Perseverative cognition: Difference between revisions

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{{Short description|Repeated thinking about negative events}}

{{independent sources|date=April 2015}}

'''Perseverative cognition'''<ref name="BPT2005">{{cite journal | last1 = Brosschot | first1 = J.F. | last2 = Pieper | first2 = S. | last3 = Thayer | first3 = J.F. | year = 2005 | title = Expanding Stress Theory: Prolonged Activation And Perseverative Cognition | url = https://www.semanticscholar.org/paper/60fcdd4312e7c5d5c72a47e3de528de8b4c38493| journal = Psychoneuroendocrinology | volume = 30 | issue = 10| pages = 1043–9 | doi = 10.1016/j.psyneuen.2005.04.008 | pmid=15939546| s2cid = 21406930 }}</ref><ref name="BGT2006">{{cite journal | last1 = Brosschot | first1 = J.F | last2 = Gerin | first2 = W. | last3 = Thayer | first3 = J.F. | year = 2006 | title = Worry and health: the perseverative cognition hypothesis | journal = Journal of Psychosomatic Research | volume = 60 | issue =2 2| pages = 113–12113–124 | doi = 10.1016/j.jpsychores.2005.06.074 | pmid = 16439263 }}</ref> is a collective term in [[psychology]] for continuous thinking about negative events<ref name= "W2008">{{cite journal | last1 = Watkins | first1 = E. R. | year = 2008 | title = Constructive and unconstructive repetitive thought | journal = Psychological Bulletin | volume = 134 | issue = 2| pages = 163–206 | doi = 10.1037/0033-2909.134.2.163 | pmid = 18298268 | pmc = 2672052 }}</ref> in the past or in the future (e.g. [[worry]], [[rumination (psychology)|rumination]] and brooding, but also [[mind wandering]] about negative topics<ref name= "OSC2013">{{cite journal | last1 = Ottaviani | first1 = C. | last2 = Shapiro | first2 = D. | last3 = Couyoumdjian | first3 = A. | year = 2013 | title = Flexibility as the key for somatic health: From mind wandering to perseverative cognition | url = https://www.semanticscholar.org/paper/b8f11f05d0e1759d2fe2df8dffca5355408a42e9| journal = Biological Psychology | volume = 94 | issue = 1| pages = 38–43 | doi = 10.1016/j.biopsycho.2013.05.003 | pmid = 23680439 | s2cid = 17843863 }}</ref><ref name= "OC2013">{{cite journal | last1 = Ottaviani | first1 = C | last2 = Couyoumdjian | first2 = A | year = 2013 | title = Pros and cons of a wandering mind: a prospective study | journal = Frontiers in Psychology | volume = 4| pages = 524 | doi = 10.3389/fpsyg.2013.00524 | pmid = 23966964 | pmc = 3743222 | doi-access = free }}</ref>).

It has been shown to have [[physiological]] effects, such as increased heart rate, blood pressure and cortisol, in daily life as well as under controlled laboratory conditions.<ref name="ZD2011">{{cite journal | last1 = Zoccola | first1 = P.M. | last2 = Dickerson | first2 = S.D. | last3 = Yim | first3 = I. S. | year = 2011 | title = Trait and state perseverative cognition and the cortisol awakening response | url = https://www.semanticscholar.org/paper/d5f68b9126c3293265544c520fab3ca93f3daa83| journal = Psychoneuroendocrinology | volume = 36 | issue = 4| pages = 592–595 | doi = 10.1016/j.psyneuen.2010.10.004 | pmid=21050668| s2cid = 23748341 }}</ref><ref name="OLMCTVB2015">{{cite journal | last1 = Ottaviani | first1 = C. | last2 = Lonigro | first2 = A. | last3 = Medea | first3 = B. | last4 = Couyoumdjian | first4 = A. | last5 = Thayer | first5 = J.F. | last6 = Verkuil | first6 = B. | last7 = Brosschot | first7 = J.F. | year = 2015 | title = Physiological Concomitants of Perseverative Cognition: A Systematic Review and Meta-Analysis | journal = Psychological Bulletin | volume = 142| issue = 3| pages = 231–259| doi = 10.1037/bul0000036 | pmid = 26689087 }}</ref> Because of these physiological effects, the psychological concept of perseverative cognition helps to explain how [[psychological stress]], such as [[work stress]] and marital stress, leads to disease, such as [[cardiovascular disease]].

