Repetitive negative thinking in adolescence: a mixed methods study

BACKGROUND: Adolescence is a critical window for preventing common mental disorders. Repetitive negative thinking (RNT) is a transdiagnostic process contributing to depression and anxiety and a key prevention target. However, little is known about adolescent experiences of RNT, especially during early adolescence. Furthermore, co-rumination, the interpersonal analogue of RNT, remains underexamined. This study characterised diverse facets of adolescent RNT and co-rumination in a self-selected community sample with elevated depression and anxiety symptoms, incorporating adolescent and parental perspectives. METHODS: A mixed‑methods online survey was completed by 72 adolescents (mean age = 14.51 years; 69% female, 10% non‑binary), including 26 younger (aged 10–14) and 46 older adolescents (aged 15–18), and 57 parents (adolescent mean age = 12.25 years; 44% female). Participants answered open- and close-ended questions regarding key aspects of adolescent RNT, and completed standardised measures of adolescent RNT, co‑rumination, depression, anxiety, wellbeing, and quality of life. Quantitative data were analysed descriptively; qualitative data were analysed using thematic coding. RESULTS: Both younger and older adolescents reported comparable levels of elevated RNT, co-rumination, depression and anxiety, moderate wellbeing, and low-to-moderate quality of life, broadly consistent with parental reports. Qualitative responses were mostly consistent across adolescent age groups. Adolescents showed comprehensive understanding of worry but low conceptual familiarity with rumination, especially among younger adolescents. RNT was primarily past-focused, verbal, and most likely to occur at night, interfering with sleep. Older adolescents reported slightly longer and more frequent RNT episodes than younger adolescents. Across both age groups, common RNT triggers included being alone or in a quiet environment, interpersonal/social, and school-related triggers. Younger adolescents were less able to identify specific RNT triggers. Common RNT-reduction strategies included distraction and interacting with others. However, almost half of adolescents were unsure what triggered their RNT and reported not doing anything to stop it. Most adolescents and parents perceived RNT as entirely unhelpful or purposeless. RNT reduction was expected to improve emotional wellbeing and engagement in valued actions. CONCLUSION: RNT and co-rumination are commonly experienced in adolescence. RNT causes distress to young people often lacking in effective coping strategies and warrants further attention alongside co-rumination as transdiagnostic targets in preventive mental health programs.