Brooding and Reflection as Subtypes of Rumination: Evidence from Confirmatory Factor Analysis in Nonclinical Samples using the Dutch Ruminative Response Scale

Concurrent and prospective associations of intolerance of uncertainty with symptoms of prolonged grief, posttraumatic stress, and depression after bereavement

This study examined associations of Prospective IU and Inhibitory IU with symptom-levels of Prolonged Grief Disorder (PGD), Posttraumatic Stress-Disorder (PTSD), and depression in a sample of bereaved individuals. Specifically, 265 bereaved individuals completed measures of IU, PGD, PTSD, and depression in the first year after the death of a loved one; 134 participants again completed symptom-measures six months later. Cross-sectional analyses showed that Inhibitory IU (but not Prospective IU) was positively associated with symptom-levels of PTSD and depression (but not PGD), even when controlling for neuroticism, worry, and rumination. Prospective analyses showed that Prospective IU (but not Inhibitory IU) at baseline, predicted PGD severity six months later (but not PTSD or depression at follow-up) while controlling for baseline symptom-levels. The findings support the notion that IU is a vulnerability factor for different emotional problems, including those developing after the death of a loved one. Clinical implications of these findings are discussed.

Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

Cognitive behavioural therapy for psychopathology in relatives of missing persons: study protocol for a pilot randomised controlled trial

BACKGROUND

It is hypothesized that the grieving process of relatives of missing persons is complicated by having to deal with uncertainty about the fate of their loved one. We developed a cognitive behavioural therapy (CBT) with mindfulness that focuses on dealing with this uncertainty. In this article, we elucidate the rationale of a pilot randomised controlled trial (RCT) for testing the feasibility and potential effectiveness of this CBT for reducing symptoms of psychopathology in relatives of missing persons.

METHODS

A pilot RCT comparing participants of the CBT condition (n = 15) with waiting list controls (n = 15) will be executed. Individuals suffering from psychopathology related to the long-term disappearance of a loved one are eligible to participate. The treatment consists of eight individual sessions. Questionnaires tapping psychological constructs will be administered before, during, and after the treatment. The feasibility of the treatment will be evaluated using descriptive statistics (e.g., attrition rate). The primary analysis consists of a within-group analysis of changes in mean scores of persistent complex bereavement disorder from baseline to immediately post-treatment and follow-up (12 and 24 weeks post-treatment).

DISCUSSION

A significant number of people experience the disappearance of a loved one. Surprisingly, an RCT to evaluate a treatment for psychopathology among relatives of missing persons has never been conducted. Knowledge about treatment effects is needed to improve treatment options for those in need of help. The strengths of this study are the development of a tailored treatment for relatives of missing persons and the use of a pilot design before exposing a large sample to a treatment that has yet to be evaluated. Future research could benefit from the results of this study.

TRIAL REGISTRATION

NTR4732 (The Netherlands National Trial Register (NTR)).

Moderating effects of brooding and co-rumination on the relationship between stress and depressive symptoms in early adolescence: a multi-wave study

The current study investigated brooding and co-rumination as moderators of the relationship between interpersonal and noninterpersonal stress and depressive symptom trajectories. The sample consisted of 368 early adolescents ages 9 to 15 (M = 11.72, 63 % female) who completed self-report measures of brooding, co-rumination, stress, and depressive symptoms at baseline with follow-up assessments of stress and depressive symptoms at 3, 8, and 12 months post-baseline. Data were analyzed using multi-level modeling. Results showed that the association between interpersonal stress and depressive symptoms was stronger for adolescents high on brooding, compared to adolescents low on brooding. Sex moderated a co-rumination × stress interaction, with girls high on co-rumination and boys low on co-rumination reporting the highest levels of depressive symptoms when faced with interpersonal stress across the 1-year study period. These findings shed light on pathways to depressive symptoms in early adolescence and suggest that adolescent boys and girls may differ in these pathways.

Rumination and Performance in Dynamic, Team Sport

People high in rumination are good at tasks that require persistence whereas people low in rumination is good at tasks that require flexibility. Here we examine real world implications of these differences in dynamic, team sport. In two studies, we found that professional male football (soccer) players from Germany and female field hockey players on the US national team were lower in rumination than were non-athletes. Further, low levels of rumination were associated with a longer career at a higher level in football players. Results indicate that athletes in dynamic, team sport might benefit from the flexibility associated with being low in rumination.

