The relationships between stress, negative affect, rumination and social anxiety

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The Mediational Role of Rumination in Social Anxiety 179

Journal of Evidence-Based Psychotherapies,

Vol. 15, No. 2, September 2015, 179-189.

THE RELATIONSHIPS BETWEEN STRESS,

NEGATIVE AFFECT, RUMINATION AND

SOCIAL ANXIETY

Sergiu Paul VĂLENAȘ* & Aurora SZENTAGOTÁI-TĂTAR Babes-Bolyai University, Cluj-Napoca, Romania

Abstract

Rumination is a vulnerability factor involved in the development of

depression and anxiety. Despite the fact that some studies have proposed a

relationship between rumination and social anxiety, more data is needed to

draw clear conclusions. Moreover, there is a need for research aiming to

find the mechanisms involved in the rumination-social anxiety relation. In

the current study, we examined whether stress, negative affect, and

rumination are predictors of social anxiety symptoms. Also, we tested if

rumination mediates the relationship between stress and social anxiety on

the one hand, and negative affect and social anxiety on the other.

Participants in this study (N = 95) were undergraduate psychology students

(females = 82, males = 13) and the mean age was 21.54 years (SD =2.95,

Range = 18–37). Self-reported stress, negative affect, rumination and social

anxiety were measured. Results showed that stress and negative affect are

predictors of both rumination and social anxiety. Both rumination and stress

significantly predicted social anxiety, but negative affect was no longer a

predictor when rumination was included in the predictive model. This study

provides evidence that rumination is involved in the relationship between

stress and social anxiety and negative affect and social anxiety. Also, this

study provides insights for developing prevention interventions in social

anxiety disorder.

Keywords: rumination, social anxiety disorder, stress, negative affect

Introduction

Rumination is defined as a repetitive cognitive pattern that focuses on the

causes and consequences of emotional states, and also on past problems and

events (Nolen-Hoeksema, 1991). Numerous studies have investigated rumination

* Correspondence concerning this article should be addressed to:

E-mail: [email protected]

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Sergiu P. Vălenaș & Aurora Szentágotai-Tătar 180

in relation with depressive symptoms (Nolen-Hoeksema, 1991; Nolen-Hoeksema,

2000; Nolen-Hoeksema, Morrow, & Fredrickson, 1993), but evidence now

suggests that rumination is also associated with anxiety (Abela & Hankin, 2011;

Brozovich & Heimberg, 2008; Fresco, Frankel, Mennin, Turk, & Heimberg,

2002; Susan Nolen-Hoeksema, 2000; Vălenaș & Szentagotai, 2014). Social

anxiety is one of the anxiety disorders most often studied in relation with

rumination; however, some ambiguous aspects still need to be clarified.

Indeed, studies have confirmed the relationship between rumination and

social anxiety (Abbott & Rapee, 2004; Edwards, Rapee, & Franklin, 2003;

Mellings & Alden, 2000). In the social anxiety context, rumination is frequently

conceptualized in terms of repetitive thoughts about a self-related experience

during/after a social interaction, which can include both self or other-related

evaluations and details about the event (Kashdan, Zvolensky, & McLeish, 2008).

In these situations rumination is seen as an effect of social anxiety. Studies have

shown that social anxiety is associated with negative rumination a day after the

interaction, even after statistically controlling for depressive symptoms (Edwards

et al., 2003; Mellings & Alden, 2000). In a social anxiety disorder sample,

Kocovski and Rector (2008) found that individuals with higher levels of social

anxiety report higher levels of rumination after the first group cognitive-

behavioral therapy (gCBT) exposure task.

However, Clark and Wells (1995) suggest that rumination plays an

important role not only following the event, but also in before it taking place.

They suggest that prior to a social interaction, socially anxious individuals engage

in negative thoughts which contribute to their anxiety (Dodge, Hope, Heimberg,

& Becker, 1988). Vassilopoulos (2004) showed that anticipatory processing

before social interactions was specific to individuals with high levels of social

anxiety, even when controlling for general negative affect (i.e., trait anxiety and

depression). In the same line, Brown and Stopa (2006) found that socially

anxious undergraduate students reported higher levels of anxiety and negative

self-images than non-anxious participants after engaging in pre-event rumination.

