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Self-referential prompts increase negative thoughts in depression and anxiety during think aloud paradigm

Creative Commons 'BY' version 4.0 license
Abstract

Individuals with depression and anxiety often experience intrusive and persistent thoughts that are difficult to disengage from. Despite their clinical importance, these dysfunctional thoughts patterns remain poorly understood. Here we recruited fifty participants (half with symptoms of depression and/or anxiety, half controls) who completed a Think Aloud task in which they verbalized their thoughts in response to self-referential or distraction prompts while being audio recorded, and rated them in emotional valence. Recordings were transcribed and segmented into thought units for which an overall valence was calculated. Results showed that participants with depression or anxiety exhibited lower overall thought valence than controls. Self-referential prompts further reduced thought valence in the clinical group, while slightly increasing valence in healthy controls. Dynamic analyses revealed that self-referential prompts disrupted the ability of the clinical group to maintain positive thought states. This suggests that self-referential cues exacerbate negative, rigid thought dynamics in depression and anxiety.