Abstract
The role of worry and rumination in eating disorders (EDs) is controversial. This meta-analysis of the literature is aimed at clarifying the relationship between repetitive negative thinking (RNT) and EDs. In accordance with the PRISMA criteria, a comprehensive search of the literature was conducted on PubMed and PsycInfo from inception to March 2021. Search terms: “eating disorder/anorexia/bulimia/binge eating disorder” AND “worry/rumination/brooding/repetitive thinking”. A manual search of reference lists was also run. Forty-three studies were included. RNT was found to be associated with anorexia, bulimia, and binge eating disorder. A moderating effect was found for “presence/absence ED diagnosis” and “subtype of ED symptom”. ED patients showed higher RNT than the general population. No differences were observed for age or between worry and rumination in the magnitude of their association with EDs.
Highlights
Elena TombaRepetitive negative thinking (RNT) is a cognitive process characterised by a repetitive, frequent, and self-focused form of thinking [1]
Through the use of meta-analytic techniques, the present study aimed to present a comprehensive evaluation of the literature on eating disorders (EDs), worry and rumination in order to: (1) extend the literature and estimate the magnitude of the association between EDs, worry and rumination; (2) explore the role of some moderators such (a) “subtypes of ED symptoms”, the (b) “presence vs. absence of a diagnosis of ED” and (c) “worry vs
The inclusion criteria applied to the literature search were: (a) English language articles published in peer-reviewed journals; (b) diagnosis of ED determined according to the standardized diagnostic criteria, including the Diagnostic and Statistical Manual of Mental Disorders (DSM) from the third to the fifth edition [35,36,37,38,39], the Research Diagnostic
Summary
Repetitive negative thinking (RNT) is a cognitive process characterised by a repetitive, frequent, and self-focused form of thinking [1]. Worry and rumination have been grouped under the construct of RNT [2,3]. Worry has been defined as a chain of thoughts and images laden with negative affects and relatively uncontrollable [4]. Worry is an attempt to engage in mental problem-solving on an issue whose outcome is unknown but contains the possibility of being negative. Rumination is defined as thoughts that repetitively focus attention on negative emotions and symptoms, their causes, meanings, and consequences [5]. Worry is usually focused on problem-solving and is more future-oriented, whereas rumination often consists of themes of loss and typically has a focus on past problems [8]
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