They suggested that individuals may hold positive meta-beliefs about the function

of anticipation and rumination before a social performance situation that maintain

social anxiety.

Despite the fact that rumination is an important risk factor for depression

and anxiety (Aldao, Nolen-Hoeksema, & Schweizer, 2010), we know relatively

few things about the predictors of ruminative response style. Investigating such

factors would contribute to: 1) a better understanding of rumination, and

2) designing effective prevention strategies.

One predictor of increased ruminative thoughts is the experiences of

stress. Stress is conceptualized as a general state defined by difficulty relaxing,

nervous arousal, feeling of being easily upset/agitated, irritable/over-reactive or

impatient. Monroe (2008) defines experiences of stress as psychological and

physiological adaptations of the organism to social and environmental

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circumstances. One conceptualization of the etiology of rumination maintains that

stressful life events can lead to rumination not only about those events, but also

about many areas of one’s life (Nolen-Hoeksema, Larson, & Grayson, 1999).

Stressful life events have also been found to predict major depression and anxiety

disorders (Kendler, Hettema, Butera, Gardner, & Prescott, 2003). Therefore, it is

possible that rumination may act as a mechanism between social anxiety

symptoms and stress. Past research found that stress caused by a natural disaster

(Nolen-Hoeksema & Morrow, 1991) or bereavement ( Nolen-Hoeksema, Parker,

& Larson, 1994) leads to high levels of rumination and a prolonged negative

mood. Moreover, according to the perseverative cognition theory rumination may

include prolonged physiological consequences (Brosschot, Gerin, & Thayer,

2006). Recent work found that rumination is related with increases in cortisol

stress responses in many different stressors (Johnson, Lavoie, Bacon, Carlson, &

Campbell, 2012; Zoccola & Dickerson, 2012).

Another line of research shows that high levels of ruminative thoughts are

predicted by negative affect. We define negative affect as a general dimension of

subjective distress that includes many aversive mood states such as anger, disgust,

guilt, fear, nervousness (Watson, Clark, & Tellegen, 1988). Research suggests

that high levels of negative mood and negative cognitions intensify rumination

(Watkins, 2008). One study found that beliefs about negative emotions, such as

sadness, fear, and anger, are difficult to control. Consequently, difficulties in

controlling negative emotions were related to a greater tendency to ruminate

(Nolen-Hoeksema & Jackson, 2001).

Given the large body of research regarding associations between stress

and negative affect on the one hand, and rumination on the other hand, and

between rumination and social anxiety symptoms, we believe it is important to

investigate how these variables interact in predicting social anxiety levels. The

aims of this study were: a) to examine the role of stress and negative affect as

predictors of rumination, b) to examine the role of stress, negative affect and

rumination as predictors of social anxiety symptoms, and c) to determine whether

rumination is a mechanism linking stress and negative affect with social anxiety

symptoms. We expected that stress, negative affect and rumination would be

associated with social anxiety symptoms, such that individuals with high levels of

negative affect, stress and rumination would show higher levels of social anxiety.

We additionally predicted that rumination would mediate the relationship between

stress and social anxiety symptoms and negative affect and social anxiety

symptoms.

Method

Participants

Participants in this study (N = 95) were undergraduate psychology

students (82 females; 13 males). The mean age of the sample was 21.54 years

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(SD =2.95, Range = 18–37). Participants who completed all tasks received course

credit.

Measures

Liebowitz Social Anxiety Scale (LSAS)

The LSAS (Liebowitz, 1987) consists of 11 items related to social

interaction and 13 items related to public performance. This scale measures fear

and avoidance of social situations in general, on 4-point Likert-type scales. The

first rating is a measure of fear/ anxiety and ranges from 0 (none) to 3 (severe).

The second rating is a measure of avoidance and ranges from 0 (never) to 3

(usually; 68–100%). A total score is calculated by summing all of the fear and

avoidance ratings. In the current study, Cronbach's alpha for the total score was

.96.

Depression and Anxiety, Stress Scale (DASS)

The DASS (Lovibond & Lovibond, 1995) comprises three self-report

scales designed to measure the negative emotional states of depression, anxiety

and stress. The Stress scale (the only one included in the analysis) is sensitive to

levels of chronic non-specific arousal. Participants are asked to use 4-point

severity/frequency scales to rate the extent to which they have experienced each

state over the past week.

