Category: Transdiagnostic


Perseverative Thought as a Predictor of Depression and Anxiety

Saturday, November 18
10:15 AM - 11:45 AM
Location: Sapphire Ballroom B, Level 4, Sapphire Level

Keywords: Cognitive Processes | GAD (Generalized Anxiety Disorder) | Depression
Presentation Type: Symposium

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are highly comorbid and both involve elevated levels of perseverative thought (PT), or the tendency to engage in negative, repetitive thinking. Although PT is strongly associated with MDD and GAD cross-sectionally, its ability to predict future disorder outcomes is unknown. Additionally, the relative predictive power of PT at rest vs. PT reactivity to stressful events has not been explored.

In the present study, adults recruited from the Philadelphia community were diagnosed with MDD, GAD, or both disorders (N = 69) using a semi-structured diagnostic interview (the ADIS-IV). They then went through a standardized, personally significant stressor involving negative performance feedback. Participants’ perseverative thoughts were sampled within a focused breathing paradigm before and after the stressor. They also reported on PT content and process following the stressor. One to two years later (M = 18 months, SD = 6.4), participants were re-assessed for MDD and GAD and assigned clinical severity ratings using an abbreviated ADIS.             

Less control over thoughts during focused breathing before the stressor predicted both GAD (diagnosis and severity) and MDD (severity) outcomes 1-2 years later. By contrast, less control over thoughts and more negative thought intrusions during focused breathing following the stressor specifically predicted GAD diagnosis and severity at follow-up, even after adjusting for pre-stressor PT levels. Similarly, PT content (task- and self-focused negative thoughts) and process (frequency, intensity, anxious/depressed quality of thoughts and distress about thoughts) following the stressor specifically predicted GAD diagnosis and severity.

Perseverative thinking in response to a stressor predicted clinical status and severity 1-2 years later. While PT at rest predicted MDD and GAD, PT reactions to failure specifically predicted GAD. Given the close relationship between MDD and GAD, these results suggest that PT reactivity could help disentangle GAD from MDD trajectories and may serve as a mechanism of specificity for anxiety relative to depression. 

Gabriela K. Khazanov

Graduate student
University of Pennsylvania


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Perseverative Thought as a Predictor of Depression and Anxiety

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