Article

When is rumination an adaptive mood repair strategy? Day-to-day rhythms of life in combat veterans with and without posttraumatic stress disorder

If you want to read the PDF, try requesting it from the authors.

Abstract

Prior research suggests that rumination and chronic negative emotions serve to maintain emotional disorders. However, some evidence suggests that pondering the nature and meaning of negative experiences can be adaptive. To better understand the function of this dimension of rumination, we studied the use of this strategy in response to negative emotions as they unfold from day to day in veterans with (n=27) and without (n=27) post traumatic stress disorder (PTSD). For two weeks, veterans completed daily questions about when they experienced a bad mood and how often they used rumination to feel differently. It was hypothesized that rumination would attenuate negative emotional reactions in veterans without PTSD, but that rigid, intense negative emotions would persist in veterans with PTSD. Using multilevel modeling, we found that on the same day, rumination was positively associated with negative affect. Because covariation fails to address directionality, we also examined lagged effects from one occasion to the next. For veterans without PTSD, more frequent use of rumination predicted less intense negative affect the next day; there was no support for a model with negative affect predicting rumination the next day. For veterans with PTSD, the prior day's intensity of negative affect was the only predictor of intensity of negative affect the next day. Results support the value of distinguishing within-day and across day effects, and the presence of PTSD, to clarify contexts when rumination is adaptive.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... In cross-lagged analyses, rumination predicted greater subsequent negative affect (e.g., at the next time point), and negative affect predicted greater subsequent rumination. In veterans with and without PTSD, daily rumination also predicted greater concurrent negative affect (Kashdan, Young, & McKnight, 2012). However, rumination predicted less negative affect the next day only in veterans without PTSD. ...
... The bidirectional associations between state rumination and anger were tested through a series of mixedmodel analyses using SAS version 9.4. Because of strong autocorrelations (associations between previous and current measurements of the same construct), and in line with previous ESM studies on rumination and negative affect (Kashdan et al., 2012;Moberly & Watkins, 2008), we created separate concurrent and cross-lagged models. We first constructed a mixed effects model to test the concurrent association (Model 1) between state anger (X) and rumination (Y). ...
... This is in line with past theorizing that rumination exacerbates existing angry moods (e.g., Denson, 2013), and that negative moods represent a discrepancy that rumination attempts to solve (Martin & Tesser, 1996). This also aligns with previous ESM studies on rumination and general negative mood (Kashdan et al., 2012;Moberly & Watkins, 2008). However, our results fill a long-extant gap in the literature by providing empirical evidence that, in any given moment, individuals' rumination and anger are bidirectionally related. ...
Article
Full-text available
Rumination is associated with exacerbated angry mood. Angry moods may also trigger rumination. However, research has not empirically tested the bidirectional associations of state rumination and anger, as experience sampling methodology can do. We predicted that state anger and rumination would be bi-directionally associated, both concurrently and over time, even controlling for trait anger and rumination. In addition, because mindfulness is associated with rumination and anger at the bivariate level, we examined the effect of trait mindfulness on the bidirectional association between state rumination and anger. We examined two hypotheses: (i) state rumination mediates the effect of trait mindfulness on state anger; and (ii) trait mindfulness weakens, or moderates, the bidirectional associations between state rumination and anger. In an experience-sampling study, 200 college students reported their current ruminative thinking and angry mood several times a day for 7 days. Mixed model analyses indicated that state anger and rumination predicted each other concurrently. In cross-lagged analyses, previous anger did not uniquely predict current rumination; previous rumination predicted current anger, although the effect was small. In support of our hypothesis, state rumination mediated the association between trait mindfulness and state anger. Additionally, trait mindfulness moderated the concurrent and cross-lagged associations between state rumination and anger, although the results were complex. This study contributes new information about the complex interplay of rumination and anger. Findings also add support to the theory that mindfulness decreases emotional reactivity. Aggr. Behav. 9999:1–10, 2016.
... However, although certain strategies have been associated with depressive symptomatology, recent theoretical and empirical contributions suggest that the adaptive value of any emotion regulation strategy depends, to a large extent, on how the strategies are calibrated to the context (Aldao, Sheppes, & Gross, 2015;Bonanno & Burton, 2013;Sheppes, Suri, & Gross, 2015). Various important contextual factors for assessing emotion regulation have been proposed, such as the very type of emotion experienced (e.g., sadness, happiness), emotional intensity (Dixon-Gordon, Aldao, & De Los Reyes, 2015), and the specific events (Galatzer-Levy, Burton, & Bonanno, 2012;Kashdan, Young, & McKnight, 2012) or memories triggering the emotions (del Palacio-Gonzalez & Berntsen, 2020;Isham, del Palacio-Gonzalez, & Dritschel, 2020). ...
... In this regard, different hypotheses have been proposed. For instance, the use of certain emotion regulation strategies may affect mood and behaviors depending on the specific emotions being regulated (Harding, Hudson, & Mezulis, 2014), or the significance of the event at hand (Del Palacio-Gonzalez & Berntsen, 2020; Kashdan et al., 2012). Further, the consequences of the use of various emotion regulation strategies would not only be evaluated at a specific moment, but over time, and in relation to a number of contextual factors (e.g., type and intensity of emotion, alignment with goals, physiological responses) (Colombo et al., 2020). ...
Article
Background and objectives Effective emotion regulation is an important marker of mental health. However, only a sparse number of studies have examined emotion regulation within the context of different emotion type and intensity levels among individuals with elevated depressive symptoms. Method We investigated emotion regulation in response to happiness and sadness experienced in the context of everyday memories of 23 dysphoric and 20 non-depressed participants. Participants completed a diary indicating the intensity of these emotions when thinking about a personal memory, as well as their employment of five emotion regulation strategies at that moment. Results Multilevel models indicated that dysphoric and non-depressed individuals differed in how they employed three emotion regulation strategies depending on the intensity of the emotions. Relative to non-depressed individuals, dysphoric individuals employed greater brooding, expressive suppression, and memory suppression when experiencing less intense happiness, and employed more brooding for more intense sadness. These effects were maintained after controlling for habitual emotion regulation, and controlling for the opposite concurrent emotion. The findings suggest that dysphoric individuals adjust the use of emotion regulation strategies differently from non-depressed individuals depending on the intensity level of happiness and sadness experienced. These patterns may be indicative of reduced emotion regulation flexibility or fear of emotional shifts. Limitations The sample consisted of mostly young women. Conclusions Clinical implications, particularly concerning emotion-focused interventions, are discussed.
... That is, active rumination the day before lead to decreased negative affect the following day in veterans without PTSD, whereas in veterans with PTSD, negative affect the next day was maintained. The authors concluded that people with PTSD may not use active rumination to adaptively regulate their mood; note that maladaptive, passive rumination was not examined (Kashdan et al., 2012). ...
... Limitations regarding sample selection included general use of small samples, large discrepancies in levels of combat exposure, differing levels of treatment between groups, use of residential patients (Kashdan et al., 2006;2012), mild representation of PTSS, and questionable generalizability to the broader PTSD population (e.g., Bunce et al., 1995;Newton & Ho, 2008). In general, studies failed to examine the key interactive effects of stress interactions (such as Glaser et al., 2006 did), and-except Kashdan et al. (2012)-failed to analyze temporal relationships among PTSS in daily life. ...
