Ruminative thought style and depressed mood

Setting the scene for boundary extension: Methods, findings, connections, and theories

A previously viewed scene is often remembered as containing a larger extent of the background than was actually present, and information that was likely present just outside the boundaries of that view is often incorporated into the representation of that scene. This has been referred to as boundary extension. Methodologies used in studies on boundary extension (terminology, stimulus presentation, response measures) are described. Empirical findings regarding effects of characteristics of the stimulus (whether the stimulus depicts a scene, semantics of the scene, view angle, object size, object cropping, object orientation, object color, number of objects, depth of field, object distance, viewpoint production, scene orientation, motion, faces, emotions, modality, whether the scene is multimodal), characteristics of the display (aperture shape, aperture size, target duration, retention interval), and characteristics of the observer (allocation of attention, imagination, age, expectations and strategies, eye fixation, eye movements, monocular or binocular view, vantage point, confinement, prior exposure, expertise, arousal, pathology) on boundary extension are reviewed. Connections of boundary extension to other cognitive phenomena and processes (evolutionary adaptation, Gestalt principles, illusions, psychophysics, invariant physical principles, aesthetics, temporal boundary extension, normalization) are noted, and theories and theoretical considerations regarding boundary extension (multisource model, boundary transformation, mental imagery, 4E cognition, cognitive modularity, neurological mechanisms of scene representation) are discussed.

What is high rumination?

OBJECTIVE

The current paper tries to illuminate the need for standard cutoff points.

INTRODUCTION

rumination is considered to be a transdiagnostic process leading to a variety of consequences. But, what is prominent ruminative tendency? Are there agreed-upon specifications or cutoff points that distinguish between high and low tendency to ruminate? In an attempt to answer these questions, we reviewed 25 works that compared people characterized as high or low in rumination. We found numerous inconsistencies in the characterization criteria and a great variability in cutoff points. Most studies did not provide enough information about the cutoff criteria or values.

METHOD

We examined a sample of 454 participants using the RRS (Ruminative Response Scale), from which we tried to identify standard cutoff points.

RESULTS SHOWED

1) distributions of RRS, brooding and reflective pondering; 2) most studies used median split, which might explain the differences among studies; 3) examination of standard scores for the various cutoffs presented big variability among the studies; and 4) women had higher scores of rumination and brooding than men.

CONCLUSION

Our paper highlights the need for homogeneity in the field. It suggests addressing the RRS, brooding and reflective pondering distributions as references for future studies. We recommend specifying: cutoff criteria, cutoff values, range, means and standard deviations. Researchers should consider the specific population (i.e., men vs. women or clinical vs. non clinical) of interest and infer specific cutoff points accordingly. Importantly, researchers should consider the implications of their choice of cutoff points and apply their criterion accordingly.

Rumination and Overrecruitment of Cognitive Control Circuits in Depression

BACKGROUND

Rumination is associated with greater cognitive dysfunction and treatment resistance in major depressive disorder (MDD), but its underlying neural mechanisms are not well understood. Because rumination is characterized by difficulty in controlling negative thoughts, the current study investigated whether rumination was associated with aberrant cognitive control in the absence of negative emotional information.

METHODS

Individuals with MDD (n = 176) and healthy control individuals (n = 52) completed the stop signal task with varied stop signal difficulty during functional magnetic resonance imaging. In the task, a longer stop signal asynchrony made stopping difficult (hard stop), whereas a shorter stop signal asynchrony allowed more time for stopping (easy stop).

RESULTS

In participants with MDD, higher rumination intensity was associated with greater neural activity in response to difficult inhibitory control in the frontoparietal regions. Greater activation for difficult inhibitory control associated with rumination was also positively related to state fear. The imaging results provide compelling evidence for the neural basis of inhibitory control difficulties in individuals with MDD with high rumination.

CONCLUSIONS

The association between higher rumination intensity and greater neural activity in regions involved in difficult inhibitory control tasks may provide treatment targets for interventions aimed at improving inhibitory control and reducing rumination in this population.

Homocysteine, hopelessness, rumination, affective temperaments, and clinical course in patients with bipolar disorder-1

PURPOSE

This study aimed to explore the associations between homocysteine, rumination, affective temperaments, clinical features, and hopelessness in bipolar disorder-1 (BD-1).

MATERIALS AND METHODS

In total, 57 euthymic patients with BD-1 and 57 healthy controls were included. The Beck Hopelessness Scale (BHS), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Ruminative Responses Scale Short Form (RRS-SF) were administered. Homocysteine, folate, and vitamin B12 levels were measured.

RESULTS

The BHS total (p = 0.047), TEMPS-A irritable (p = 0.007), and TEMPS-A cyclothymic (p= 0.001) scores were significantly higher than the control group in the BD-1 group. Hyperhomocysteinemia (HHcy) was found in 33.3% of the patients (n = 19). In the HHcy group, age of onset of disease (p = 0.020) was significantly lower than the non-HHcy group in patients. Previous suicide attempt number was significantly correlated with scores of reflective pondering, brooding, and global rumination in BD-1 (p ˂ 0.05). Except for hyperthymic temperament, all types of affective temperaments were correlated with the scores of RRS-SF brooding (p ˂ 0.05) in the BD-1 group. The RRS-SF brooding scores significantly correlated with the BHS total scores (r = 0.263, p < 0.05); the TEMPS-A hyperthymic (β = -0.351, p = 0.001) and TEMPS-A irritable (β = 0.536, p < 0.001) scores significantly predicted the BHS total scores in the BD-1 group.

CONCLUSIONS

The findings may lead clinical efforts and future clinical trials to explore and intervene in related sources and presentations of BD-1's adverse consequences.

Relationships Between Function, Pain Severity and Psychological and Cognitive Levels in People With Chronic Neck Pain: Cross-Sectional Study

OBJECTIVE

This study aimed to investigate the relationship between pain and functional levels with pain catastrophizing, rumination, decision-making, and critical thinking in people with chronic neck pain.

METHODS

The study included 62 patients with chronic neck pain who had presented to a physiotherapy center with pain complaints for at least 3 months. The visual analog scale for pain severity, the Neck Disability Index for functional level, the Pain Catastrophizing Scale, the Ruminative Thinking Scale, the Melbourne Decision-Making Scale I-II, and the Marmara Critical Thinking Inventory were used for assessments.

RESULTS

Activity pain, night pain, and disability were positively correlated with rumination (rho: 0.368, p = .003; rho: 0.423, p = <.001; rho = 0.334, p = .008). There was a positive correlation between night pain, disability, and pain catastrophizing (rho = 0.298, p = .019; rho = .434 p < .001). A negative correlation was observed between patients' pain severity and disability with critical thinking scores (rho = -0.393, p = .002; rho = -0.377 p = .003, rho = -0.428 p < .001, rho = -0.441 p < .001).

CONCLUSIONS

The study suggested that there were positive correlations between pain severity and disability with rumination and pain catastrophizing. Additionally, chronic neck pain was found to have negative correlations with critical thinking scores, indicating potential impacts on cognitive processes. These findings may provide insights into the complex interplay between chronic pain and psychological factors, which can inform the development of interventions to enhance chronic pain management.

