COVID-19 fear and anxiety as mediators in the relationship between repetitive negative thinking and psychopathology: a community-based study during the 2nd confinement in Portugal.

Repetitive negative thinking is a cognitive dimension of the onset and maintenance of psychopathology, and increased levels of psychopathology have been observed during COVID-19 lockdowns. The role of fear of COVID-19 and COVID-19 anxiety has been poorly explored in terms of psychopathology during lockdowns due to the pandemic crisis. This study examines the mediating role of fear of COVID-19 and COVID-19 anxiety in the relationship between repetitive negative thinking and psychopathology during the second lockdown in Portugal. Participants completed a web survey that included a sociodemographic questionnaire, the Fear of COVID-19 Scale, the COVID-19 Anxiety Scale, the Persistent and Intrusive Negative Thoughts Scale, and the Depression, Anxiety, and Stress Scale - 21. The results showed a positive and significant correlation between all variables and identified fear of COVID-19 and COVID-19 anxiety as significant mediators in the relationship between repetitive negative thinking and psychopathology during the second lockdown in Portugal, after controlling for being isolated, being infected, and working in first line response of COVID-19. Overall, the current findings highlight the role of cognitive dimensions such as anxiety and fear in the context of COVID-19, nearly a year after the pandemic outbreak and after the release of a vaccine. Mental health programs should consider improving coping strategies for emotion regulation, particularly fear and anxiety, during major catastrophic health-related events.

Feasibility and effect of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking for Colombian young women

Online psychological interventions (OPI) are evidence-based programs that provide mental health treatment over the internet. Meta-analytic data suggests that OPI's effectively treat emotional symptomatology. RNT-focused ACT consider psychological inflexibility and RNT as trans-diagnostic process that significantly predict emotional symptomatology. The present study analyzed the effect of a self-help OPI which contents have previously shown content validity, user feasibility and effectivity. This is an open trial design with repeated measures of emotional symptomatology and behavioral change processes. Bayesian analysis of variance for repeated measures was conducted with JASP for each variable, Bayes Factors (BF10) determined how much the evidence favored OPI effect. Effect sizes, reliable and significant change and moderation analyses were also conducted. 18 cisgender women around 30 years old mostly heterosexual, single and unemployed finished the OPI. There is decisive evidence for OPI effect on emotional symptomatology and behavioral change processes (experiential avoidance, cognitive fusion and RNT). There is also anecdotal evidence for the moderating role of the number of hierarchical RNT triggers ( private events), their type and intimate partner relationship distress as well as anecdotal evidence against the moderating role of being a psychologist. Results need to be considered in the context of the study limitations and future research should explore the program's feasibility and effect in other populations and cultures. However, the program is feasible and efficacious for the treatment of emotional symptomatology at least for young cisgender women in Colombia.

Repetitive negative thinking during ambiguous situations: Interactive roles of looming cognitive style and intolerance of uncertainty.

BACKGROUND AND OBJECTIVES: Looming cognitive style (LCS) and intolerance of uncertainty (IUC) are both cognitive risk factors that play an important role in development of anxiety disorders. Even though both are known to be triggered by ambiguous situations, there is inadequate research on how they predict anxiety and repetitive negative thinking (RNT) patterns in response to ambiguity. The current study aimed to examine the interactive association of IUC and LCS with state anxiety and intensity of RNT following exposure to a stressor that involves ambiguity. METHODS: Data were collected from 292 (153 women) individuals aged between 18 and 63 (M = 20.82, SD = 5.20) who were administered self-report measures of LCS, IUC, and anxiety followed by a vignette describing an ambiguous situation. State RNT and anxiety were assessed following exposure to the vignette. RESULTS: The results indicated that IUC moderated the association of physical looming with state RNT. Individuals who have elevated levels of both physical looming and IUC reported experiencing more higher frequency of RNT when compared with other individuals. LIMITATIONS: Although the manipulation check has shown that the scenario is effective it was not pilot tested. Also, since the manipulation was conducted online, the manipulation may not have been presented in a standardized way to all the participants. CONCLUSIONS: Overall, the study shows that the two risk factors enhance each other's effect and lead to more intense levels of repetitive, uncontrollable, and distressing thoughts following exposure to ambiguity.