Article
Full-text available
This review examined the assessment of posttraumatic stress symptoms (PTSS) in daily life using experience sampling methodology (ESM)/ecological momentary assessment (EMA) and daily diary studies in adult samples. Fifteen peer-reviewed studies were identified and categorized into areas of total PTSD/multiple PTSS (studies including three or more symptom clusters), intrusive memories, and mood and anxiety symptoms. Overall, ESM and the daily diary method proved feasible for assessing the real-world expression of PTSS, resulted in minimal reactivity, and offered a number of advantages over classical assessment. Even within the two measurement types of ESM and daily diary, there was great variability in study design and analysis. The benefits and limitations of the different approaches are discussed. Different themes in content emerged as well, such as coping strategies and affective instability throughout the course of a day. Gaps in our current understanding are highlighted and suggestions for methodology and future areas of research are proposed.
... Previous studies have shown that rumination is associated with negative emotions. (Kashdan, Young, & McKnight, 2012;Moberly & Watkins, 2008;Kirkegaard Thomsen, 2006). Reductions in rumination have been proposed as a potential mechanism through which mindfulness trainings exert beneficial effects . ...
Article
While the majority of studies have focused on dispositional mindfulness and the efficacy of mindfulness meditation, there has been limited study exploring the effect of state mindfulness on emotions and its potential mechanism. Therefore, we conducted an ambulatory assessment study to monitor state mindfulness and emotions in daily life and examine the mediating effect of rumination in a natural context. One hundred Chinese university students rated their state mindfulness, rumination, and emotions (e.g., anxiety, depression, happiness) five times per day for a week. Using hierarchical linear models, we and found that at the within‐person level, higher current state mindfulness was associated with more subsequent positive emotions and less subsequent negative emotions. Current rumination partially mediated the relation between current state mindfulness and subsequent positive emotions (happiness, relaxation, contentment, interest) and negative emotions (depression, anger, boredom, sadness). At the between‐person level, higher state mindfulness was associated with more positive emotions and less negative emotions. Individuals’ overall rumination partially mediated the relation between state mindfulness and emotions (depression, anger, boredom, sadness, relaxation). We concluded that higher state mindfulness was associated with lower rumination, which in turn resulted in more positive emotions and less negative emotions. More important, state mindfulness also exerted a dynamic impact on daily emotions via rumination.
... It is possible that rumination could be acting as a protective barrier to some mental health issues (e.g., suicidality). Some previous studies suggest that rumination is an adaptive behavior in veterans, when such rumination focuses on the meaning and nature of negative experiences (Kashdan, Young, & McKnight, 2012). Another study suggests that action rumination (task-focused thinking) can improve later performance (Ciarocco, Vohs, & Baumeister, 2010). ...
Article
Moral injury is hypothesized to develop from witnessing or engaging in events that violate one's beliefs about oneself and has been shown to be associated with negative mental health symptoms. Although there has been an increase in research examining moral injury among military veterans, mechanisms that link moral injury to mental health outcomes are not well understood. The present study examined rumination subcomponents (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) as possible mediators of the associations between moral injury (both self-directed and other-directed symptoms) and negative mental health symptoms (i.e., depression, anxiety, suicidality, sleep disturbance, memory problems, and posttraumatic stress disorder symptoms). Participants were 189 combat-wounded veterans (180 men; M age = 43.14 years) who had experienced one or more deployments (defined as 90 days or more). Nearly all participants reported a service-connected disability (n = 176, 93.1%), with the average participant reporting a 90% total Veterans Affairs (VA) disability ranking, and most participants had received a purple heart (n = 163, 86.2%). Within our comprehensive mediation model, we found eight significant mediation effects, with the most consistent mediator being problemfocused thoughts. Specifically, both self-directed and other-directed moral injury were associated with increased problem-focused thoughts, which in turn was associated with higher reported symptoms of depression, anxiety, and posttraumatic stress disorder. Taken together, rumination, and in particular, problem-focused thoughts, is relevant to understand the increased vulnerability of military veterans to exhibit poor mental health outcomes when experiencing moral injury.
... However, continued fervor gave rise to questioning whether a single strategy is actually "adaptive" or "maladaptive" across all contexts. For example, studies of expressive suppression (Le & Impett, 2013) and rumination (Kashdan, Young, & McKnight, 2012) suggest that these strategies can actually be beneficial to well-being in certain contexts, despite their reputations as "maladaptive". Additionally, the putatively "adaptive" strategy of cognitive reappraisal can actually lead to greater cognitive depletion in certain contexts (Keng, Robins, Smoski, Dagenbach, & Leary, 2013). ...
Article
Full-text available
Background and objectives: A promising method of capturing the complex nature of emotion regulation is to assess composite profiles of regulation (i.e., default pattern of regulation across multiple strategies). However, it remains unclear whether regulatory profiles demonstrate consistency across samples and in relation to mental health. Design: Two studies are presented here. Both utilized a cross-sectional design, and the second study presents a replication of the first. Method: Both studies utilized self-report data from independent undergraduate samples to perform latent profile analyses of emotion regulation use. Results: Studies 1 and 2 demonstrated evidence for four replicable regulatory profiles: Adaptive, Accepting (with or without Suppression), Non-accepting, and Maladaptive. Profiles were also related to symptoms of depression and anxiety, such that those consistently relying on adaptive strategies reported lower symptoms than those relying more heavily on maladaptive strategies. Conclusions: These findings clarify previous work which tied regulatory profiles to psychological health by extending a person-centered approach to understanding the ways in which individuals regulate their emotions.
... Overall, same-day rumination was positively associated with same-day negative affect. But for veterans without PTSD, the more they ruminated on a given day, the less intense negative affect they reported the following day (Kashdan, Young, & McKnight, 2012). In a laboratory study, participants who ruminated about how they could improve on a laboratory task performed better on a similar task in the future (Ciarocco, Vohs, & Baumeister, 2010). ...
Chapter
Full-text available
Emotions guide action in ways that are frequently adaptive. Fear, disgust, and anger motivate people to act to avoid danger, shun contamination, and overcome obstacles to their goals. But what good does feeling sad do? This seemingly passive state is often characterized by behavioral withdrawal and rumination. This chapter reviews theory and research concerning the types of situations that elicit sadness and the effects of sadness on expression, behavior, and cognition. Evidence suggests that, far from being passive, sadness is an architect of cognitive change, directing the challenging but essential work of reconstructing goals and beliefs when people face irrevocable loss.
... reflection (e.g., Kashdan, Young, & McKnight, 2012;Puterman, DeLongis, & Pomaki, 2010) or have not distinguished the two (e.g., Nezlek, 2002). Nevertheless, this research has consistently found positive, same-day relationships between rumination and negative affect or negative events (e.g., Dickson, Ciesla, & Reilly, 2012;Genet & Siemer, 2012;Jose & Lim, 2015;Moberly & Watkins, 2008). ...
Article
The present study moved beyond trait reports of rumination, reflection, and meaning in life (presence and search) by examining within-person relationships between daily states of these constructs and well-being. Participants (N = 130) completed reports at the end of the day for 14 days. When analyzed together, daily rumination was negatively related to daily well-being whereas daily reflection was not (with one exception). In contrast, daily reflection was positively related to daily search for meaning in life, whereas rumination was not related to daily search for meaning in life. Reflection moderated the within-person relationships between rumination and well-being such that negative relationships between rumination and well-being were stronger at higher levels of reflection. In contrast, rumination had virtually no effect on search for meaning in life at higher levels of reflection. Lagged analyses found that daily reflection led to increases in daily positive deactivated affect (e.g., relaxation) and searching for meaning in life, and daily rumination led to increased presence of meaning in life the following day. These results highlight the importance of considering both reflection and rumination in studies of within-person variation and the value of considering within-person variability in understanding presence of and search for meaning in life.