Rumination and self-reflection in stress narratives and relations to psychological functioning

The longitudinal study aims to expand what is known about the costs and benefits of narrating stressful experiences by exploring changes in rumination within the narrative process and comparing it to changes in self-reflection. Rumination (e.g., brooding, self-criticism, and negative emotions) and self-reflection were measured in stress narratives of 56 college students. There were several goals: (1) examine changes in narrative rumination and narrative self-reflection over 3 days of writing, (2) examine the relations among the changes in narrative rumination variables and narrative self-reflection and (3) examine how changes in narrative rumination and narrative self-reflection relate to multiple measures of psychological functioning. Overall, individuals increased self-reflection over the 3-day writing task. Individuals who increased ruminative brooding across the 3 days of writing showed lower ego identity development (short term and long term) and self-esteem (short term), while increased self-criticism was positively correlated with identity distress (short term). Implications of the different aspects of narrative rumination, specifically in the context of stressful experiences, are discussed.

Is Trait Rumination Associated with the Ability to Generate Effective Problem Solving Strategies? Utilizing Two Versions of the Means-Ends Problem-Solving Test

This study examined the relationship between trait rumination and the effectiveness of problem solving strategies as assessed by the Means-Ends Problem-Solving Test (MEPS) in a nonclinical population. The present study extended previous studies in terms of using two instructions in the MEPS: the second-person, actual strategy instructions, which has been utilized in previous studies on rumination, and the third-person, ideal-strategy instructions, which is considered more suitable for assessing the effectiveness of problem solving strategies. We also replicated the association between rumination and each dimension of the Social Problem-Solving Inventory-Revised Short Version (SPSI-R:S). Japanese undergraduate students (N = 223) completed the Beck Depression Inventory-Second Edition, Ruminative Responses Scale (RRS), MEPS, and SPSI-R:S. One half of the sample completed the MEPS with the second-person, actual strategy instructions. The other participants completed the MEPS with the third-person, ideal-strategy instructions. The results showed that neither total RRS score, nor its subscale scores were significantly correlated with MEPS scores under either of the two instructions. These findings taken together with previous findings indicate that in nonclinical populations, trait rumination is not related to the effectiveness of problem solving strategies, but that state rumination while responding to the MEPS deteriorates the quality of strategies. The correlations between RRS and SPSI-R:S scores indicated that trait rumination in general, and its brooding subcomponent in particular are parts of cognitive and behavioral responses that attempt to avoid negative environmental and negative private events. Results also showed that reflection is a part of active problem solving.

A randomized controlled trial of Mindfulness-Based Cognitive Therapy (MBCT) versus treatment-as-usual (TAU) for chronic, treatment-resistant depression: study protocol

BACKGROUND

Major depression is a common psychiatric disorder, frequently taking a chronic course. Despite provision of evidence-based treatments, including antidepressant medication and psychological treatments like cognitive behavioral therapy or interpersonal therapy, a substantial amount of patients do not recover. Mindfulness-Based Cognitive Therapy (MBCT) has been found to be effective in reducing relapse in recurrent depression, as well as lowering symptom levels in acute depression. The effectiveness of MBCT for chronic, treatment-resistant depression has only be studied in a few pilot trials. A large randomized controlled trial is necessary to examine the effectiveness of MBCT in reducing depressive symptoms in chronic, treatment-resistant depression.

METHODS/DESIGN

A randomized-controlled trial is conducted to compare MBCT with treatment-as-usual (TAU). Patients with chronic, treatment-resistant depression who have received antidepressant medication and cognitive behavioral therapy or interpersonal therapy are included. Assessments take place at baseline and post intervention/TAU-period. The primary outcome are depressive symptoms. Secondary outcomes are: remission rates, quality of life, rumination, mindfulness skills and self-compassion. Patients in the TAU condition are offered to participate in the MBCT after the post TAU-period assessment. From all completers of the MBCT (MBCT condition and patients participating after the TAU-period), follow-up assessments are taken at three and six months after the completion of the MBCT.

DISCUSSION

This trial will result in valuable information about the effectiveness of MBCT in chronic, treatment-resistant depressed patients who previously received antidepressant medication and psychological treatment.

TRIAL REGISTRATION

trialregister.nl NTR4843, registered 14th October 2014.

