Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Is your mind mainly replaying what happened or trying to prevent what might happen next?

Most useful distinction

Rumination revisits distress, causes, and meanings; worry rehearses future threat and uncertainty.

Common confusion

Both can be described as overthinking and both can interfere with sleep and concentration.

Treatment difference

Rumination often needs concrete action or attention shifting; worry often needs problem sorting and uncertainty tolerance.

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Rumination

Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.

CognitionAffectBehaviour

Definition

ARepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

BRepetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.

Core process

AFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

BAttention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.

Look for

AWhat-if chains · Reassurance seeking

BLong repetitive analysis · Difficulty shifting attention

Patient language

A“What if something goes wrong?”

B“I keep going over it”

Maintaining cycle

AUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

BNegative event -> repetitive analysis -> mood worsens -> more negative material becomes salient

Treatment leverage

ASeparate solvable problems from hypothetical threat loops.

BMove from repetitive analysis to values-based action or specific problem-solving.

Check before using

AThe main loop is past-focused rumination rather than future threat simulation.

BThe person is doing concrete planning that leads to action.

Formulation language

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

Open full guide

Formulation language

Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.

Open full guide

Browse the map Use both hypotheses

Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Is your mind mainly replaying what happened or trying to prevent what might happen next?

Most useful distinction

Rumination revisits distress, causes, and meanings; worry rehearses future threat and uncertainty.

Common confusion

Both can be described as overthinking and both can interfere with sleep and concentration.

Treatment difference

Rumination often needs concrete action or attention shifting; worry often needs problem sorting and uncertainty tolerance.

Worry

Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.

CognitionAffectBehaviour+1

Rumination

Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.

CognitionAffectBehaviour

Definition

ARepetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.

BRepetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.

Core process

AFuture threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.

BAttention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.

Look for

AWhat-if chains · Reassurance seeking

BLong repetitive analysis · Difficulty shifting attention

Patient language

A“What if something goes wrong?”

B“I keep going over it”

Maintaining cycle

AUncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty

BNegative event -> repetitive analysis -> mood worsens -> more negative material becomes salient

Treatment leverage

ASeparate solvable problems from hypothetical threat loops.

BMove from repetitive analysis to values-based action or specific problem-solving.

Check before using

AThe main loop is past-focused rumination rather than future threat simulation.

BThe person is doing concrete planning that leads to action.

Formulation language

Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.

Open full guide

Formulation language

Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.

Open full guide

Browse the map Use both hypotheses