... Pondering is a form of active rumination, which emphasizes understanding and problem solving. 46 This distinction is significant as it can help explain why rumination is helpful among healthy veterans who engage in pondering, while rumination is harmful in veterans with PTSD, as this population is more likely to engage in brooding. ...
Chapter
Full-text available
Stress has been conceptualized as a threat to physiological or psychological homeostasis. Reappraisal, suppression, and rumination are emotion regulation techniques utilized to alter the affective components of stress. Reappraisal consists of activation of prefrontal cortical areas that reduces cortical activity in limbic areas such as the amygdala. Suppression and rumination involve similar brain areas but have different patterns of activation. Pathological chronic stress, such as posttraumatic stress disorder (PTSD), is associated with disruptions in emotion regulation, particularly suppression and rumination. Although there are no significant disruptions in reappraisal in PTSD, brain activity during reappraisal differs compared to individuals without PTSD. These findings indicate that chronic stress is associated with emotion regulation functioning and its neural underpinnings.
... In both cases, after a while, our internal dynamics recovers its usual trajectory. Both Fredrickson and Joinder (2002) and Kashdan, Young, and McKnight (2012) analyzed long-term effects with similar conclusions. ...
Article
Full-text available
Emotions imply a revision of our beliefs inasmuch as they are triggered by a discrepancy between our expectancies and new situations. I will study the converse relation: how emotions, particularly recurrent emotions that reappear in similar situations in the long term, are incentives to revise not only our beliefs but also the order of priorities between their related desires. Understanding how affects can revise both beliefs—under their committing aspect—and the order of desires, implies seeing the dynamics of affects as interacting with external dynamics and the order of priorities as a weak one (“pseudo-distance”; Schlechta, 2004). These philosophical considerations shed new light on the diversity of emotions, on their different temporalities, and on the paradox of emotional sharing.
Article
Mental contamination (MC)—feelings of dirtiness triggered by internal sources—is a potentially important yet understudied factor for survivors of sexual trauma. MC has been linked to disgust and other negative emotions (e.g., shame, guilt) cross-sectionally and in lab-based paradigms but not yet examined in ecological contexts. Additionally, links between MC and distinct negative emotions have not been studied systematically. The present study thus modeled relationships between MC and specific emotions both across and within days over a daily monitoring period. Forty-one females with sexual trauma history and associated MC completed twice-daily assessments of MC and seven emotions (disgust, shame, guilt, anger, hopelessness, sadness, anxiety) over two weeks via a smartphone app. Baseline MC and average daily MC were largely associated with higher daily averages of negative emotions. Concurrently, within-person changes in MC and negative emotions were also positively linked. Unexpectedly, intraindividual changes in MC were largely not associated with later negative emotions, whereas several emotions were negatively associated with later MC. Notably, MC among screened sexual trauma survivors was much more prevalent compared to prior research. Clinical relevance and future recommendations for ecological research in trauma-related mental contamination are discussed.
Article
Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.
Chapter
Stress has been conceptualized as a threat to physiological or psychological homeostasis. Reappraisal, suppression, and rumination are emotion regulation techniques utilized to alter the affective components of stress. Reappraisal consists of activation of prefrontal cortical areas that reduces cortical activity in limbic areas such as the amygdala. Suppression and rumination involve similar brain areas but have different patterns of activation. Pathological chronic stress, such as posttraumatic stress disorder (PTSD), is associated with disruptions in emotion regulation, particularly suppression and rumination. Although there are no significant disruptions in reappraisal in PTSD, brain activity during reappraisal differs compared to individuals without PTSD. These findings indicate that chronic stress is associated with emotion regulation functioning and its neural underpinnings
Thesis
Full-text available
Cómo citar: García, F. (2014). Estrategias de Afrontamiento, Rumiación, Compartir Social y Crecimiento Postraumático, en Personas Desplazadas de su Hogar por el Terremoto de Chile del 27/F del 2010. (Tesis Doctoral). Universidad de Concepción, Chile. doi: 10.13140/RG.2.1.3113.5608 Resumen: El propósito de este estudio es evaluar un modelo explicativo de los procesos psicológicos implicados en dos consecuencias probables de los eventos traumáticos: la sintomatología postraumática (SPT) y el crecimiento postraumático (CPT). La SPT ha sido una de las respuestas más estudiadas frente a eventos catastróficos. Por su parte, el CPT es un constructo más reciente, vinculado a la psicología positiva, que alude a la percepción de cambios positivos que un individuo experimenta a partir de la vivencia de un suceso traumático. El modelo sometido a prueba en este estudio incluyó como variables predictoras la severidad subjetiva del trauma, compartir social, estrategias de afrontamiento centradas en el problema y distintas formas de pensamientos rumiativos. Para ello se seleccionaron 351 personas adultas que perdieron su hogar debido al terremoto y tsunami de Chile del 27/F de 2010. El análisis se realizó a través de modelamiento por ecuaciones estructurales (SEM). El modelo obtuvo adecuados índices de ajuste y muestra que la SPT y el CPT se producen por vías distintas, aun cuando en algunas fases del proceso participan las mismas variables psicológicas. Una reespecificación del modelo que elimina las rutas no significativas mostró índices de ajuste ligeramente superiores (χ2=191.5; gl=123; p<0.001; χ2/gl=1.54; NFI=0.95; TLI=0.98; CFI=0.98; PNFI=0.76; RMSEA=0.04; IC 90%=0.03-0.05). Se observa un efecto directo sobre el CPT de las estrategias de afrontamiento centradas en el problema y la rumiación deliberada, y un efecto indirecto de la severidad subjetiva, el brooding, el compartir social y la rumiación intrusiva. Se observa un efecto directo sobre la SPT de la rumiación intrusiva y el brooding, y un efecto indirecto de la severidad subjetiva. Se presentan los resultados y se discuten los alcances de estos hallazgos para la promoción y prevención de salud en sobrevivientes de desastres naturales. PALABRAS CLAVES: Crecimiento postraumático, rumiación intrusiva, rumiación deliberada, rumiación depresiva, estrategias de afrontamiento, compartir social, sintomatología postraumática, desastre natural. Abstract: The aim of this study is to evaluate an explanatory model of the psychological processes involved in two likely consequences of traumatic events: the posttraumatic symptomatology (PTS) and posttraumatic growth (PTG). The PTS has been one of the most studied responses from catastrophic events. For its part, the PTG is a recent construct, linked to positive psychology, which refers to the perception of positive changes that an individual experiences as a result of the struggle undertaken after the experience of a traumatic event. The model tested in this study included as predictors: the subjective severity of trauma, social sharing, problem-focused coping strategies and different ways of ruminative thoughts. Participated adults who lost their homes due to the earthquake and tsunami in Chile 27/F 2010 (N = 351). The analysis was performed using structural equation modeling (SEM). The model obtained adequate fit indices and shows that the SPT and CPT are produced in different ways, although in some phases of the process are involved the same psychological variables. A re-specification of the model that eliminates the non-significant paths showed fit indices slightly higher (χ2=191.5; gl=123; p >0.001; χ2/gl=1.54; NFI=0.95; TLI=0.98; CFI=0.98; PNFI=0.76; RMSEA=0.04; IC 90%=0.03-0.05). The model shows a direct effect of problem-focused coping strategies and deliberate rumination and an indirect effect of the subjective severity, the brooding, social sharing and rumination intrusive on PTG. The model also shows a direct effect of the intrusive rumination and brooding, and an indirect effect on the subjective severity on PTS. Results are presented and the implications of these findings for health promotion and prevention in survivors of natural disasters are discussed. KEY WORDS: KEYWORDS: Coping strategies, deliberate rumination, depressive rumination, intrusive rumination, natural disaster, posttraumatic growth, posttraumatic symptomatology, social sharing.
