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Moderating effects of brooding on the link between functional impairment and interpersonal needs in survivors of serious trauma

  • Portland Psychotherapy--Clinic, Research, and Training Center


Objectives: Trauma and resulting functional limitations demonstrate associations with perceived burdensomeness and thwarted belongingness, factors contributing to elevated risk for suicidal ideation. However, survivors display differential risk in response to impairment, highlighting the need for research on exacerbating factors. The current study examined the impact of brooding on the association of functional impairment with burdensomeness and belongingness among trauma-exposed undergraduates (N = 262). Method: Trauma was assessed via clinical interview with questionnaires for study variables. Regression models examined the unique and interactive effects of physical impairment, emotional impairment, and brooding on burdensomeness and thwarted belongingness. Results: An interaction of brooding and impairment due to emotional difficulties was observed for burdensomeness with impairment linked to elevated burdensomeness at high (β = -0.46; p < 0.001), but not low (β = -0.07; p = 0.476) brooding. Impairment due to emotional difficulties (β = -0.38; p < 0.001) and brooding (β = 0.25; p < 0.001) were associated with belongingness. Conclusions: Findings identify brooding as a potential target for assessment and intervention in trauma-exposed individuals.
Moderating Effects of Brooding on the Link Between Functional Impairment and
Interpersonal Needs in Survivors of Serious Trauma
Kozina, R. M.*, Lear, M. K., Stacy, S. E., Kern, S. M., Ripley, A. J., Clapp, J. D.
University of Wyoming
Department of Psychology
1000 E. University Ave.
Laramie, WY 82071
United States
Correspondence regarding this manuscript should be directed to Ryan M. Kozina at:
Department of Psychology
University of Wyoming
1000 E. University Avenue
Laramie, WY 82070
Phone: (916) 529-9942
Fax: 307.766.2926
Objectives: Trauma exposure is associated functional impairment in response to both physical
and emotional difficulties. Limitations in these domains have been subsequently shown to hold
relations with perceptions of burdensomeness and thwarted belongingness, factors contributing
to further negative outcomes including suicidal ideation. However, not all survivors demonstrate
equal levels of risk in the face of common impairment, highlighting the need for research on
possible exacerbating factors. The current study examined the potential impact of brooding on
the association of physical and emotional impairment with burdensomeness and thwarted
belongingness among trauma-exposed undergraduates (N = 262).
Method: Trauma exposure was assessed via clinical interview with questionnaire measures
completed for study variables. Regression models examined the unique and interactive effects of
physical impairment, emotional impairment, and brooding on burdensomeness and thwarted
Results: An interaction of brooding and impairment due to emotional difficulties was observed
for burdensomeness with impairment linked to elevated burdensomeness at high (β = -.46; p
<.001), but not low (β = -.07; p = .476) levels of brooding. Impairment due to emotional
difficulties (β = -.38; p <.001) and brooding (β = .25; p <.001) were associated with thwarted
Conclusions: Findings identify brooding as a potential target for assessment and intervention in
trauma-exposed individuals.
Moderating Effects of Brooding on the Link Between Functional Impairment and
Interpersonal Needs in Survivors of Serious Trauma
Individuals exposed to traumatic events are at increased risk for a range of negative
outcomes including psychopathology, physical injury, chronic health issues, and elevated rates of
self-harm (e.g., Atwoli et al., 2016; Fullerton & Ursano, 2005; Goldney et al., 2000). Survivors
may also experience considerable levels of functional impairment due to corresponding
emotional and physical concerns (e.g., Clapp et al., 2010; Momartin et al., 2003). Current
research indicates that impairment related to physical and emotional difficulties may increase
survivors’ perceptions of social isolation and being a burden to others, outcomes known to
increase risk of suicidal ideation (Calandre et al., 2021; Khazem et al., 2015; Wiblin et al., 2021).
