Transdiagnostic Perspective on Repetitive Negative Thinking: Theoretical Foundations, Subtypes, Assessment, and Intervention Methods

Abstract

Repetitive negative thinking is a transdiagnostic mechanism that includes subtypes such as rumination, worry, obsession, and pre- and post-event processing, and is associated with various psychopathologies. Findings in the literature indicate that repetitive negative thinking is a risk factor for the development and maintenance of anxiety, depression, obsessive-compulsive disorder, post-traumatic stress disorder, eating disorders, substance use disorders, somatic symptom disorders, sleep problems, and personality disorders. Factors such as neuroticism, intolerance of uncertainty, negative metacognitive beliefs, and low cognitive flexibility are identified as risk factors for repetitive negative thinking, while processes such as self-compassion, mindfulness, and psychological flexibility stand out as protective factors. Additionally, during adolescence, limitations in executive functioning and egocentric cognitive tendencies increase the risk of repetitive negative thinking; this risk tends to decrease with adulthood. An examination of the literature in Türkiye reveals that most intervention studies are diagnosis-specific; comprehensive, transdiagnostic experimental studies targeting processes such as repetitive negative thinking, cognitive flexibility, metacognition, and emotion regulation remain limited. Globally, although interventions aimed at reducing RNT are promising, comprehensive intervention programs that address repetitive negative thinking from a transdiagnostic perspective are quite rare. Overall, the present review study examines the relationship between repetitive negative thinking and psychopathologies from a transdiagnostic perspective.