Differences in Cognitive Avoidance,Anger Rumination,and The General Anxiety in Light of The Gender and Emotional Regulation Disturbance Among Undergraduate Students

Abstract

The current study aimed to determine the differences in cognitive avoidance, anger rumination, and general anxiety in response to the gender and the emotional regulation disturbance variables. The sample was (418) university students who were asked to answer on study tools of cognitive avoidance, anger rumination, general anxiety, and emotional regulation disturbance. The factor analysis revealed that the study tools coincide with the original factorial structures of these tools. In addition, the current finding showed appropriate indicators of validity and reliability in the Egyptian students. Moreover, the results revealed that the gender differences possessed no significant differences in cognitive avoidance, generalized anxiety, and anger rumination. Furthermore, the students with high difficulties in emotion regulation revealed significantly higher cognitive avoidance and anger rumination (92.298 ± 1.126; 45.114 ± 0.764) than those with low difficulties in emotional regulation (82.842 ± 1.927; 41.354 ± 1.307). However, these significant effects were absent on generalized anxiety. The cognitive avoidance, anger rumination, general anxiety, and emotional regulation disturbance scales showed good validity and reliability fit on the Egyptian student sample. Moreover, there were no gender differences in cognitive avoidance, anger rumination, and generalized anxiety. In comparison, the individuals who showed high emotional regulation disturbance had high cognitive avoidance and anger rumination.

Keywords

cognitive avoidance anger rumination general anxiety emotional regulation disturbance

Introduction

The beginning of university education is a transitional moment in which the student moves from one setting to another. While some students may be able to adjust to their new surroundings at this time, others may experience difficulty, worry, tension, despair, and rage (Mohd Sidik et al., 2003). Emotional problems are a mental health concern that can lead to depression episodes worsening (Tomoda et al., 2000). Comorbidity, personality changes, and suicide attempts are all linked to these issues (Dahlin et al., 2005). About 57% of medical students in Singapore suffer from mental anguish, according to the report (Ko et al., 1999). Furthermore, around 23% of medical students in the United States suffer from depression, and 57% have significant levels of emotional discomfort (Mosley et al., 1994). Emotional disorders also interfere with young people’s ability to perform tasks, such as hard to maintain appropriate social relationships with their peers and adults, and succeeding in school.

Academic and behavioral issues, aggressive and disruptive behaviors, and tantrums are all common among children and adolescents with behavioral disorders (Maughan et al., 2006; Mayfield et al., 2005). Furthermore, adolescents with behavioral issues have weak academic skills and attain low levels of performance (Malmgren & Leone, 2008). These pupils are also less likely to join a club or engage in social activities. Furthermore, this student’s average score is lower than any other impairment category, with significant dropout rates (55%) (Wagner, 2005).

Anger plays a significant role in emotional disorders (Barlow et al., 2014). Exposure to an intense wave of anger could result in a loss of self-controlling, the appearance of the domination idea with strong competitive behavior, and negative feelings in many individuals. The effect of this anger wave can extend even after the end of its original situation and this may be accompanied by a state of anxiety, tension, and excitement. This sequence of anger is termed what is called anger rumination. Rumination causes people to focus on problems that trigger negative emotions (Nolen-Hoeksema et al., 2008). furthermore, Anger rumination also has a poor impact on social adjustment (Bushman, 2002), lowers the ability to manage anger, and even converts anger into aggressive conduct toward innocent persons who were not involved in the provocation (Besharat & Pourbohlool, 2013; García-Sancho et al., 2016). Anger has also been linked to mental problems (Bravo et al., 2020) and has been shown to worsen bad moods (Genet & Siemer, 2012).

Rumination on the causes, situational aspects, and consequences of rage is known as anger rumination (Sukhodolsky et al., 2001). As well, Spielberger (1991) also defines anger as an emotional status varying from a simple level to a high level. Individuals with high-level anger deal with more stress, health problems, negative effects, and psychological distress (Besharat et al., 2009). Individuals with high anger rumination are more likely to perceive situations as irritating and repress anger than those with low anger rumination (Takebe et al., 2016). Similar to fear and anxiety anger is a negative emotional state related to high levels of a negative impact, therefore it may probably play a significant role in emotional disorders (Barlow et al., 2014).

Rumination has been linked to despair, anxiety, and shock reactions (Kubota et al., 2015; Nolen-Hoeksema et al., 2008). Rumination and rage were also found to be detrimental factors in tolerance (Fatfouta et al., 2015; Wu et al., 2019). The student who suffers from severe rumination is more likely to internalize the thoughts and feelings associated with anger or sadness. While, the student expressed a low level of rumination is more willing to allow these feelings to dissipate (Collins & Bell, 1997). As a result, adolescents with high trait-anger ratings demonstrated a mix of good and negative social behaviors (social conformance, social sensitivity, and help collaboration) (aggressiveness, dominance, and antisocial-delinquent) (Garaigordobil, 2011).

Anxiety acts as a cognitive response to avoid disturbing thoughts or emotions. Anxiety disorders commonly appear in youth (Polanczyk et al., 2015). Youth with anxiety frequently avoid interactions, and their anxiety problems are linked to negative outcomes such as poor peer perception (Verduin & Kendall, 2008), bad social relationships (Kingery et al., 2010), and low academic accomplishment (Nail et al., 2015). Moreover, individuals with high worry may use several cognitive avoidance strategies to distract from distressing thoughts (Koerner & Dugas, 2006; Sexton & Dugas, 2008). The fear of anxiety and negative perceptions about anxiety were linked to all cognitive avoidance methods (Sexton & Dugas, 2008). Self-blame, ruminating, blaming others, and avoidance of frightening stimuli were also significantly higher among those with generalized anxiety and high worriers (Nasiri et al., 2020).