However, few studies have examined specific factors that may influence the magnitude of these
effects. Rumination, an emotion regulation strategy associated with elevated mental health
difficulties, may heighten perceptions of burdensomeness and isolation following trauma. The
present study builds on existing research by examining rumination as a potential exacerbating
factor in the relation of physical and emotional impairment with burdensomeness and thwarted
Exposure to traumatic events involving actual or threatened death, serious injury, and/or
sexual violence (APA, 2013) is linked to deleterious effects on both physical and emotional
health (Wen et al., 2012; Fullerton & Ursano, 2005). In addition to difficulties resulting from
acute physical injury (e.g., Galarneau et al., 2006), data suggests that individuals exposed to
significant trauma are more likely than non-exposed individuals to develop chronic physical
conditions contributing to long-term functional impairment (e.g., Atwoli et al., 2016; Schnurr &
Green, 2004; Wen et al., 2012). For example, survivors of military sexual trauma have been
found to report worse overall health outcomes and more frequent somatic complaints than
personnel who were not victimized (Millegan et al., 2016). Similarly, research exploring the
long-term health effects of earthquake survivors suggests that those most impacted by the quake
report more physical conditions and resulting impairment than those living outside the disaster
area (Wen et al., 2012).
In addition to increased risk for medical and health-related sequelae, trauma exposure
holds well-established associations with compromised emotional functioning (Kilpatrick et al.,
2003; Fullerton & Ursano, 2005). In a nationally representative sample of adolescents, exposure
to potentially traumatic events was linked to symptoms of depression and posttraumatic stress
disorder (PTSD), conditions commonly associated with functional impairment (Kilpatrick et al.,
2003). Increased rates of emotional difficulties including anxiety, depression, PTSD, and other
forms of psychopathology have been noted across survivors of motor vehicle trauma (e.g.,
Medetsky & Parnes, 1993), sexual assault (e.g., Millegan et al., 2016), combat (e.g., Dedert et
al., 2009), and intimate partner violence (e.g., Ogunsiji & Clisdell, 2017).
Elevations in the prevalence of suicidal ideation and self-harm are also noted in trauma-
exposed populations (e.g., LeBouthillier et al., 2015; Bryan et al., 2010). Joiner’s (2005)
Interpersonal Psychological Theory of Suicide (IPTS), an influential model developed to account
for specific relations between suicidal thoughts and subsequent behavior, identifies unmet
interpersonal needs as a primary factor in the development of suicidal ideation. Specific
interpersonal needs in Joiner’s model include perceptions of burdensomeness and thwarted
belongingness. Burdensomeness refers to the belief that one is an encumbrance on support
members and/or loved ones, resulting in self-hatred, perceptions that the individual is a liability
to others, and beliefs that friends and family would be “better off” without them. Thwarted
belongingness - a sense of alienation from friends, family, and other important social groups -
involves feelings of loneliness and the belief that the individual is left without resources for
support (Van Orden et al., 2010). Research has indicated that perceived burdensomeness and
thwarted belongingness are individually sufficient for passive suicidal ideation (Van Orden et al.,
2010), with recent meta-analyses providing evidence for robust associations with thoughts of
suicide (Chu et al., 2017). Results suggest that the evaluation of factors contributing to unmet
interpersonal needs is relevant for clinical risk assessment and treatment as well as for clarifying
the theoretical underpinnings of suicide more generally.
Within the context of trauma exposure, individuals experiencing functional impairment
as a result of chronic physical and/or emotional difficulties may experience greater perceptions
of burdensomeness due to an increased reliance on others for emotional, functional, and/or
financial support (e.g., disability due to chronic pain or travel avoidance following a serious
motor vehicle accident; Blanchard & Hickling, 1997). Survivors may also develop feelings of
isolation if participation in social activities is restricted as a consequence of emotional and/or
health-related impairments (e.g., changes in social relations as a result of stigma or emotional
lability following sexual assault; Ullman, 1999). Consistent with these hypotheses, data from the
extant literature provide evidence of elevated burdensomeness and thwarted belongingness
across a number of clinical populations. Wiblin and colleagues (2021) found that functional
impairment as a result of mental health difficulties were associated with greater perceptions of
unlovability among male and female survivors of military sexual assault. Similarly, Khazem et
al. (2015) observed elevations in burdensomeness among undergraduates reporting histories of
physical disability as compared to those without. Examination of impairment as a result of
fibromyalgia (Calandre et al., 2021), chronic pain (Hirsch et al., 2016), and general mental health
difficulties (Bryan, 2011) provide additional evidence for associations with both perceived
burdensomeness and thwarted belongingness.
