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.

Keywords

• Transdiagnostic approach
• repetitive negative thinking
• psychopathology
• psychotherapy

Tekrarlayıcı Olumsuz Düşünmeye Tanılar Üstü Bir Bakış: Kuramsal Temel, Alt Türler, Ölçüm ve Müdahale Yöntemleri

Öz

Tekrarlayıcı olumsuz düşünme, ruminasyon, endişe, obsesyon, olay öncesi ve sonrası işlemleme gibi türleri kapsayan farklı psikopatolojilerle ilişkili bir tanılar üstü mekanizmadır. Alanyazındaki bulgular tekrarlayıcı olumsuz düşünmenin anksiyete, depresyon, obsesif-kompulsif bozukluk, travma sonrası stres bozukluğu, yemek bozuklukları, madde kullanım bozuklukları, somatik belirti bozuklukları, uyku sorunları ve kişilik bozukluklarının gelişimi ve sürmesinde bir risk faktörü olduğunu göstermektedir. Nörotizm, belirsizliğe tahammülsüzlük, olumsuz üst bilişsel inançlar ve düşük bilişsel esneklik gibi faktörler tekrarlayıcı olumsuz düşünme için risk faktörüyken; öz-şefkat, bilinçli farkındalık ve psikolojik esneklik gibi süreçler koruyucu faktörler olarak öne çıkmaktadır. Ayrıca, ergenlik döneminde yürütücü işlevlerdeki sınırlılıklar ve benmerkezci bilişsel eğilimler tekrarlayıcı olumsuz düşünme riskini artırmakta; bu risk yetişkinlikle beraber azalmaktadır. Türkiye’de alanyazın incelendiğinde, çoğu müdahale çalışmasının tanıya özgü olduğu; tekrarlayıcı olumsuz düşünme, bilişsel esneklik, metakognisyon ve duygu düzenleme gibi süreçleri hedefleyen bütüncül tanılar üstü deneysel çalışmaların sınırlı kaldığı görülmektedir. Dünyada ise tekrarlayıcı olumsuz düşünmeyi azaltmaya yönelik müdahaleler umut verici olsa da; tekrarlayıcı olumsuz düşünmeyi tanılar üstü perspektiften ele bütüncül müdahale programları oldukça nadirdir. Bu bağlamda, bu çalışmda tekrarlayıcı olumsuz düşünmenin psikopatolojilerle ilişkisini tanılar üstü perspektiften incelenmiştir.

Anahtar Kelimeler

• Tanılar üstü yaklaşım
• tekrarlayıcı olumsuz düşünme
• psikopatoloji
• psikoterapi

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