Exploring the Personality Characteristics of Rhinoplasty Patients: Perfectionism, Rumination, and Self-Compassion

OBJECTIVE

This study investigates differences in personality characteristics, including perfectionism, ruminative thinking style, and self-compassion, between individuals who have undergone rhinoplasty and a control group without any history of cosmetic surgery.

METHODS

The study included 33 adult patients who underwent rhinoplasty between 2021 and 2023 at Bursa Uludağ University Faculty of Medicine Hospital and 33 adult patients who visited our centre for other complaints as a control group. The rhinoplasty group consisted of primary surgical patients with functional and cosmetic concerns, excluding those who sought revision surgery or had only functional problems. The control group consisted of individuals with no prior cosmetic surgery history and no expectations of aesthetic interventions. Psychiatric analysis was performed using Frost multidimensional perfectionism scale, ruminative thinking style questionnaire, and self-compassion scale.

RESULTS

This research revealed that individuals who had rhinoplasty scored higher in perfectionism 109.3 (±23.3) and ruminative thinking 87.9 (±22) compared to those who did not undergo surgery 94.15 (±22.2) and 77.7 (±23), respectively. Additionally, the rhinoplasty group had lower self-compassion scores, 80.4 (±17.3), than the control group, 86.1 (±11.2). Statistically significant differences were observed in perfectionism between the groups (p = 0.009). In rhinoplasty patients, a notably positive correlation was found between perfectionism and ruminative thinking scores (r = 0.482; p = 0.005), while a moderately significant negative correlation was observed between self-compassion and ruminative thinking scores (r = - 0.465; p = 0.006).

CONCLUSION

Individuals who undergo rhinoplasty generally show increased levels of perfectionism and are more prone to ruminative thinking. They also demonstrate reduced self-compassion compared to non-surgical control groups. Cosmetic surgeons should be aware of these psychological trends and consider using appropriate scales during pre-surgery consultations and follow-up visits. Adopting this informed approach can improve the surgeon-patient relationship and help overcome communication challenges.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Association Between Rumination and Craving in Chinese Methamphetamine-Dependent Patients: The Masking Effect of Depression

BACKGROUND

Craving is a core feature of addiction. Rumination and depression play a crucial role in the process of methamphetamine addiction. The aim of this study was to examine the relationship between rumination, depression and craving in methamphetamine patients, which has not been explored yet.

METHODS

A total of 778 patients with methamphetamine user disorder (MUD) at the Xinhua Drug Rehabilitation Center, located in Mianyang City, Sichuan Province, China. We used a set of self-administered questionnaires that included socio-demographic, detailed drug use history, rumination, depression and craving information. The Rumination Response Scale (RRS) was used to measure rumination, the Beck Depression Inventory (BDI) to measure depression and the Visual Analogue Scale (VAS) to measure craving.

RESULTS

There was a significant positive correlation between rumination and craving, or depression, and between depression and craving. Furthermore, depression mediated between rumination and craving, with a mediation effect of 160%.

CONCLUSIONS

Our findings suggest that there is a close interrelationship between rumination, craving and depression in MUD patients, and that depression may play a mediating role between rumination and craving.

Rumination and Forgiveness in Emerging Adults: Mediating Role of Mindfulness and Humility

The objective of this study was to examine whether mindfulness and humility mediate the influence of rumination on forgiveness among emerging adults. The sample consisted of 392 individuals in the emerging adulthood stage, residing in Türkiye, with 69.10% females and 30.90% males, aged between 18 and 25 years (M = 20.19, SD = 1.77). Data were collected through a demographic information form and four self-report scales. In addition to descriptive statistics, Pearson's correlation coefficient and bootstrap analysis were employed for data analysis. According to the study's findings, it can be inferred that ruminative thoughts among emerging adults hinder their ability to forgive. Furthermore, the study revealed that mindfulness and humility serve as mediators in the relationship between ruminative thoughts and forgiveness in emerging adults. In this context, it can be concluded that leveraging the positive effects of mindfulness and humility can mitigate the adverse impact of rumination on forgiveness among emerging adults, thus enhancing their inclination towards forgiveness.

The role of rumination in the relationship between symptoms of insomnia and depression in adolescents

There is a strong relationship between the symptoms of insomnia and depression, however, little is understood about the factors that mediate this relationship. An understanding of these underlying mechanisms may inform the advancement of existing treatments to optimise reductions in insomnia and depression when they co-occur. This study examined rumination and unhelpful beliefs about sleep as mediators between symptoms of insomnia and depression. It also evaluated the effect of cognitive behavioural therapy for insomnia (CBT-I) on rumination and unhelpful beliefs about sleep, and whether these factors mediated the effect of CBT-I on depressive symptoms. A series of mediation analyses and linear mixed modelling were conducted on data from 264 adolescents (12-16 years) who participated in a two-arm (intervention vs. control) randomised controlled trial of Sleep Ninja®, a CBT-I smartphone app for adolescents. Rumination, but not unhelpful beliefs about sleep, was a significant mediator between symptoms of insomnia and depression at baseline. CBT-I led to reductions in unhelpful beliefs about sleep, but not in rumination. At the between-group level, neither rumination, nor unhelpful beliefs about sleep emerged as mechanisms underlying improvement in depression symptoms, however, rumination mediated within-subject improvements following CBT-I. The findings suggest rumination links symptoms of insomnia and depression and provide preliminary evidence that reductions in depression following CBT-I occurs via improvements in rumination. Targeting rumination may improve current therapeutic approaches.

Rumination in dementia and its relationship with depression, anxiety, and attentional biases

Rumination (self-referential and repetitive thinking), attentional biases (AB), and impaired cognitive control are theorized as being integral factors in depression and anxiety. Yet, research examining the relationship between rumination, mood, and AB for populations with reduced cognitive control, e.g., people living with dementia (PwD), is lacking. To explore whether literature-based relationships are demonstrated in dementia, PwD (n = 64) and healthy controls (HC) (n = 75) completed an online self-report survey measuring rumination and mood (twice), and a telephone cognitive status interview (once). Rumination was measured as an emotion-regulation style, thinking style, and response to depression. We examined the test-retest reliability of PwD's (n = 50) ruminative-scale responses, ruminative-scale internal consistency, and correlations between rumination, age, cognitive ability, and mood scores. Also, nine participants (PwD = 6, HC = 3) completed an AB measure via eye-tracking. Participants fixated on a cross, naturally viewed pairs of facial images conveying sad, angry, happy, and neutral emotions, and then fixated on a dot. Exploratory analyses of emotional-face dwell-times versus rumination and mood scores were conducted. Except for the HC group's reflective response to depression measure, rumination measures were reliable, and correlation strengths between rumination and mood scores (.29 to .79) were in line with literature for both groups. For the AB measure subgroup, ruminative thinking style scores and angry-face metrics were negatively correlated. The results of this study show that literature-based relationships between rumination, depression, and anxiety are demonstrated in dementia, but the relationship between rumination and AB requires further investigation.

If it Ain't Broke, Don't Fix it: Positive Versus Negative Emotion Regulation in Daily Life and Depressive Symptoms

BACKGROUND

Despite the importance of positive emotions for affective psychopathology, prior research primarily focused on negative emotion regulation. To address this gap, this ecological momentary assessment study compared a broad set of emotion regulation strategies in the context of positive versus negative emotions regarding their effectiveness and associations with depressive symptoms.

