Transdiagnostic mechanisms in depression and anxiety: The role of rumination and attentional control
Open accessAbstract
Background Deficits in attentional control have been hypothesized to cause rumination, suggesting that the relationships between attentional control and clinical symptoms may be mediated in part by rumination. However, to date, no clinical study has examined these constructs transdiagnostically in a path analysis model.Methods Fifty-one adults presenting for treatment completed measures of self-reported attentional control, rumination, and depression and anxiety symptoms. A bias-corrected path analysis-based approach was employed to test whether indirect (i.e., mediating) effects of rumination were significantly associated with the direct effects of attentional control on depression and anxiety symptoms. Separate models for depression and anxiety symptoms were tested along with reverse models using attentional control as a proposed mediator.Results The relationship between attentional control and clinical symptomatology (i.e., both depression and anxiety symptoms) was mediated by rumination. Poor attentional control was associated with more rumination and consequently more severe symptoms of depression and anxiety. The reverse relationship (i.e., attentional control mediating the relationship between rumination and depression or anxiety symptoms) was not significant.Limitations Study design did not allow testing of temporal precedence for the mediation models. All constructs were assessed via self-report.Conclusions Attentional control appears to impact depression and anxiety symptoms through rumination. The pathway between poor attentional control and emotion dysregulation via rumination suggests that interventions targeting attentional control may decrease maladaptive ruminative processes, leading to improved emotion regulation and reduced clinical symptomatology. Future studies should examine the stability of this mediational relationship over time (and in the face of targeted interventions).
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Decreased self-reported cognitive control is linked to increased depression severity via increased rumination.
“↓ Self-reported cognitive control linked to ↑ depression severity via ↑ rumination 158”
From Neuroplasticity in cognitive and psychological mechanisms of depression: an integrative model (2020) · cites this paper as [158]
Studies have reported strong associations between self-reported attentional difficulties and greater rumination, fears, worry, and internalizing symptoms.
“In line with this possibility, studies have reported strong associations between self-reported attentional difficulties and greater rumination, fears, worry, and internalizing symptoms (Devito et al., 2019; Hsu et al., 2015; Williams et al., 2017).”
From Disentangling the effects of attentional difficulties on fears of social evaluation and social anxiety symptoms: Unique interactions with sluggish cognitive tempo (2020) · cites this paper as Hsu et al., 2015
Attentional difficulties are linked to greater threat-related attentional biases, fears, and internalizing symptoms.
“Although prior research had shown that attentional difficulties are associated with increased threat-related attentional biases, fears, and internalizing symptoms (Hsu et al., 2015; Koster et al., 2011; Van Bockstaele et al., 2014)”
From Disentangling the effects of attentional difficulties on fears of social evaluation and social anxiety symptoms: Unique interactions with sluggish cognitive tempo (2020) · cites this paper as Hsu et al., 2015
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- Authors
- Hsu, K. J., Beard, C., Rifkin, L., Dillon, D. G., Pizzagalli, D. A., & Björgvinsson, T.
- Affiliations
- Harvard University (US)
- McLean Hospital (US)
- Corresponding author
- Hsu, Kean J.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 188
- Pages
- 22-27
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC4765997
- OpenAlex
- W1813114717
- Cited by
- 167
- References
- 61
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 23 · 2023: 14 · 2022: 18 · 2021: 22 · 2020: 16 · 2019: 13 · 2018: 13 · 2017: 11 · 2016: 5
- FWCI
- 14.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R00MH094438)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- rumination, attentional control, depression, anxiety, transdiagnostic mechanisms, mediation, emotional dysregulation, emotion regulation
- MeSH terms
- Adult, Anxiety, Attention, Depression, Female, Humans, Male, Models, Psychological, Psychiatric Status Rating Scales, Young Adult, Self Report, Symptom Assessment
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