Despite evidence for associations with these outcomes, the majority of trauma survivors
who develop limitations due to physical and/or emotional difficulties will show resilience to
ideation and self-harm, suggesting that an assessment of factors that impact these relations is
warranted. Cognitive processes including rumination are known to exacerbate risk for a range of
negative outcomes in the general population. (e.g., Kirkegaard Thomsen, 2006, Smith & Alloy,
2009). Brooding, a distinct component of rumination, is conceptualized as an inclination to
reflect judgmentally on one’s situation, feelings, or past actions with an emphasis on barriers to
solving problems (Nolen-Hoeksema et al., 2008; Treynor et al., 2003). Brooding has been shown
to impact problem solving ability (Haigh et al., 2018) and is believed to contribute to difficulties
related to depression, anxiety, and substance use (Nolen-Hoeksema et al., 2008; Xavier et al.,
2016). It is also possible that brooding may play a role in strengthening the relation between
functional impairment and the development and/or exacerbation of thwarted interpersonal needs
in individuals exposed to significant trauma. Specifically, survivors with a predisposition for
brooding appraisals are likely to focus on the consequences of trauma as well as current physical
and emotional limitations in ways that do not facilitate growth or practical, value-driven
solutions. This approach to processing the experience may, in turn, strengthen associations
between increasing functional impairment and perceptions of burdensomeness and thwarted
belonging. Research evaluating the impact of coping strategies on interpersonal difficulties has
noted associations between rumination and reductions in relationship satisfaction (Pearson et al.,
2010), intimacy, and sociability (Lam et al., 2003). However, no studies to date have tested the
specific interrelations between brooding, physical and emotional limitations, and interpersonal
needs in trauma survivors as indexed by measures of perceived burdensomeness and thwarted
Aims of the current study were to examine the extent to which brooding may strengthen
the associations of physical and emotional impairment with indices of burdensomeness and
thwarted belongingness in individuals exposed to significant trauma. Participants included 262
university students involved in an ongoing study of functional outcomes following Criterion-A
exposure (APA, 2013). Regression models were used to evaluate the direct and interactive
effects of brooding and functional impairment due to physical and emotional difficulties on
perceived burdensomeness and thwarted belongingness. Based on existing theoretical models
(Joiner, 2005; Van Orden et al., 2010) and evidence of rumination as a potential exacerbating
factor for negative behavioral outcomes (Nolen-Hoeksema et al., 2008; Smith & Alloy, 2009),
indices of functional impairment were expected to demonstrate stronger relations with perceived
burdensomeness and thwarted belongingness in survivors reporting high versus low levels of
Participants and Procedure
Participants included university students enrolled in an ongoing project evaluating
functional outcomes following significant trauma. Students endorsing exposure to one or more
potentially traumatic events on a checklist administered in an initial mass testing protocol were
invited to participate in the larger study (reference omitted for anonymous review). Following the
provision of informed consent, participants completed a series of structured and semi-structured
interviews with a graduate- or doctoral-level clinician. Interviews were used to determine the
frequency and severity of Criterion-A exposure as well as the presence of trauma-related
psychopathology and potential comorbid disorders. Following interviews, participants completed
a series of online questionnaires targeting domains of psychosocial functioning. Participants
received course credit for their involvement in the project. All study procedures received
Institutional Review Board approval.
A total of 271 individuals completed the initial clinical interview. Two participants failed
to report an event consistent with Criterion-A trauma as outlined in DSM-5 and were excluded
from subsequent analyses. Four individuals were excluded due to missing data. Three additional
cases were identified as multivariate outliers during tests of underlying model assumptions.