METHODS

We analyzed data from 1066 participants who were notified five times daily for seven consecutive days to complete a smartphone survey assessing their predominant emotions, strategies to regulate them, and subsequent emotional outcomes.

RESULTS

Findings show that the effectiveness of most regulation strategies depended on whether the emotional context was positive or negative. While acceptance and savoring predicted improved emotional outcomes across emotional contexts, reappraisal and problem-solving were associated with deteriorated emotional outcomes and increased depressive symptoms when regulating positive but not negative emotions.

LIMITATIONS

Future studies should replicate our findings in demographically and culturally diverse clinical samples to improve generalizability.

CONCLUSION

These results emphasize that strategies effective for regulating negative emotions may be less helpful in the context of positive emotions. Thus, context-specific interventions may be a promising approach to improve the treatment of affective disorders.

Examination of Rumination's Mediating Role in the Relation Between Distal Personality Predictors, Cannabis Coping Motives, and Negative Cannabis-Related Consequences

Objective

Perseverative cognitive processes, such as rumination, may indirectly influence effects of personality traits on cannabis use and related problems. Understanding relations among personality, rumination, and cannabis use motives may lead to better understanding of problematic cannabis use. The present study examined personality traits' influence on negative cannabis-related consequences via rumination and cannabis use coping motives.

Methods

We tested a sequential path model across two independent samples such that the model was tested in one sample and replicated in the second sample. Participants were U.S. undergraduate students from multiple universities who reported using cannabis at least once in the prior thirty days.

Results

Results partially supported hypotheses such negative urgency and distress tolerance were indirectly related to negative cannabis-related consequences via rumination and coping motives. Specifically, higher negative urgency and lower distress tolerance were related to higher rumination. Higher rumination was related to higher coping motives; which in turn was related to more negative cannabis-related consequences. Results indicate that rumination is a risk factor belying associations between personality and cannabis use to cope and negative consequences of use.

Conclusions

Implementing techniques that attenuate rumination for individuals high in negative urgency or low in distress tolerance may reduce or prevent problematic cannabis and unintended outcomes.

Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy

Educational assessments can affect students' mental health, particularly during a pandemic. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are widely efficacious for reducing test anxiety, as well as general anxiety and rumination. However, the effectiveness of these two therapies for students during COVID-19 is unclear. We measured the effectiveness of ACT and CBT for managing test anxiety, general anxiety, and rumination during COVID-19 for 77 students taking Türkiye's national university entrance exam, assigned to either the ACT or CBT psychoeducation programs. Both programs reduced test anxiety, general anxiety, and rumination, and showed similar levels of effectiveness. This suggests that ACT and CBT are both important for improving students' mental health during COVID-19 and either may be beneficial.

What Are the Predictors of Post-traumatic Stress Disorder Among Road Traffic Accident Survivors: A Systematic Review

ABSTRACT

Traffic accidents put tremendous burdens on the psychosocial aspects of communities. Post-traumatic stress disorder (PTSD), after an accident, is one of the most prevalent and incapacitating psychiatric conditions worldwide. In this systematic review, we aimed to investigate the predictors of PTSD in traffic accident victims. Primary search was conducted in November 2021 and updated in 2023. Studies were excluded if they used any analysis except regression for predictors. Cumulatively, primary and update searches retrieved 10,392 articles from databases, and of these, 87 studies were systematically reviewed. The predictors were categorized into sociodemographics, pretrauma, peritrauma, and post-trauma factors. The PTSD assessment time varied between 2 weeks and 3 years. Being a woman, having depression and having a history of road traffic accidents pretraumatically, peritraumatic dissociative experiences, acute stress disorder diagnosis, rumination, higher injury severity, and involvement in litigation or compensation after the trauma were significant predictors of PTSD.

Childhood bullying victimization, emotion regulation, rumination, distress tolerance, and depressive symptoms: A cross-national examination among young adults in seven countries

Existing research suggests a robust association between childhood bullying victimization and depressive symptoms in adulthood, but less is known about potential mediators of this link. Furthermore, there is limited cross-national research evaluating similarities and differences in bullying victimization and its associations with mental health. The current study addressed gaps in the literature by evaluating cognitive and affective responses to stress (i.e., emotion regulation, rumination, and distress tolerance) as potential mediators of the link between recalled bullying victimization and current depressive symptoms among 5909 (70.6% female) college students from seven countries. Results revealed specific indirect associations of bullying victimization through distress tolerance and three out of four facets of rumination, as well as a persistent direct association of childhood bullying on adulthood depression. Emotion regulation strategies were not significantly associated with bullying victimization and did not mediate its association with depressive symptoms. Constrained multigroup models indicated that results were invariant across country and gender. Findings provide evidence of statistical mediation in a cross-sectional sample and await replication in prospective studies. Rumination and distress tolerance may be promising targets for resilience-promoting interventions among children experiencing peer victimization. Ongoing research is needed to clarify cross-national patterns in childhood bullying, identify additional mediators accounting for the remaining direct association, and evaluate emotion regulation as a potential moderator of associations between bullying victimization and adult mental health.

The psychometric properties of the Turkish version of the Pre-sleep Arousal Scale

Purpose

The aim of the present study was to examine the psychometric properties of the Turkish version of the Pre-sleep Arousal Scale (PSAS), which measures pre-sleep arousal, a significant predictor of insomnia symptoms.

Methods

651 participants were recruited via social media and the Internet. Confirmatory factor analysis was conducted in the total sample (65.28% females; Mage1 = 28.09 ± 14.00). Convergent, divergent, incremental, and known-groups validity and internal consistency coefficients were assessed in a subsample of 556 participants (62.77% females; Mage2 = 29.25 ± 14.81). A second separate sample of 88 participants (80.68% females; Mage3 = 22.19 ± 4.98) was used to evaluate three-week test-retest reliability.

Results

The results of factor analysis confirmed the two-factor structure of the Turkish PSAS with cognitive (PSAS-C) and somatic (PSAS-S), similar to the original scale. The correlations of the PSAS with convergent and divergent measures showed that the Turkish form had good convergent and acceptable divergent validity. PSAS-C and PSAS-S were able to explain an 18% additional variance in insomnia severity beyond depression and anxiety, an 18% additional variance in depression beyond insomnia severity, and a 35% additional variance in anxiety beyond insomnia severity. Moreover, insomnia patients had significantly higher PSAS-C and PSAS-S scores than good sleepers. Finally, the PSAS, PSAS-C, and PSAS-S had satisfactory internal consistency coefficients (α = 0.92, 0.91, and 0.86, respectively) and three-week test-retest correlations (ICC = 0.82, 0.82, and 0.71, respectively).

Conclusion

The Turkish form of the PSAS was a valid and reliable measure of pre-sleep arousal and can be utilized in sleep studies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41105-023-00483-z.