Internet-Based Exposure and Behavioral Activation for Complicated Grief and Rumination: A Randomized Controlled Trial

This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated grief and grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated grief, posttraumatic stress, depression, grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated grief, posttraumatic stress, and grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated grief and grief rumination (d=0.6-1.2), and for BA on complicated grief, posttraumatic stress, and grief rumination (d=0.8-0.9). EX reduced depression more strongly than BA (d=0.6). Completers analyses corroborated results for EX, and partially those for BA, but no group differences were detected. BA suffered from high dropout (59%), relative to EX (33%) and the waiting-list (17%). Feasibility appeared higher for EX than BA. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination.

Trial for the Prevention of Depression (TriPoD) in final-year secondary students: study protocol for a cluster randomised controlled trial

BACKGROUND

Evidence suggests that current treatments cannot fully alleviate the burden of disease associated with depression but that prevention approaches offer a promising opportunity to further reduce this burden. Adolescence is a critical period in the development of mental illness, and final school examinations are a significant and nearly universal stressor that may act as a trigger for mental health difficulties such as depression. The aim of the present trial is to investigate the impact of SPARX-R, an online, gamified intervention based on cognitive behavioural principles, on the prevention of depression in secondary school students before their final examinations.

METHODS/DESIGN

Government, independent and Catholic secondary schools in New South Wales, Australia, will be recruited to participate in the trial. All students enrolled in their final year of high school (year 12) in participating schools will be invited to participate. To account for possible attrition, the target sample size was set at 1600 participants across 30 schools. Participating schools will be cluster randomised at the school level to receive either SPARX-R or lifeSTYLE, an attention-controlled placebo comparator. The control intervention is an online program aimed at maintaining a healthy lifestyle. The primary outcome will be symptoms of depression, and secondary outcomes will include symptoms of anxiety, suicidal ideation and behaviours, stigma and academic performance. Additional measures of cost-effectiveness, as well as process variables (e.g., adherence, acceptability) and potential predictors of response to treatment, will be collected. Consenting parents will be invited to complete measures regarding their own mental health and expectations for their child. Assessments will be conducted pre- and post-intervention and at 6- and 18-month follow-up. Primary analyses will compare changes in levels of depressive symptomatology for the intervention group relative to the attention control condition using mixed-effects model repeated-measures analyses to account for clustering within schools.

DISCUSSION

This is the first trial of a universal depression prevention intervention delivered to school students in advance of a specific, significant stressor. If found to be effective, this program may offer schools a new approach to preparing students for their final year of schooling.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry identifier: ACTRN12614000316606 . Registered 25 March 2014.

Factor Structure of the Ruminative Responses Scale

Abstract. The 10-item Ruminative Responses Scale is used to measure two facets of rumination: brooding and reflection. These subscales are used to seek differential correlations with other variables of interest (e.g., depression). The validity of these facets, however, is questionable because brooding and reflection were distinguished based on factor analyses, but subsequent analyses have been inconsistent. We investigated these facets using factor analyses in a large community-based sample (N = 625). Other measures of rumination and depression were used as criteria for validity analyses. Only the brooding items formed a robust scale. A consistent reflection factor did not emerge. Brooding showed convergent validity with other measures of rumination as well as depression, all rs > .4. Brooding was also higher among participants with a history of depression compared with never-depressed participants. Implications for the interpretation of past research and for conducting future research are discussed.

Phenomenological aspects of the cognitive rumination construct

OBJECTIVE

To evaluate the importance of phenomenological aspects of the cognitive rumination (CR) construct in current empirical psychiatric research.

METHOD

We searched SciELO, Scopus, ScienceDirect, MEDLINE, OneFile (GALE), SpringerLink, Cambridge Journals and Web of Science between February and March of 2014 for studies whose title and topic included the following keywords: cognitive rumination; rumination response scale; and self-reflection. The inclusion criteria were: empirical clinical study; CR as the main object of investigation; and study that included a conceptual definition of CR. The studies selected were published in English in biomedical journals in the last 10 years. Our phenomenological analysis was based on Karl Jaspers' General Psychopathology.

RESULTS

Most current empirical studies adopt phenomenological cognitive elements in conceptual definitions. However, these elements do not seem to be carefully examined and are indistinctly understood as objective empirical factors that may be measured, which may contribute to misunderstandings about CR, erroneous interpretations of results and problematic theoretical models.

CONCLUSION

Empirical studies fail when evaluating phenomenological aspects of the cognitive elements of the CR construct. Psychopathology and phenomenology may help define the characteristics of CR elements and may contribute to their understanding and hierarchical organization as a construct. A review of the psychopathology principles established by Jasper may clarify some of these issues.