Avoidance is a natural reaction that is sensitive to the survival of individuals (Hayes et al., 1996). Distraction, concern, and thought suppression are all examples of cognitive avoidance. This sort of avoidance is used to get away from or avoid thinking about unpleasant situations or difficulties (Sagui-Henson, 2017). Anxiety disorders, depression, social phobia, generalized anxiety disorder, and obsessive-compulsive disorder were all linked to thought control mechanisms (Barlow, 2014; Goodwin et al., 2017). According to several studies, cognitive avoidance plays a significant role in generalized anxiety (Tempesta et al., 2013). Additionally, one of the cognitive avoidance variables that can play a key role in anxiety disorders is cognitive emotion regulation (Bruggink et al., 2016). Furthermore, cognitive avoidance is a coping strategy for dealing with the effects of potentially dangerous or scary situations. Coping mechanisms with disconnection targeted avoidance of conflict with threat or avoidance emotions associated with stress (Skinner et al., 2003). Also, Cognitive avoidance methods have also been researched as fundamental aspects of mental diseases such as depression, social phobia, generalized anxiety disorder, and obsessive-compulsive disorder (Barlow et al., 2014). Moreover, repetition and enhancement of cognitive avoidance reduced the regulation of negative feelings and enabled the individual to avoid inner experiences (Borkovec et al., 2004).

Cognitive avoidance is thought to be one of the causes of anxiety in general (Sexton & Dugas, 2008). An approach for controlling worried thoughts is cognitive avoidance. It’s referred to as an automatic mechanism for avoiding uncomfortable thoughts (Borkovec & Roemer, 1995). Generally, cognitive avoidance is linked with individuals with a high tendency to worry (Koerner & Dugas, 2006). Therefore, cognitive avoidance could be used to differentiate adult individuals with generalized anxiety and healthy ones (Donovan et al., 2017). Linearly, avoidance of threatening stimuli could be used to discover people suffering from general anxiety disorder from healthy persons (Nasiri et al., 2020).

Emotion regulation disturbance has recently gained popularity among university students. The term “difficulties in emotion regulation” (also known as “emotional regulation disturbance” or “emotional dysregulation”) refers to a poorly regulated emotional reaction. It’s also known as mood swings, mood lability, or marked mood fluctuation (Bjureberg et al., 2016). Emotional disorders were found to be prevalent in 48.3% of Malaysian university students (Al-Naggar & Al-Naggar, 2012). Emotion control disorders have been linked to a variety of psychological issues, including depression (Werner-Seidler et al., 2013), aggression (Donahue et al., 2014), anger (Beauchaine & Thayer, 2015), and anxiety (Southam-Gerow & Kendall, 2002). Moreover, difficulties in emotion regulation have been different in response to gender (Fanti & Henrich, 2010). Linearly, gender significantly influences emotional disorders among university students (Tice & Bratslavsky, 2000). Briefly, girls have exhibited more internalizing symptoms such as worry, sadness, withdrawal, and fear. On another hand, boys have exhibited more externalizing symptoms like impulsivity, verbal and physical violence, and agitation (Benarous et al., 2015). In addition, one of the causes of failure in self-regulation and self-control was emotional management problems (Tice & Bratslavsky, 2000).

Concerning the link between emotion regulation problems and anxiety, the inability to control emotions is linked to anxiety (Martin & Dahlen, 2005; Mennin & Farach, 2007). Moreover, Leahy (2002) suggested that individuals who suffer from generalized anxiety tend to have an inadequate understanding of their emotions. In addition, individuals with generalized anxiety could suffer from anxiety, sadness, anger, rumination, and self-criticism (Martin & Dahlen, 2005). Also, these individuals tended to respond reactively, as they attempt to gain control over the situation by trying to escape or decrease the intensity of emotional experience (Fresco et al., 2007). The current work aimed to determine the effect of gender, and emotional regulation disturbance on cognitive avoidance, anger rumination, and general anxiety in undergraduate students. Study 1’s goal was to look at the psychometric aspects of emotional regulation disturbance, cognitive avoidance, angry rumination, and generalized anxiety. Study 2’s goals were to find out about:

Differences in cognitive avoidance, angry rumination, and generalized anxiety between males and females.

Differences between low and high levels of emotion regulation in cognitive avoidance, anger rumination, and generalized anxiety.

The interaction between gender (male and female) and emotion regulation (low and high) affect cognitive avoidance, anger rumination, and generalized anxiety.

Study 1

Methods

Participants and Procedure

Participants were requested to voluntarily reply to the online study instruments using Google Forms (Google Inc.). Students could use their smartphones to react to research tools online. The data was acquired in two phases: initially, data was collected from (80) participants in order to examine the study instruments’ factor structure (difficulties in emotion regulation, cognitive avoidance, anger rumination, and generalized anxiety scales). Second, data was collected from (150) people in order to examine the research tools’ confirmatory component (difficulties in emotion regulation, cognitive avoidance, anger rumination, and generalized anxiety scales). The Cronbach’s alpha and internal consistency of the research instruments were examined using three samples drawn from (99) participants.

Measures

The Difficulties in Emotion Regulation Scale (Bjureberg et al., 2016) has 16 items that assess non-acceptance (Items 1, 2, 3), difficulties engaging in goal-directed behavior (Items 4, 5, 6), impulse control difficulties (7, 8, 9), limited access to effective emotion regulation strategies (Items 10, 11, 12, 13, 14), and lack of emotional clarity (Items 10, 11, 12, 13, 14). (Items 15, 16). On this scale, total scores can vary from 16 to 80.

The Cognitive Avoidance Sale is a 25-item self-report questionnaire that assesses the proclivity to adopt cognitive avoidance as a coping technique when confronted with threatening intrusive thoughts (Sexton & Dugas, 2008). The responses on this scale ranged from 1 to 5, with 1 indicating significant disagreement and 5 indicating strong agreement. Thought suppression subscale (items 1, 2, 5, 6, 14), thought substitution subscale (items 4, 11, 17, 20, 25), distraction subscale (items 8, 10, 12, 13, 21), avoidance of threatening stimuli subscale (items 7, 9, 16, 18, 22), and transformation of images into thoughts subscale (items 3, 15, 19, 23, 24).

Anger Rumination Scale consisted of 19 items (Sukhodolsky et al., 2001). This scale had four subscales including understanding causes (items 12, 16, 11, 10), revenge thoughts (items 4, 15, 13, 6), anger memories (items 2, 3 14, 1, 5), and thoughts after anger (items 19, 18, 17, 9, 7, 8).