Factors perpetuating functional cognitive symptoms after mild traumatic brain injury

INTRODUCTION

Self-reported memory difficulties (forgetting familiar names, misplacing objects) often persist long after a mild traumatic brain injury (mTBI), despite normal neuropsychological test performance. This clinical presentation may be a manifestation of a functional cognitive disorder (FCD). Several mechanisms underlying FCD have been proposed, including metacognitive impairment, memory perfectionism, and misdirected attention, as well as depression or anxiety-related explanations. This study aims to explore these candidate perpetuating factors in mTBI, to advance our understanding of why memory symptoms frequently persist following mTBI.

METHODS

A cross-sectional study of 67 adults (n = 39 with mTBI mean = 25 months ago and n = 28 healthy controls). Participants completed standardized questionnaires (including the Functional Memory Disorder Inventory), a metacognitive task (to quantify discrepancies between their trial-by-trial accuracy and confidence), and a brief neuropsychological test battery. We assessed candidate mechanisms in two ways: (1) between-groups, comparing participants with mTBI to healthy controls, and (2) within-group, examining their associations with functional memory symptom severity (FMDI) in the mTBI group.

RESULTS

Participants with mTBI performed similarly to controls on objective measures of memory ability but reported experiencing much more frequent memory lapses in daily life. Contrary to expectations, metacognitive efficiency did not differentiate the mTBI and control groups and was not associated with functional memory symptoms. Memory perfectionism was strongly associated with greater functional memory symptoms among participants with mTBI but did not differ between groups when accounting for age. Depression and checking behaviors produced consistent results across between-groups and within-group analyses: these factors were greater in the mTBI group compared to the control group and were associated with greater functional memory symptoms within the mTBI group.

CONCLUSIONS

This study highlights promising (e.g., depression, checking behaviors) and unlikely (e.g., metacognitive impairment) mechanisms underlying functional memory symptoms after mTBI, to guide future research and treatment.

Increase in physiological inhibitory control results in better suppression of unwanted memories

Forgetting or suppressing a memory with unwanted content is just as important as remembering a desirable one. In addition to emphasizing the role of inhibitory control in memory suppression processes, neuropsychological studies have indicated that an intentional inhibition targeting a brain area may exert its inhibitory effects in seemingly unrelated areas through a common inhibitory network. In this study, we aimed to investigate whether the suppression of unwanted memories can be strengthened by recruiting an inhibitory task that can be simultaneously performed with a memory suppression task. Therefore, we manipulated the level of urinary urgency-induced inhibition of participants (N = 180) and test its effect on the suppression of unwanted memories using a Think/No-Think (T/NT) task. The results of our study indicated that individuals with high levels of urinary urgency demonstrated greater memory suppression compared to those with low urinary urgency. Findings and their implications are discussed within the context of cognitive and clinical perspectives, and recommendations are made for future research.

Association between rumination and drug craving in Chinese male methamphetamine use disorder patients with childhood trauma

BACKGROUND

In China, males make up the majority of methamphetamine (MA) dependent individuals and the majority of treatment seekers. Childhood trauma (CT) and rumination are associated with an increased risk of MA use. However, the association between CT, rumination, and drug craving remains largely unknown.

OBJECTIVE

The present study aims to explore the association between rumination and drug craving in methamphetamine use disorder (MAUD) patients with CT.

PARTICIPANTS AND SETTING

This study recruited 404 male participants with MAUD from a male drug rehabilitation center in Southwest China.

METHODS

Patients with CT were identified by the short form of Childhood Trauma Questionnaire (CTQ-SF). Rumination and drug craving were assessed by the Ruminative Responses Scale (RRS) and the Obsessive Compulsive Drug Use Scale (OCDUS), respectively.

RESULTS

188 patients (46.5 %) experienced CT. Patients who had experienced CT showed significantly higher RRS symptom rumination score and OCDUS total score than those who had not. In patients with CT, RRS total and all subscale scores were positively associated with OCDUS interference of drug. Furthermore, the RRS brooding (β = 0.34, p < 0.001) and total scores (β = 0.38, p < 0.001) were determined to be separate contributors to the OCDUS total score in patients with CT.

CONCLUSIONS

Our study suggests that CT is common in male MAUD patients, and those who have suffered CT may exhibit higher levels of rumination and drug craving. Moreover, CT may play an influential role in the association between rumination and drug craving in patients with MAUD.

Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study

BACKGROUND

Stress-related disorders such as anxiety and depression are highly prevalent and cause a tremendous burden for affected individuals and society. In order to improve prevention strategies, knowledge regarding resilience mechanisms and ways to boost them is highly needed. In the Dynamic Modelling of Resilience - interventional multicenter study (DynaM-INT), we will conduct a large-scale feasibility and preliminary efficacy test for two mobile- and wearable-based just-in-time adaptive interventions (JITAIs), designed to target putative resilience mechanisms. Deep participant phenotyping at baseline serves to identify individual predictors for intervention success in terms of target engagement and stress resilience.

METHODS

DynaM-INT aims to recruit N = 250 healthy but vulnerable young adults in the transition phase between adolescence and adulthood (18-27 years) across five research sites (Berlin, Mainz, Nijmegen, Tel Aviv, and Warsaw). Participants are included if they report at least three negative burdensome past life events and show increased levels of internalizing symptoms while not being affected by any major mental disorder. Participants are characterized in a multimodal baseline phase, which includes neuropsychological tests, neuroimaging, bio-samples, sociodemographic and psychological questionnaires, a video-recorded interview, as well as ecological momentary assessments (EMA) and ecological physiological assessments (EPA). Subsequently, participants are randomly assigned to one of two ecological momentary interventions (EMIs), targeting either positive cognitive reappraisal or reward sensitivity. During the following intervention phase, participants' stress responses are tracked using EMA and EPA, and JITAIs are triggered if an individually calibrated stress threshold is crossed. In a three-month-long follow-up phase, parts of the baseline characterization phase are repeated. Throughout the entire study, stressor exposure and mental health are regularly monitored to calculate stressor reactivity as a proxy for outcome resilience. The online monitoring questionnaires and the repetition of the baseline questionnaires also serve to assess target engagement.

DISCUSSION

The DynaM-INT study intends to advance the field of resilience research by feasibility-testing two new mechanistically targeted JITAIs that aim at increasing individual stress resilience and identifying predictors for successful intervention response. Determining these predictors is an important step toward future randomized controlled trials to establish the efficacy of these interventions.

Psychophysiological stress response after a 6-week Mindful Self-Compassion training in psychiatric rehabilitation inpatients: a randomized post-test only study

Objectives

Mindfulness-based interventions (including self-compassion interventions) are effective in improving stress management at psychological and physical levels. Mindful Self-Compassion (MSC) is a newly developed program particularly aimed at increasing self-compassion. The main objective of this study was to determine whether the psychophysiological stress response during a social-evaluative speaking task differs in inpatients participating in the MSC or the Progressive Muscle Relaxation (PMR) program at the end of their 6-week psychiatric rehabilitation stay (i.e., post-test only design).

Method

Data from 50 inpatients (25 MSC, 25 PMR, 35 female) aged 19 to 76 years (M = 47.22, SD = 12.44) were analyzed in terms of psychophysiological stress response. For this purpose, heart rate variability, heart rate, and blood pressure were assessed together with several psychometric variables: positive and negative affect (PANAS), subjective stress perception (Visual Analog Scale), self-compassion (Self-Compassion Scale), cognitive reappraisal and suppression (Emotion Regulation Questionnaire), psychological distress (Brief Symptom Inventory-18), and appraisal and rumination (selected items).

