RT best predicted PG. Furthermore, RT qualities largely accounted for a negative between-person relationship between PWB and PG.

CONCLUSIONS

Different qualities of RT promoted different kinds of EWB, and a negative association between different kinds of EWB could be attributed to their different RT antecedents.

Stress, health and illness: four challenges for the future

The concept of stress has a long and perhaps foundational history in health psychology. However, it is also not without its detractors, who point out imprecise and simplistic use of the concept. Four challenges for stress research in health psychology delineate the nuanced and contextualised future. First, 'stress' can be located in the environment, in appraisal or in response (e.g., emotions or physiology). Careful conceptualisation and assessment can differentiate among these locales, as well as reveal interactions among them. Second, coping refers to the transaction between stress and the affected person. Understanding exactly why coping moderates the effects of stress is a major challenge for coping research. Third, stress happens to different people with different personalities and temperaments and at different stages of their lives. People may even be different from themselves at different life stages. These individual differences can impact all manner of stress and coping. Fourth, stress is dynamic. Minor events come and go, and major events create a cascade of changes in the individual's life. Understanding how stress, coping and health change over time within individuals (i.e., in a multi-level framework) will be a major advance for the field.

A lifespan view of anxiety disorders

Neurodevelopmental changes over the lifespan, from childhood through adulthood into old age, have important implications for the onset, presentation, course, and treatment of anxiety disorders. This article presents data on anxiety disorders as they appear in older adults, as compared with earlier in life. In this article, we focus on aging-related changes in the epidemiology, presentation, and treatment of anxiety disorders. Also, this article describes some of the gaps and limitations in our understanding and suggests research directions that may elucidate the mechanisms of anxiety disorder development later in life. Finally we describe optimal management of anxiety disorders across the lifespan, in "eight simple steps" for practitioners.

Rumination: relationships with physical health

Rumination is a form of perserverative cognition that focuses on negative content, generally past and present, and results in emotional distress. Initial studies of rumination emerged in the psychological literature, particularly with regard to studies examining specific facets of rumination (e.g., positive vs. negative rumination, brooding vs. self-reflection, relationships with catastrophic thinking, role of impaired disengagement, state vs. trait features) as well as the presence of rumination in various psychiatric syndromes (e.g., depression, alcohol misuse, generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, bulimia nervosa). Rumination studies are now emerging in the somatic literature, particularly in relationship to pain. In these studies, rumination appears to be associated with symptom magnification as well as poorer clinical outcomes. While still a nascent field, the assessment and treatment of rumination in primary care settings is beginning to unfold.

Episodic repetitive thought: dimensions, correlates, and consequences

Repetitive thought (RT) - attentive, prolonged, or frequent thought about oneself and one's world - plays an important role in many models of psychological and physical ill health (e.g., rumination and worry), as well as models of recovery and well-being (e.g., processing and reminiscing). In these models, repetitive thought is typically treated as stable or trait-like. In contrast, episodic RT reflects what people have "on their minds" at a particular point in time. In four studies, young women (N=94), college students (N=166), first-year law students (N=73), and older adults (N=174) described their episodic RT, which was then rated for qualities including valence, purpose, and theme. Episodic RT valence was associated with mood and depressive symptoms both between (Studies 1-4) and within people (Studies 3-4), and it mediated the effects of dispositional coping through emotional approach (Study 1). The effect of episodic RT valence in turn was moderated by other properties of episodic RT, including purpose, "trait" valence, and theme (Studies 1-4). The study of episodic RT complements that of trait RT and allows for observations of how RT and psychological adjustment change in concert and in context, as well as examining how the RT qualities that are not reflected in trait measures affect adjustment.