The Generalized Anxiety Scale (Spitzer et al., 2006) is a one-dimensional scale with seven components. Furthermore, the responses on this scale were organized in a Likert-type, with not at all sure = 0, many days = 1, over half the days = 2, and virtually every day = 3.

Analytical Statistics

The SPSS software package version 24 was used to analyze the data. The research instruments’ validity was investigated using exploratory factor analysis and principal component analysis utilizing the Varimax rotation approach with Kaiser Normalization. Cronbach’s alpha test was also used to verify the measurements’ reliability.

Results

Exploratory Factor Analyses of the Research Tools

Difficulties in emotion control scale exploratory component analysis revealed four factors with a cumulative explained variance of 87.33% of the total variation (Table 1). The first component accounted for 36.99% of the variance, whereas the second, third, and fourth factors accounted for 20.297%, 17.28%, and 12.76% of the variance, respectively. To achieve a good fit for the factor analysis, items 15 and 16 from the lack of emotional clarity dimension were removed. After eliminating item (25) from the cognitive avoidance scale, an exploratory component analysis revealed five factors with a cumulative explained variance of 82.39% (Table 1). The first component explained 36.81% of the total variance, followed by the second 19.37 %, the third 10.29 %, the fourth 8.90 %, and the fifth 7.03 % factors. Additionally, the results of the anger rumination scale also revealed that four factors accounted for 75.88% of the total variation. The first factor accounted for 43.80% of total variation, while the second factor accounted for 13.65%. Furthermore, the third factor explained 10.46% of the variance, followed by the fourth factor at 7.97%. In addition, the generalized anxiety scale’s exploratory factor analysis revealed only one factor with a 70.02% explained variance.

Table 1.

Eigenvalues, Total Variances of Difficulties in Emotion Regulation, the Cognitive Avoidance, Anger Rumination, and the Generalized Anxiety.

Scale	Factor	Initial Eigenvalues
Scale	Factor	Total	% of Variance	Cumulative %
Difficulties in emotion regulation	1	5.178	36.989	36.989
	2	2.842	20.297	57.286
	3	2.420	17.283	74.569
	4	1.787	12.764	87.333
Cognitive avoidance	1	8.833	36.805	36.805
	2	4.649	19.370	56.175
	3	2.469	10.288	66.463
	4	2.137	8.903	75.366
	5	1.686	7.026	82.391
Anger rumination	1	8.322	43.802	43.802
	2	2.593	13.649	57.451
	3	1.987	10.459	67.910
	4	1.515	7.974	75.884
Generalized anxiety	1	4.902	70.023	70.023

Table 2 shows the distribution of items on the dimensions of difficulties in emotion regulation, cognitive avoidance, anger rumination, and generalized anxiety after the exploratory factor analysis. Furthermore, all items have good saturation, and the factor is named by the content of the highest saturation item within.

Table 2.

The Items and Factor Structure of Difficulties in Emotion Regulation, the Cognitive Avoidance, Anger Rumination, and the Generalized Anxiety Scale After Factor Reduction Procedures.

scale	Item number	Factor 1	Factor 2	Factor 3	Factor 4	scale	Item number	Factor1	Factor2	Factor3	Factor4	Factor5
Difficulties in emotion regulation	10	0.937				The cognitive avoidance	12	0.871
	12	0.913					13	0.859
	11	0.904					10	0.845
	14	0.885					21	0.832
	13	0.879					8	0.828
	7		0.981				16		0.890
	8		0.981				18		0.864
	9		0.949				9		0.859
	4			0.951			22		0.844
	6			0.923			7		0.794
	5			0.898			5			0.886
	2				0.881		14			0.865
	1				0.872		1			0.848
	3				0.866		2			0.839
							6			0.828
							23				0.889
							3				0.833
							19				0.825
							15				0.817
							24				0.707
							17					0.910
							4					0.908
							11					0.907
							20					0.900
Anger rumination	18	0.864				Generalized anxiety	3	0.871
	19	0.810					2	0.855
	17	0.726					1	0.850
	7	0.709					5	0.837
	8	0.695					7	0.826
	9	0.674					4	0.811
	14		0.861				6	0.805
	2		0.841
	3		0.807
	1		0.752
	5		0.715
	16			0.869
	11			0.865
	10			0.860
	12			0.817
	4				0.879
	15				0.853
	13				0.813
	6				0.702

The confirmatory factor analysis of the study of the tool revealed that the scale items had appropriate saturation values. It also demonstrated an excellent model fit for the problems with emotion regulation (Figure 1). The NFI, RFI, IFI, TLI, CFI, and GFI values were 0.954, 0.940, 0.981, 0.975, 0.981, and 0.903, respectively, indicating that the model fit was good. Similarly, the root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) values were 0.060 and 0.0519, respectively, indicating a reasonable model fit because these values were less than 0.07 and 0.08. Furthermore, the cognitive avoidance model fits. The NFI, RFI, IFI, TLI, CFI, and GFI values were 0.902, 0.90, 0.958, 0.952, 0.958, and 0.900, indicating an excellent fit. Similarly, the root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) values were 0.061 and 0.0510, respectively, indicating a reasonable model fit because these values were less than 0.07 and 0.08. (Figure 2). Furthermore, the model matched the angry rumination. NFI, RFI, IFI, TLI, CFI, and GFI were all 0.903, 0.900, 0.957, 0.949, 0.957, and 0.900, indicating that the model fit was good. Similarly, the root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) values were 0.060 and 0.0549, respectively, indicating a reasonable model fit because these values were less than 0.07 and 0.08 (Figure 3). The model also fit the generalized anxiety. NFI, RFI, IFI, TLI, CFI, and GFI were all 0.976, 0.959, 0.989, 0.981, 0.989, and 1.000, indicating that the model fit was good. Similarly, the root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) values were 0.060 and 0.0214, respectively, indicating a strong model fit because these values were less than 0.07 and 0.08 (Figure 4).