Results

After correction for alpha inflation no differences in the psychophysiological stress response and psychometric parameters between the MSC and PMR group were found.

Discussion

In general, our results indicate that MSC is not superior to PMR training. However, more research with clinical randomized controlled trials investigating larger samples are needed to further affirm these initial findings.

Systematic Review: Questionnaire-Based Measurement of Emotion Dysregulation in Children and Adolescents

OBJECTIVE

Emotion dysregulation, understood as a critical transdiagnostic factor in the etiology and maintenance of psychopathology, is among the most common reasons youth are referred for psychiatric care. The present systematic review examined 2 decades of questionnaires used to assess emotion (dys)regulation in youth.

METHOD

Using "emotion (dys)regulation," PsycINFO, PubMed, and Web of Science were searched for empirical, peer-reviewed journal studies published before May 2021 in clinical and/or nonclinical youth. A total of 510 studies met selection criteria and were included.

RESULTS

Across the literature, 115 distinct self-, parent-, or other informant-reported measures of emotion (dys)regulation were used in cross-sectional (67.1%), longitudinal (22.4%), intervention (9.0%), and mixed design (1.6%) studies. Out of 115 different questionnaires, a subset of 5 measures of emotion (dys)regulation were used in most of the literature (ie, 59.6% of studies). Moreover, reviewed studies examined emotion (dys)regulation in more than 20 distinct clinical groups, further supporting emotion dysregulation as a transdiagnostic construct.

CONCLUSION

Numerous themes emerged. Broadly, measures differed in their ability to capture internal vs external components of emotion dysregulation, the use of adaptive vs maladaptive responses, and subjective experiences more broadly vs particular affective states. These findings serve to guide researchers and clinicians in selecting appropriate measurement tools for assessing specific domains of child and adolescent emotion dysregulation.

The effect of rumination and elder abuse level on successful aging in elderly individuals: Analysis with a machine learning approach

BACKGROUND

This study aimed to determine the effect of rumination and elder abuse levels on successful aging in elderly individuals.

METHODS

This descriptive-correlational study was conducted with older individuals (n = 297) in Ağrı, Turkey, between October 2021 and May 2022. SPSS-22 and R v.4.1.3 were used in the study. Analysis was done with machine learning and artificial neural networks.

RESULTS

In the study, the mean age of the older individuals was 67.49 ± 3.04. Statistical estimates showed the regression model to be significant and usable, F(2,294) = 116.659, P = 0.001. Elder abuse and ruminative thought levels together explained 43.9% of the total variance (R²  = 0.439) of successful aging. The regression model indicated that increases in both the elder abuse level (t = -3.672, P < 0.001) and the ruminative thought level (t = -12.771, P < 0.001) of participants caused a statistically significant decrease in the successful aging level. The combined elder abuse and ruminative thought levels had a greater effect on successful aging (Model 1: F = 45.321, Model 2: F = 116.659, R² Change = 0.309). The R² value of the Random Forest regression model was 0.529, showing that the independent variables could explain 52.92% of the variation in the dependent variable. According to the SHapley Additive exPlanation values, which show the contribution or importance of each variable in the estimation of the model, it was determined that the most important variables for estimating the Successful Aging Scale variable were ruminative thought style and elder abuse screening.

CONCLUSIONS

Our study indicates that a decrease in the levels of rumination and elder abuse could lead to improvement in successful aging. Longitudinal studies on successful aging in older individuals are recommended.

Is rumination associated with psychological distress after a cancer diagnosis? A systematic review

Objective: The aim of this work was to review evidence on the association between psychological rumination and distress in those diagnosed with cancer. Methods: Six databases were searched for studies exploring rumination alongside overall assessments of psychological distress, depression, anxiety, or stress. Results: Sixteen studies were identified. Rumination was associated with distress cross-sectionally and longitudinally. However, once baseline depression was controlled for, the association was no longer seen. The emotional valence of ruminative thoughts and the style in which they were processed, rather than their topic, was associated with distress. Brooding and intrusive rumination were associated with increased distress, deliberate rumination had no association, and reflection/instrumentality had mixed findings. Conclusions: This review highlights that it is not necessarily the topic of content, but the style and valence of rumination that is important when considering its association with distress. The style of rumination should be the target of clinical intervention, including brooding and intrusion.

Internalizing symptoms, rumination, and problematic social networking site use: A cross national examination among young adults in seven countries

BACKGROUND

As daily engagement with social networking sites (SNS) increases globally, identifying and understanding the risk factors associated with problematic SNS use is of utmost importance. Researchers are interested in understanding internalizing symptoms as both a risk factor and a negative consequence of problematic SNS use. Prior research has proposed rumination alongside internalizing symptoms as a risk factor, though limited research has examined these associations across different cultures.

OBJECTIVE

The present study examined the indirect associations between internalizing symptoms (specifically depressive and social anxiety symptoms) and problematic SNS use via rumination among a cross-cultural sample.

METHOD

Participants were 8,912 (70.8 % female; Mean age = 20.25, SD = 3.95) college students recruited across seven countries (U.S., Canada, Spain, England, Argentina, Uruguay, and South Africa) who completed measures of internalizing symptoms, rumination, weekly SNS use, and problematic SNS use.

RESULTS

We found that higher internalizing symptoms were associated with more problematic SNS use via higher ruminative thinking. Specifically, problem-focused thoughts (a rumination subtype) uniquely accounted for 22.89% and 28.15% of the total effect of depressive and social anxiety symptoms on problematic SNS use, respectively. Other rumination subtypes (i.e., anticipatory thoughts and repetitive thinking) also demonstrated significant indirect effects, though weaker effects than for problem-focused thoughts. Findings were invariant across countries.

CONCLUSIONS

These findings provide support for further exploring the role rumination plays in determining and comparing problematic SNS use cross-culturally in longitudinal and experimental work.

Patient-reported outcome measures for life engagement in mental health: a systematic review

Background

Life engagement in the context of mental health is a broad term that describes positive health aspects relating to cognition, vitality, motivation and reward, and the ability to feel pleasure—concepts that are meaningful to patients. The aim of this systematic literature review was to identify validated patient-reported outcomes (PROs) that can assess any aspect of life engagement in adults, in the field of general mental health.

Methods

This was a systematic literature review of articles in English from the MEDLINE database (date of search: September 9, 2020). The search strategy had three components: (1) terms to capture PROs; (2) terms to capture mental health; and (3) terms to capture aspects of life engagement. Articles were eligible if they included a PRO that: (1) is named; (2) can be used across mental health disorders; (3) is used to assess any aspect of life engagement; and (4) has undergone psychometric validation and/or qualitative content validation. A list of PROs was extracted.

