Cognitive Therapy and Research

, Volume 36, Issue 4, pp 321–337 | Cite as

Responding to Anxiety with Rumination and Hopelessness: Mechanism of Anxiety-Depression Symptom Co-Occurrence?

  • Lisa R. Starr
  • Joanne Davila
Original Article


The current research proposes that certain anxiety response styles (specifically, responding to anxiety symptoms with rumination or hopeless cognitions) may increase risk of depressive symptoms, contributing to anxiety-depression comorbidity. We delineate preliminary evidence for this model in three studies. In Study 1, controlling for anxiety response styles significantly reduced the association between anxiety and depressive symptoms in an undergraduate sample. In Study 2, these findings were replicated controlling for conceptually related variables, and anxiety interacted with anxiety response styles to predict greater depressive symptoms. In Study 3, anxiety response styles moderated the prospective association between anxiety and later depression in a generalized anxiety disorder sample. Results support a role for anxiety response styles in anxiety-depression co-occurrence, and show that hopeless/ruminative anxiety response styles can be measured with high reliability and convergent and divergent validity.


Depression Anxiety Comorbidity Anxious rumination Hopelessness Response styles 



This research was made possible in part by National Institutes of Mental Health grants F31MH082545 (awarded to Lisa Starr) and R01 MH063904-1A2 (awarded to Joanne Davila) and by a grant from the American Psychological Association awarded to Lisa Starr. Manuscript preparation was funded by NIMH training grant T32 MH082719. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIMH or the APA.


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Authors and Affiliations

  1. 1.Department of PsychologyUniversity of California, Los Angeles (UCLA)Los AngelesUSA
  2. 2.Department of PsychologyState University of New YorkStony BrookUSA

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