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08-08-2022 | Original Article

Symptom-Level Network Analysis Distinguishes Unique Associations of Repetitive Negative Thinking and Experiential Avoidance with Depression and Anxiety in a Transdiagnostic Clinical Sample

Auteurs: Kean J. Hsu, Michael Mullarkey, Mallory Dobias, Christopher G. Beevers, Thröstur Björgvinsson

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2022

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Abstract

Introduction

Repetitive negative thinking and experiential avoidance have been hypothesized to be related, transdiagnostic maintenance factors for depression and anxiety, yet is unclear how these processes overlap or diverge. Here we use a symptom-level approach to address this question.

Methods

Adults presenting for treatment to an intensive CBT program (n = 492) completed measures of depression and anxiety symptom severity, repetitive negative thinking, and experiential avoidance. Our pre-registered network analysis approach examined the contribution of these transdiagnostic maintenance factors to the predictability of a depression and anxiety symptom network. Exploratory analyses used permutation testing to formally evaluate the predictability of the symptom network.

Results

Permutation testing indicates that repetitive negative thinking significantly improved the predictability of worrying and poor concentration, whereas experiential avoidance improved the predictability of difficulties relaxing, being afraid something bad was going to happen, and feeling like a failure.

Limitations

Our sample was cross-sectional and a predominantly white, educated, industrialized, rich, and democratic (WEIRD) sample.

Conclusions

Repetitive negative thinking and experiential avoidance each were associated with symptoms of depression and anxiety but did not overlap across the comorbid symptom network. More broadly, applying network analysis helps to more precisely identify which symptoms of depression and anxiety are associated with transdiagnostic maintenance factors, thus providing insight into how these factors may contribute to the maintenance of co-occurring disorders.
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To attempt to contextualize the importance of repetitive negative thinking and experiential avoidance, we also permuted each individual symptom using a similar process to examine how overall network predictability and individual symptom predictability are impacted. As it is not possible to compare whether the increase in predictability across these different permuted networks significantly differ, these results are only included in the Supplemental Materials.
 
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Metagegevens
Titel
Symptom-Level Network Analysis Distinguishes Unique Associations of Repetitive Negative Thinking and Experiential Avoidance with Depression and Anxiety in a Transdiagnostic Clinical Sample
Auteurs
Kean J. Hsu
Michael Mullarkey
Mallory Dobias
Christopher G. Beevers
Thröstur Björgvinsson
Publicatiedatum
08-08-2022
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 6/2022
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-022-10323-y

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