Subsequent screening failed to identify further violations of normality, linearity,
multicollinearity, or homoscedasticity. Characteristics of the final sample (N = 262) are provided
in Table 1.
Medical Outcomes Study Short Form 36 (SF-36). The SF-36 (Ware & Sherbourne,
1992) is a self-report health status questionnaire designed to measure health-related outcomes in
the four weeks prior to administration. For the current study, role limitations due to physical
problems (Role-Physical) and role limitations due to emotional problems (Role-Emotional) were
used as indices of domain-specific impairment. Items from the SF-36 Role-Physical specifically
target difficulties with work and/or other daily activities (e.g., reducing the amount of time spent
on activities, accomplishing less than intended, difficulty performing certain tasks) as a result of
physical health symptoms. Role-Emotional items addressing similar impairment in response to
emotional concerns. Both metrics are scored on a 0 to 100 scale with higher values representing
increased functioning in physical and emotional domains. The psychometric properties of the
SF-36 are well-established in university, medical, and psychiatric samples (Burton et al., 2012;
DeBerard & Masters, 2014; McHorney et al., 1993). Internal consistencies for this sample were
excellent for Role-Physical (α = 0.80) and Role-Emotional (α = 0.82) scales.
Ruminative Response Scale—Brooding Scale (RRS-B). The RRS-B (Treynor et al.,
2003) is a self-report measure developed to assess trait-level rumination. For the current study,
the 5-item Brooding subscale was used to index respondent tendency to passively self-reflect on
circumstances in ways that augment negative mood. RRS-B items (e.g., What am I doing to
deserve this; Why do I have problems that other people don’t have) are rated on a 1 (Almost
Never) to 4 (Always) Likert scale. Responses are summed to create a total score with higher
values indicating more frequent brooding. Existing research provides strong support for the
reliability and factorial validity of RRS-B scores across diverse clinical, community, and
undergraduate samples (He et al., 2021; Schoofs et al., 2010; Thanoi & Klainin-Yobas, 2015;
Treynor et al. 2003). Internal consistency for this sample was excellent (α = 0.84).
Interpersonal Needs Questionnaire, 10-Item Version (INQ-10). The INQ-10 (Bryan et
al., 2010) is a self-report instrument designed to assess thwarted belongingness and perceived
burdensomeness consistent with Joiner’s (2005) IPTS model. Participants rate each item on a 7-
point Likert scale (1 = Not at all true for me; 7 = very true for me). Scores for 5-item
burdensomeness and belongingness subscales are calculated as item means with greater values
representing higher levels of perceived burdensomeness or thwarted belongingness, respectively.
INQ-10 subscales have demonstrated good reliability and predictive validity in both university
students and adult outpatient samples (Bryan et al., 2010; Hill et al., 2015). Internal consistencies
were excellent for both perceived burdensomeness (α = 0.91) and thwarted belongingness (α =
0.88) scales in the current sample.
Analytic Approach
Separate regression models were used to examine the unique and interactive effects of
physical role limitations, emotional role limitations, and brooding on perceived burdensomeness
and thwarted belongingness, respectively. Interactive effects and simple slopes were analyzed
consistent with procedures outlined by Aiken and West (1991). All predictors were mean
centered prior to analyses. Effect sizes for individual regression coefficients in this study are
reported as Cohen’s f2. Values of .02, .15, and .35 are consistent with small, medium, and large
effects, respectively (Cohen, 1988). Sensitivity analysis for the planned models identified the
effective sample (N = 262) as adequately powered (1 – β = .80) to detect small-magnitude effects
(f2 = .030) in these data (GPower; Faul et al., 2009).