Coexistence and different determinants of posttraumatic stress disorder and posttraumatic growth among Chinese survivors after earthquake: role of resilience and rumination

Posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) are two different outcomes that may occur after experiencing traumatic events. Resilience and rumination are two important factors that determine the development of these outcomes after trauma. We investigated the association between these two factors, PTSD and PTG, among Chinese survivors in an earthquake. With a convenience sample of 318 survivors from earthquake, we measured trauma exposure, PTSD, PTG, resilience, and rumination (Impact of Event Scale-Revised, Posttraumatic Growth Inventory, 10 item Connor-Davidson Resilience Scale, Ruminative Response Scale). Then we used bivariate correlation and structural equation modeling to examine the structure of relations among these factors. Results showed that resilience and reflective rumination have a positive effect on PTG (β = 0.32, p < 0.001; β = 0.17, p = 0.049). Earthquake exposure, brooding rumination and depressed-related rumination are related with higher level of PTSD (β = 0.10, p = 0.021; β = 0.33, p < 0.001; β = 0.36, p < 0.001). The findings suggest distinct determinants of the negative and positive outcomes, and this may provide better understanding about the risk and protective factors for traumatic reactions.

PROSPECTIVE ASSOCIATIONS OF DEPRESSIVE RUMINATION AND SOCIAL PROBLEM SOLVING WITH DEPRESSION: A 6-MONTH LONGITUDINAL STUDY(.)

The main purpose of this study was to examine whether depressive rumination and social problem solving are prospectively associated with depressive symptoms. Nonclinical university students (N = 161, 64 men, 97 women; M age = 19.7 yr., SD = 3.6, range = 18-61) recruited from three universities in Japan completed the Beck Depression Inventory-Second Edition (BDI-II), the Ruminative Responses Scale, Social Problem-Solving Inventory-Revised Short Version (SPSI-R:S), and the Means-Ends Problem-Solving Procedure at baseline, and the BDI-II again at 6 mo. later. A stepwise multiple regression analysis with the BDI-II and all subscales of the rumination and social problem solving measures as independent variables indicated that only the BDI-II scores and the Impulsivity/carelessness style subscale of the SPSI-R:S at Time 1 were significantly associated with BDI-II scores at Time 2 (β = 0.73, 0.12, respectively; independent variables accounted for 58.8% of the variance). These findings suggest that in Japan an impulsive and careless problem-solving style was prospectively associated with depressive symptomatology 6 mo. later, as contrasted with previous findings of a cycle of rumination and avoidance problem-solving style.

Influence of maternal depression on children's brooding rumination: Moderation by CRHR1 TAT haplotype

There is growing evidence that brooding rumination plays a key role in the intergenerational transmission of major depressive disorder (MDD) and may be an endophenotype for depression risk. However, less is known about the mechanisms underlying this role. Therefore, the goal of the current study was to examine levels of brooding in children of mothers with a history of MDD (n = 129) compared to children of never depressed mothers (n = 126) and to determine whether the variation in a gene known to influence hypothalamic-pituitary-adrenal axis functioning--corticotropin-releasing hormone receptor 1 (CRHR1)--would moderate the link between maternal MDD and children's levels of brooding. We predicted children of mothers with a history of MDD would exhibit higher levels of brooding than children of mothers with no lifetime depression history but that this link would be stronger among children carrying no copies of the protective CRHR1 TAT haplotype. Our results supported these hypotheses and suggest that the development of brooding among children of depressed mothers, particularly children without the protective CRHR1 haplotype, may serve as an important mechanism of risk for the intergenerational transmission of depression.

Depressive Rumination and Social Problem Solving in Japanese University Students

The relationship between depressive rumination and dimensions of social problem solving were investigated in a Japanese, nonclinical population. University students (N = 227) completed the Beck Depression Inventory-Second Edition, Ruminative Responses Scale, Means-Ends Problem-Solving (MEPS) test, and Social Problem-Solving Inventory-Revised Short Version (SPSI-R:S). Results indicated that after controlling for depression, trait rumination, especially its brooding subcomponent, was positively correlated with negative problem orientation and avoidance style. Unexpectedly, trait rumination was weakly but positively associated with an effective problem-solving style, as assessed by the SPSI-R:S and MEPS. These findings suggest that one pathway through which rumination leads to depression in nonclinical populations could be through increasing negative problem orientation and avoidance problem-solving style. Results also suggested that reflection, compared to brooding, was positively associated with positive problem orientation and more strongly associated with rationale problem-solving style. These findings suggest that reflection leads to active problem solving.

