(PS2-C53) The Impact of Repetitive Negative Thinking on Social Functioning and Well-being in a Transdiagnostic Sample

Background: Repetitive negative thinking (RNT), including worry and rumination, is a transdiagnostic process involving perseverative, unproductive, and difficult to disengage from thoughts in response to negative emotions. RNT may impede adaptive emotion regulation by prolonging negative mood states, strengthening cognitive biases, and preventing effective problem-solving (Joormann & Stanton, 2016). Accordingly, RNT is a major risk factor for the development and maintenance of both internalizing and externalizing disorders, including major depressive disorder (MDD) and bipolar disorder (BD) (Samtani et al., 2021). While prior research has shown that depression and mania are reliably associated with impaired social functioning and reduced quality of life (Coryell et al., 1993), it is unknown if RNT may play a role in conferring risk for poor psychosocial outcomes. The present study addresses this gap in the literature by examining (1) if RNT predicted social functioning and well-being outcomes in a transdiagnostic sample, as well as (2) if RNT mediated the relationship between symptoms of depression and poor functional outcomes.

Methods: 19 adults with BD, 63 adults with MDD, and 63 adults with no psychiatric history aged 45-70 (M = 57.6, SD = 7.1) completed measures of RNT (Perseverative Thinking Questionnaire; PTQ; Ehring et al., 2011), social functioning impairments (Social Adjustment Scale-Self Report; SAS-SR; Weissman et al., 1999), and subjective well-being (Satisfaction With Life Scale; SWLS; Diener et al., 2010). Symptoms of depression were assessed via clinical interview using the Hamilton Rating Scale for Depression (HAMD; Hamilton, 1986).

Results: Linear regression models revealed that PTQ significantly predicted SAS (B = .02 p < .001) and SWLS (B = -.22, p < .001) scores after controlling for age and depression severity (HAMD). A mediation model revealed that the effect of HAMD on SAS was significantly mediated by PTQ (indirect effect = .04, SE= .10, 95% CI: .02, .06). A second mediation model revealed that the effect of HAMD on SWLS was significantly mediated by PTQ (indirect effect = -.39, SE = .10, 95% CI: -.62, -.22).

Discussion: Results show that RNT is a significant predictor of key psychosocial outcomes in adulthood, even after accounting for the effects of current depression levels. Results point to RNT as one of the mechanisms by which symptoms of depression have an effect on functional impairment and well-being. Findings lend support to the notion of RNT as a transdiagnostic cognitive process and suggest that RNT may be an important therapeutic target for adults with poor social functioning and/or life satisfaction.