Results

A total of 1585 records were screened and 233 articles were eligible for inclusion. Within these 233 articles, 49 distinct PROs were identified, two of which specifically captured their authors’ interpretation of life engagement: the Engaged Living Scale (ELS) and the Life Engagement Test (LET). However, while the ELS and LET covered motivation and reward, life fulfillment, and value-based living, neither scale captured the cognitive or vitality aspects of life engagement. The remaining identified PROs generally captured single aspects of life engagement, most commonly motivation/reward/energy–apathy, pleasure–anhedonia, and mental/psychological well-being.

Conclusion

Numerous PROs are available that may capture aspects of life engagement. However, a need remains for a new PRO that can be used in clinical trials to provide a more comprehensive description of the improvements in life engagement that patients with mental health disorders may experience with successful treatment.

Nomophobia in today’s overlapping work and family domains: The influences on organizational identification

Drawing on attentional control theory, this study addresses the influences of nomophobia (no-mobile-phone-phobia) on organizational identification and work-family conflict. It also examines the mediation role of work-family conflict in the relationship between nomophobia and organizational identification. Its hypotheses were tested using data from 398 teachers employed in public and private schools. The results revealed that by disrupting cognitive and perceptual processes, nomophobia contributes to conflicts between employees’ roles in their work and family domains, and eventually prevents them from identifying with organizational goals and values. The results also confirmed the mediation role of work-family conflict. By adopting a pure psychological approach (i.e., attentional control theory), as a new and different perspective for the organizational behavior and work-family conflict literatures, the findings are expected to contribute to increasing the awareness of organizations about negative attitudes and behaviors of nomophobic employees and highlight the needs of nomophobic employees for appropriate social and psychological supports.

Predictors of Attrition and Response in Cognitive Processing Therapy for Interpersonal Trauma Survivors with PTSD

With the establishment of empirically validated treatments for posttraumatic stress disorder (PTSD), concerns remain regarding the effectiveness of such treatments in real-world clinical settings. Specifically, premature termination and treatment response limit the effectiveness of these interventions. The current study investigated factors potentially related to premature termination and treatment response in Cognitive Processing Therapy with Account (CPT-A). Participants in this study included 42 women (Mage = 30.70 SDage = 9.40) with PTSD from exposure to interpersonal trauma. Demographic characteristics, pre-treatment symptoms of PTSD and depression, and transdiagnostic factors were examined as predictors of attrition and treatment response. Hierarchical regression and logistic regression models were analyzed to test the variance explained and predictive value of these factors. The present study revealed that age was a significant factor related to dropout from CPT-A whereas baseline PTSD symptom severity was significantly related to treatment response. Results of this study suggest the importance of the interrelationships among pre-treatment predictors as well as the consideration of attrition and treatment response as distinct metrics of treatment outcome. Further, these results inform the application of CPT-A for PTSD in survivors of interpersonal trauma, as consideration of the identified predictors of dropout and non-response at intake may contribute to treatment retention and response.

Mindfulness to Manage Moral Injury: Rationale and development of a live online 7-week group intervention for veterans with moral injury

Background

Military service puts service members at risk for moral injury. Moral injury is an array of symptoms (e.g., guilt, shame, anger) that develop from events that violate or transgress one's moral code.

Objective

We describe adaption of in-person mindfulness training program, Mindfulness to Manage Chronic Pain (MMCP), to address symptoms of moral injury to be delivered live via the web. We discuss how we will assess benchmarks (i.e., recruitment, credibility and acceptability, completion rates, and adherence) of the Mindfulness to Manage Moral Injury (MMMI) program.

Methods

Aim 1: To develop and then adapt the MMCP program based on feedback from experts and veterans who took part in Study 1. Aim 2: To develop an equally intensive facilitator-led online Educational Support (ES) program to serve as a comparison intervention and conduct a run-through of each program with 20 veterans (10 MMMI; 10 ES). Aim 3: To conduct a small-scale randomized controlled trial (N = 42 veterans; 21 MMMI; 21 ES) in which we will collect pre-post-test and weekly benchmark data for both refined intervention arms.

Results

Study 1 and 2 are completed. Data collection for Study 3 will be completed in 2022.

Conclusion

MMMI is designed to provide a live facilitated mindfulness program to address symptoms of moral injury. If Study 3 demonstrates good benchmarks, with additional large-scale testing, MMMI may be a promising treatment that can reach veterans who may not seek traditional VAMC care and/or who prefer a web-based program.

Trauma exposure and depression among frontline health professionals during COVID-19 outbreak in China: the role of intrusive rumination and organizational silence

BACKGROUND

Healthcare professionals bared particularly high risk and stress during the COVID-19 outbreak. Previous studies have demonstrated that healthcare professionals exposed to COVID-19 incurred various affective disorders including depressive symptoms, anxiety, insomnia, and distress. However, the mechanism underlying the relationship between trauma exposure and depressive symptom among frontline hospital staff has yet to be investigated. This study aims to assess the prevalence of depressive symptoms among frontline healthcare professionals in Shenzhen, China, and elucidate the complex relationship among trauma exposure, intrusive rumination, and organizational silence.

METHODS

The data of this study were collected through a time-lagged panel questionnaire survey with three rounds of measurements from February 2020 to May 2020 at an infectious disease hospital in Shenzhen, in which all the confirmed cases of COVID-19 patients were accommodated. Based on cluster sampling design, a total of 134 frontline healthcare professionals directly involved in providing diagnosis, treatment, and nursing services for COVID-19 patients completed three times of web survey. The depressive symptom and trauma exposure were measured via the 12-items General Health Questionnaire and the Explosion Exposure Questionnaire respectively. A moderated mediation model examined the complex interplay among the major study variables. Gender and working year were included as control variables.

RESULTS

Trauma exposure was significantly associated with depression in frontline healthcare professionals. Intrusive rumination mediated the effect of trauma exposure on the depressive symptom, which was moderated by organizational silence. Intrusive rumination presented a more substantial impact on depression while organization silence was lower.

CONCLUSIONS

This research demonstrates that intrusive rumination and organizational silence are imperative for predicting the depressive symptoms among the frontline healthcare professionals during the COVID-19 pandemic.

Examination of the latent structure of the Ruminative Thoughts Style Questionnaire across countries, gender, and over time

The present work aimed to extend the evidence of the structure validity of the Ruminative Thought Style Questionnaire (RTSQ) 15-item version testing: (1) the structure of two competing models (i.e., four-factor correlated model vs a second-order factor model); (2) the measurement invariance of the final model across four countries (U.S., Spain, Argentina, and the Netherlands) and gender groups (male and female); and (3) the invariance across three assessment waves in a subsample of Spanish youths. Participants were college students (mean age = 20.87, SD = 4.47) from the U.S. (n = 1875; 67.1% of females), Spain (T1, n = 732, 63.9% females; T2, n = 370, 71.6% females: T3, n = 307, 60.6% females), Argentina (n = 368, 65.6% females) and the Netherlands (n = 295, 74.8% females). Confirmatory Factor Analyses supported both correlated factors and second-order factor structure in the whole sample. Due to similar fit indices being observed for both models, and considering the theoretical and practical advantages, we kept the second-order model to examine its invariance across groups and time. Measurement invariance analyses showed that the second-order model was invariant across countries, gender, and over time. Comparisons of the total mean score and the subfacet mean scores (i.e., Repetitive Thoughts, Counterfactual Thoughts, Problem-focused Thoughts, and Anticipatory Thoughts) reveled only small differences across country and gender groups. The present work extends the structural validity evidence of the RTSQ, and provides the first evidence concerning its longitudinal stability across time.