Perceived Burdensomeness. Means, standard deviations, and correlations for the
primary study variables are provided in Table 2. Results of the model for perceived
burdensomeness are provided in Table 3. Unique effects were noted for Brooding (β = .31; p
< .001; f2 = .099) and Role-Emotional (β = -.26; p < .001; f2 = .056), such that increased brooding
and lower emotional role functioning were associated with greater perceptions of
burdensomeness. These effects were qualified by a significant interaction of Brooding and Role-
Emotional (β = -.18; p = .005; f2 = .030). Simple slopes analyses indicated a reliable association
between role limitations due to emotional difficulties and perceived burdensomeness at high
levels of brooding (β = -.46; p < .001; f2 = .092). Results indicate that greater impairment was
related to elevated perceptions of burdensomeness (see Figure 1). By contrast, data failed to
support an association between Role-Emotional and burdensomeness at low levels of brooding (β
= -.07; p = .476; f2 = .003). No other direct or interactive effects were noted in the model (all p
≥ .476).
Thwarted Belongingness. Results of the analysis for thwarted belongingness are
provided in Table 3. Unique effects were noted for brooding (β = .25; p < .001; f2 = .067) and
Role-Emotional (β = -.38; p < .001; f2 = .122), such that increased brooding and functional
impairment due to emotional problems were associated with greater reported thwarted
belongingness. No direct effect of Role-Physical on thwarted belongingness was detected in the
data (β = .04; p = .585; f2 = .001). Contrary to hypotheses, no interaction effects were noted in
this model (all p ≥ .426).
The present study builds on existing research by exploring factors that may help to
qualify the association of functional impairment with unmet interpersonal needs in those exposed
to significant trauma. Previous studies have noted specific links between limitations due to
physical and/or emotional difficulties and perceptions of burdensomeness and thwarted
belongingness in a variety of clinical populations (e.g., Calandre et al., 2021; Hirsch et al., 2016;
Wiblin et al., 2021). In line with this research, impairment related to physical and emotional
concerns reported in the current sample demonstrated expected bivariate associations with both
perceived burdensomeness and thwarted belongingness.
Analyses also identified a moderating effect of brooding on the relation between
limitations due to emotional difficulties and perceived burdensomeness. Consistent with
hypotheses, impairment related to emotion symptoms was associated with greater perceptions of
burdensomeness at high, but not low, levels of brooding. Similar to effects noted in previous
studies (e.g., Aldao et al., 2010; Hong, 2007), results suggest that ruminative tendencies may, in
some cases, enhance the impact of affective symptoms (e.g. depression, anxiety) commonly
associated with trauma exposure. For survivors, impairment occurring within the context of
increased judgmental reflection may increase beliefs that one’s death would be beneficial to
others, a core component of perceived burdensomeness (Van Orden et al., 2010). Brooding may
also exacerbate feelings of self-hatred in response to functional impairment resulting from
psychological difficulties (e.g., reduced performance at work, less engagement with valued
activities). The current data, by contrast, provide little evidence for greater perceptions of
burdensomeness as a result of impairment due to emotional difficulties in those reporting little
judgmental reflection on current feelings and past actions. Results offer support for brooding as a
potential compounding factor in survivors experiencing functional difficulties as a result of
emotional concerns.
Analyses also identified unique effects of limitations due to emotional difficulties and
brooding on reports of thwarted belongingness. Data from the extant literature indicate that
symptoms related to depression, anxiety, substance use, and PTSD are associated with various
forms of social impairment, which could, in turn, contribute directly to feelings of loneliness and
isolation (Girard et al., 2017; Hassel et al., 2013; King et al., 2006; McEvoy et al., 2013). Trait-
level rumination is similarly associated with a variety of interpersonal concerns (Lam et al.,
2003). In contrast to interactive effects observed for perceived burdensomeness, results of the
current study suggest that brooding and impairment as a result of emotional concerns
independently predict feelings of alienation from friends, family, and other important social
groups. It is possible that impairment due to emotional difficulties in trauma survivors may
preclude involvement in social activities (e.g., missing opportunities for socialization as a result
of depressed mood and fatigue), contributing directly to feelings of isolation regardless of
individual tendencies towards brooding. Alternatively, ruminative behavior may cause
individuals to mischaracterize those social interactions that do occur, independent of level of
functional impairment. Whereas specific effects in this study await replication, preliminary
results suggest subtle differences in the pattern of associations of brooding and impairment due
to emotional difficulties across reports of burdensomeness and thwarted belongingness.