Article
Full-text available
The Event Related Rumination Inventory (ERRI) is an instrument designed to evaluate the intrusive and deliberated repetitive thoughts after an important stressor. The aim of this study is to analyze their psychometric properties in Chilean population exposed to different kind of stressors. The instrument was applied to 281 adult persons, inhabitants of Concepción, Chile, who recognized had lived a stressful event the last 3 years. Through the result of an exploratory factorial analysis, the scale was reduced from 20 elements of the original scale (10 intrusive rumination and 10 deliberate rumination) to 12 items (7 intrusive rumination and 5 deliberate rumination). This brief version showed high intern consistency for the total scale and each sub scale. In the other hand, showed construct validity, by finding both factors in the factorial analysis, and evidence of criterion validity, by relating both factors positively with the subjective severity of the event and by showing that deliberate rumination predicted posttraumatic growth and intrusive rumination predicted posttraumatic symptoms. The results indicate that the ERRI is a useful instrument to research and evaluate the rumination process related to a stressful event in Chilean population.
Article
The aim of this study was to test a cognitive model of posttraumatic symptoms (PTS) and posttraumatic growth (PTG) after exposure to a natural disaster. It was hypothesized that although subjective severity of trauma would be related to the severity of PTS, this relation would be mediated by brooding and cognitive strategies related to the presence of repetitive negative content in thoughts. Furthermore, the relation between severity and PTG would be fully mediated by deliberate rumination (DR), cognitive strategies related to conscious efforts focused on handling the event. To evaluate the cognitive model, adults (N=351) who lost their homes as a result of the earthquake and tsunami that occurred in Chile on February 27, 2010, were selected. Structural equation modeling was used to analyze the data. The resulting model had adequate indices of goodness adjustment and showed that brooding completely mediated the relation between subjective severity and PTS, and DR completely mediated the relation between subjective severity, brooding, and PTG. These results highlight the role of both the content and process of rumination in mediating the association between subjective severity of trauma, PTS, and PTG. The implications of these results for a more comprehensive model of symptom severity that occurs after trauma are discussed.
Article
Full-text available
Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or ist sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualisation, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies provided preliminary support for several aspects of the model.
Article
Full-text available
Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms. To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD. Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms. All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms. Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.
Article
Full-text available
A distinction between ruminative and reflective types of private self-attentiveness is introduced and evaluated with respect to L. R. Goldberg's (1982) list of 1,710 English trait adjectives (Study 1), the five-factor model of personality (FFM) and A. Fenigstein, M. F. Scheier, and A. Buss's(1975) Self-Consciousness Scales (Study 2), and previously reported correlates and effects of private self-consciousness (PrSC; Studies 3 and 4). Results suggest that the PrSC scale confounds two unrelated motivationally distinct disposition-rumination and reflection-and that this confounding may account for the "self-absorption paradox" implicit in PrSC research findings: Higher PrSC sources are associated with more accurate and extensive self-knowledge yet higher levels of psychological distress. The potential of the FFM to provide a comprehensive Framework for conceptualizing self-attentive dispositions, and to order and integrate research findings within this domain, is discussed.
Article
Full-text available
Is there an adaptive side to rumination? We tested whether rumination that is focused on correcting past mistakes and active goal achievement could produce positive outcomes; this is in contrast to rumination that focuses on the implications of failure (i.e., state rumination) and task-irrelevant rumination. in all studies, participants received failure feedback on an initial task. a second task similar to the first provided an opportunity for improvement. Studies 1 and 2 manipulated type of ruminative thought such that it was action-focused, state-focused, or task-irrelevant. action-focused rumination led to performance improvement relative to the other two conditions. experiment 3 allowed participants to ruminate naturalistically. the more that participants' rumination contained action-focused thoughts, the more their performance improved. hence, rumination can yield benefits if it focuses on correcting errors and goal attainment.
Article
Full-text available
Background Dissociative symptoms during trauma predict post-traumatic stress disorder (PTSD), but they are often transient. It is controversial whether they predict chronic PTSD over and above what can be predicted from other post-trauma symptoms. Aims To investigate prospectively the relationship between dissociative symptoms before, during and after a trauma and other psychological predictors, and chronic PTSD. Method Two samples of 27 and 176 road traffic accident survivors were recruited. Patients were assessed shortly after the accident and followed at intervals over the next 6 months. Assessments included measures of dissociation, memory fragmentation, data-driven processing, rumination and PTSD symptoms. Results All measures of dissociation, particularly persistent dissociation 4 weeks after the accident, predicted chronic PTSD severity at 6 months. Dissociative symptoms predicted subsequent PTSD over and above the other PTSD symptom clusters. Memory fragmentation and data-driven processing also predicted PTSD. Rumination about the accident was among the strongest predictors of subsequent PTSD symptoms. Conclusions Persistent dissociation and rumination 4 weeks after trauma are more useful in identifying those patients who are likely to develop chronic PTSD than initial reactions.
Article
Full-text available
Mildly-to-moderately depressed and nondepressed subjects were randomly assigned to spend 8 minutes focusing their attention on their current feeling states and personal characteristics (rumination condition) or on descriptions of geographic locations and objects (distraction condition). Depressed subjects in the rumination condition became significantly more depressed, whereas depressed subjects in the distraction condition became significantly less depressed. Rumination and distraction did not affect the moods of nondepressed subjects. These results support the hypothesis that ruminative responses to depressed mood exacerbate and prolong depressed mood. whereas distracting response shorten depressed mood.
Article
Full-text available
[the terms ruminative thoughts or rumination] refer to a class of conscious thoughts that revolve around a common instrumental theme and that recur in the absence of immediate environmental demands requiring the thoughts / propose a formal definition of rumination and a theoretical model / the model addresses [goals and other] factors that initiate and terminate rumination as well as those that influence its content / the model also outlines some of the consequences of rumination for a variety of cognitive, affective, and behavioral phenomena / believe the model not only suggests a way in which to integrate what are currently separate yet related literature on ruminative phenomena (e.g., meaning analysis, daydreaming, problem solving, reminiscence, anticipation) but also suggests directions for future research / present evidence for some of the model's assumptions and then discuss some consequences of rumination varieties of conscious thought / the mechanisms of rumination / additional considerations [the relation between affect and rumination, individual differences, is the model falsifiable] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Multilevel modeling is a technique that has numerous potential applications for social and personality psychology. To help realize this potential, this article provides an introduction to multilevel modeling with an emphasis on some of its applications in social and personality psychology. This introduction includes a description of multilevel modeling, a rationale for this technique, and a discussion of applications of multilevel modeling in social and personality psychological research. Some of the subtleties of setting up multilevel analyses and interpreting results are presented, and software options are discussed.