Pilot Study of Compassion Meditation Training to Improve Well-being Among Older Adults

OBJECTIVES

Compassion meditation (CM) training has demonstrated potential in improving well-being and psychosocial functioning. However, most prior studies of CM training have focused on younger adults. The generalizability of the effectiveness of CM training with older adults requires further study. This pilot study was intended to inform future randomized controlled studies of CM training in older adults.

METHODS

Participants included 24 older adults who attended a 10-week group CM training. Exploratory outcome measures were administered prior to, during, and after the intervention. Participants also completed logs of mood and meditation practice, and provided descriptive comments in response to open-ended questions administered at the end of treatment.

RESULTS

High treatment completion rates (87.5%) and reported adherence (85.7% of assigned meditation) were observed. Descriptive feedback from participants indicated older adults are interested in and capable of learning and applying new concepts and skills in support of their well-being. Pre- to post-intervention changes were explored with a variety of self-report measures. Weekly journals suggested increased feelings of love, closeness, or trust, and decreased feelings of stress, nervousness, or being overwhelmed.

CONCLUSIONS

These findings provide preliminary support for the feasibility of CM training in community-dwelling older adults, and suggest the need for future efficacy and effectiveness clinical trials.

CLINICAL IMPLICATIONS

CM training offers potential benefits for improving well-being among older adults, and, as an example of a strengths-based approach, can be tailored to the specific needs of older adults.

Links between Savoring, Rumination, and Sleep-Related Experiences across Adulthood: Implications for Older Adults

OBJECTIVES

Sleep problems are pervasive, particularly in older adults. Much work examines psychological factors that adversely affect sleep; fewer studies examine those with a positive effect. Savoring is a form of positive repetitive thought that is linked to several aspects of health but has been understudied in relation to sleep. We examined cross-sectional associations of both savoring and rumination with subjective sleep experiences, and assessed if these associations vary by age.

METHODS

Adults and older adults (N = 216) ranging from 20-80 years in age (M = 44.9 ± 15.6 years) completed an online survey of validated measures of savoring, rumination, sleep disturbance, and sleep-related impairment.

RESULTS

Higher levels of savoring were significantly associated with lower levels of sleep-related impairment but not sleep disturbance in regression analyses. Higher levels of rumination were significantly associated with higher levels of sleep disturbance and sleep-related impairment. Associations of savoring and rumination with sleep-related experiences did not vary by age.

CONCLUSIONS

Savoring and rumination are relevant to sleep-related experiences in adults ranging from younger to older. Further investigation of the potential positive impact of savoring on sleep-related experiences is needed.

CLINICAL IMPLICATIONS

Engagement in savoring and rumination should be considered when assessing sleep and sleep-related impairment in adults.

Exploring working memory, self-criticism, and rumination as factors related to self-harm

The prevalence of self-harm and the relative emotional influences are well understood, but certain cognitive factors such as working memory, rumination, and self-criticism are not fully explored. The aim of the current study is to examine specific aspects of cognition to explore their influence on self-harming behaviors. Participants included 101 undergraduates from a British University. Factors were measured using the Centre for Epidemiological Studies Depression Scale, the Depressive Experiences Questionnaire, Ruminative Response Scale, and the Automated Working Memory Assessment. Findings indicated a greater incidence of self-harming behaviors among those who demonstrated higher depressive symptoms, but depression scores were not significantly related to self-harm. Additionally, a binary logistic regression indicated that self-criticism was associated with the presence of self-harming behavior, and a Classification and Regression Trees found that the single strongest predictor of self-harming behavior was a belief that love needs to be continually earned from others. Incorporating treatments that reduce self-criticism, such as improving self-compassion with Compassionate Mind Training, may address underlying mechanisms that trigger self-harm behavior. Keywords: rumination, depression, self-criticism, working memory, self-harm.

Grief and ruminative thought after perinatal loss among Turkish women: one-year cohort study

BACKGROUND

Among women who have suffered loss of pregnancy, the level of grief decreases gradually. Age, mental health status and childlessness are the factors known to mostly affect women's levels of grief.

OBJECTIVES

To assess the levels of grief among women who experienced perinatal loss and the changes in their ruminative thought styles over the first year after their loss.

DESIGN AND SETTING

One-year follow-up study carried out in a university hospital in Turkey.

METHODS

The study population included 70 women who experienced loss of pregnancy in the hospital. The sample size was calculated using G*Power V3.1. Data were collected at 48 hours, at the third month, at the sixth month and at one year after pregnancy loss, between June 2018 and June 2019. A personal information form, the Perinatal Grief Scale and the Ruminative Thought Style Questionnaire were used for data collection.

RESULTS

The women's highest levels of grief and ruminative thought style were in the first 48 hours. Their tendency towards grief and ruminative thought styles decreased over the repeated measurements during the follow-up. Women aged 20-29 years had the highest levels of grief at the third month after perinatal loss.

CONCLUSIONS

Nursing assessments regarding grief and ruminative thought style over the first 48 hours after perinatal loss should be integrated into nursing care for these women. Grief follow-up programs for these women can be developed through nursing research.

Social anxiety and rumination in the context of the revised reinforcement sensitivity theory and the mediation model of social anxiety

The aim of this study was to examine the relationship between temperament, ruminative thought style and social anxiety using latent variable modeling. Before examining the integrated model that specifies the relations between the constructs, relevant measurement issues were examined. The study was conducted on a heterogeneous sample from the general population that included 1,029 participants (62.1% female) aged 19 to 79. The findings show that the Behavioural Inhibition System is the most important vulnerability factor for the development of social anxiety, and it has both a direct effect and an indirect one through the ruminative thought style. Also, Freeze has an additional contribution to the increased experience of social anxiety. The Behavioural Approach System has complex effects on social anxiety ? with a direct protective effect, and indirectly ? with a facilitation of the ruminative thought style. Thus, BAS can also act as a risk factor. The findings support the revised Reinforcement Sensitivity Theory and provide a basis for the extension of the Kimbrel?s Mediation Model of Social Anxiety.

Linking Depression with Negative Alcohol-Related Consequences: A Structural Equation Model Among a Clinically Depressed Population

Background and Objectives: Previous research suggests that rumination acts as a mediating mechanism in the association between depression and drinking motives, particularly drinking to cope, as well as negative alcohol-related consequences. In this study, we tested the connections between depressive symptoms, rumination, drinking motives, alcohol consumption, and alcohol-related problems in a clinically depressed population (N = 209). Methods: Structural equation modeling was used to test the models. Specifications were based on the results of a previously evaluated model in a sample of college students. Results: The complex model showed a significant positive association between depressive symptoms and rumination. Drinking motives (enhancement and coping) were linked to more negative alcohol-related consequences. In a simplified model, pronounced depressive symptoms were associated with both increased ruminative thinking and more negative alcohol-related problems. Rumination was connected with stronger drinking motives (combined in one general factor), which were again associated with alcohol consumption and alcohol-related problems. Limitations: The use of self-report measures to determine diagnostic validity. Conclusions: In a clinically depressed sample, depressive symptoms were linked to increased negative alcohol-related consequences. This association was partially explained by rumination and drinking motives. However, rumination was less relevant than previous studies suggested.