Content validity and perceived utility of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking.

Telehealth strategies have become essential for responding to the sanitary emergency due to the COVID-19 pandemic. In this context, developing online psychological interventions (OPIs) that can treat and prevent psychological difficulties is gaining more relevance. This article describes an acceptance and commitment therapy (ACT) based OPI focused on repetitive negative thinking (RNT). This OPI is called Disentangled, Aware, and Committed (DAC) and represents an attempt to adapt previous RNT-focused ACT protocols to this format type. Study 1 evaluated content validity through the assessment of four experts in ACT regarding clarity, utility, pertinence, conceptual adjustment, and therapeutic goal fulfillment for each component of the DAC program. In Study 2, forty-one undergraduate clinical psychology trainees rated the components of the DAC program according to its clarity and perceived utility. These participants were enrolled in a randomized controlled trial that analyzed the efficacy of the DAC to prevent the usually observed increase in emotional symptoms and RNT among this population. Expert reviewers in Study 1 rated all DAC components as clear and useful for potential users, following a logical order, theoretically coherent with the ACT model, and successfully fulfilling its stated goals. In Study 2, the participants also rated the DAC components as clear and potentially useful for their lives. In conclusion, the DAC appears to be a feasible transdiagnostic OPI for treating and preventing emotional symptoms, which warrants further studies analyzing its efficacy.

Loneliness and Depression in College Students During the COVID-19 Pandemic: the Role of Boredom and Repetitive Negative Thinking.

The COVID-19 pandemic triggered increased rates of depression, especially among college students. Due to social distancing guidelines, loneliness has been suspected as a prominent factor in depression during the pandemic. Research is needed to identify possible mechanisms through which loneliness conveys risk for pandemic-era depression. Two potential mechanisms are boredom and repetitive negative thinking (RNT). This study examined cross-sectional associations between depression, loneliness, boredom, and RNT in a sample of college students (N = 199) in April 2020 immediately following campus closure. Results showed a serial indirect effect of loneliness on depression through boredom then RNT. Moreover, specific indirect effects of loneliness on depression were found through boredom and RNT, individually. Though limited by the cross-sectional design, these data align with cognitive-behavioral theory and identify boredom and RNT as possible mechanisms of the association between loneliness and depression in college students during the COVID-19 pandemic.

Limited negative effects of the COVID-19 pandemic on mental health measures of Ghanaian university students.

BACKGROUND: Stress and mental health outcomes are negatively correlated among university students throughout the world. Reports of differences in stress perception by gender exist, but there is limited data on students from sub-Saharan African countries. This study describes the burden of perceived and financial stress; characterizes mood and degree of anxiety symptoms; examines stress coping mechanisms, including resilience and repetitive negative thinking (RNT); and explores how students at a Ghanaian university believed the COVID-19 pandemic affected these measures. METHODS: Students (n = 129) were recruited from the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana from October 2020 - January 2021. Validated surveys were used. Participants were asked "Are your answers to the questions affected by the COVID-19 pandemic?" RESULTS: No differences in mean scores were observed between genders. For female students, financial stress was positively associated with RNT (p = 0.009), negative mood (p = 0.002), and anxiety (p < 0.001). Males were more likely to report decreased stress during the pandemic (p = 0.002), but there was no difference in mental health outcomes by perceived stress (PS) change category among males. Effects of the pandemic on mental health outcomes were mixed, but substantial proportions of students reported improvements or no change in financial stress, mood, anxiety, and RNT. LIMITATIONS: Students from one university particiapted in this cross-sectional survey. CONCLUSIONS: This study adds to the understanding of how higher education students are experiencing stress and are coping with the uncertainties of the COVID-19 pandemic in Ghana.

COVID-19 psychological impact: The role of perfectionism.