Figure 1.

The confirmatory factor analysis of the difficulties in emotion regulation.

Figure 2.

The confirmatory factor analysis of the cognitive avoidance.

Figure 3.

The confirmatory factor analysis of the anger rumination.

Figure 4.

The confirmatory factor analysis of the generalized anxiety.

Cronbach’s Alpha and Internal Consistency Analysis

Tables 3 and 4 show the internal consistency, Cronbach’s alpha, means, and standard deviations for all research instruments. Internal consistency of emotion regulation issues ranged from 0.59 to 0.84. Furthermore, the internal consistency of cognitive avoidance ranged from 0.50 to 0.77, while rage rumination ranged from 0.56 to 0.78. The generalized anxiety’s internal consistency ranged from 0.85 to 0.93. Furthermore, Cronbach’s alpha of the present study’s difficulties in emotion control is 0.91. Furthermore, Cronbach’s alpha for cognitive avoidance was .94 to .97, with a total scale of .92. Cronbach’s alpha for anger rumination ranged from .90 to .94, with a total scale value of .89, compared to .96 for the generalized anxiety scale.

Table 3.

Internal Consistencies of the Study Tools.

Variable	Subscales	Internal consistencyN = 99
Variable	Subscales	1	2	3	4	5	6	7
Difficulties in emotion regulation	1-Non-acceptance	1
	2-Difficulties Engaging in Goal-Directed Behavior	0.25	1
	3-Impulse Control Difficulties	0.18	0.32^**	1
	4-Limited Access to Effective Emotion Regulation Strategies	0.39^**	0.34^**	0.41^**	1
	5- Total	0.66^**	0.59^*	0.66^**	0.84^**	1
Variable	Subscales	1	2	3	4	5	6	7
Cognitive avoidance	1-Thought Suppression	1
	2-Thought Substitution	0.18	1
	3-Distraction	0.46^**	0.14	1
	4-Avoidance of Threatening Stimuli	0.16	0.32^**	−0.09	1
	5-Transformation of Images into Thoughts	0.58^**	0.24^*	0.46^**	0.25^*	1
	6-total	0.72^**	0.61^**	0.62^**	0.50^**	0.77^**	1
Anger rumination	1-understanding causes	1
	2- Revenge thoughts	−0.01	1
	3- Anger memories	0.24^*	0.39^**	1
	4- Thoughts after anger	0.32^**	0.18	0.46^**	1
	5- Total	0.56^**	0.58^**	0.78^**	0.75^**	1
Variable		Item1	Item2	Item3	Item4	Item5	Item6	Item7
Generalized anxiety	Total score of the scale	0.91**	0.89**	0.91**	0.85**	0.93**	0.88**	0.92**

Note. M = mean; SD = standard deviation.

p < .05. **p < .01.

Table 4.

The Study Tools’ Cronbach’s Alpha.

Variables	Subscales	Cronbach’s alpha(α)N = 99
Variables	Subscales	α	M	SD
Difficulties in emotion regulation	Total	.91	42.68	11.71
Cognitive avoidance	Thought Suppression	.94	20.24	4.40
	Thought Substitution	.96	10.01	4.46
	Distraction	.97	18.90	4.93
	Avoidance of Threatening Stimuli	.96	19.50	4.44
	Transformation of Images into Thoughts	.96	18.77	4.79
	Total	.92	87.43	14.92
Anger rumination	Understanding causes	.93	9.26	3.08
	Revenge thoughts	.94	7.97	3. 25
	Anger memories	.92	12.08	3.25
	Thoughts after anger	.90	14.93	3.53
	Total	.89	41.79	8.33
Generalized anxiety	Total	.96	8.85	7. 15

Discussion

The factor structure of the challenges in the emotion control scale revealed four-factor structures in the current investigation. Furthermore, the findings revealed that all items on the associated factor were saturated. These findings concurred with Fowler et al. (2014) but differed from those of Bjureberg et al. (2016). In addition, the factorial structure of the challenges in the emotion regulation model included four factors: restricted availability to effective emotion regulation tools, impulse control difficulties, difficulty engaging in goal-directed activity, and non-acceptance of negative feelings. The fifth factor of emotional ambiguity was eliminated. These findings corroborated prior findings (Fowler et al., 2014).

The cognitive avoidance scale was found to have a five-factor structure that included distraction, avoidance of threatening stimuli, thought suppression, transformation of images into thoughts, and thought replacement. These findings were previously published (Sexton & Dugas, 2008).

Remarkably, the factors of the thoughts after anger, the anger memories, the understanding causes, and the revenge thoughts formed the factorial structure of the anger rumination scale. The findings match those of Sukhodolsky et al. (2001). Besides, the generalized anxiety scale was composed of only a one-factor structure with efficient item saturation. This result matches Spitzer et al. (2006).

Internal consistency was found in the measures for difficulty with emotion regulation, cognitive avoidance, angry rumination, and generalized anxiety. These scales also exhibited a good Cronbach’s alpha match.

Study 2

Methods

Participants and Procedure

The participants voluntarily responded to study tools on the Google Forms application (Google Inc.) using their smartphones. The data were collected from (418) university students 42 males with an age average of 20.12, SD = 1.66, and 376 females with an age average of 19.43, SD = 1.28 to estimate the effect of gender differences and emotion regulation disturbances and their interaction on cognitive avoidance, anger rumination, and generalized anxiety.

Measures

After establishing the good fit of the research instruments to the Egyptian student samples in Study 1 and testing their validity and reliability, the tools were used in Study 2 as follows:

Bjureberg et al. (2016) developed a 14-item Difficulties in Emotion Regulation Scale (M = 45.57, SD = 9.90; =0.88).

Cognitive Avoidance scale (Sexton & Dugas, 2008), as its five factors were the thought suppression subscale (M = 20.59, SD = 3.36; α = .905), thought substitution subscale (M = 12.86, SD = 5.09; α = .95), distraction subscale (M = 19.50, SD = 3.97; α = .95), avoidance of threatening stimuli subscale (M = 19.37, SD = 4.29; α = .95), and transformation of images into thoughts subscale (M = 18.76, SD = 4.33; α = .95).