==Definition==

The definition of perseverative cognition is: "the repeated or chronic activation of the cognitive representation of one or more psychological stressors".<ref name="BGT2006"/><ref name = "VBGT2010">{{cite journal | last1 = Verkuil | first1 = B. | last2 = Brosschot | first2 = J.F. | last3 = Gebhardt | first3 = W.A. | last4 = Thayer | first4 = J.F. | year = 2010 | title = When worries make you sick: A review of perseverative cognition, the default stress response and somatic health | journal = Journal of Experimental Psychopathology | volume = 1 | pages = 87–118 | doi = 10.5127/jep.009110 | doi-access = free }}</ref> [[Worry]], [[rumination (psychology)|rumination]] and all other forms of thoughtthoughts ([[cognition]]), involvingabout stressful events, inthat thehave pasthappened or inmight the futurehappen, fall under the definition of perseverative cognition. 'Just thinking about your problems, without calling it worrying or rumination', is also perseverative cognition, as is [[mind wandering]] when it concerns negative topics.<ref name="OSC2013"/><ref name="OC2013"/> Importantly, thereThere is a large body of knowledge about the typical constituents of perseverative cognition, such as worry, rumination, repetitive thinking and (negative) mind wandering (reviewed in Watkins, 2008<ref name="W2008"/>).

Perseverative cognition may partly be [[Unconsciousness|unconscious]].<ref name="B2010">{{cite journal | last1 = Brosschot | first1 = J.F. | year = 2010 | title = Markers of chronic stress: Prolonged physiological activation and (un)conscious perseverative cognition | url = https://www.semanticscholar.org/paper/b78516fb305d378d1793b158a5bc96666239febd| journal = Neuroscience and Biobehavioral Reviews | volume = 35 | issue = 1| pages = 46–50 | doi = 10.1016/j.neubiorev.2010.01.004 | pmid = 20096302 | s2cid = 38978073 }}</ref><ref name="BVT2010">{{cite journal | last1 = Brosschot | first1 = J.F. | last2 = Verkuil | first2 = B. | last3 = Thayer | first3 = J.F. | year = 2010 | title = Conscious and unconscious perseverative cognition: Is a large part of prolonged physiological activity due to unconscious stress? | journal = Journal of Psychosomatic Research | volume = 69 | issue = 4| pages = 407–16 | doi = 10.1016/j.jpsychores.2010.02.002 | pmid = 20846542 }}</ref> Just as people are not aware of the larger part of their thoughts (cognition),<ref name="BM2008">{{cite journal | last1 = Bargh | first1 = J.A. | last2 = Morsella | first2 = E. | year = 2008 | title = The unconscious mind | journal = Perspectives on Psychological Science | volume = 3 | issue = 1| pages = 73–9 | doi = 10.1111/j.1745-6916.2008.00064.x | pmid=18584056 | pmc=2440575}}</ref><ref name="DN2006">{{cite journal | last1 = Dijksterhuis | first1 = A. | last2 = Nordgren | first2 = L.F. | year = 2006 | title = A theory of unconscious thought | journal = Perspectives on Psychological Science | volume = 1 | issue = 2| pages = 95–109 | doi = 10.1111/j.1745-6916.2006.00007.x | pmid = 26151465 | citeseerx = 10.1.1.513.2448 | s2cid = 7875280 }}</ref> they may also not be aware ofthey thecontinue cognitiveto representationthink ofabout stressors.

== Perseverative cognition hypothesis ==

The ''perseverative cognition hypothesis''<ref name="BGT2006" /> holds that stressful events begin to affect people's [[health]] when they think about them repetitively or continuously (that is, '[[wiktionary:perseveration|perseverate]] [[Cognition|cognitively]]').