The neural basis of unwanted thoughts during resting state

Human beings are constantly engaged in thought. Sometimes thoughts occur repetitively and can become distressing. Up to now the neural bases of these intrusive or unwanted thoughts is largely unexplored. To study the neural correlates of unwanted thoughts, we acquired resting-state fMRI data of 41 female healthy subjects and assessed the self-reported amount of unwanted thoughts during measurement. We analyzed local connectivity by means of regional homogeneity (ReHo) and functional connectivity of a seed region. More unwanted thoughts (state) were associated with lower ReHo in right dorsolateral prefrontal cortex (DLPFC) and higher ReHo in left striatum (putamen). Additional seed-based analysis revealed higher functional connectivity of the left striatum with left inferior frontal gyrus (IFG) in participants reporting more unwanted thoughts. The state-dependent higher connectivty in left striatum was positively correlated with rumination assessed with a dedicated questionnaire focussing on trait aspects. Unwanted thoughts are associated with activity in the fronto-striatal brain circuitry. The reduction of local connectivity in DLPFC could reflect deficiencies in thought suppression processes, whereas the hightened activity in left striatum could imply an imbalance of gating mechanisms housed in basal ganglia. Its functional connectivity to left IFG is discussed as the result of thought-related speech processes.

If I only knew why: the relationship between brooding, beliefs about rumination, and perceptions of treatments

People who tend to engage in brooding, the maladaptive subtype of rumination, are at risk to develop depression. Brooders often endorse metacognitive beliefs that self-focused ruminative thinking is beneficial. In the current study, we examined whether brooding and positive beliefs about rumination are associated with perceptions of and preferences for treatments for depression. Participants (N=118) read descriptions of two different clusters of treatments for depression, Insight-Oriented (IO) treatments and Activation-Oriented (AO) treatments. They then rated treatment efficacy and credibility and completed self-report measures of rumination (including brooding and reflection subscales), beliefs about rumination, and depression. Brooding and metacognitive positive beliefs about rumination were associated with positive perceptions of IO (but not AO) treatments. Positive beliefs about rumination contributed to the prediction of perceptions of IO treatments (but not AO treatments) beyond the effect of brooding. We discuss the implications of these findings for individuals' decision-making processes regarding which type of treatment to seek.

Reduced autobiographical memory specificity relates to weak resistance to proactive interference

BACKGROUND AND OBJECTIVES

Reduced autobiographical memory specificity (rAMS), experiencing intrusive memories, and rumination appear to be risk factors for depression and depressive relapse. The aim of the current study was to investigate whether a weak resistance to proactive interference (PI) might underlie this trio of cognitive risk factors. Resistance to PI refers to being able to ignore cognitive distracters that were previously relevant but became irrelevant for current task goals.

METHOD

Students (N = 65) and depressed patients (N = 37) completed tasks measuring resistance to PI and AMS, and completed questionnaires on intrusive memories and rumination.

RESULTS

In both samples, weaker resistance to PI was associated with rAMS. There was no evidence for a relationship between resistance to PI and intrusive memories or rumination.

LIMITATIONS

As we did not assess other measures of executive functioning, we cannot conclude whether the observed relationship between rumination and PI is due to unique qualities of PI.

CONCLUSIONS

Difficulties to deliberately recall specific, rather than general or categoric autobiographical memories appear to be related to more general problems with the inhibition of interference of mental distracters. The results are in line with the executive control account of rAMS.

Depressive Rumination and Past Depression in Japanese University Students: Comparison of Brooding and Reflection

The Ruminative Responses Scale, a measure of depressive rumination, contains two subscales: Brooding and Reflection. Treynor, Gonzalez, and Nolen-Hoeksema (2003) proposed that Brooding is maladaptive and Reflection is adaptive. This article examined the relationships among Brooding, Reflection, and previous depression in two samples of Japanese undergraduates, who were non-depressed at the time of their participation. Based on answers to a self-report measure, participants were divided into a formerly depressed group, who had experienced an episode that met the criteria for major depression, and a never-depressed group. Logistic regression analyses were conducted with Brooding, Reflection, and current depression as the independent variables and past depression as the dependent variable. Brooding had consistent positive associations with past depression. The relationship between Reflection and past depression was not significant for one sample, but was statistically significant and positive in the second sample. In the second sample, Brooding and Reflection both were related with past depression after controlling for worry.