Article
Full-text available
Two studies tested the hypothesis that women are more likely than men to focus on themselves and their mood when in a depressed mood, and that this leads them to experience longer periods of depressed mood. In both studies subjects were predominantly Caucasian college students. In our first study, a laboratory study, females chose to engage in an emotion-related task significantly more often than did males, even when this lead them to focus on an existing sad mood. In the second study, a prospective naturalistic study, females were more likely than males to evince an emotion-focused ruminative style of coping with their moods. A ruminative response style at Time 1 was a significant predictor of depression scores at Time 2, even after initial levels of depressed mood were taken into account. Furthermore, once rumination levels were controlled for, gender was no longer a potent predictor of depression outcome. The implications of these response styles for treatment are discussed.
Article
Full-text available
Rumination has been associated with depression and negative health effects. Yet measures of rumination appear to index multiple constructs that may be differentially related to clinical phenomena. To clarify this literature, we explored convergence and divergence among self-report measures of rumination in 349 undergraduates, 59 depressed adults, 81 healthy adults, and 15 never-depressed adults with Systemic Lupus Erythematosis (SLE). Results suggested there are separate constructs labeled rumination with different relationships to depression. Yet, aggregate measures index a central construct. Depressed individuals ruminated more, across measures, than individuals with SLE, who ruminated more than healthy individuals; this relationship was mediated by dysphoria. Thus, administering multiple rumination measures and attending to constructs assessed by rumination measures appears important in clinical studies.
Article
Full-text available
The tendency to engage in depressive rumination is typically measured with the Ruminative Response Styles (RRS) scale. Treynor et al. (2003) reported that this scale is composed of two 5-item factors, reflection and brooding, and that the brooding but not the reflection factor is associated with more severe depression over time. These two factors were derived using data from a randomly selected community sample, and it is not clear if these factors would be obtained in samples of currently depressed, formerly depressed, and never depressed individuals. We conducted factor analyses on scores on the RRS scale from three such samples. We found support for the distinction between reflection and brooding in never depressed and formerly depressed individuals; we did not obtain this distinct factor structure in the currently depressed sample. We did, however, find evidence of a second factor in the depressed sample that we labeled ‘intentional rumination.’ The results of this study also suggested that an item from the reflection factor should be replaced with another item from the RRS scale. These findings indicate that the distinction between brooding and reflection is blurred in currently depressed individuals. KeywordsRumination–Depression–Brooding–Reflection–Factor analysis
Article
Full-text available
Alcohol expectancies refer to beliefs about positive and negative alcohol effects. Research has explored the role of this construct in maintaining alcohol use but results remain unclear. Recent theories have suggested that the absence of a clear distinction between cognitive and metacognitive expectancies on alcohol effects may be responsible for this ambiguity. This study explored associations between cognitive and metacognitive expectancies about alcohol use. A sample of inpatients with problem drinking diagnosis and individuals from the general population were compared on presence or absence of different expectancies through a semi-structured interview. Results indicate that the two samples significantly differed on frequency of cognitive and metacognitive expectancies. In particular, the clinical sample presented less negative cognitive expectancies (health damage, interpersonal relations damage) and more positive metacognitive expectancies (relating to thought control and cognitive efficiency). No differences on positive cognitive expectancies and negative metacognitive expectancies about alcohol use we observed. The clinical implications of these findings are discussed.
Article
Full-text available
Rumination has been linked to posttraumatic stress disorder (PTSD) and depression following trauma. A cross-sectional (N = 101) and a prospective longitudinal study (N = 147) of road traffic accident survivors assessed rumination, PTSD and depression with self-report measures and structured interviews. We tested the hypotheses that (1) rumination predicts the maintenance of PTSD and depression and (2) reduced concreteness of ruminative thinking may be a maintaining factor. Rumination significantly predicted PTSD and depression at 6 months over and above what could be predicted from initial symptom levels. In contrast to the second hypothesis, reduced concreteness in an iterative rumination task was not significantly correlated with self-reported rumination frequency, and did not consistently correlate with symptom severity measures. However, multiple regression analyses showed that the combination of reduced concreteness and self-reported frequency of rumination predicted subsequent PTSD better than rumination frequency alone. The results support the view that rumination is an important maintaining factor of trauma-related emotional disorders.
Article
Full-text available
In an attempt to eliminate similar item content as an alternative explanation for the relation between depression and rumination, a secondary analysis was conducted using the data from S. Nolen-Hoeksema, J. Larson, and C. Grayson (1999). After constructing a measure of rumination unconfounded with depression content, support for a two factor model of rumination was found. These analyses indicate that the 2 components, reflective pondering and brooding, differentially relate to depression in terms of predictive ability and gender difference mediation. The results presented here support the general premise of Nolen-Hoeksema's Response Styles Theory (S. Nolen-Hoeksema 1987) that rumination can contribute to more depressive symptoms and to the gender difference in depression, but suggest important refinements of the theory. Such refinements include the need to differentiate between the reflective pondering component of rumination and the brooding component in rumination research. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/44342/1/10608_2004_Article_464752.pdf
Article
Full-text available
Depressive rumination, as assessed by Nolen-Hoeksema's Response Styles Questionnaire (RSQ), predicts the onset, chronicity, and duration of depressed mood. However, some RSQ items contain depressive content and result in a heterogeneous factor structure. After the a priori elimination of items potentially confounded with depressed item content, Treynor, Gonzalez, and Nolen-Hoeksema identified two factors within the remaining RSQ rumination sub-scale that were differentially related to depression: brooding and pondering. However, Treynor et al. used a nonstandard form and administration of the RSQ. The present study sought to address these methodological idiosyncrasies and replicate the factor structure of Treynor et al. through exploratory factor analysis and structural equation modeling. Findings support the brooding and pondering solution and demonstrate that brooding relates more strongly to depression and anxiety than does pondering.
Article
Full-text available
The past several decades have witnessed unidimensional decline models of aging give way to life-span developmental models that consider how specific processes and strategies facilitate adaptive aging. In part, this shift was provoked by the stark contrast between findings that clearly demonstrate decreased biological, physiological, and cognitive capacity and those suggesting that people are generally satisfied in old age and experience relatively high levels of emotional well-being. In recent years, this supposed "paradox" of aging has been reconciled through careful theoretical analysis and empirical investigation. Viewing aging as adaptation sheds light on resilience, well-being, and emotional distress across adulthood.
Article
Full-text available
Measures of emotional health and styles of responding to negative moods were obtained for 137 students 14 days before the Loma Prieta earthquake. A follow-up was done 10 days again 7 weeks after the earthquake to test predictions about which of the students would show the most enduring symptoms of depression and posttraumatic stress. Regression analysis showed that students who, before the earthquake, already had elevated levels of depression and stress symptoms and a ruminative style of responding to their symptoms had more depression and stress symptoms for both follow-ups. Students who were exposed to more dangerous or difficult circumstances because of the earthquake also had elevated symptom levels 10 days after the earthquake. Similarly, students who, during the 10 days after the earthquake, had more ruminations about the earthquake were still more likely to have high levels of depressive and stress symptoms 7 weeks after the earthquake.