Stressful events themselvesand arethe often too short, as are thedirect physiological responses to them. Therefore,are theoften physiologicaltoo responsesshort duringin these stressors are unlikelyduration to cause bodily harm. MoreBut importantly,people manycan stressfulhave eventscontinuing are merely worriedthoughts about, orevents feared infrom the futurepast, while they often do not happen or doabout notpotential havefuture theevents, feared consequences. Nevertheless,and the body reacts withto prolonged physiological responses tothe continuousrepeated thoughts (perseverative cognition) aboutwith theseprolonged stressorsphysiological stress responses. Therefore, it is the perseverative cognition, and not the stressors that can eventually lead to disease. In scientific terms, it is said that perseverative cognition is a [[wikt:Special:Search/mediator|mediator]] of the detrimental effects of [[stress (psychological)|stress]] on one's health. Since its publication scientific evidence for this hypothesis has been accumulating.<ref name="VBGT2010" /><ref name="GS2006">{{cite journal | last1 = Geurts | first1 = S.A. | last2 = Sonnentag | first2 = S. | year = 2006 | title = Recovery as an explanatory mechanism in the relation between acute stress reactions and chronic health impairment | journal = Scandinavian Journal of Work, Environment & Health| volume = 32 | issue = 6| pages = 482–92 | doi = 10.5271/sjweh.1053 | pmid = 17173204 | doi-access = free }}</ref><ref name="LC2009">{{cite journal | last1 = Larsen | first1 = B.A | last2 = Christenfeld | first2 = N.J.S. | year = 2009 | title = Cardiovascular Disease and Psychiatric Comorbidity: The Potential Role of Perseverative Cognition | journal = Cardiovascular Psychiatry and Neurology | volume = 2009| pages = 1–8| doi = 10.1155/2009/791017 | pmid = 20029626 | pmc = 2790803 | doi-access = free }}</ref><ref name="FMBK2012">{{cite journal | last1 = Flaxman | first1 = P. E. | last2 = Ménard | first2 = J. | last3 = Bond | first3 = F. W. | last4 = Kinman | first4 = G. | year = 2012 | title = Academics' experiences of a respite from work: Effects of self-critical perfectionism and perseverative cognition on postrespite well-being | url = http://openaccess.city.ac.uk/6323/1/Flaxman%20et%20al%20%282012%29%20JAP.pdf| journal = Journal of Applied Psychology | volume = 97 | issue = 4| pages = 854–865 | doi = 10.1037/a0028055 | pmid=22545621}}</ref>

== Physiological effects and disease ==

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Perseverative cognition is involved with a “stress-disease link".<ref name="BPT2005" /> Further, it is the thinking about the stress, or rather the obsessing over it, that establishes a link between stress and disease. Perseverative cognition also focuses on the effects that worrying over anticipated events have on the physical body and mind.<ref name="BGT2006" /> This could suggest that obsessive worrying over past events or the future could lead to physical issues.

There are some physical evidences of the effects of perseverative cognition, as noted in an analysis article.<ref name="OLMCTVB2015" /> The article found that [[cortisol]] levels, as well as the average heart rates of individuals, were higher when perseverative cognitive processes were present.<ref name="OLMCTVB2015" /> Another article<ref name="VBGT2010" /> says that “worrying about stressful events increases the total amount of time that stress has a ‘[[wiktionary:wear and tear|wear and tear]]’ effect on the human body.” Studies<ref name=":0">{{Cite journal|last1=Kocsel|first1=Natália|last2=Köteles|first2=Ferenc|last3=Szemenyei|first3=Eszter|last4=Szabó|first4=Edina|last5=Galambos|first5=Attila|last6=Kökönyei|first6=Gyöngyi|date=July 2019|title=The association between perseverative cognition and resting heart rate variability: A focus on state ruminative thoughts|journal=Biological Psychology|volume=145|pages=124–133|doi=10.1016/j.biopsycho.2019.04.004|pmid=31051207|s2cid=140254575 |issn=0301-0511|url=https://www.semanticscholar.org/paper/efe007775072c47823f3b9a5cad5924708011be4}}</ref> have been done that show links between cognitive perseverance and increased heart rates. The consistent, ruminating thoughts circulating in one's mind could lead to physical responses.

It is also discussed in another article<ref name="BVT2010" /> that these worries create psychological issues that in turn create physical negative outcomes. It is not, as the article claims, the events themselves that create the physical issues, but rather the consistent worrying about them that causes the issues.