Positive and Negative Affect Schedule (PANAS)

We used the Basic Negative Emotion Scales (i.e., fear, hostility, guilt and

sadness) of the PANAS (Watson et al., 1988). These consist of two 10-item

mood scales and were developed to provide brief measures of positive affect (PA)

and negative affect (NA). Respondents are asked to rate the extent to which they

have experienced each particular emotion within a specified time period, with

reference to a 5-point scale. The scale points are: 1 (‘very slightly or not at all’),

2 (‘a little’), 3 (‘moderately’), 4 (‘quite a bit’), and 5 (‘very much’).

The Rumination-Reflection Questionnaire (RRQ)

The RRQ (Trapnell & Campbell, 1999) was developed to discriminate

between neurotic and intellective forms of private self-consciousness. The 12-

item Rumination subscale assesses repetitive thoughts about threats to the self

(e.g., “I tend to ‘ruminate’ or dwell over things that happen to me for a really long

time afterward”), whereas the 12-item Reflection subscale assesses reflections on

the self-motivated by intellectual curiosity (e.g., “I love exploring my ‘inner’

self”). In the current study, only RRQ rumination subscale was used. The scale

showed good psychometric properties (Cronbach's alpha coefficient was .89).

Results

Data analysis

In order to examine the suitability of the current data for regression

analysis, a series of analyses were performed. Each model showed a normal

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distribution of residuals. Tests conducted to see if the data met the assumption of

collinearity indicated that multicollinearity was not a concern (Rumination

Scores, Tolerance = .75, VIF = 1.33; Stress, Tolerance = .66, VIF = 1.51,

Negative affect, Tolerance = .66, VIF = 1.50). The data met the assumption of

independent errors (Durbin–Watson values = 2.28). Overall, the results indicate

that these data are adequate for regression analysis. Table (1) presents Pearson

correlations between social anxiety scores and stress, negative affect and

rumination scores.

Table 1. Correlations of social anxiety scores, stress, negative affect, and rumination

(N = 95).

Social anxiety Stress Negative affect

Social anxiety

Stress

Negative affect

Rumination

.52*

.49*

.69

.53*

.43*

.44*

Note: p < 0.01

A multiple regression analysis (enter method) was conducted to see if

stress and negative affect predict rumination levels. We found that stress level and

negative affect level explain a significant amount of the variance of rumination

(F(2, 92) = 15.31, p < .01, R2 =.25, R2Adjusted = .23)Both stress (β = .27, t(94) =

2.59, p < .05) and negative affect (β = .29, t(94) = 2.27, p < .01) significantly

predicted rumination.

A second multiple regression analysis (enter method) was conducted to

assess whether stress and negative affect predict social anxiety in students. We

found that stress level and negative affect level explain a significant amount of the

variance in social anxiety symptoms (F(2, 92) = 23.47, p < .01, R2 =.34, R2Adjusted

= .32).Both stress (β = .36, t(94) = 3.63, p < .01) and negative affect (β = .29,

t(94) = 2.29, p < .01) were significant predictors of social anxiety symptoms.

A third multiple regression analysis was conducted to see if adding

rumination would increase the prediction of social anxiety symptoms. We found

that rumination, stress and negative affect explain a significant proportion of the

variance in social anxiety symptoms (F(3, 91) = 37.05, p < .05, R2 =.55, R2Adjusted

= .54).Results show that negative affect does not significantly predict social

anxiety symptoms (β = .14, t(94) = 1.64, p > .05); however rumination (β = .53,

t(94) = 6.5, p < .01) and stress (β = .21, t(94) = 2.51, p < .05) significantly predict

social anxiety symptoms.

Bootstrapping analyses (bias-corrected, with 1000 iterations) were used to

test whether rumination had a mediator role in the relation between negative

affect and social anxiety symptoms. In the first model, rumination was a

significant mediator. As shown in Figure (a), negative affect was a significant

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positive predictor of both rumination and social anxiety and bootstrapping 95%

CI [.48, 1.24] supported the indirect effect of negative affect on social anxiety,

carried by rumination.

