Underlying Structure of Ruminative Thinking: Factor Analysis of the Ruminative Thought Style Questionnaire

The Relationship Between Attitudes Toward Death, Rumination, and Psychological Resilience of Oncology Nurses

OBJECTIVES

The study aimed to examine the relationship between attitudes toward death, rumination, and psychological resilience of oncology nurses.

METHODS

The study design was cross-sectional. Data were collected from 118 oncology nurses using the Demographic Data Form, Work-Related Rumination Scale, Connor-Davidson Resilience Scale Short Form, and Death Attitude Profile-Revised Scale. For data analysis, correlation and regression analyses were performed.

RESULTS

The study findings showed that oncology nurses` work related rumination score was moderate, while psychological resilience score was severely high. More than two-thirds of the work-related ruminations of oncology nurses were explained by psychological resilience and attitudes toward death. Even though there is a negative correlation between negative attitudes toward death and psychological resilience, the acceptance of death scores showed positive relations with psychological resilience.

CONCLUSION

Nurses with positive attitudes toward death can also develop psychological resilience and experience fewer work-related ruminations. This result reveals the necessity of determining oncology nurses' attitudes toward death in order to protect their psychological resilience and reduce work-related ruminations. It is also evident that the results are valuable in presenting how nurses' work-related ruminations relate to psychological resilience and attitudes toward death.

IMPLICATIONS FOR NURSING PRACTICE

Nurses are the main care providers in oncology settings, and they are witnessing the suffering process of their patients and experiencing the loss of their patients. These challenges bring work-related ruminations that lower the psychological resilience of nurses and affect attitudes toward death. Therefore, nurses can build an awareness of their ruminations and develop coping skills with intrusive ruminations.

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.

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.

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.

"I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer

OBJECTIVE

This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer.

DATA SOURCES

The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method.

CONCLUSION

The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts.

IMPLICATIONS FOR NURSING PRACTICE

Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.

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.

Neural differences between internal and external episodic counterfactual thoughts

Episodic counterfactual thoughts (eCFT) consist of imagining alternative outcomes to past experiences. A common sub-class of eCFT-upward eCFT-involves imagining how past negative experiences could have been better, either because one could have done something differently (internal) or because something about the circumstances could have been different (external). Although previous neuroimaging research has shown that the brain's default mode network (DMN) supports upward eCFT, it is unclear how it is differentially recruited during internal versus external upward eCFT. We collected functional magnetic resonance imaging data while participants remembered negative autobiographical memories, generated either internal or external upward eCFT for the memory, and then rated the plausibility, perceived control and difficulty of eCFT generation. Both internal and external eCFT engaged midline regions of cingulate cortex, a central node of the DMN. Most activity differentiating eCFT, however, occurred outside the DMN. External eCFT engaged cuneus, angular gyrus and precuneus, whereas internal eCFT engaged posterior cingulate and precentral gyrus. Angular gyrus and precuneus were additionally sensitive to perceived plausibility of external eCFT, while postcentral gyrus and insula activity scaled with perceived plausibility of internal eCFT. These results highlight the key brain regions that might be involved in cases of maladaptive mental simulations. This article is part of the theme issue 'Thinking about possibilities: mechanisms, ontogeny, functions and phylogeny'.

Neuroticism, rumination, depression and suicidal ideation: A moderated serial mediation model across four countries

Background/objective

Research has highlighted the role of neuroticism, rumination, and depression in predicting suicidal thoughts, but studies on how these variables interplay are scarce. The aims of the present study were to test a model in which emotional stability (i.e., low neuroticism) would act as an antecedent and moderator of rumination and depressed mood in the prediction of suicidal ideation (i.e., moderated serial-mediation), and to explore their replicability across four countries and sex, among college students as an at-risk-group for suicide.

Method

Participants were 3482 undergraduates from U.S, Spain, Argentina, and the Netherlands. Path analysis and multi-group analysis were conducted.

Results

Emotional stability was indirectly linked to suicidal ideation via rumination and depressed mood. Moreover, emotional stability moderated the associations between rumination and depressed mood, and between depressed mood and suicidal ideation. Findings were consistent in males and females, and across countries studied.

Discussion

Regardless of sex and country, people with low emotional stability reported higher levels of rumination, which in turn was associated with more depressed mood, and these were associated with higher reports of suicidal thoughts. This cascade of psychological risk factors for suicidal ideation seems to be more harmful in people who endorse low levels of emotional stability.

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.

Impact of abstract vs. concrete processing on state rumination: An exploration of the role of cognitive flexibility

BACKGROUND AND OBJECTIVES

Abstract and concrete modes of rumination may be associated with different mental health outcomes; whereby concrete rumination strategies increase the individual's tendency to seek solutions to problems and thus leading to significant improvements in the mood state as well as reductions in the intensity of ruminative thoughts. However, related studies also are suggestive of other variables that are potentially effective in the outcome of abstract and concrete processing. The current study aimed to examine how abstract and concrete processing are associated with state rumination and explore the role of cognitive flexibility in this relationship.

METHOD

A total of 111 (78 female) participants were assessed for state rumination prior and post induction of abstract versus concrete processing.

RESULTS

Although all participants reported higher levels of state rumination following both processing inductions, participants that were instructed to engage in abstract processing reported higher levels of state rumination as opposed to concrete processing group. Moreover, participants with lower levels of cognitive flexibility reported significant increases in state rumination following the manipulation, independent of type of processing induction.

