Repetitive Negative Thinking and Eating Disorders: A Meta-Analysis of the Role of Worry and Rumination

Abstract

The role of worry and rumination in eating disorders (EDs) is controversial. This meta-analysis of the literature is aimed at clarifying the relationship between repetitive negative thinking (RNT) and EDs. In accordance with the PRISMA criteria, a comprehensive search of the literature was conducted on PubMed and PsycInfo from inception to March 2021. Search terms: “eating disorder/anorexia/bulimia/binge eating disorder” AND “worry/rumination/brooding/repetitive thinking”. A manual search of reference lists was also run. Forty-three studies were included. RNT was found to be associated with anorexia, bulimia, and binge eating disorder. A moderating effect was found for “presence/absence ED diagnosis” and “subtype of ED symptom”. ED patients showed higher RNT than the general population. No differences were observed for age or between worry and rumination in the magnitude of their association with EDs.

The role of emotion regulation in eating disorders: a network meta-analysis approach

“…The present review adds to the steady accumulation of evidence highlighting the relationship between maladaptive emotion regulation based on rumination and ED symptomatology (Palmieri et al, 2021;Smith, Mason, & Lavender, 2018). Over the recent years, studies using ecological momentary assessments (EMAs) have reported that rumination and repetitive negative thinking predicts engagement in ED behaviour, including body checking and binge eating (Sala, Brosof, & Levinson, 2019;Smith et al, 2021;Svaldi, Werle, Naumann, Eichler, & Berking, 2019).…”

“…Over the recent years, several reviews have recommended the use of interventions aimed at reducing rumination and repetitive negative thinking, Metacognitive Therapy (MCT) and Rumination-Focused Cognitive Behavioural Therapy (RFCBT), such as in the treatment of EDs (Palmieri et al, 2021;Prefit et al, 2019;Smith et al, 2018;Trompeter et al, 2021). MCT and RFCBT have been successfully used to treat anxiety and depression among other psychiatric disorders, and there is some evidence suggesting that rumination-focused treatments may help reduce the risk of relapse in depression (Normann, van Emmerik, & Morina, 2014;Spinhoven et al, 2018;Watkins et al, 2011).…”

“…MCT and RFCBT have been successfully used to treat anxiety and depression among other psychiatric disorders, and there is some evidence suggesting that rumination-focused treatments may help reduce the risk of relapse in depression (Normann, van Emmerik, & Morina, 2014;Spinhoven et al, 2018;Watkins et al, 2011). Furthermore, one of the meta-analytic reviews found a very high correlation between rumination and ED symptomatology among the general population, which led the authors to suggest that rumination may be a useful target for interventions aiming to prevent EDs and other forms of disordered eating (Palmieri et al, 2021). To date, very few studies examining the impact of interventional designed to target rumination in EDs have been conducted.…”

The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach

“…The present review adds to the steady accumulation of evidence highlighting the relationship between maladaptive emotion regulation based on rumination and ED symptomatology (133,134). Over the recent years, studies using ecological momentary assessments (EMAs) have reported that rumination and repetitive negative thinking predicts engagement in ED behavior, including body checking and binge eating (135)(136)(137).…”

Interactional Effects of Multidimensional Perfectionism and Cognitive Emotion Regulation Strategies on Eating Disorder Symptoms in Female College Students

“…Specifically, numerous lines of evidence suggest that eating disorder symptoms are linked to the use of maladaptive strategies, such as rumination, catastrophizing, and self-blame, that are characterized by persevering thoughts or self-criticism [ 17 , 18 , 19 , 20 , 21 , 22 ]. For instance, several meta-analyses [ 18 , 19 , 23 ] have elucidated relations between eating disorder symptoms and elevated levels of rumination. In particular, Meule et al [ 18 ] found that individuals with restrictive anorexia nervosa and bulimia nervosa report greater use of dysfunctional cognitive regulatory strategies (i.e., self-blame, rumination, and catastrophizing) than healthy controls.…”