Figure (a) Unstandardized regression coefficients from the models

in which rumination has a significant mediator role in the relationship between

the level of stress and social anxiety. * p < .01

In the second model, rumination was also a significant mediator. As

shown in Figure (b), stress was a significant positive predictor of both rumination

and social anxiety and the bootstrapping 95% CI [0.75, 1.92] supported the

indirect effect (effect size k2 = 0.1) of stress on social anxiety, carried by

rumination.

Figure (b) Unstandardized regression coefficients from the models

in which rumination has a significant mediator role in the relationship between

the level of stress and social anxiety. * p < .01

Discussion

This study shows that individuals with a ruminative response style tend to

have high levels of negative affect and stress, a result which is consistent with a

generous line of research ( Nolen-Hoeksema & Morrow, 1991; Watkins, 2008).

Negative affect and stress showed a medium positive association with rumination,

based on Cohen’s (1988) classification of effect sizes. Also, negative affect

showed a medium positive association with social anxiety symptoms, while stress

and rumination showed a high positive association. Stress and negative affect

were significant predictors of rumination. When entered into the regression

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model, negative affect and stress explained 34% of the variance in social anxiety.

When rumination was added, in the second model, all variables explained 55% of

the variance in social anxiety. These findings suggest that rumination might play a

role in social anxiety disorder.

The current study shows that rumination explains the association between

both stress and negative affect and social anxiety symptoms. These results are in

line with other studies showing that attempting to reduce the discrepancy between

goals and current state is an important factor involved in the process of

rumination (Martin & Tesser, 1996; Watkins, 2008). In a broad definition,

rumination includes “past-centered negative, unwanted and persistent thoughts”,

has components of emotional sadness, anger, depression/anxiety (Nolen-

Hoeksema, Wisco, & Lyubomirsky, 2008; Segerstrom, Tsao, Alden, & Craske,

2000) and is seen as a maladaptive response to stress prolonging physiological

consequences (Brosschot et al., 2006). A recent review showed that rumination

enhanced cortisol responses to a large variety of stressors (Zoccola & Dickerson,

2012). In this context, the persistence of rumination following negative emotions

or stress responses is understandable if the person focuses on the feelings and

physiological reactions. Additionally, daily life stress interferes with emotion

regulation processes required for individuals to cope with negative emotions

(Wenzlaff, Wegner, & Roper, 1988) and may affect executive functions (i.e.,

increase attention to negative thoughts and feelings), and lead to negative future

expectations (Segal & Ingram, 1994).

Interestingly, when we entered rumination, stress and negative affect in

the regression model trying to predict social anxiety, negative affect was not a

significant predictor. This suggests that, in a social situation, from a wide range of

negative affective reactions, a person will experience anxiety symptoms if he/she

is stressed and ruminates on perceived social failure. One possible explanation

may be that items measuring negative affect tend to be predominantly associated

with symptoms of depression (i.e., “upset”, “guilty”, “hostile”) than social anxiety

(i.e., “stressed”, “nervous”).

The causal direction between rumination and anxiety symptoms cannot be

clearly inferred due to the cross-sectional design of the current study. However,

the results of the present study allow us to speculate that if we aim to reduce

social anxiety symptoms linked to experiences of stress and negative emotions,

we may also have to reduce cognitive rumination. Frequently, when individuals

are confronted with anxiety-provoking situations, a range of unpleasant thoughts

and emotions arise. Trying to control or avoid these psychological experiences

will exacerbate the initial distress.

An important finding of this study is that rumination partially mediates

the relation between stress and social anxiety and negative affect and social

anxiety. These results add to previous findings on factors maintaining social

anxiety symptoms (Clark & Wells, 1995; Hofmann, 2007; Rapee & Heimberg,

1997).

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Limitations of the current study must also be acknowledged. First, our

investigation relied on self-report measures and all of the limitations pertaining to

this strategy are relevant, although the validity of the self-report measures used in

this study is well-established (Liebowitz, 1987; Lovibond & Lovibond, 1995;

Trapnell & Campbell, 1999; Watson et al., 1988). Second, due to the cross

sectional nature of the research design, it is not possible to make causal

inferences. An important next step would be to use prospective methodologies or

to experimentally test these variables for causal conclusions. Third, the current

findings were based on a relatively homogenous community sample. It is

important to examine whether the current models still hold in clinical samples and

ethnically diverse samples. Finally, our analysis focused on self-reported

symptoms of social anxiety; we believe that future studies should also include a

clinical assessment, in order to establish a clear association between rumination

and anxiety disorders.

