The effects of different types of treatment for anxiety on repetitive negative thinking: A meta-analysis

Sabrina Monteregge, Anesteia Tsagkalidou, Pim Cuijpers, Philip Spinhoven*

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review


It is not clear if treatments for anxiety specifically targeting repetitive negative thinking (RNT: rumination, worry, and content-independent perseverative thinking) have a specific effect on RNT resulting in better outcomes than other psychological and nonpsychological treatments. We conducted a systematic search of randomized controlled trials comparing RNT-focused and non-RNT-focused psychological treatments, as well as nonpsychological treatments for anxiety with control groups and reporting outcomes on RNT. Inclusion criteria were met by 46 studies with a total of 3,194 participants. RNT-focused and non-RNT-focused psychological treatments had comparable effects on RNT, and level of anxiety and changes in RNT and anxiety were highly associated across treatments. Further mediation and mechanistic studies to test whether reductions in RNT during RNT-focused cognitive behavioral therapy predict subsequent reductions in anxiety are called for.

Original languageEnglish
Article numbere12316
Pages (from-to)1-20
Number of pages20
JournalClinical Psychology: Science and Practice
Issue number2
Early online date6 Jan 2020
Publication statusPublished - 1 Jun 2020


  • anxiety
  • cognitive behavior therapy
  • meta-analysis
  • randomized controlled trial
  • repetitive negative thinking
  • rumination
  • worry


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