Interpretation bias characterizes trait rumination

BACKGROUND AND OBJECTIVES

Rumination, a maladaptive cognitive style of responding to negative mood, is thought to be maintained by a variety of cognitive biases. However, it is unknown whether rumination is characterized by interpretation biases.

METHODS

Two experiments examined the link between rumination and interpretation biases, revealed in lexical-decision tasks (LDT). A homograph with both benign and ruminative or otherwise negative meaning was presented on each trial and followed by a letter string, to which participants responded by judging whether it was a word or a non-word. Letter strings were non-words or words related or unrelated to one meaning of the homograph.

RESULTS

In both experiments, faster latencies to respond to targets related to the ruminative meaning of the homographs were produced by students with higher scores on self-report measures of rumination. Moreover, these biases were associated with both brooding, the maladaptive form of rumination, and reflection, the more adaptive component. No measure of rumination was significantly correlated with general biases toward negative meaning (Experiment 1) or with threatening interpretations of homographs (Experiment 2).

LIMITATIONS

The paucity of available rumination-related homographs dictated the use of non-fully randomized stimuli presentation (Experiment 1) or the use of only one set of the meanings associated with the homographs (Experiment 2).

CONCLUSIONS

Rumination is associated with a tendency to interpret ambiguous information in a rumination-consistent manner. This tendency may exacerbate ruminative thinking and can possibly be a target for future intervention.

Translation and initial validation of the Japanese version of the Ruminative Responses Scale

The Ruminative Responses Scale (RRS) is a measure of depressive rumination and, although several versions have been developed, the version by Treynor and colleagues has been used most frequently in research. This version contains two subscales: Brooding and Reflection. In the present study, the 22-item RRS was translated into Japanese and psychometric properties of the measure were examined in two samples of Japanese undergraduate students (ns = 299 and 56). Confirmatory factor analysis indicated that a two-factor model of the RRS showed a moderate to good fit to the data. The total and subscale scores indicated adequate reliability and construct validity. Consistent with previous studies, correlational analyses indicated that Brooding, rather than Reflection, assessed maladaptive aspects of rumination. The Japanese RRS was shown to be a reliable and valid measure that has the potential to contribute to future depression research and clinical practice.

Cognitive inflexibility and suicidal ideation: mediating role of brooding and hopelessness

Previous research suggests that cognitive inflexibility prospectively increases vulnerability to suicidal ideation, but the specific cognitive factors that may explain the relation have not been examined empirically. The present study examined the brooding subtype of rumination and hopelessness as potential mediators of the prospective relation between cognitive inflexibility and suicidal ideation. Fifty-six young adults who completed a measure of cognitive inflexibility and suicidal ideation at baseline were followed up 2-3 years later and completed measures of brooding, hopelessness, and suicidal ideation. Cognitive inflexibility at baseline predicted suicidal ideation at follow up, adjusting for baseline ideation. This relation was mediated by brooding but not by hopelessness. However, there was an indirect relation between perseverative errors and suicidal ideation through brooding, followed by hopelessness, such that brooding was associated with greater hopelessness and hopelessness, in turn, was associated with greater suicidal ideation. Cognitive inflexibility may increase vulnerability to suicidal thinking because it is associated with greater brooding rumination, while brooding, in turn, is associated with hopelessness.

Longitudinal Predictions of the Brooding and Reflection Subscales of the Japanese Ruminative Responses Scale for Depression

The Ruminative Responses Scale (RRS) is a measure of depressive rumination which has two subscales: Brooding and Reflection. This article examines the longitudinal predictions for depression and the test-retest reliability of the Brooding and Reflection of the Japanese RRS. Japanese university students ( N = 378) completed the RRS, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Inventory to Diagnose Depression, Lifetime Version (IDDL) which was modified to assess symptoms experienced in the 8-wk. follow-up period. The standardized betas of the initial Brooding and Reflection subscales for the IDDL scores were significant and positive after controlling for baseline CES-D scores, but those for the CES-D scores at Time 2 were not significant. Longitudinal predictions of Brooding were partially consistent with those of other language versions (significant in almost all studies); however, longitudinal predictions of Reflection were not consistent with those of other language versions (negative in previous studies). The test-retest correlations of both subscales were similar to those obtained in Western countries.