Even though the consequences of engaging in rumination have been

frequently studied, few studies have examined vulnerability factors for rumination

itself. Our study shows that stress and negative affect are associated with

rumination. Moreover, results indicate that stress, negative affect and rumination

are positively associated with social anxiety symptoms. Our results also show that

rumination is involved in the association between stress and negative affect and

social anxiety symptoms. Such results can guide the development of prevention

programs aimed at reducing social anxiety symptoms and risk factors associated

with it.

Acknowledgments

This paper is a result of a doctoral research made possible by the financial support

of the Sectoral Operational Programme for Human Resources Development 2007-

2013, co-financed by the European Social Fund, under the project

POSDRU/159/1.5/S/132400 - “Young successful researchers – professional development

in an international and interdisciplinary environment”.

REFERENCES

Abbott, M. J., & Rapee, R. M. (2004). Post-event rumination and negative self-appraisal

in social phobia before and after treatment. Journal of Abnormal Psychology,

113(1), 136–144. http://doi.org/10.1037/0021-843X.113.1.136

Abela, J. R. Z., & Hankin, B. L. (2011). Rumination as a vulnerability factor to depression

during the transition from early to middle adolescence: A multiwave longitudinal

study. Journal of Abnormal Psychology, 120(2), 259–271.

http://doi.org/10.1037/a0022796

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies

across psychopathology: A meta-analytic review. Clinical Psychology Review,

30(2), 217–237. http://doi.org/10.1016/j.cpr.2009.11.004

Articles Section


Brosschot, J. F., Gerin, W., & Thayer, J. F. (2006). The perseverative cognition

hypothesis: A review of worry, prolonged stress-related physiological activation,

and health. Journal of Psychosomatic Research, 60(2), 113–124.

http://doi.org/10.1016/j.jpsychores.2005.06.074

Brown, M., & Stopa, L. (2007). Does Anticipation Help or Hinder Performance in a

Subsequent Speech? Behavioural and Cognitive Psychotherapy, 35(02), 133.

http://doi.org/10.1017/S1352465806003481

Brozovich, F., & Heimberg, R. G. (2008). An analysis of post-event processing in social

anxiety disorder. Clinical Psychology Review, 28(6), 891–903.

http://doi.org/10.1016/j.cpr.2008.01.002

Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. Social Phobia:

Diagnosis, Assessment, and Treatment, 41(68), 00022–3.

Dodge, C. S., Hope, D. A., Heimberg, R. G., & Becker, R. E. (1988). Evaluation of the

Social Interaction Self-Statement Test with a social phobic population. Cognitive

Therapy and Research, 12(2), 211–222. http://doi.org/10.1007/BF01204932

Edwards, S. L., Rapee, R. M., & Franklin, J. (2003). Postevent Rumination and Recall

Bias for a Social Performance Event in High and Low Socially Anxious

Individuals. Cognitive Therapy and Research, 27(6), 603–617.

http://doi.org/10.1023/A:1026395526858

Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002).

Distinct and Overlapping Features of Rumination and Worry: The Relationship of

Cognitive Production to Negative Affective States. Cognitive Therapy & Research,

26(2), 179–188.

Hofmann, S. G. (2007). Cognitive Factors that Maintain Social Anxiety Disorder: a

Comprehensive Model and its Treatment Implications. Cognitive Behaviour

Therapy, 36(4), 193–209. http://doi.org/10.1080/16506070701421313

Johnson, J. A., Lavoie, K. L., Bacon, S. L., Carlson, L. E., & Campbell, T. S. (2012). The

effect of trait rumination on adaptation to repeated stress. Psychosomatic Medicine,

74(3), 258–262.

