Rumination and worry are both forms of repetitive negative thinking, and while they have some similarities, there are also significant differences. Rumination focuses attention on the negative, or thoughts or distress and its causes and consequences, generally in the past or present. Worry tends to center more around uncertainty and is generally more focused on the future or anticipated threat. (Sansone 2012)

Rumination is associated with the development of depression and anxiety and can contribute to worsening existing conditions. Several recent studies show a variety of effective ways to reduce rumination and help address the related mental health conditions.

New Research on Treatments

A recent systematic review and meta-analysis looked at psychological treatments to address pre- and post-event rumination in adults with social anxiety disorder. (Donohue 2024) For people with social anxiety disorder, rumination before and after specific events can contribute to worsening social anxiety symptoms. Social anxiety disorder involves significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions. People with this disorder will try to avoid the situation or endure it with great anxiety, such as public speaking, meeting new people or eating/drinking in public.

Among the interventions reviewed, about one third specifically targeted rumination and were found to be significantly more effective at reducing rumination than those that did not. Of these, most interventions were a form of cognitive based therapy (CBT), others were mindfulness-based or metacognitive therapy interventions. The other two-thirds of interventions did not target rumination directly but aimed to reduce social anxiety symptoms overall or addressed rumination secondarily or indirectly and were less effective at reducing rumination. Individual and group therapy formats were found to be equally effective.

A recent randomized controlled trial examined an online intervention, the Managing Rumination and Worry program, targeting both rumination and worry in adults. (Joubert 2023) The intervention involved a 3-lesson online program delivered over 6 weeks. The 137 study participants were randomly allocated to the self-delivery of the program, the clinician guided delivery (participants received phone support after each session), and a control group which continued any previous treatment and waited 18 weeks to receive the program.

Participants in the self-help and clinician guided groups had significant improvement in levels of rumination, worry, and symptoms of depression, anxiety, and general psychological distress after the treatment and at a 3-month follow-up compared to the control group. Those in the clinician guided program showed greater improvement than those in the self-help program.

A third study found that a walk in nature can help reduce rumination. (Bratman 2015) Among healthy participants, researchers compared a 90-minute walk in nature with a 90-minute walk in an urban setting. The found that the walk in nature decreased both self-reported rumination and neural activity in the subgenual prefrontal cortex (part of the brain associated with a self-focused behavioral withdrawal linked to rumination in both depressed and healthy individuals) while the walk in an urban setting had neither effect. The authors concluded that the study “reveals a pathway by which nature experience may improve mental well-being.”

Finally, another recent study examined the effectiveness of a specific type of cognitive behavioral therapy designed to manage rumination (rumination-based CBT). (Li and Tang, 2024) RBCBT involves helping the individual recognize rumination as a mental habit, identify situations and triggers, and develop and practicing more positive ways to respond. The review study found evidence of significant potential benefits for RBCBT, including reducing depressive symptoms, preventing individuals from developing depression, and preventing relapse of depression, in addition to reducing rumination. The authors suggest “RBCBT could be promoted to treat depressive symptoms, especially for those with a high tendency toward rumination.”