Repetitive Thinking in Alcohol-Dependent Patients

Background: Recent studies proposed that a tendency to have repetitive negative thinking (RNT) could be a predictor of alcohol use. Nevertheless, results differ depending on the studied population (non-clinical samples or patients with alcohol abuse or alcohol dependence) and on the type of repetitive thinking (rumination or worry). These heterogeneous results might be explained by the impact of anxiety and depression level on RNT and alcohol consumption. Objectives: The aim of the present study was to explore different type of repetitive thinking (i.e., worry, brooding and reflection rumination, analytic-abstract repetitive thinking, and concrete-experiential thinking) in a clinical sample of alcohol-dependent patients and a non-clinical sample and the role played by depression and anxiety. Method: Eighty-four inpatients with a diagnosis of alcohol dependence and 68 individuals from a nonclinical sample completed questionnaires evaluating repetitive thinking, anxiety, depression and alcohol consumption. Results: Mann-Whitney U tests showed that patients with alcohol dependence reported more analytic-abstract repetitive thinking, brooding and reflection rumination and worry, as well as anxious and depressive symptoms, compared with social drinkers, who reported more concrete-experiential repetitive thinking. Moreover, a multiple mediation model indicated that the link between RNT and alcohol consumption was significantly mediated by both anxiety and depression. Conclusion/Importance: The results support the implication of RNT in alcohol dependence and the distinction between different types of repetitive thinking with adaptive or maladaptive consequences. This link seems to be explained by the levels of depression and anxiety that mediate the impact of RNT on alcohol consumption.