Understanding causes (M = 9.98, SD = 2.55; =0.90), vengeance thoughts (M = 7.45, SD = 2.85; =0.90), rage memories (M = 12.37, SD = 3.03; =0.91), and thoughts after anger (M = 15.07, SD = 3.35; =0.90) are the four subscales of the Anger Rumination Scale (Sukhodolsky et al., 2001).

Generalized Anxiety Scale (Spitzer et al., 2006), with only one factor including seven items (M = 8.43, SD = 6.73; α = .95).

Analytical Statistics

The data was collected and entered into IBM SPSS statistics version 24 for statistical analysis. The data were analyzed using a two-way ANOVA with the Bonferroni mean separation test as the mean separation test. The findings were reported as least square means ±SE, with a significance threshold of (p < .05).

Results

Concerning the effect of gender, difficulties in emotional regulation, and their interaction on cognitive avoidance, generalized anxiety, and anger rumination (Tables 5 and 6), the male students were not significantly different in cognitive avoidance (86.440 ± 2.094) than female ones (88.700 ± 0.770). The same trend appeared in either generalized anxiety or anger rumination findings, as the males possessed no significant differences in generalized anxiety and anger rumination (6.148 ± 1.161; 42.485 ± 1.421) than the females (7.758 ± 0.427; 43.982 ± 0.522) (p < .05). Generally, the findings revealed that the student gender possessed no significant effects on cognitive avoidance, anger rumination, and generalized anxiety (p < .05).

Table 5.

Effect of gender and difficulties in emotion regulation on cognitive avoidance, generalized anxiety, and anger rumination

Parameters		Cognitive avoidance	The generalized anxiety	Anger rumination
Gender
Male		86.440 ± 2.094	6.148 ± 1.161	42.485 ± 1.421
Female		88.700 ± 0.770	7.758 ± 0.427	43.982 ± 0.522
Difficulties in emotion regulation
Low		82.842 ± 1.927^b	6.075 ± 1.068	41.354 ± 1.307^b
High		92.298 ± 1.126^a	7.831 ± 0.624	45.114 ± 0.764^a
Gender difficulties in emotion regulation*
Low	Male	81.364 ± 3.599	5.909 ± 1.995	40.455 ± 2.441
Low	Female	84.320 ± 1.378	6.240 ± 0.764	42.253 ± 0.935
High	Male	91.516 ± 2.144	6.387 ± 1.188	44.516 ± 1.454
High	Female	93.080 ± 0.688	9.276 ± 0.381	45.711 ± 0.467

Note. Values are presented as least square mean±SE. ^{a, b}Means within the same column for each parameter with different superscripts are statistically different at (p < .05) (Two-way ANOVA, Bonferroni post-hoc test).

Means the interaction between gender and difficulties in emotion regulation.

Table 6.

Two Way ANOVA Analysis for the Effect of Gender and Difficulties in Emotion Regulation on Cognitive Avoidance, Generalized Anxiety, and Anger Rumination.

Dependent variable	Source	Sum of squares	Df	Mean square	F	Sig.
The cognitive avoidance	Gender	146.114	1	146.114	1.026	.312
	emotion regulation	2,558.041	1	2,558.041	17.957	.000
	Gender* emotion regulation	13.873	1	13.873	0.097	.755
	Error	58,974.694	414	142.451
	Total	3,532,481.000	418
The generalized anxiety	Gender	74.134	1	74.134	1.693	.194
	emotion regulation	88.301	1	88.301	2.017	.156
	Gender* emotion regulation	46.788	1	46.788	1.069	.302
	Error	18,126.057	414	43.783
	Total	48,593.000	418
Anger rumination	Gender	64.094	1	64.094	0.978	.323
	emotion regulation	404.359	1	404.359	6.169	.013
	Gender* emotion regulation	2.609	1	2.609	0.040	.842
	Error	27,138.510	414	65.552
	Total	869,411.000	418

Means the interaction between gender and difficulties in emotion regulation.

Interestingly, the individuals with high difficulties in emotional regulation sustained high cognitive avoidance and anger rumination (92.298 ± 1.126; 45.114 ± 0.764) compared with others with low emotional regulation disturbance (82.842 ± 1.927; 41.354 ± 1.307) (p < .05). In contrast, the students of either low (6.075 ± 1.068) or high (7.831 ± 0.624) emotional regulation disturbances showed no significant differences in generalized anxiety. Moreover, the outcomes revealed no significant interaction between gender and difficulties in emotional regulation on cognitive avoidance, generalized anxiety, and anger rumination (p < .05).

Discussion

A complex mix of biological, developmental, and cultural variables caused gender variations in mental functioning and behaviors. These distinctions have been discovered in a range of areas, including mental health, cognitive aptitude, personality, and emotions (Geary, 2010). The current research found that student gender had no influence on cognitive avoidance. These findings contradicted (Matud, 2004; Mazure & Maciejewski, 2003), which found that women are more likely than men to utilize emotion-focused coping mechanisms to deal with stressors. Furthermore, these findings were in agreement with Dickson (2012). Similarly, there were no significant variations in generalized anxiety between males and girls. Females showed higher generalized anxiety symptoms than males, which differed from prior studies (Lavanya & Manjula, 2017; Teer, 2012), as females had more generalized anxiety symptoms than males.

Females had significantly higher stress and anxiety symptoms, according to Hou et al. (2020), whereas males had stronger stress resilience. According to Gao et al. (2020), both female and male college students experience minor anxiety during their first 3 years of education. In the first and second years of the study, female students rated significantly higher in anxiety than male students. Furthermore, when compared to male students, female students had more symptomatology related to pain and weariness (Bitsika et al., 2010).

In terms of anger rumination, the study found no differences between male and female pupils. This result was in line with expectations (Garaigordobil, 2011; Kannis-Dymand et al., 2019). In the Spanish sample, Kannis-Dymand et al. (2019) found that gender differences had no effect on rage. In the Australian sample, Kannis-Dymand et al. (2019) discovered that males have greater rage scores than females.