The relationship between worry, rumination, and comorbidity: evidence for repetitive negative thinking as a transdiagnostic construct

BACKGROUND

Repetitive negative thinking (RNT) increases vulnerability to multiple anxiety and depressive disorders and, as a common risk factor, elevated RNT may account for the high levels of comorbidity observed between emotional disorders. The aims of this study were to (a) compare two common forms of RNT (worry and rumination) across individuals with non-comorbid anxiety or depressive disorders, and (b) to examine the relationship between RNT and comorbidity.

METHODS

A structured diagnostic interview and measures of rumination, worry, anxiety, and depression were completed by a large clinical sample with an anxiety disorder or depression (N=513) presenting at a community mental health clinic.

RESULTS

Patients without (n=212) and with (n=301) comorbid diagnoses did not generally differ across the principal diagnosis groups (depression, generalised anxiety disorder, social anxiety disorder, panic disorder) on worry or rumination. As predicted, comorbidity was associated with a higher level of RNT.

LIMITATIONS

Cross-sectional design precluded causal conclusions and findings may not generalize to excluded anxiety disorders.

CONCLUSIONS

Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.

How brooding minds inhibit negative material: an event-related fMRI study

Depressive brooding - a passive ruminative focus on one's problems, negative mood and their consequences - is a thinking style that places individuals at a greater risk to develop future psychopathology. In this study, we investigated whether inter-individual differences in depressive brooding are related to neural differences underlying the inhibition of a dominant response towards negative information in favor of the concurrent (positive) response. To exclude the possibility that information processes would be confounded by sustained negative mood or enhanced stress responses, a sample of thirty never-depressed healthy individuals was selected. The Cued Emotional Control Task (CECT) was used to index the ability to enhance cognitive control when encountering a negative stimulus associated with an incompatible stimulus-response mapping. Individual brooding scores were not related to behavioral performances on the CECT. On the other hand, whole brain analyses demonstrated that trait depressive brooding scores were positively associated with activation in the posterior parts of the dorsal anterior cingulate cortex (pdACC) while successfully inhibiting a response to negative relative to positive information. These findings demonstrate that brooding minds need to recruit more pdACC activation when inhibiting a dominant response towards negative information (in favor of a response towards positive), although they are performing similarly as low brooders at the behavioral level. Future research should investigate whether and how these brooding related neural adjustments in healthy volunteers are related to future psychopathology.

Why ruminators won't stop: the structural and resting state correlates of rumination and its relation to depression

BACKGROUND

Rumination is a good predictor of major depression. The current study explores the structural and functional neural correlates of rumination.

METHODS

To explore structural correlates of rumination (RRS, Treynor et al., 2003) we used voxel-based morphometry. We relate these correlates of rumination to concurrence of grey matter reductions in depressed patients by means of a quantitative meta-analysis on 16 VBM studies. Resting state data was used to compute maps of the amplitude of low frequency fluctuations.

RESULTS

Rumination correlated negatively with grey matter volume in bilateral inferior frontal gyrus (IFG), left anterior cingulate cortex (ACC), and bilateral mid cingulate cortex. The volume reductions were within proximity of grey matter reductions identified in the meta-analysis on depressed patients in bilateral IFG and ACC. Moreover reductions in resting state activity were overlapping with volume reductions correlated with rumination in ACC and right IFG.

LIMITATIONS

The participants were all healthy control subjects. Future research is needed to explore the neural correlates of rumination in major depression.

CONCLUSIONS

The results show that rumination is associated with volume and resting state reductions in brain areas that have been related to cognitive control process of inhibition and thought suppression. We conclude that rumination not only qualifies as a behavioural predictor of major depression but also goes along with neuroanatomical abnormalities that are similar to those identified for depression.

Repetitive thought and self-reported sleep disturbance

Repetitive thought has been focused upon as a transdiagnostic risk factor for depression, anxiety, and poor physical health. Among the forms of repetitive thought, rumination and worry are considered to play important roles in the onset and maintenance of insomnia. However, there have been few attempts to clarify the similarities, differences, and interaction between the functions of rumination and worry in sleep problems. Furthermore, no study has investigated the prospective relationships between these two forms of repetitive thought and sleep disturbance. In the present study, we examined the prospective associations between repetitive thought and subjective sleep quality, measured by a self-report questionnaire. A total of 208 undergraduates participated in a 2-wave longitudinal survey with an interval of 3weeks between assessments. Hierarchical multiple regression analyses showed that baseline rumination predicted reduction in the follow-up assessment of subjective sleep quality, controlling for levels of depressive and anxious symptoms. This main effect of rumination was qualified by the levels of worry; for individuals with higher levels of worry, rumination was associated with greater reduction in subjective sleep quality. These results suggest that both rumination and worry have unique associations with sleep and that their interaction is especially important in sleep problems.