Kashdan, T. B., Zvolensky, M. J., & McLeish, A. C. (2008). Anxiety sensitivity and affect

regulatory strategies: Individual and interactive risk factors for anxiety-related

symptoms. Journal of Anxiety Disorders, 22(3), 429–440.

http://doi.org/10.1016/j.janxdis.2007.03.011

Kendler KS, Hettema JM, Butera F, Gardner CO, & Prescott CA. (2003). LIfe event

dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets

of major depression and generalized anxiety. Archives of General Psychiatry,

60(8), 789–796. http://doi.org/10.1001/archpsyc.60.8.789

Kocovski, N. L., & Rector, N. A. (2007). Post-Event Processing in Social Anxiety

Disorder: Idiosyncratic Priming in the Course of CBT. Cognitive Therapy and

Research, 32(1), 23–36. http://doi.org/10.1007/s10608-007-9152-z

Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22,

141–173.

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states:

Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck

Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3),

335–343.

Articles Section


Martin, L. L., & Tesser, A. (1996). Some ruminative thoughts. Advances in Social

Cognition, 9, 1–47.

Mellings, T. M., & Alden, L. E. (2000). Cognitive processes in social anxiety: the effects

of self-focus, rumination and anticipatory processing. Behaviour Research and

Therapy, 38(3), 243–257.

Monroe, S. M. (2008). Modern Approaches to Conceptualizing and Measuring Human

Life Stress. Annual Review of Clinical Psychology, 4(1), 33–52.

http://doi.org/10.1146/annurev.clinpsy.4.022007.141207

Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of

depressive episodes. Journal of Abnormal Psychology, 100(4), 569–582.

Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed

anxiety/depressive symptoms. Journal of Abnormal Psychology, 109(3), 504.

Nolen-Hoeksema, S., & Jackson, B. (2001). Mediators of the Gender Difference in

Rumination. Psychology of Women Quarterly, 25(1), 37–47.

http://doi.org/10.1111/1471-6402.00005

Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference

in depressive symptoms. Journal of Personality and Social Psychology, 77(5),

1061.

Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and

posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta

Earthquake. Journal of Personality and Social Psychology, 61(1), 115–121.

Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the

duration of episodes of depressed mood. Journal of Abnormal Psychology, 102(1),

20–28. http://doi.org/10.1037/0021-843X.102.1.20

Nolen-Hoeksema, S., Parker, L. E., & Larson, J. (1994). Ruminative coping with

depressed mood following loss. Journal of Personality and Social Psychology,

67(1), 92–104.

Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking Rumination.

PERSPECTIVES ON PSYCHOLOGICAL SCIENCE, 3(5), 400–424.

http://doi.org/10.1111/j.1745-6924.2008.00088.x

Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in

social phobia. Behaviour Research and Therapy, 35(8), 741–756.

Segal, Z. V., & Ingram, R. E. (1994). Mood priming and construct activation in tests of

cognitive vulnerability to unipolar depression. Clinical Psychology Review, 14(7),

663–695. http://doi.org/10.1016/0272-7358(94)90003-5

Segerstrom, S. C., Tsao, J. C. I., Alden, L. E., & Craske, M. G. (2000). Worry and

Rumination: Repetitive Thought as a Concomitant and Predictor of Negative

Mood. Cognitive Therapy & Research, 24(6), 671.

Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor

model of personality: distinguishing rumination from reflection. Journal of

Personality and Social Psychology, 76(2), 284–304.

Vălenaș, S., & Szentagotai, A. (2014). Rumination in Generalized Anxiety and Social

Phobia: A Qualitative Systematic Review. Transylvanian Journal of Psychology,

15(1), 61–88.

Vassilopoulos, S. P. (2004). Anticipatory processing in social anxiety. Behavioural and

Cognitive Psychotherapy, 32(03), 303–311.

Articles Section


Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological

Bulletin, 134(2), 163–206. http://doi.org/10.1037/0033-2909.134.2.163

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief

measures of positive and negative affect: the PANAS scales. Journal of

Personality and Social Psychology, 54(6), 1063.

Wenzlaff, R. M., Wegner, D. M., & Roper, D. W. (1988). Depression and mental control:

the resurgence of unwanted negative thoughts. Journal of Personality and Social

Psychology, 55(6), 882–892.

Zoccola, P. M., & Dickerson, S. S. (2012). Assessing the relationship between rumination

and cortisol: A review. Journal of Psychosomatic Research, 73(1), 1–9.

http://doi.org/10.1016/j.jpsychores.2012.03.007

The relationships between stress, negative affect, rumination and social anxiety

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