Relations between trait anxiety and depression: A mediated moderation model
Abstract
Background This study proposed a mediated moderation model based on the cognitive theory and susceptibility phenotype theory for depression to explore the moderating role of cognitive flexibility in the relationship between trait anxiety and depression and the mediating role of rumination in this interactive effect.Methods The subjects were selected via the cluster sampling method. A cross-sectional survey of 1619 Chinese adults of Han nationality was recruited from three cities in central and western China. The trait anxiety subscale of the State-Trait Anxiety Inventory (STAI-Trait scale), Short Ruminative Response Scale (SRRS), Cognitive Flexibility Inventory (CFI) and Beck Depression Inventory (BDI-II) were used for a paper-and-pencil evaluation. The data were statistically processed using correlation analysis, multiple linear regression analysis, and a test of mediated moderation.Results (1) Trait anxiety was significantly positively correlated with rumination and depression. There was a significant negative correlation between cognitive flexibility and trait anxiety, rumination, and depression. (2) The moderating effect of cognition flexibility on the relationship between trait anxiety and depression was mediated by rumination, and the indirect moderating effect accounted for 79.25% of the total variance.Limitations Cross-sectional studies do not reveal the causal relationships between observed variables well. Self-report questionnaires lack objective indicators. The applicability of the current results in the clinical depression population requires further experimental tests.Conclusions The results support the important role of trait anxiety in the development of depression. Cognitive flexibility moderates the relationship between trait anxiety and depression and has a risk-buffering effect on this relationship. Rumination plays a mediating role in the moderating effects of cognitive flexibility on the relationship between trait anxiety and depression. The findings enrich the research on the relationship between trait anxiety and depression and have important practical implications for the early prevention and intervention of depression, which can increase individual cognitive flexibility and address rumination to regulate depression.
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CI is associated with anxiety and depression in autistic youth and adult general population samples.
“CI has been linked to flexible problem solving and transition between activities in autistic individuals (Uddin, 2021) and associated with anxiety and depression in autistic youth (Hollocks et al., 2019) and adult general population samples (Gabrys et al., 2018; Wang et al., 2019).”
From Investigating the Effects of Transdiagnostic Processes on Anxiety and Depression Symptoms in Autistic Young People: the Mediating Role of Emotion Dysregulation. (2025) · cites this paper as Wang et al., 2019
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Trait anxiety is associated with reduced reward-related replay at rest
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“Individuals with higher trait anxiety are often thought to ruminate on negative outcomes 55,56 , and if such rumination is expressed via replay during rest 27 , one might predict a positive correlation between neutral-sequence replay strength and anxiety traits.”
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“They find it difficult to adapt their behaviour and emotions in response to incoming information, which is caused by low cognitive plasticity (Wang et al., 2019).”
Effects of Rumination on State Shame in Adolescents: An Online Experimental Investigation
McDermott, L., Cooper, M., & Lau-Zhu, A. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10768-5
“Higher cognitive flexibility has been associated with less shame in adults following potentially 3 for descriptive statistics. morally injurious events (Cenkner et al., 2023), whereas lower flexibility with higher state rumination (Altan-Atalay et al., 2022; Wang et al., 2019 ).”
- Authors
- Wang, T., Li, M., Xu, S., Liu, B., Wu, T., Lu, F., Xie, J., Peng, L., & Wang, J.
- Affiliations
- Army Medical University (CN)
- Corresponding author
- Li, Min
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 244
- Pages
- 217-222
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2890102264
- Cited by
- 58
- References
- 49
- Citations by year
- 2026: 4 · 2025: 17 · 2024: 8 · 2023: 12 · 2022: 6 · 2021: 7 · 2020: 4
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Military Research Foundation of the Chinese P.L.A (AWS16J025)
- Advance Research Fund of the Third Military Medical University (2016XYY06)
- Humanities and Social Sciences Fund of Army Medical University (2017XRW19)
- Technology Innovation and Application Demonstration (cstc2018jscx-msybX0063)
- 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 › Psychological Treatments and Assessments
- Keywords
- trait anxiety, depression, cognitive flexibility, rumination, mediated moderation, cognitive theories of depression, risk buffering, depression prevention
- MeSH terms
- Rumination, Cognitive, Adolescent, Adult, Anxiety, China, Cognition, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Personality, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Young Adult, Self Report
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