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'''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 = | journal = Psychoneuroendocrinology | volume = 30 | issue = 10| pages = 1043–9 | doi = 10.1016/j.psyneuen.2005.04.008 | pmid=15939546}}</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 | url = | journal = Journal of Psychosomatic Research | volume = 60 | issue = 2| pages = 113–12 | doi = 10.1016/j.jpsychores.2005.06.074 | pmid = 16439263 }}</ref> is a collective term in scientific [[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 | url = | 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 = | journal = Biological Psychology | volume = 94 | issue = 1| pages = 38–43 | doi = 10.1016/j.biopsycho.2013.05.003 }}</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 | url = | journal = Frontiers in Psychology | volume = 4| issue = |
==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 | url = | journal = Journal of Experimental Psychopathology | volume = 1 | issue = | pages = 87–118 | doi = 10.5127/jep.009110 }}</ref> [[Worry]], [[rumination (psychology)|rumination]] and all other forms of thought ([[cognition]]) involving stressful events, in the past or in the future, 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, there 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 = | journal = Neuroscience and Biobehavioral Reviews | volume = 35 | issue = 1| pages = 46–50 | doi = 10.1016/j.neubiorev.2010.01.004 | pmid = 20096302 }}</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? | url = | journal = Journal of Psychosomatic Research | volume = 69 | issue = 4| pages = 407–16 | doi = 10.1016/j.jpsychores.2010.02.002 }}</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 | url = | 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 }}</ref> they may also not be aware of the cognitive representation of stressors.
'''The 'perseverative cognition hypothesis{{'}}'''<ref name="BGT2006" /> holds that stressful events cannot affect people's health, unless they think repetitively or continuously (that is, 'perseverate cognitively') about these stressful events. Stressful events themselves are often too short, as are the physiological responses to them. Therefore the physiological responses during these stressors are unlikely to cause bodily harm. More importantly, many stressful events are merely worried about, or feared in the future, while they often do not happen or do not have the feared consequences. Nevertheless, the body reacts with prolonged physiological responses to continuous thoughts (perseverative cognition) about these stressors. 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 | url = | journal = Scandinavian Journal of Work and Environtal Health | volume = 32 | issue = 6| pages = 482–92 | doi = 10.5271/sjweh.1053 }}</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 | url = | journal = Cardiovascular Psychiatry and Neurology | volume = 2009| issue = | pages = 1–8| doi = 10.1155/2009/791017 | pmid = 20029626 | pmc = 2790803 }}</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>
It is said that Perseverative cognition is involved with a “stress-disease link".<ref name="BPT2005" /> Further, it is the thought about the stress, or rather the obsessing over it, that causes stress and disease to be linked to it. Perseverative cognition also focuses on the effects that worry over things that will occur in the future 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 ‘wear and tear’ effect on the human body.” Studies<ref name=":0">{{Cite journal|last=Kocsel|first=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
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|last=Van Laethem|first=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
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|last=Makovac|first=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
In addition, perseverative cognition has potential to make other mental illnesses worse. In another article, its effect on Posttraumatic Stress Disorder.<ref name=":4" /> They found that with severe PTSD and the perseverative cognition, it correlated with less recovery regarding cardiovascular disease.
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