High emotional dysregulation resulted in higher cognitive avoidance and anger rumination. Moreover, either low or high emotional regulation disturbance didn’t influence the generalized anxiety. This finding differed from those of Hofmann et al. (2012) and Liverant et al. (2008). According to Hofmann et al. (2012), problems with emotion regulation have been linked to a variety of emotional disorders, including anxiety and major depressive disorder. Furthermore, Liverant et al. (2008) claim that expressive suppression helps people with low anxiety levels feel less melancholy. However, this impact was lost on people who had significant levels of worry. Rumination, thought suppression, and reappraisal were strongly linked with symptoms of sadness, anxiety, and eating disorders, according to Aldao and Nolen-Hoeksema (2010). Also, significant relationships were reported between generalized anxiety and high levels of difficulties in emotional regulation, low level of mindfulness (Roemer et al., 2009), and defects in specific regulation, impulse control, emotional clarity, acceptance of emotion, access to effective regulation strategy, and ability in involving in goal-directed behaviors (Salters-Pedneault et al., 2006).

Conclusion

The study concluded the fitting of cognitive avoidance, anger rumination, general anxiety, and emotional regulation disturbance scales to the Egyptian student’s environment with efficient validity and reliability indicators. Moreover, the student's gender didn’t influence cognitive avoidance, anger rumination, and generalized anxiety. Also, the student with high difficulties in emotion regulation could suffer from anger rumination and use cognitive avoidance as a strategy to gain control over the difficulty of the positions.

Limitations

There are some limitations to this study. First, the sample size was acquired from students at Egypt’s University of Sadat City. Second, this study was limited to investigating differences in cognitive avoidance, anger rumination, and general anxiety in response to gender, and emotional regulation disturbance variables. Third, in cognitive avoidance, angry rumination, and generalized anxiety, there were no differences between males and females. In contrast, Individuals with significant emotional regulation disturbance, on the other hand, reported strong cognitive avoidance and rage rumination. In light of, the fourth technological revolution, meta-virus technology, and the isolation of the university student from real social interaction. Which will cause behavioral and emotional disturbances, putting the student in dire need of aid to reduce his disorders. we recommend further studies on this subject.

Footnotes

Acknowledgements

The author wishes to express his gratitude to the students who agreed to respond to the research instruments with attention and without becoming exhausted.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Rehab Tahoon

Data Availability and Materials

On reasonable request, the corresponding author will provide the data sets utilized in this study.

References

Aldao

Nolen-Hoeksema

(2010). Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behaviour Research and Therapy, 48, 974–983.

Al-Naggar

R. A.

Al-Naggar

D. H.

(2012). Prevalence and associated factors of emotional disorder among Malaysian University students. International Journal of Collaborative Research on Internal Medicine and Public Health, 4, 1401–1411.

Barlow

D. H.

(Ed.). (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual (5th ed.). Guilford Press.

Barlow

D. H.

Sauer-Zavala

Carl

J. R.

Bullis

J. R.

Ellard

K. K.

(2014). The nature, diagnosis, and treatment of neuroticism: Back to the future. Clinical Psychological Science, 2, 344–365. https://doi.org/10.1177/2167702613505532

Beauchaine

T. P.

Thayer

J. F.

(2015). Heart rate variability as a transdiagnostic biomarker of psychopathology. International Journal of Psychophysiology, 98, 338–350. https://doi.org/10.1016/j.ijpsycho.2015.08.004

Benarous

Hassler

Falissard

Consoli

Cohen

(2015). Do girls with depressive symptoms exhibit more physical aggression than boys? A cross-sectional study in a national adolescent sample. Child and Adolescent Psychiatry and Mental Health, 9, 41. https://doi.org/10.1186/s13034-015-0064-5

Besharat

M. A.

Hoseini

S. A.

Mohammad Mehr

Azizi

(2009). Reliability, validity, and factorial analysis of the anger rumination scale. Research in Educational Systems, 2, 9–23.

Besharat

M. A.

Pourbohlool

(2013). Mediation effect of anger rumination on the relationship between dimensions of anger and anger control with mental health. International Journal of Research Studies in Zoology, 2, 71–80. https://doi.org/10.5861/ijrsp.2012.211

Bitsika

Sharpley

C. F.

Melhem

T. C.

(2010). Gender differences in factor scores of anxiety and depression among Australian University students: Implications for counseling interventions. Canadian Journal of Counselling, 44, 51–64.

10.

Bjureberg

Ljótsson

Tull

M. T.

Hedman

Sahlin

Lundh

L. G.

Bjärehed

DiLillo

Messman-Moore

Gumpert

C. H.

Gratz

K. L.

(2016). Development and validation of a brief version of the difficulties in emotion regulation scale: The DERS-16. Journal of Psychopathology and Behavioral Assessment, 38, 284–296.

11.

Borkovec

T. D.

Alcaine

O. M.

Behar

(2004). Avoidance theory of worry and generalized anxiety disorder. In Heimber

R. G.

Turk

C. L.

Mennin

D. S.

(Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). Guilford Press.

12.

Borkovec

T. D.

Roemer

(1995). Perceived functions of worry among generalized anxiety disorder subjects: Distraction from more emotionally distressing topics? Journal of Behavior Therapy and Experimental Psychiatry, 26, 25–30.

13.

Bravo

A. J.

Kelley

M. L.

Mason

Ehlke

Vinci

Redman Ret

L. J. C.

(2020). Rumination as a mediator of the associations between moral injury and mental health problems in combat-wounded veterans. Traumatology, 26, 52–60. https://doi.org/10.1037/trm0000198

14.

Bruggink

Huisman

Vuijk

Kraaij

Garnefski

(2016). Cognitive emotion regulation, anxiety, and depression in adults with autism spectrum disorder. Research in Autism Spectrum Disorders, 22, 34–44.

15.

Bushman

B. J.

(2002). Does venting anger feed or extinguish the flame? Catharsis, rumination, distraction, anger, and aggressive responding. Personality and Social Psychology Bulletin, 28, 724–731.

16.

