Cognitive-Emotional Model of Depression Persistence in Adults: The Role of Repetitive Thought Styles, Emotional Suppression, and Psychological Resilience

Background: Major depressive disorder is marked by high recurrence despite effective treatments, making the identification of perpetuating mechanisms a research priority. This study aimed to test a cognitive-emotional model in which repetitive thought styles (rumination) affect depression severity through emotional suppression (experiential avoidance), and psychological resilience moderates these paths.Methods: A descriptive-correlational design using structural equation modeling was employed. Participants were ۴۱۲ adults aged ۲۵–۵۵ years residing in Tehran in ۲۰۲۴, selected via convenience sampling. They completed the Cognitive Emotion Regulation Questionnaire (rumination subscale), Acceptance and Action Questionnaire–II, Connor-Davidson Resilience Scale, and the depression subscale of DASS-۲۱. Data were analyzed using path analysis and moderated mediation analysis in AMOS version ۲۶.Results: Rumination correlated positively with experiential avoidance (r = .۴۳, P < .۰۰۱) and depression (r = .۵۱, P < .۰۰۱). Experiential avoidance also correlated positively with depression (r = .۴۷, P < .۰۰۱). Resilience showed negative correlations with depression (r = –.۳۸) and experiential avoidance (r = –.۳۴) (Ps < .۰۰۱). Path analysis revealed that experiential avoidance mediated the rumination–depression relationship (indirect effect: β = .۲۰, P < .۰۰۱). Moreover, resilience negatively moderated the direct path from rumination to experiential avoidance (β = –.۱۲, P = .۰۰۳) and the path from experiential avoidance to depression (β = –.۱۷, P < .۰۰۱).Conclusion: The findings support a cognitive-emotional model of depression persistence in which rumination predicts depression severity via increased emotional suppression, while high resilience attenuates this vicious cycle. Strengthening resilience and reducing avoidant strategies may help interrupt the maintenance of depression.

کلیدواژه ها:

Depression ، Rumination ، Emotional Suppression ، Resilience ، Adults