Article
Full-text available
The Mississippi Scale for Combat-Related Posttraumatic Stress Disorder is a 35-item self-report scale derived from Diagnostic and Statistical Manual of Mental Disorders criteria for the disorder. This article describes a series of three studies designed to explore the psychometric properties of the scale. Study 1 used 362 Vietnam veterans seeking help at Vet Centers (Operation Outreach) to confirm the internal consistency of the instrument and provide an assessment of its factor structure. Study 2 demonstrated the high test—retest reliability of the instrument over a period of 1 week. Study 3 indicated that the test’s sensitivity was .93, specificity was .89, and overall hit rate was .90 when it was used to differentiate between a posttraumatic stress disorder (PTSD) group and two non-PTSD comparison groups. The utility of the test when it is administered within the context of a multiaxial approach to assess military-related PTSD is discussed.
Article
Full-text available
The authors tested and extended S. Nolen-Hoeksema's (1991) response styles (RSs) theory of depression by assessing the role of RSs in the onset of depressive episodes (DEs), controlling for the effects of concurrent depression, examining the dispositional aspects of RS, clarifying the role of distraction in the course of a DE, and studying the predictive validity of the Response Styles Questionnaire, Nondepressed (ND) participants who reported that they ruminate in response to their depressive symptoms were more likely to experience a DE over 18 months than were participants who reported that they distract themselves from their symptoms. Both a ruminative RS as measured in an ND state and the use of rumination during the first DE predicted the severity of that episode. In contrast, neither trait nor state rumination predicted the duration of the first DE. Participants showed moderate stability of RSs over 1 year and responded in a consistent manner when depressed.
Article
Full-text available
Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood. The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions. The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished well-being, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders. The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients.
Article
Full-text available
A distinction between ruminative and reflective types of private self-attentiveness is introduced and evaluated with respect to L. R. Goldberg's (1982) list of 1,710 English trait adjectives (Study 1), the five-factor model of personality (FFM) and A. Fenigstein, M. F. Scheier, and A. Buss's (1975) Self-Consciousness Scales (Study 2), and previously reported correlates and effects of private self-consciousness (PrSC; Studies 3 and 4). Results suggest that the PrSC scale confounds two unrelated, motivationally distinct dispositions--rumination and reflection--and that this confounding may account for the "self-absorption paradox" implicit in PrSC research findings: Higher PrSC scores are associated with more accurate and extensive self-knowledge yet higher levels of psychological distress. The potential of the FFM to provide a comprehensive framework for conceptualizing self-attentive dispositions, and to order and integrate research findings within this domain, is discussed.
Article
Full-text available
Previous research has shown that, compared with a rumination induction, a brief distraction procedure reduces overgeneral autobiographical memory in depression. The authors investigated whether this effect depends on reductions in analytic thinking or reductions in self-focus. Focus of attention (high vs. low self-focus) and thinking style (high vs. low analytical thinking) were independently manipulated in depressed patients in a 2 x 2 design. Autobiographical recall was measured pre- and postmanipulation. Thinking style significantly affected overgeneral memory, whereas focus of attention significantly affected despondent mood. Reducing analytical self-focus reduced overgeneral memory, suggesting that high levels of naturally occurring ruminative analytic thinking may be important in the maintenance of overgeneral memory. Overgeneral memory in depression may be associated with chronic ruminative attempts to make sense of current or past difficulties.
Article
Item response theory was used to examine the measurement qualities of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder, with data taken from the 2,348 veteran participants in the National Vietnam Veterans Readjustment Study. Using Samejima's (1969) graded response model, estimates of each item's discrimination and difficulty parameters were derived, and item and test information functions were then computed. Various item information patterns and sample items are discussed in terms of improved assessment of posttraumatic stress disorder.
Article
A total of 100 experimental, cross-sectional and longitudinal studies on the association between rumination and negative affects are reviewed. Experimental and cross-sectional studies support a positive association between rumination and sadness-depression whereas longitudinal studies show more diverse results. Longitudinal studies sampling clinical populations and with treatment during the follow-up display more null results. Concerning the relation between rumination and other negative affects there is strongest evidence for a positive association between rumination and anxiety, but more studies are necessary to illuminate the relation between rumination and other negative affects. The functionality of rumination is discussed along with possible explanations for the associations between rumination and different negative affects. The need for further differentiation of rumination is highlighted in order to distinguish the concept from other types of repetitive, negative thoughts.
Article
A number of recent laboratory and prospectivefield studies suggest that the tendency to ruminateabout dysphoric moods is associated with more severe andpersistent negative emotional experiences (e.g., Morrow & Nolen-Hoeksema, 1990;Nolen-Hoeksema & Morrow, 1991). The current paperreports two studies that tested the hypotheses that (a)ruminative response styles act as a trait vulnerabilityto dysphoria, particularly to relativelypersistent episodes of dysphoria; (b) aspects ofrumination that are not likely to be contaminated withthe presence and severity of previous symptomatology(introspection/self-isolation, self-blame) demonstrate vulnerability effects;and (c) rumination mediates the effects of gender andneuroticism on vulnerability to dysphoria. Consistentsupport was found for each of these hypotheses. Overall, our data suggest that rumination mightreflect an important cognitive manifestation ofneuroticism that increases vulnerability to episodes ofpersistent dysphoria.
Article
This article presents a methodological critique of the predominant research paradigms in modern social psychology, particularly social cognition, taking the approach of Solomon Asch as a more appropriate model. The critique has 2 parts. First, the dominant model of science in the field is appropriate only for a well-developed science, in which basic, real-world phenomena have been identified, important invariances in these phenomena have been documented, and appropriate model systems that capture the essence of these phenomena have been developed. These requirements are not met for most of the phenomena under study in social psychology. Second, the model of science in use is a caricature of the actual scientific process in well-developed sciences such as biology. Such research is often not model or even hypothesis driven, but rather relies on “informed curiosity” to motivate research. Descriptive studies are considered important and make up a substantial part of the literature, and there is less exclusive reliance on experiment. The two parts of the critique are documented by analysis of articles in appropriate psychology and biology journals. The author acknowledges that important and high quality work is currently being done in social psychology, but believes that the field has maladaptively narrowed the range of the phenomena and methodological approaches that it deems acceptable or optimal.
Article
Simple slopes, regions of significance, and confidence bands are commonly used to evaluate interactions in multiple linear regression (MLR) models, and the use of these techniques has recently been extended to multilevel or hierarchical linear modeling (HLM) and latent curve analysis (LCA). However, conducting these tests and plotting the conditional relations is often a tedious and error-prone task. This article provides an overview of methods used to probe interaction effects and describes a unified collection of freely available online resources that researchers can use to obtain significance tests for simple slopes, compute regions of significance, and obtain confidence bands for simple slopes across the range of the moderator in the MLR, HLM, and LCA contexts. Plotting capabilities are also provided.
Article
Objective: This investigation assessed whether current post-traumatic stress disorder (PTSD) was associated with impaired functioning in a nationally representative sample of female Vietnam veterans. Methods: Logistic models were used to determine the association between PTSD and outcome while adjusting for demographic characteristics and medical and psychiatric co-morbidities. Results: PTSD was associated with significantly elevated odds of poorer functioning in five of the six outcome domains; only the association between perpetration of violence in the past year and PTSD did not achieve statistical significance. After adjusting for demographics and medical and psychiatric co-morbidities, PTSD remained associated with significantly elevated odds of bed days, poorer physical health, and currently not working. Conclusions: Among female Vietnam veterans PTSD is associated with a broad profile of functional impairment. The significantly increased odds of impaired functioning and diminished quality of life suggest that PTSD may be the core problem of the set of problems afflicting female Vietnam veterans.