Overall, results suggest that brooding processes may serve as an important target for
intervention, to be considered in conjunction with packages aimed at reducing condition-specific
symptoms and resulting impairment. An example of this approach is the Collaborative
Assessment and Management of Suicidality (Jobes, 2006) which highlights the need to address
“suicidal drivers”, referring to specific experiences or behaviors that contribute to suicidal crises.
Given broad acknowledgement of perceived burdensomeness and thwarted belongingness as
drivers of risk (Joiner, 2005), strategies designed to manage ruminative self-judgement (e.g.,
mindfulness-based techniques such as those central to Dialectical Behavior Therapy and
Acceptance and Commitment Therapy; Hayes, Strosahl, & Wilson, 2012, Linehan, 2015) could
be beneficial, either directly or in combination with empirically-supported treatments for trauma-
related concerns. A greater understanding of the ways in which functional impairment and
ruminative processes contribute to individual risk may help to guide the selection and integration
of specific therapeutic tools.
Limitations and Future Directions
Results of this study should be interpreted within the context of the relative strengths and
limitations of the data. The current project is the first to examine the impact of maladaptive
rumination on the relation between functional impairment and unmet interpersonal needs in
survivors of significant trauma. Additionally, the use of interview-based assessment permitted a
more accurate and inclusive evaluation of Criterion-A trauma relative to data based on common
self-report measures of exposure (Dohrenwend, 2006). Despite these strengths, analyses were
limited to a non-treatment-seeking sample of university students. Although, research identifies
emerging adulthood as a period of increased risk for trauma exposure, suicidal ideation, and
suicide attempts (e.g., Breslau et al., 1998; Eskin et al., 2016), it is possible that more prominent
effects could be noted in formal, help-seeking populations. Impairment due to physical and
emotional concerns among participants in this study was significantly greater that estimates for
previous unselected student (DeBerard & Masters, 2014), trauma-exposed undergraduate (Flood
et al., 2009), and young adult community samples (Ware, 1994). Specific limitations due to
emotional difficulties were similar to scores reported in help-seeking medical (Burton et al.,
2012) and comorbid medical and psychiatric samples (McHorney et al., 1993) although estimates
of impairment resulting from physical concerns is generally higher in primary care and surgical
settings. It is possible that mild to intermediate levels of physical health impairment in the
current study masked potential effects on target outcomes. Bivariate associations of limitations
due to physical difficulties with perceived burdensomeness and thwarted belongingness
replicated those observed in the larger literature (e.g., Hirsch et al., 2016; Khazem et al., 2015).
However, the effects of SF-36 Role-Physical scores was no longer significant with the addition
of brooding and limitations due to emotional difficulties, suggesting that for emerging adults,
impairment arising from psychological concerns may exert a greater influence on unmet
interpersonal needs.
Homogeneity of the sample in terms of racial and ethnic background may also limit the
generalizability of findings. Epidemiological research suggests differential rates of exposure to
certain traumatic events across racial/ethnic groups in the U.S. with members of minority
communities less likely to receive services than White Europeans (Roberts et al., 2011). By
contrast, African American and Hispanic/Latino(a) Americans evidence lower rates of suicide as
compared to European Americans (Drapeau & McIntosh, 2018). Disparities are typically
attributed to variability in the role of family and social support in minority communities
(O’Donnell et al., 2004), suggesting that cultural differences and values of independence versus
collectivism may affect perceptions of burdensomeness and thwarted belongingness. Continued
research would help to clarify the extent to which cultural moderators affect the relation between
functional impairment and interpersonal needs.