Collins

Bell

(1997). Personality and aggression: The dissipation-rumination scale. Personality and Individual Differences, 22, 751–755.

17.

Dahlin

Joneborg

Runeson

(2005). Stress and depression among medical students: A cross-sectional study. Medical Education, 39, 594–604.

18.

Dickson

(2012). Gender differences in depressive symptoms: The interaction of cognitive avoidance coping and specific stressor domains during freshmen adaptation to college [Master Theses]. Loyola University.

19.

Donahue

J. J.

Goranson

A. C.

McClure

K. S.

Van Male

L. M.

(2014). Emotion dysregulation, negative affect, and aggression: A moderated multiple mediator analysis. Personality and Individual Differences, 70, 23–28. https://doi.org/10.1016/j.paid.2014.06.009

20.

Donovan

C. L.

Holmes

M. C.

Farrell

L. J.

Hearn

C. S.

(2017). Thinking about worry: Investigation of the cognitive components of worry in children. Journal of Affective Disorders, 208, 230–237.

21.

Fanti

K. A.

Henrich

C. C.

(2010). Trajectories of pure and co-occurring internalizing and externalizing problems from age 2 to age 12: Findings from the National Institute of Child Health and Human Development Study of early child care. Developmental Psychology, 46, 1159–1175. https://doi.org/10.1037/a0020659

22.

Fatfouta

Gerlach

T. M.

Schröder-Abé

Merkl

(2015). Narcissism and lack of interpersonal forgiveness: The mediating role of state anger, state rumination, and state empathy. Personality and Individual Differences, 75, 36–40.

23.

Fowler

J. C.

Charak

Elhai

J. D.

Allen

J. G.

Frueh

B. C.

Oldham

J. M.

(2014). Construct validity and factor structure of the difficulties in emotion regulation scale among adults with severe mental illness. Journal of Psychiatric Research, 58, 175–180.

24.

Fresco

D. M.

Segal

Z. V.

Buis

Kennedy

(2007). Relationship of posttreatment decentering and cognitive reactivity to relapse in major depression. Journal of Consulting and Clinical Psychology, 75, 447–455. https://doi.org/10.1037/0022-006X.75.3.447

25.

Gao

Ping

Liu

(2020). Gender differences in depression, anxiety, and stress among college students: A longitudinal study from China. Journal of Affective Disorders, 263, 292–300.

26.

Garaigordobil

(2011). Feelings of anger: Gender differences, correlations with behavioural-cognitive variables and predictors of anger expression in adolescence. In Welty

J. P.

(Ed.), Psychology of anger: Symptoms, causes, and coping (1st ed.). Nova Science Publisher.

27.

García-Sancho

Martín Salguero

Vasquez

E. A.

FernándezBerrocal

(2016). Validity and reliability of the Spanish version of the Displaced Aggression Questionnaire. Psicothema, 28, 96–101.

28.

Geary

D. C.

(2010). Male, female: The evolution of human sex differences (2nd ed.). American Psychological Association.

29.

Genet

J. J.

Siemer

(2012). Rumination moderates the effects of daily events on negative mood: Results from a diary study. Emotion, 12, 1329–1339. https://doi.org/10.1037/a0028070

30.

Goodwin

Yiend

Hirsch

C. R.

(2017). Generalized anxiety disorder worries and attention to threat: A systematic review. Clinical Psychology Review, 54, 107–122. https://doi.org/10.1016/j.cpr.2017.03.006

31.

Hayes

S. C.

Wilson

K. G.

Gifford

E. V.

Follette

V. M.

Strosahl

(1996). Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168. https://doi.org/10.1037//0022-006x.64.6.1152

32.

Hofmann

S. G.

Sawyer

A. T.

Fang

Asnaani

(2012). Emotion dysregulation model of mood and anxiety disorders. Depression and Anxiety, 29, 409–416.

33.

Hou

Jiao

Luo

Song

(2020). Gender differences of depression and anxiety among social media users during the COVID-19 outbreak in China: A cross-sectional study. BMC Public Health, 20, 1–11.

34.

Kannis-Dymand

Salguero

J. M.

Ramos-Cejudo

Novaco

R. W.

(2019). Dimensions of anger reactions-revised (DAR-R): Validation of a brief anger measure in Australia and Spain. Journal of Clinical Psychology, 75, 1233–1248. https://doi.org/10.1002/jclp.22757

35.

Kingery

J. N.

Erdley

C. A.

Marshall

K. C.

Whitaker

K. G.

Reuter

T. R.

(2010). Peer experiences of anxious and socially withdrawn youth: An integrative review of the developmental and clinical literature. Clinical Child and Family Psychology Review, 13, 91–128.

36.

Koerner

Dugas

M. J.

(2006). A cognitive model of generalized anxiety disorder: The role of intolerance of uncertainty. In Davey

G. C. L.

Wells

(Eds.), Worry and its psychological disorders: Theory, assessment, and treatment (pp. 201–216). Wiley Publishing.

37.

S. M.

Kua

E. H.

Fones

C. S.

(1999). Stress and the undergraduates. Singapore Medical Journal, 40, 627–630.

38.

Kubota

Nixon

R. D. V.

Chen

(2015). Trauma-related rumination mediates the effect of naturally occurring depressive symptoms but not momentary low mood on trauma intrusions. Australian Journal of Psychology, 67, 75–86.

39.

Lavanya

T. P.

Manjula

(2017). Emotion regulation and psychological problems among Indian college youth. Indian Journal of Social Psychiatry, 33, 312–318.

40.

Leahy

R. L.

(2002). Improving homework compliance in the treatment of generalized anxiety disorder. Journal of Clinical Psychology, 58, 499–511.

41.

Liverant

G. I.

Brown

T. A.

Barlow

D. H.

Roemer

(2008). Emotion regulation in unipolar depression: The effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect. Behaviour Research and Therapy, 46, 1201–1209.

42.

Malmgren

K. W.

Leone

P. E.

(2008). Effects of short-term auxiliary reading program on the reading skills of incarcerated youth. Education and Treatment of Children, 23, 239–247.

43.