Article
Specificity and categoric descriptions of autobiographical memories (AM) are reported to be psychological trait markers for vulnerability for depression. Thus, they should permit the prediction of future affective changes. 50 pregnant women were tested for their recall of AM as well as twice—during pregnancy and 3 mo after delivery—with the Edinburgh Postnatal Depression Scale. The main scope of the study was the evaluation of the potential of AM in predicting affective changes in a nonclinical sample of women following childbirth. Using a hierarchical multiple regression analysis, categoric descriptions in response to negative cue words allowed a significant prediction of affective changes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Much social and behavioral research involves hierarchical data structures. . . . Recent developments in the statistical theory of hierarchical linear models now afford an integrated set of methods for such applications. This introductory text explicates the theory and use of hierarchical linear models (HLM) through rich, illustrative examples and lucid explanations. The presentation remains reasonably nontechnical by focusing on three general research purposes—improved estimation of effects within an individual unit, estimating and testing hypotheses about cross-level effects, and partitioning of variance and covariance components among levels. This innovative volume describes use of both two and three level models in organizational research, studies of individual development and meta-analysis applications, and concludes with a formal derivation of the statistical methods used in the book. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The response styles theory (Nolen-Hoeksema, 1991) was proposed to explain the insidious relationship between rumination and depression. We review the aspects of the response styles theory that have been well-supported, including evidence that rumination exacerbates depression, enhances negative thinking, impairs problem solving, interferes with instrumental behavior, and erodes social support. Next, we address contradictory and new findings. Specifically, rumination appears to more consistently predict the onset of depression rather than the duration, but rumination interacts with negative cognitive styles to predict the duration of depressive symptoms. Contrary to original predictions, the use of positive distractions has not consistently been correlated with lower levels of depressive symptoms in correlational studies, although dozens of experimental studies show positive distractions relieve depressed mood. Further, evidence now suggests that rumination is associated with psychopathologies in addition to depression, including anxiety, binge eating, binge drinking, and self-harm. We discuss the relationships between rumination and worry and between rumination and other coping or emotion-regulation strategies. Finally, we highlight recent research on the distinction between rumination and more adaptive forms of self-reflection, on basic cognitive deficits or biases in rumination, on its neural and genetic correlates, and on possible interventions to combat rumination. © 2008 Association for Psychological Science.
Article
Many important research hypotheses concern conditional relations in which the ef- fect of one predictor varies with the value of another. Such relations are commonly evaluated as multiplicative interactions and can be tested in both fixed- and ran- dom-effects regression. Often, these interactive effects must be further probed to fully explicate the nature of the conditional relation. The most common method for probing interactions is to test simple slopes at specific levels of the predictors. A more general method is the Johnson-Neyman (J-N) technique. This technique is not widely used, however, because it is currently limited to categorical by continuous in- teractions in fixed-effects regression and has yet to be extended to the broader class of random-effects regression models. The goal of our article is to generalize the J-N technique to allow for tests of a variety of interactions that arise in both fixed- and random-effects regression. We review existing methods for probing interactions, ex- plicate the analytic expressions needed to expand these tests to a wider set of condi- tions, and demonstrate the advantages of the J-N technique relative to simple slopes with three empirical examples.
Article
A total of 100 experimental, cross-sectional and longitudinal studies on the association between rumination and negative affects are reviewed. Experimental and cross-sectional studies support a positive association between rumination and sadness-depression whereas longitudinal studies show more diverse results. Longitudinal studies sampling clinical populations and with treatment during the follow-up display more null results. Concerning the relation between rumination and other negative affects there is strongest evidence for a positive association between rumination and anxiety, but more studies are necessary to illuminate the relation between rumination and other negative affects. The functionality of rumination is discussed along with possible explanations for the associations between rumination and different negative affects. The need for further differentiation of rumination is highlighted in order to distinguish the concept from other types of repetitive, negative thoughts.
Article
The study examined the prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) following road traffic accidents (RTAs), and cross-sectional and prospective relationships with thought-control strategies and perceived social support and criticism from a key significant other. Four hundred and thirty-four consecutive admissions to accident and emergency clinics following an RTA were assessed within 4 weeks of the accident, and 265 reassessed within 6 months. Twenty-one percent met symptom criteria for ASD at initial assessment, and 23% met criteria for PTSD at 4 to 6 months post-accident. These results agree closely with other studies recruiting similar populations in a similar manner. Subjects classified as suffering ASD at initial assessment were 20 times (odds ratio = 20.04) more likely to be classified as suffering PTSD at follow-up. Of the ASD cases assessed at Time 1, 72% were PTSD cases at Time 2. Loss, individual differences in thought-control strategies, and perceived negative quality of social support independently predicted ASD at Time 1 and PTSD at Time 2 in cross-sectional analyses. Analysis of prospective predictors of PTSD at Time 2 indicated that ASD at Time 1, the use of worry to control thoughts at Time 1, a change in perceived social support from Time 1 to Time 2, and an interaction between perceived social support and the use of social control as a coping strategy at Time 1 significantly predicted subsequent PTSD. Those who rated highly on the use of social control and on perceived negative social support had greater probability of subsequently developing PTSD (odds ratio = 8.2). The results were mainly as predicted and conform to models of trauma in which persistent disorders are associated with inhibition of emotional processing.
Article
While some individuals develop PTSD subsequent to traumatic experiences, many individuals resume prior functioning naturally. Diathesis-stress models suggest that stable individual differences present in individuals prior to trauma may serve as vulnerability factors to symptom development. The high levels of comorbidity and symptom similarity suggest that established vulnerability factors for anxiety and depression may also serve as vulnerability factors for PTSD. The examination of multiple vulnerability factors simultaneously may increase understanding of the etiology of PTSD and comorbid post-trauma symptomatology and account for a greater percentage of variance in PTSD symptoms. In addition, the vulnerability factors may be related to distinct sets of symptoms, with vulnerabilities predicting the PTSD symptoms most similar to their associated disorders. Research examining the relations between attributional style, rumination, anxiety sensitivity, and the looming cognitive style and the development of PTSD after trauma exposure is reviewed and suggestions for future research are provided.
Article
Prolonged exposure, a cognitive behavioral therapy including both in vivo and imaginal exposure to the traumatic memory, is one of several empirically supported treatments for chronic posttraumatic stress disorder (PTSD). In this article, we provide a case illustration in which this well-validated treatment did not yield expected clinical gains for a client with PTSD and co-occurring major depression. After providing an overview of the literature, theory, and treatment protocol, we discuss the clinical cascade effect that underlying ruminative processes had on the treatment of this case. Specifically, we highlight how ruminative processes, focusing on trying to understand why the traumatic event happened and why the client was still suffering, resulted in profound emotional distress in session and in a lack of an "optimal dose" of exposure during treatment.
