Could repetitive negative thinking interfere with corrective learning? The example of anorexia nervosa

Erin E. Reilly*, Jason M. Lavender, Laura A. Berner, Tiffany A. Brown, Christina E. Wierenga, Walter H. Kaye

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Identifying processes that may interfere with corrective learning during treatments for anorexia nervosa (AN) may help to improve the effectiveness of existing interventions. We propose that certain cognitive processes characteristic of the AN temperament may help explain previous findings in AN suggesting difficulty updating previously learned associations and learning from feedback. Specifically, we hypothesize that engagement in repetitive negative thinking (RNT), including worry and rumination, could interfere with corrective learning that is critical to the success of behavioral treatments. In doing so, we draw from existing work in anxiety and mood disorders linking RNT to the maintenance of symptoms and poorer response to cognitive-behavioral treatments. Next, we outline hypothesized mechanisms through which engagement in RNT before, during, and after exposure to aversive stimuli could interfere with learning in AN. We then provide recommendations for how these hypothesized associations could be tested in future research. Although prior work has suggested that RNT processes are common among individuals with AN, this work has been primarily descriptive in nature. We propose that extending this work through direct examination of the impact of active engagement in RNT on corrective learning could aid in identifying AN maintenance processes that could be explicitly targeted in treatment.

Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalInternational Journal of Eating Disorders
Issue number1
StatePublished - Jan 2019
Externally publishedYes


  • anorexia nervosa
  • eating disorders
  • learning
  • repetitive negative thinking
  • rumination
  • worry


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