Giani, L., De Francesco, S., Caselli, G., Ruggiero, G. M., Sassaroli, S., Della Morte, S., Piron, R., & Scaini, S. (2025). Linking Anger-Related Cognitions, Rumination, and Psychopathology in Adolescence: Insights into Internalizing and Externalizing Pathways. Evidence-Based Practice in Child and Adolescent Mental Health, 1–18.
ABSTRACT
Objective: In adolescents, dysfunctional behaviors often stem from accumulated psychological tension, amplified by anger rumination. This study investigates how anger-biased cognitions, anger rumination, and psychopathological symptoms – specifically oppositional defiant disorder (ODD), anxiety, and depression – interrelate.
Method: A sample of 180 students (mean age = 13.72; 99 males, 81 females) from middle (N = 94) and high school (N = 86) participated in this observational study and completed assessments measuring anger-related cognitive distortions (Angry Cognitions Scale-Revised), anger rumination (Anger Rumination Scale), and symptoms of ODD, anxiety, and depression. Network analysis was used to explore the structure of associations, focusing on centrality and bridge strength (BS).
Results: Anger rumination emerged as a central node linking cognitive distortions and psychopathological symptoms. Among cognitive patterns, hostile verbal labels and catastrophic attributions showed the highest centrality. BS analysis revealed that these distortions were most strongly connected to ODD symptoms (r = .18), while anger rumination had the strongest ties to anxiety (r = .32) and to the key cognitive distortions (r = .33).
Conclusion: Anger rumination plays a pivotal bridging role between maladaptive cognitions and emotional-behavioral symptoms, contributing to both internalizing (e.g. anxiety) and externalizing (e.g. ODD) outcomes. These findings challenge the strict dichotomy between internalizing and externalizing disorders, suggesting instead a shared underlying process. Therapeutic interventions should target both cognitive distortions and emotion regulation strategies to more effectively address adolescents’ overt behavioral issues.
Acknowledgments: The authors would like to thank all the children and their families for their valuable participation, which enabled the completion of this study.