Article
The response styles theory suggests that rumination in response to depressed mood exacerbates and prolongs depression, while distraction ameliorates and shortens it. Gender differences in response styles are said to contribute to the observed gender differences in the prevalence of unipolar depression. While empirical support for the theory has been found from a variety of non-clinical studies, its generalizability to clinically depressed patient populations remains unclear. A cohort of 52 unipolar depressed in-patients was assessed with the Response Styles Questionnaire during in-patient stay (T1) and 4 weeks after discharge (T2). The patients were followed up 4 months after discharge (T3). Clinical assessment included the SCAN-PSE-10. Moderate and statistically significant retest-stabilities for rumination and distraction were found, comparable for patients with stable and changing depression status from T1 to T2. A cross-sectional diagnosis of a major depressive episode was associated with rumination, while gender was not. Post-discharge baseline rumination (T2), adjusted for concurrent depression, predicted follow-up levels of depression (T3), and, in patients who were non-remitted at post-discharge baseline, it predicted presence of a major depressive episode at follow-up (T3). Results on distraction were more ambiguous. Our results suggest that rumination is likely to have a deteriorating impact on the course of clinical episodes of depression in unipolar depressed patients. Larger longitudinal patient studies are needed to validate these findings.
Article
The high rate of comorbidity among mental disorders has driven a search for factors associated with the development of multiple types of psychopathology, referred to as transdiagnostic factors. Rumination is involved in the etiology and maintenance of major depression, and recent evidence implicates rumination in the development of anxiety. The extent to which rumination is a transdiagnostic factor that accounts for the co-occurrence of symptoms of depression and anxiety, however, has not previously been examined. We investigated whether rumination explained the concurrent and prospective associations between symptoms of depression and anxiety in two longitudinal studies: one of adolescents (N=1065) and one of adults (N=1317). Rumination was a full mediator of the concurrent association between symptoms of depression and anxiety in adolescents (z=6.7, p< .001) and was a partial mediator of this association in adults (z=5.6, p< .001). In prospective analyses in the adolescent sample, baseline depressive symptoms predicted increases in anxiety, and rumination fully mediated this association (z=5.26, p< .001). In adults, baseline depression predicted increases in anxiety and baseline anxiety predicted increases in depression; rumination fully mediated both of these associations (z=2.35, p= .019 and z=5.10, p< .001, respectively). These findings highlight the importance of targeting rumination in transdiagnostic treatment approaches for emotional disorders.
Article
We examined the relationships between six emotion-regulation strategies (acceptance, avoidance, problem solving, reappraisal, rumination, and suppression) and symptoms of four psychopathologies (anxiety, depression, eating, and substance-related disorders). We combined 241 effect sizes from 114 studies that examined the relationships between dispositional emotion regulation and psychopathology. We focused on dispositional emotion regulation in order to assess patterns of responding to emotion over time. First, we examined the relationship between each regulatory strategy and psychopathology across the four disorders. We found a large effect size for rumination, medium to large for avoidance, problem solving, and suppression, and small to medium for reappraisal and acceptance. These results are surprising, given the prominence of reappraisal and acceptance in treatment models, such as cognitive-behavioral therapy and acceptance-based treatments, respectively. Second, we examined the relationship between each regulatory strategy and each of the four psychopathology groups. We found that internalizing disorders were more consistently associated with regulatory strategies than externalizing disorders. Lastly, many of our analyses showed that whether the sample came from a clinical or normative population significantly moderated the relationships. This finding underscores the importance of adopting a multi-sample approach to the study of psychopathology.
Article
This review examined evidence for some core predictions of the response styles theory (RST) concerning the relation between response styles and symptoms of depression and gender differences in the use of response styles in non-clinical children and adolescents. In summarizing the literature, effect sizes (pooled correlation coefficients) were calculated for cross-sectional and longitudinal studies. Stability of the obtained effect sizes was evaluated by means of a fail-safe N analysis. Results indicated that stable and significant effect sizes were found for rumination being associated with concurrent and future levels of depression. When controlling for baseline levels of depression, effect sizes for rumination and distraction were not stable, indicating that these findings should be interpreted with considerable caution. Finally, significant and stable effect sizes for gender differences in response styles were found only for rumination among adolescents. Taken together, the findings partly support the predictions of the response styles theory examined in this meta-analysis and may implicate that rumination is a cognitive vulnerability factor for depressive symptoms among adolescents.
Article
Rumination has been widely studied and is a crucial component in the study of cognitive vulnerabilities to depression. However, rumination means different things in the context of different theories, and has not been uniformly defined or measured. This article aims to review models of rumination, as well as the various ways in which it is assessed. The models are compared and contrasted with respect to several important dimensions of rumination. Guidelines to consider in the selection of a model and measure of rumination are presented, and suggestions for the conceptualization of rumination are offered. In addition, rumination's relation to other similar constructs is evaluated. Finally, future directions for the study of ruminative phenomena are presented. It is hoped that this article will be a useful guide to those interested in studying the multi-faceted construct of rumination.
Article
I propose that the ways people respond to their own symptoms of depression influence the duration of these symptoms. People who engage in ruminative responses to depression, focusing on their symptoms and the possible causes and consequences of their symptoms, will show longer depressions than people who take action to distract themselves from their symptoms. Ruminative responses prolong depression because they allow the depressed mood to negatively bias thinking and interfere with instrumental behavior and problem-solving. Laboratory and field studies directly testing this theory have supported its predictions. I discuss how response styles can explain the greater likelihood of depression in women than men. Then I intergrate this response styles theory with studies of coping with discrete events. The response styles theory is compared to other theories of the duration of depression. Finally, I suggest what may help a depressed person to stop engaging in ruminative responses and how response styles for depression may develop.
Article
Vietnam combat veterans with (n = 19) and without (n = 13) posttraumatic stress disorder (PTSD) participated in an autobiographical memory experiment in which they attempted to retrieve specific personal memories exemplifying traits denoted by positive (e.g. loyal) and negative (e.g. guilty) cue words. Veterans with PTSD exhibited difficulties retrieving specific autobiographical memories, especially in response to positive trait cue words. These deficits were especially pronounced in PTSD Ss who wore Vietnam War regalia (e.g. medals, fatigues) to the laboratory. Regalia-wearing PTSD Ss disproportionately retrieved memories from the Vietnam War, unlike other Ss who retrieved relatively recent memories. Wearing regalia in daily life may be emblematic of psychological fixation to a war fought more than two decades ago. Difficulties remembering one's past may underlie difficulties envisioning one's future, as reflected in the PTSD symptom of 'future foreshortening', and difficulties using memory specifically may also hamper efforts to solve personal problems.
Article
A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.
Article
Rachman's (1980) analysis [Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18, 51-60] of emotional processing is extended and applied to the prevention of relapse and recurrence in depression. It is proposed that effective emotional processing leads to changes in the ability of triggering cues to reactivate depressogenic processing cycles at times of potential relapse. Available evidence supports the usefulness of the probe methodology of the emotional processing framework as a way to investigate processes mediating relapse prevention by cognitive therapy. It is proposed that effective emotional processing involves creation of modified affect-related schematic mental models and that this occurs most effectively only within certain processing configurations or modes of mind. Within the Interacting Cognitive Subsystems (ICS) framework, three modes of processing emotional material can be distinguished: 'mindless emoting'; 'conceptualising/doing' and 'mindful experiencing/being'. Only the last of these facilitates emotional processing; the second may prevent effective emotional processing and perpetuate depression by ruminative, conceptually dominated processing. This analysis suggests a further strategy to prevent relapse, in addition to modifying depressogenic schematic models, by teaching recovered depressed patients skills to switch processing modes by intentional redeployment of attention. Results of a recent trial of mindfulness-based cognitive therapy support the effectiveness of this novel alternative strategy.
Article
Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model.