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Although studies have documented heightened stress sensitivity in major depressive disorder (MDD) and generalized anxiety disorder (GAD), the mechanisms involved are poorly understood. One possible mechanism is the tendency to ruminate in response to stress. We used ecological momentary assessment to study ruminative thoughts following stressful events in 145 adults with MDD, GAD, comorbid MDD-GAD, or no psychopathology. Diagnosed individuals reported more event-related rumination than controls, even after adjusting for event stressfulness. Rumination was equally common in MDD and GAD and was especially severe among comorbid cases. More rumination immediately after the event predicted poorer affect, more maladaptive behavior, and more MDD and GAD symptoms at the next signal, even when pre-event levels of these variables were controlled. Rumination mediated, but did not moderate, the association of stress with affect and with symptoms. Stress-related rumination was more deleterious for diagnosed than healthy individuals, more intense for more severe clinical cases, and more persistent for cases with a greater temperamental vulnerability for emotional disorders. These results implicate rumination as a mechanism of stress sensitivity and suggest pathways through which it may maintain depression and anxiety in everyday life.Correspondence concerning this article should be addressed to Ayelet Meron Ruscio, Department of Psychology, University of Pennsylvania, 3720 Walnut Street, Philadelphia, PA 19104. ruscio@psych.upenn (Blazer, Hughes, & George, 1987;Kendler, Karkowski, & Prescott, 1998) but exhibit heightened sensitivity to stress, reacting more strongly than healthy individuals even to relatively minor stressors (Bale, 2006;Vrieze & Claes, 2009;Wichers et al., 2009). Stress sensitivity has been identified as a risk factor for the development and maintenance of emotional disorders (Mezulis, Funasaki, Charbonneau, &, Hyde, 2010;Morris, Ciesla, & Garber, 2010;Morris, Rao, & Garber, 2012;Siegrist, 2008). However, little is known about the mechanisms underlying stress sensitivity, nor the pathways through which they contribute to symptoms in daily life.Rumination may be one mechanism linking stress with depression and anxiety (Brosschot, Gerin, & Thayer, 2006;Ciesla, Felton, & Roberts, 2011;Verkuil, Brosschot, Gebhardt, &Thayer, 2010). Rumination reflects a negative, repetitive style of thinking about present and past symptoms, loss, and failure (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008). Whereas initial conceptualizations of rumination emphasized its focus on symptoms and their causes and consequences, more recent elaborations have broadened the concept to include attention to negative life events that the individual has experienced (Alloy et al., 2000;Smith & Alloy, 2009). Moreover, while rumination originally was proposed as a causal and maintaining factor for depression, a growing body of research suggests that rumination may be equally associated with anxiety (e.g., Nolen-Hoeksema, 2000), underscoring ...

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur, yet the reasons for their comorbidity remain poorly understood. In the present experiment, we tested whether a tendency to engage in negative, repetitive thinking constitutes a common risk process for the two disorders. A mixed sample of adults with comorbid GAD-MDD (n = 50), GAD only (n = 35), MDD only (n = 34), or no lifetime psychopathology (n = 35) was administered noncontingent failure and success feedback on consecutive performance tasks. Perseverative thought (PT), measured by negative thought intrusions during a baseline period of focused breathing, emerged as a powerful prospective predictor of responses to this experimental challenge. Participants reporting more frequent negative thought intrusions at baseline, irrespective of thought content or diagnostic status, exhibited a stronger negative response to failure that persisted even after subsequent success. Higher PT over the course of the experiment was associated with later behavioral avoidance, with negative affect and other traits closely linked to anxiety and depression, and with the presence and severity of GAD and MDD. These findings provide evidence for a broadly-defined PT trait that is shared by GAD and MDD and contributes to adverse outcomes in these disorders.

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Diverse theories of psychopathology suggest that reactions to internal experiences, such as emotion, are important in the development and maintenance of psychological distress and symptomatology. This study examines the relationships between one type of reaction to emotion, fear of emotion, and reactivity to, recovery from, and interference of emotional material. As predicted, fear of emotion was related to greater increases in distress, negative affect, and skin conductance in reaction to an emotional film clip, and to greater interference of film-related material in a modified emotional Stroop task. These relationships remained when variance contributed by general negative affect was removed. Findings provide preliminary evidence that fear of emotion may be related to emotional distress and physiological arousal, and that this relationship may exist beyond shared variance due to self-report response style and general negative affectivity.