Predictors of psychosocial impairment in a transdiagnostic sample: Unique effects of repetitive negative thinking.

Background: Repetitive negative thinking (RNT) is a transdiagnostic process involving perseverative, unproductive, and uncontrollable thoughts. Although RNT may impede adaptive psychosocial functioning by prolonging negative mood states, strengthening cognitive biases, and preventing effective problem-solving, the extent to which RNT is associated with risk for poor psychosocial outcomes is unclear. Given that this has clear transdiagnostic treatment implications, the present study aimed to isolate the unique relationship of RNT with social functioning and life satisfaction in a mixed clinical and non-clinical sample.
Methods: In 201 mid-to-later life adult participants (27 with primary diagnoses of bipolar disorder, 84 with major depressive disorder, and 90 healthy volunteers), we measured RNT, social functioning, life satisfaction, trait rumination, DSM-5 diagnoses, depressive symptoms, manic symptoms, cognitive control performance, and global cognitive functioning.
Results: Linear regression models revealed that RNT, but not rumination, was significantly associated with poorer social functioning (β = 0.42 p < .001) and reduced life satisfaction (β = -0.42, p < .001) after controlling for clinical and cognitive covariates.
Limitations: Limited demographic diversity, cross-sectional design, self-reporting of outcomes.
Conclusions: Results suggest that RNT may confer risk for key psychosocial outcomes during middle to later adulthood, over and above the effects of clinical and cognitive variables and independent of diagnostic status. Findings lend support to the notion of RNT as a transdiagnostic process and suggest that RNT may be an important therapeutic target for adults with poor social functioning and/or reduced life satisfaction.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: KEB receives honorarium from the Breakthrough Discoveries for thriving with Bipolar Disorder for her role as Scientific Director of the Integrated Network and as an advisory board member for Merck & Co. FMD receives financial support from the American Medical Association that is unrelated to the work presented in this manuscript. All other authors declare that they have no known competing financial interests or personal relationships that could appear to influence the work reported in this paper.
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