Psychological reactions to pandemics and their constraints depend heavily on personality. Although perfectionism is consistently associated to depression, anxiety and stress, its role in the pandemics' psychological impact has not been yet empirically studied. Our aim was to analyze the role of perfectionism in psychological distress during the pandemic of COVID-19, testing whether it is mediated by fear of COVID-19 and repetitive negative thinking/RNT. Participants (N = 413 adults; 269.2% women) were recruited from September until December 2020, via social networks. They completed self-report validated questionnaires to evaluate perfectionism dimensions (self-critical, rigid and narcissistic perfectionism), fear of COVID-19, RNT and psychological distress (sum of anxiety, depression and stress symptoms). As women had significantly higher levels of self-critical perfectionism, RNT, fear of COVID-19 and psychological distress, gender was controlled in mediation analysis. The three perfectionism dimensions correlated with RNT, fear of COVID-19 and psychological distress. The effect of self-critical perfectionism on psychological distress was partially mediated by fear of COVID-19 and RNT whereas the effect of rigid and narcissistic perfectionism was fully mediated. Perfectionism influences emotional and cognitive responses to the COVID-19 and therefore should be considered both in the prevention and psychological consequences of the pandemic.

Support from friends moderates the relationship between repetitive negative thinking and postnatal wellbeing during COVID-19.

BACKGROUND: Increasing evidence has linked repetitive negative thinking (RNT) to postnatal depression and anxiety, yet the factors moderating this relationship have been minimally investigated. During the COVID-19 pandemic of 2020, social restrictions imposed to reduce viral transmission limited access to social support, which is critical to postnatal psychological wellbeing - potentially intensifying RNT. OBJECTIVE: We examined whether perceived social support (from friends, family, and a significant other) played a moderating role in the relationship between RNT and maternal postnatal anxiety and depressive symptoms. METHODS: A sample of women (N = 251) who had given birth in the preceding 12 months completed an online battery of standardised measures during the COVID-19 'lockdown' of May 2020. RESULTS: As predicted, social support moderated the relationship between RNT and depression such that the association between RNT and depression was stronger for women who reported lower levels of social support. Interestingly, this finding emerged for social support from friends only; for support from family and significant other, social support did not play a moderating role. Further, and unexpectedly, overall social support did not moderate the relationship between RNT and postnatal anxiety, however, social support from friends was a significant moderator. CONCLUSIONS: High levels of perceived social support from friends (but not family or significant others) buffered the effects of RNT on depression and anxiety during the postpartum period. Strategies to bolster peer social support may be a valuable inclusion in interventions to prevent and treat postnatal depression and anxiety.

Perceived social support and prenatal wellbeing; The mediating effects of loneliness and repetitive negative thinking on anxiety and depression during the COVID-19 pandemic.

PROBLEM: Prenatal depression and anxiety are linked to poor maternal and infant outcomes. We need to understand predictors of poor mental health to identify at-risk women, and targets for support. BACKGROUND: Previous research has demonstrated a relationship between low levels of perceived social support, and depression and anxiety in pregnant women. However, there is a lack of research into the factors that may mediate this relationship. AIM: As social distancing measures (e.g., lockdown) are likely to negatively affect women's perceived support in the prenatal period, we investigated the relationship between perceived social support and both anxiety and depression in UK-based pregnant women during the COVID-19 pandemic. Further, we examined two potential mediators that may contribute to psychological symptoms: repetitive negative thinking and loneliness. METHODS: We administered a battery of online measures to a sample of pregnant women (N=205) between May-June 2020, during the first peak of the pandemic in the UK, when perceived social support was likely to be low. RESULTS: Consistent with predictions, perceived social support was significantly negatively related to depression, anxiety, loneliness and repetitive negative thinking. Furthermore, repetitive negative thinking and loneliness mediated the relationship between perceived social support and both depression and anxiety. Moreover, perceived social support and loneliness were associated with specific types of online behaviours. CONCLUSIONS: Taken together, the findings shed light on the processes through which social support may exert its effects on depression and anxiety and highlight potential therapeutic targets for interventions which aim to prevent and treat mood disorders in perinatal cohorts.