In another article, it is discussed that perseverative cognition increases heart rate, and also impacts parts of the [[brain]], notably in the prefrontal and amygdala areas.<ref name=":0" /> There is a connection between the brain and the heart when it comes to perseverative cognition. When present, it impacts not only mental facilities, but also physical components.<ref name=":0" /> One article describes the physical components as a response to the thoughts, “as if the individual were facing an external stressor”.<ref name=":1">{{Cite journal|last1=Van Laethem|first1=Michelle|last2=Beckers|first2=Debby G. J.|last3=Geurts|first3=Sabine A. E.|last4=Garefelt|first4=Johanna|last5=Magnusson Hanson|first5=Linda L.|last6=Leineweber|first6=Constanze|date=2017-09-12|title=Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality|journal=International Journal of Behavioral Medicine|volume=25|issue=2|pages=231–242|doi=10.1007/s12529-017-9683-y|pmid=28900837|issn=1070-5503|pmc=5852204}}</ref> The article also talks about how obsessive thoughts of worry lead to greater depression. Cognitive perseverance leads to multiple issues, ranging from [[Mood (psychology)|mood]] to heart rate.

Cognitive perseverance not only impacts mental and physical processing, but it also has the possibility of impacting [[sleep]], as explored in one article.<ref name=":2">{{Cite journal|last1=Makovac|first1=Elena|last2=Fagioli|first2=Sabrina|last3=Rae|first3=Charlotte L.|last4=Critchley|first4=Hugo D.|last5=Ottaviani|first5=Cristina|date=January 2020|title=Can't get it off my brain: Meta-analysis of neuroimaging studies on perseverative cognition|journal=Psychiatry Research: Neuroimaging|volume=295|pages=111020|doi=10.1016/j.pscychresns.2019.111020|pmid=31790922|issn=0925-4927|doi-access=free}}</ref> In this article, the impact of obsessive worrying regarding jobs, therefore creating perseverative cognition, on sleep was explored. They found that there was a correlation between excessive job centered perseverative cognition and a lack of good sleep. Perseverative cognition impacts several parts of life. Another article<ref name=":3">{{Cite journal|last1=Ottaviani|first1=Cristina|last2=Medea|first2=Barbara|last3=Lonigro|first3=Antonia|last4=Tarvainen|first4=Mika|last5=Couyoumdjian|first5=Alessandro|date=April 2015|title=Cognitive rigidity is mirrored by autonomic inflexibility in daily life perseverative cognition|journal=Biological Psychology|volume=107|pages=24–30|doi=10.1016/j.biopsycho.2015.02.011|pmid=25749107|s2cid=9641909 |issn=0301-0511|url=https://www.semanticscholar.org/paper/30df81eed35f9c3b40570f8db6e2113bb2d0631f}}</ref> talks about how poor sleep could happen when one had perseverative cognition. The article uses the term mind wandering to talk about “persistent and repetitive” thoughts<ref name=":4">{{Cite journal|last=Kibler|first=Jeffrey L.|date=February 2018|title=An Extension of the Perseverative Cognition Hypothesis to Posttraumatic Stress Disorder Symptomatology: Cardiovascular Recovery in Relation to Posttraumatic Stress Disorder Severity and Cognitive Appraisals of Stress|journal=Journal of Traumatic Stress|volume=31|issue=1|pages=25–34|doi=10.1002/jts.22252|pmc=6190589|issn=0894-9867|pmid=29388694}}</ref> and correlates with other mental disorders. Perseverative cognition can affect more than physical components, as stated earlier. The same article<ref name=":5">{{Cite journal|last=Ottaviani|first=Cristina|date=2018-04-01|title=Brain-heart interaction in perseverative cognition|journal=Psychophysiology|volume=55|issue=7|pages=e13082|doi=10.1111/psyp.13082|pmid=29607505|issn=0048-5772|doi-access=free}}</ref> also talked about how mental rigidity ties in with perseverative cognition and impacts individuals in multiple ways.

In addition, perseverative cognition has potential to make other [[Mental disorder|mental illnesses]] worse. In another article, on its effect on [[Posttraumatic stress disorder|PTSD]],<ref name=":4" /> it was found that with severe PTSD and the perseverative cognition, it correlated with less recovery regarding cardiovascular disease.