Think Again: Adaptive Repetitive Thought as a Transdiagnostic Treatment for Individuals Predisposed to Repetitive Thinking Styles

Maladaptive repetitive thought (RT) is a transdiagnostic construct associated with several psychopathological disorders, including major depressive disorder and anxiety disorders. However, not all forms of RT are maladaptive. Adaptive RT is characterized by primarily positive and concrete thought content, is usually focused on the present rather than the past or future, and frequently from a self-distanced perspective. From a behavioral therapy perspective, interventions that promote adaptive RT may interrupt or decrease engagement in maladaptive RT. In this review, we explore the distinction between adaptive and maladaptive RT and examine the utility of various forms of adaptive RT. Empirical evidence for several examples of adaptive RT (e.g., savoring, reminiscing, compassion, gratitude, mantra-based intervention) are provided, with demonstrated efficacy in the treatment of psychopathology or as components of empirically supported psychotherapies. Using adaptive RT therapeutically may be beneficial for those who are already predisposed to RT, either as an individual difference (e.g., neural default mode connectivity) or in response to a stressful life event. Recommendations for future research into adaptive RT and its potential utility in addressing maladaptive RT in vulnerable populations are discussed.