Abstract

Rumination contributes to the maintenance and onset of depression and anxiety, acts as a final common pathway for multiple vulnerabilities, and is identified as a transdiagnostic mechanism (Nolen-Hoeksema & Watkins, 2011). Thus, understanding and targeting it is a potential way to improve the effectiveness and efficacy of psychotherapy. This talk reviews the application of cognitive science principles to understanding rumination and its translation to innovations in CBT (Watkins, 2015), providing proof-of-principle of how psychological science can enhance interventions (Holmes et al., 2014). Cognitive science research using lab-based experimental manipulations has explored what underlies pathological rumination, suggesting (a) rumination can be usefully conceived as a mental habit (Watkins & Nolen-Hoeksema; 2014; Hertel, 2004) with particular patterns of selective information processing implicated in its development (e.g., Koster et al., 2011; Hertel et al., 2011); (b) the consequences of repetitive thinking about negative content depend upon the thinking style adopted, with an abstract, decontextualized thinking style, characteristic of rumination, causally implicated in increased negative emotional reactivity and impaired problem solving, relative to concrete and contextualised processing (Watkins, 2008). This led to Rumination-focused CBT (RFCBT), which explicitly uses functional analysis to target rumination-as-habit, and uses exercises and experiments to shift thinking style, instead of challenging thought content. In clinical trials, RFCBT is efficacious for difficult-to-treat residual depression (Watkins et al., 2010), outperforms standard CBT in treating major depression (Hvennegard et al., submitted) and prevents anxiety and depression in high risk young adults via an e-technology variant (Topper et al., in press).