Rumination relates to reduced autobiographical memory specificity in formerly depressed patients following a self-discrepancy challenge: the case of autobiographical memory specificity reactivity

BACKGROUND AND OBJECTIVES

Reduced Autobiographical Memory Specificity (rAMS) is a hypothesized vulnerability factor for depression. Rumination is thought to be one of the processes underlying rAMS, but research has failed to show an association between trait rumination and rAMS in individuals who are not currently depressed (e.g., community samples, college samples, and formerly depressed samples). The present study tested whether a challenge procedure that induces a self-discrepancy focus can elicit an association between trait rumination and rAMS in formerly depressed participants.

METHODS

Trait rumination was assessed via self-report. Measures of psychopathology and cognitive function, including depression, were assessed via self-report and interview. Autobiographical Memory Specificity (AMS) was evaluated before and after the induction of a self-discrepancy focus in formerly depressed participants.

RESULTS

Results showed that trait rumination was indeed negatively correlated with AMS after, but not before the induction. Moreover, high trait ruminating participants showed a decrease in AMS following the induction. In other words, memory specificity was reactive to the induction, but no such decrease was observed in low trait ruminating individuals.

LIMITATIONS

This study is mostly of women. These results may not generalize well to men. Our experimental control was within-subjects, which, although powerful and economical, cannot rule out certain confounding processes including natural changes in self-discrepancy, or non-specific or unintended effects of the induction.

CONCLUSIONS

In order to detect rAMS in formerly depressed individuals or to observe associations between rAMS and trait measures of rumination, state ruminative processing needs to be activated. Results are discussed by framing rAMS as an example of cognitive reactivity, a general type of processing that is associated with depression.

Memory specificity in borderline personality disorder: associations with depression and self-discrepancy

Reduced memory specificity (RMS) is a robust finding in (previously) depressed patients and patients suffering from posttraumatic symptoms. It has been associated with depression severity, rumination, and--more recently--with cue content (e.g., cues referring to highly discrepant self-guides are assumed to hinder specific memory retrieval more likely than cues that match one's self-concept). In this study we have investigated the presence of these relationships in 34 patients diagnosed with borderline personality disorder (BPD). All participants completed the Self-Description Questionnaire (SDQ), the Autobiographical Memory Test (AMT), the Beck Depression Inventory (BDI-II), and the Ruminative Response Scale (RRS). First, it was observed that both rumination and depression severity were associated with RMS. However, when confounding between rumination and depression severity was considered using partial correlations, only depression severity was found to be significantly associated with RMS. Second, in the currently depressed BPD patients (n = 11), memory specificity was significantly related to cue content suggesting that, at least for depressed BPD patients RMS is related to the extent to which cues activate highly discrepant personal domains. Although our data suggest that depression severity as well as current depression (in interaction with cue content) play an important role in the occurrence of RMS in BPD, we will discuss that these findings could be moderated by posttraumatic stress and/or executive functioning.

Validation of the Dutch Version of the Perseverative Thinking Questionnaire (PTQ-NL)

Repetitive negative thinking (RNT) has been shown to be involved in the maintenance of a variety of emotional problems. In addition, earlier research found that different forms of RNT such as worry and rumination show very similar characteristics. It was therefore suggested that RNT is best conceptualized as a transdiagnostic process. The Perseverative Thinking Questionnaire (PTQ) was developed as a content-independent measure of RNT to allow research into this process from a transdiagnostic perspective. In a recent study, good psychometric properties were established for the original German and English versions of the measure. The current study describes the crossvalidation of the PTQ in two Dutch-speaking samples, one from the Netherlands and one from Belgium (total N = 1,845). The factor structure of the original PTQ with one higher-order factor and three lower-order factors was replicated for the Dutch-language version of the measure (PTQ-NL) using confirmatory factor analyses. In addition, the PTQ-NL showed good internal consistency and satisfactory stability. The validity of the measure was supported by substantial correlations with existing measures of RNT as well as with symptom levels of depression and anxiety.