The impact of rumination and anhedonia on daily social and occupational function.

Abstract

Introduction: Rumination (repetitive negative thinking; RNT) and anhedonia are hallmark features of depression and other psychiatric disorders known for their association with executive functioning. However, limited work has directly evaluated associations between these indices and their potential contribution to impairments in social and occupational function. This study investigated cross-sectional and longitudinal associations between RNT and anhedonia with functional outcomes at 6- and 12-months among individuals with elevated depression or anxiety symptoms.

Method: Participants (N = 92, AgeM[SD] = 22[2.9], 72% female) completed Hamilton Depression and Anxiety Rating Scales, Perseverative Thinking Questionnaire (RNT), Snaith-Hamilton Pleasure Scale, Social Adjustment Scale (SAS-SR), and Health and Work Performance Questionnaire (HPQ). Participants also completed 7-day daily-diaries capturing social and occupational function; SAS-SR, HPQ, and daily-diaries were repeated at 6- and 12-months. General linear models evaluated baseline associations and linear mixed models tested longitudinal effects of baseline RNT and anhedonia on functional outcomes. Depression, anxiety, age, and sex-at-birth were covaried.

Results: At baseline, RNT and anhedonia were associated with lower global and social function, and greater work impairment (ps ≤ .03). Daily diaries showed baseline associations between anhedonia and lower social satisfaction (p = .04) and RNT and greater work impairment (p = .01). Function generally improved over time (ps ≤ .03), and baseline associations with anhedonia tended to diminish (ps < .001). By contrast, baseline RNT continued to impact global, social, and work function and absenteeism (ps ≤ .01) at 12-months. Per daily diaries, baseline RNT predicted reduced social satisfaction (p = .01) and elevated work impairment 12 months later (p = .04).

Conclusions: There were independent clinically significant associations for both anhedonia and RNT with multiple aspects of functioning. Some functional improvements occurred over time, accompanied by attenuated relationships with anhedonia. In contrast, RNT to functioning relationships persisted over 12 months.