The Effect of Cognitive-Affective Factors on PTSD and Alcohol Use Symptoms: An Investigation on Rumination, Suppression, and Reappraisal

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are mental health conditions that often co-occur. The complexity of this comorbidity is well-documented, though the role of malleable cognitive-affective factors in PTSD/AUD warrants further study. Specifically, attaining a more comprehensive understanding of the role of malleable cognitive-affective factors in individuals with symptoms of PTSD/AUD may have important implications for future research, such as in treatment-seeking individuals. Extant examinations of cognitive-affective factors have demonstrated unique associations of cognitive reappraisal, expressive suppression, and rumination in PTSD symptom severity, though these effects had yet to be explored in subgroups of comorbid PTSD/AUD.Methods: In a sample of trauma-exposed individuals (n = 334) recruited to participate through an internet labor market, we first empirically examined latent subgroups of PTSD/AUD symptoms using latent profile analysis, then included expressive suppression, cognitive reappraisal, and four dimensions in the model to elucidate their role in specific profile patterns of PTSD/AUD symptom typologies.Results: Our results support a four-class model of PTSD/AUD symptoms, with unique predictive effects of expressive suppression, problem-focused thoughts, repetitive thoughts, and anticipatory thoughts on latent profile status.Conclusions: These findings may have important implications for future research focused on examining cognitive-affective patterns as they apply to intervention techniques in treatment-seeking individuals with symptoms of PTSD/AUD.

Determining the potential link of self-compassion with eating pathology and body image among women: a longitudinal mediational study

PURPOSE

This longitudinal study aims to determine what factors mediate the previously established link between self-compassion and eating pathology/body image concerns, over a 6-month period.

METHODS

A community sample of 274 adult women (M = 29.50 years) completed standardised validated measures of self-compassion (Self-Compassion Scale), rumination (Ruminative Thought Style Questionnaire), shame (Other as Shamer Scale), perfectionism (Short Form of the Revised Almost Perfect Scale), self-criticism (Levels of Self-Criticism Scale), eating pathology (Eating Disorder Examination Questionnaire) and body image (Body Shape Questionnaire). They reported levels of: self-compassion at Time 1, potential mediators (rumination, shame, self-criticism, perfectionism) at 3 months; and eating pathology and body dissatisfaction a further 3 months later. Missing data were handled using multiple imputation. Stepwise multiple regression showed that shame was the most consistent mediator.

RESULTS

Shame acted as a full mediator of the self-compassion-eating/body image relationship {respectively, [B = .04, SE = .01, t(268) = 3.93, p < .001], [B = .33, SE = .15, t(268) = 2.25, p < .05]}. Discrepancy perfectionism also played a mediating role in the link between self-compassion and body image dissatisfaction [B = .59, SE = .28, t(268) = 2.10, p < .05].

CONCLUSION

These results support the hypothesis that self-compassion is relevant to eating pathology and body image disturbance, and demonstrate that shame is an important mechanism in that relationship. This pattern suggests that interventions that reduce shame should be considered when addressing issues relating to self-compassion and its links to eating disorders.

LEVEL OF EVIDENCE

Level IV, multiple time series without intervention.

The relationships between self-compassion, rumination, and depressive symptoms among older adults: the moderating role of gender

OBJECTIVES

Depression is a significant mental health issue for older adults. Rumination is a key risk factor for depressive symptoms, and self-compassion is a protective factor. The aim of the current study was to test the processes by which self-compassion might act as a protective factor among older adults by investigating a mediation model, and whether the model is conditional on gender. It was hypothesised that self-compassion and its six components (self-kindness, common humanity, mindfulness, self-judgement, isolation, and over-identification) would be indirectly associated with depressive symptoms via rumination.

METHOD

A sample of 135 older Australian women and 106 older Australian men aged between 65 and 89 years completed the Centre for Epidemiologic Studies Depression Scale, the Ruminative Thought Style Questionnaire, and the Self-Compassion Scale.

RESULTS

Results supported the mediation models for self-compassion for both men and women, however, support for the models involving the individual components of self-compassion varied according to gender. The mediation effects were stronger for women than men.

CONCLUSION

Interventions aimed at increasing self-compassion might have benefits for older adults. Future research investigating whether tailoring interventions according to gender of participants is efficacious is needed.

Rumination as a widespread emotion-based cognitive vulnerability in borderline personality disorder: A meta-analytic review

OBJECTIVE

The current quantitative review aims at comprehensively clarifying the role of rumination in borderline personality disorder (BPD) considering its relevance for several clinical models of the disorder.

METHOD

This meta-analysis included 29 independent studies assessing different forms of rumination-general tendency to engage in ruminative thinking patterns and four types of emotion-based rumination among both nonclinical subjects reporting BPD features and patients with BPD. Furthermore, the study tested whether rumination could be considered a widespread emotion-based cognitive vulnerability in BPD.

RESULTS

Meta-analytic procedures were based on 46 r coefficients that showed large pooled effect sizes for all forms of rumination. With the exception of interpersonal rumination, the remaining forms of rumination were equally involved in BPD features.

CONCLUSIONS

Rumination should be considered a widespread emotion-based cognitive vulnerability in BPD. Future studies should provide longitudinal and contextual-based evaluations of rumination among treatment-seeking individuals with BPD.

The relationship between rumination and NSSI: A systematic review and meta-analysis

BACKGROUND

Rumination is a cognitive process that has been implicated in the onset and maintenance of a variety of psychological difficulties. The purpose of this review and meta-analysis was to examine the nature and strength of the relationship between rumination and non-suicidal self-injury (NSSI).

METHODS

The protocol for this review was pre-registered (CRD42019148186). A literature search of electronic databases PsycINFO, CINAHL, MEDLINE, and Web of Science was performed from the earliest date available to March 2020. Thirty-nine eligible papers were identified. An additional seven papers were identified from a search conducted in September 2021, resulting in a total of 46 papers. Separate meta-analyses were undertaken for NSSI frequency and NSSI history, with studies grouped by rumination type (depressive, transdiagnostic, anger, brooding, reflection, catastrophising, overall). Moderator analyses were also conducted along with a narrative synthesis of adjusted associations and longitudinal studies.

RESULTS

Rumination had a positive small association with NSSI frequency and a positive moderate association with NSSI history. The adjusted associations yielded mixed findings and most longitudinal research found rumination to be associated with prospective NSSI.

LIMITATIONS

Most included studies had a moderate risk of bias and used a student sample. A limitation of this review was that only English language papers were included.

CONCLUSIONS

Findings indicate that rumination is associated with NSSI, but more so the likelihood of engaging in NSSI overall than the frequency. Rumination-focused techniques for NSSI may therefore be of benefit. Further research is needed to understand this association, particularly with longitudinal studies that focus on state rumination rather than stable trait rumination.

PRACTITIONER POINTS

Rumination was found to have a small to moderate association with NSSI. Some individuals who engage in NSSI may benefit from psychological techniques that target rumination. Most of the studies included had a moderate risk of bias.