Finally, measures utilized for the current study provided only general indices of global
emotional and physical functioning. Although role limitations due to emotional and physical
difficulties demonstrated expected associations with burdensomeness and belongingness, the
extent to which reported impairment was directly associated with index events identified by
participants unclear. It is possible impairment occurring in direct response to specific events
(e.g., chronic pain resulting from traumatic injury) may be more emotionally salient given the
acute onset of such difficulties (Clapp et al., 2010; Follick et al., 1985). While the current
approach permitted assessment of general impairment and its association with interpersonal
needs, future research should aim to examine impairment directly associated with experienced
traumatic events.
The present results offer support for the impact of brooding on the relation between
emotional role limitations and perceived burdensomeness in emerging adults exposed to
Criterion-A trauma. Effects are generally consistent with prior research noting the influences of
functional impairment and rumination on suicidal ideation and attempts. Findings indicate that
rumination may be an important target for suicide risk assessment and suicide specific
interventions among trauma exposed individuals.
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Table 1
Sample Characteristics (N =262)
Age 20.55 (4.77)
Sex (% female) 198 75.9%
European American
Index Trauma
Sexual Assault
Physical Assault
Motor Vehicle Accident
Witnessed Suicide
Threatened Death/Injury
Table 2
Means, Standard Deviations, and Correlations between Primary Study Variables
Measure 12345
1: INQ-10 Burden [.51, .67] [-.33, .06] [-.51, -.30] [.33, .54]
2: INQ-10 Belonging .59** [-.35, -.09] [-.57, -.38] [.32, .52]
3: Role-Physical -.20** -.23** [.42, .60] [-.43, -.17]
4: Role-Emotional -.41** -.48** .52** [-.58, -.39]
5: Brooding .44** .42** -.31** -.49**
M1.59 3.04 77.48 57.38 10.17
SD 0.90 1.46 32.22 42.22 3.64
*p < 0.05, **p < 0.01
Note: INQ-10 Burden = Interpersonal Needs Questionnaire - 10 Perceived Burdensomeness; INQ-10 Belonging = Interpersonal Needs
Questionnaire - 10 Thwarted Belongingness; Role-Physical = SF-36 Role Limitations due to Physical Problems; Role-Emotional =
SF-36 Role Limitations due to Emotional Problems; Brooding = Ruminative Response Scale—Brooding Subscale.
Table 3
Coefficients, Confidence Intervals, and Effect Sizes for Moderation of Perceived Burdensomeness and Thwarted Belongingness
R2β b β (SE) β CI95% p f2
INQ-10 Burden .269
Brooding .312 .077 .062 [.190, .434] < .001 .099
Role-Physical .046 .001 .064 [-.081, .173] .476 .003
Role-Emotional -.263 -.006 .069 [-.398, -.128] < .001 .056
BroodxRPa.047 .000 .059 [-.075, .159] .479 .002
BroodxREa-.179 -.001 .068 [-.326, -.057] .005 .030
INQ-10 Belonging .262
Brooding .253 .102 .062 [.132, .375] < .001 .067
Role-Physical .035 .002 .064 [-.091, .161] .585 .001
Role-Emotional -.376 -.013 068 [-.511, -.242] < .001 .122
Brooding x RPa.000 .000 .059 [-.117, .116] .995 .000
Brooding x REa.051 .001 .068 [-.079, .188] .426 .003
Note: Brood = Ruminative Response Scale—Brooding Subscale; Role-Physical = SF-26 Role Limitations due to Physical Problems;
Role-Emotional = SF-36 Role Limitations due to Emotional Problems.
Interpretive benchmarks for f2: small =.020, medium = .150, large = .350 (Cohen, 1988).
a Standardized coefficients for interaction terms were calculated as the product of standardized main effects, consistent with
procedures outlined by Aiken and West (1991, pg. 43).
Low Role-Emoonal (-1SD) High Role-Emoonal (+1SD)
Figure 1. Simple slopes analysis for the association of emotional role limitations and perceived burdensomeness for high and low
levels of brooding
High Brooding: b = -.010, p < .001, f2 = .092
Low Brooding: b = -.002, p = .476, f2 = .003
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