Martin

R. C.

Dahlen

E. R.

(2005). Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Personality and Individual Differences, 39, 1249–1260.

44.

Matud

M. P.

(2004). Gender differences in stress and coping styles. Personality and Individual Differences, 37, 1401–1415.

45.

Maughan

Pickles

Hagell

Rutter

Yule

(2006). Reading problems and antisocial behavior: Developmental trends in comorbidity. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 37, 405–418.

46.

Mayfield

Goldston

D. B.

Walsh

A. K.

Reboussin

B. A.

Sergent

Hickman

(2005). severity of emotional and behavioral problems among poor and typical readers. Journal of Abnormal Child Psychology, 33, 205–217.

47.

Mazure

C. M.

Maciejewski

P. K.

(2003). The interplay of stress, gender and cognitive style in depressive onset. Archives of Women’s Mental Health, 6, 5–8.

48.

Mennin

Farach

(2007). Emotion and evolving treatments for adult psychopathology. Clinical Psychologist, 14, 329–352.

49.

Mohd Sidik

Rampal

Kaneson

(2003). Prevalence of emotional disorders among medical students in a Malaysian university. Asia Pacific Family Medicine, 2, 213–217.

50.

Mosley

T. H.

Jr Perrin

S. G.

Neral

S. M.

Dubbert

P. M.

Grothues

C. A.

Pinto

B. M.

(1994). Stress, coping, and well-being among third-year medical students. Academic Medicine, 69, 765–767.

51.

Nail

J. E.

Christofferson

Ginsburg

G. S.

Drake

Kendall

P. C.

McCracken

J. T.

Birmaher

Walkup

J. T.

Compton

S. N.

Keeton

Sakolsky

(2015). Academic impairment and impact of treatments among youth with anxiety disorders. Child and Youth Care Forum, 44, 327–342.

52.

Nasiri

Mashhadi

Bigdeli

Chamanabad

A. G.

(2020). How to differentiate generalized anxiety disorder from worry: The role of cognitive strategies. Journal of Rational-Emotive and Cognitive-Behavior Therapy: RET, 38, 44–55.

53.

Nolen-Hoeksema

Wisco

B. E.

Lyubomirsky

(2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400–424.

54.

Polanczyk

G. V.

Salum

G. A.

Sugaya

L. S.

Caye

Rohde

L. A.

(2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56, 345–365.

55.

Roemer

Lee

J. K.

Salters-Pedneault

Erisman

S. M.

Orsillo

S. M.

Mennin

D. S.

(2009). Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary evidence for independent and overlapping contributions. Behavior Therapy, 40, 142–154. https://doi.org/10.1016/j.beth.2008.04.001

56.

Sagui-Henson

S. J.

(2017). Cognitive avoidance. In Hill

V. Z.

Shackelford

T. K.

(Eds.), Encyclopedia of personality and individual differences (pp. 1–3). Springer International Publishing.

57.

Salters-Pedneault

Roemer

Tull

M. T.

Rucker

Mennin

D. S.

(2006). Evidence of broad deficits in emotion regulation associated with chronic worry and generalized anxiety disorder. Cognitive Therapy and Research, 30, 469–480. https://doi.org/10.1007/s10608-006-9055-4

58.

Sexton

K. A.

Dugas

M. J.

(2008). The cognitive avoidance questionnaire: Validation of the English translation. Journal of Anxiety Disorders, 22, 355–370. https://doi.org/10.1016/j.janxdis.2007.04.005

59.

Skinner

E. A.

Edge

Altman

Sherwood

(2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129, 216–269.

60.

Southam-Gerow

M. A.

Kendall

P. C.

(2002). Emotion regulation and understanding: Implications for child psychopathology and therapy. Clinical Psychology Review, 22, 189–222. https://doi.org/10.1016/s0272-7358(01)00087-3

61.

Spielberger

C. D.

(1991). State-trait anger expression inventory (pp. 67–80). Psychological Assessment Resources.

62.

Spitzer

R. L.

Kroenke

Williams

J. B.

Löwe

(2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092–1097.

63.

Sukhodolsky

D. G.

Golub

Cromwell

E. N.

(2001). Development and validation of the anger rumination scale. Personality and Individual Differences, 31, 689–700.

64.

Takebe

Takahashi

Sato

(2016). Anger rumination as a risk factor for trait anger and anger-in: A longitudinal study. Personality and Individual Differences, 101, 451–455. https://doi.org/10.1016/j.paid.2016.06.038

65.

Teer

O. A.

(2012). Gender differences and cognitive constructs in generalized anxiety disorder. Honors College. University of Maine. https://digitalcommons.library.umaine.edu/honors/84

66.

Tempesta

Mazza

Serroni

Moschetta

F. S.

Di Giannantonio

Ferrara

De Berardis

(2013). Neuropsychological functioning in young subjects with generalized anxiety disorder with and without pharmacotherapy. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 45, 236–241.

67.

Tice

D. M.

Bratslavsky

(2000). Giving in to feel good: The place of emotion regulation in the context of general self-control. Psychological Inquiry, 11, 149–159. https://doi.org/10.1207/S15327965PLI1103_03

68.

Tomoda

Mori

Kimura

Takahashi

Kitamura

(2000). One-year prevalence and incidence of depression among first-year university students in Japan: A preliminary study. Psychiatry and Clinical Neurosciences, 54, 583–588.

69.

Verduin

T. L.

Kendall

P. C.

(2008). Peer perceptions and liking of children with anxiety disorders. Journal of Abnormal Child Psychology, 36, 459–469.

70.

Wagner

M. M.

(2005). Outcomes for youths with serious emotional disturbance in secondary school and early adulthood. The Future of Children, 5, 90–112.

71.

Werner-Seidler

Banks

Dunn

B. D.

Moulds

M. L.

(2013). An investigation of the relationship between positive affect regulation and depression. Behavior Research and Therapy, 51, 46–56. https://doi.org/10.1016/j.brat.2012.11.001

72.

Chi

Zeng

Lin

(2019). Roles of anger and rumination in the relationship between self-compassion and forgiveness. Mindfulness, 10, 272–278.