LIMITATIONS

The impact of the manipulation was assessed only via the BSRI and lacks physiological assessment of arousal levels of participants.

CONCLUSIONS

Clinical implications that involve concrete processing and CF ability trainings may be beneficial for the management of state rumination.

Using Schema Modes for Case Conceptualization in Schema Therapy: An Applied Clinical Approach

This article is situated within the framework of schema therapy and offers a comprehensive and clinically useful list of schema modes that have been identified as being relevant to conceptualizing complex psychological problems, such as those posed by personality disorders, and, in particular, the way that those problems are perpetuated. Drawing on the schema therapy literature, as well as other literature including that of cognitive behavior therapy and metacognitive therapy, over eighty modes are identified altogether, categorized under the widely accepted broad headings of Healthy Adult, Child modes, Parent modes and coping modes which are, in turn, divided into Surrender, Detached/Avoidant, and Overcompensator. An additional category is included: Repetitive Unproductive Thinking. This draws attention to the recognition by metacognitive therapists that such covert behaviors play a significant role in amplifying distress and perpetuating a range of psychological problems and symptoms. In addition to the modes themselves, several concepts are defined that are directly relevant to working with modes in practice. These include: default modes, blended modes, mode suites and mode sequences. Attention is also drawn to the way in which Child modes may be hidden "backstage" behind coping modes, and to the dyadic relationship between Child modes and Parent modes. Also relevant to practice are: (1) the recognition that Critic voices may have different sources and this has implications for treatment, (2) the concept of complex modes in which several submodes work together, and (3) the fact that in imagery work and image of a child may not represent a Vulnerable Child, but a Coping Child. The modes and mode processes described are directly relevant to clinical practice and, in addition to being grounded in the literature, have grown out of and proved to be of practical use in conceptualizing my own cases, and in supervising the cases of other clinicians working within the schema therapy framework.

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.

Mechanisms of Change in Trauma-Focused Treatment for PTSD: The Role of Rumination

OBJECTIVE

Cognitive behavioral therapy (CBT) has been well established in the treatment of posttraumatic stress disorder (PTSD). In recent years, researchers have begun to investigate its underlying mechanisms of change. Dysfunctional cognitive content, i.e. excessively negative appraisals of the trauma or its consequences, has been shown to predict changes in PTSD symptoms over the course of treatment. However, the role of change in cognitive processes, such as trauma-related rumination, needs to be addressed. The present study investigates whether changes in rumination intensity precede and predict changes in symptom severity. We also explored the extent to which symptom severity predicts rumination.

METHOD

As part of a naturalistic effectiveness study evaluating CBT for PTSD in routine clinical care, eighty-eight patients with PTSD completed weekly measures of rumination and symptom severity. Lagged associations between rumination and symptoms in the following week were examined using linear mixed models.

RESULTS

Over the course of therapy, both ruminative thinking and PTSD symptoms decreased. Rumination was a significant predictor of PTSD symptoms in the following week, although this effect was at least partly explained by the time factor (e.g., natural recovery or inseparable treatment effects). Symptom severity predicted ruminative thinking in the following week even with time as an additional predictor.

CONCLUSIONS

The present study provides preliminary evidence that rumination in PTSD is reduced by CBT for PTSD but does not give conclusive evidence that rumination is a mechanism of change in trauma-focused treatment for PTSD.

Validating the bifactor structure of the Ruminative Thought Style Questionnaire-A psychometric study

The Ruminative Thought Style Questionnaire (RTSQ) is a self-report measure that aims to capture rumination globally, unbiased by depressive symptoms. We explored its psychometric properties among university students (N = 1123), as the existing models about the factor structure of the RTSQ have been inconclusive. In a second study (N = 320) we tested its convergent validity compared to the Ruminative Response Scale (RRS) and its construct validity compared to the Zung Self-rating Depression Scale (ZSDS). The results of Study 1 suggest that the factor structure of the RTSQ is best described with a 19-item bifactor Exploratory Structural Equation Modelling (ESEM), where most of the variance is explained by the general factor. The model was found to be invariant across genders. The correlations in Study 2 demonstrated that the RTSQ is congruent with the RRS, and that rumination captured by the RTSQ is rather maladaptive, as it was more strongly associated with the brooding subscale of the RRS than with reflective pondering. Significant positive associations were found with depressive symptoms, reaffirming the validity of the RTSQ due to the well-known association between rumination and depressive symptoms. Our results support that RTSQ assesses rumination globally, and it is a valid measure of ruminative thinking style that is rather negatively valenced but does not solely focus on depressive mood and symptoms.

Rumination Mediates the Relationship Between Negative Affect and Posttraumatic Stress Disorder Symptoms in Female Interpersonal Trauma Survivors

Prior research has identified both rumination and negative affect (NA) as dimensional constructs related to the development and maintenance of posttraumatic stress disorder (PTSD). While both dimensions demonstrate significant positive relationships with symptoms of PTSD, the relationship between the two within the context of the disorder has yet to be explored. Consistent with prior research in the social anxiety literature, the present study seeks to examine a model of mediation by which rumination accounts for the significant relationship between NA and PTSD symptoms. Participants included 65 female interpersonal trauma survivors diagnosed with PTSD using structured, clinician-administered interviews. Both NA and rumination were observed as significant predictors of PTSD symptoms, and the variables were significantly associated with each other. However, NA was no longer a significant predictor of PTSD symptoms when rumination was entered into the mediation model, suggesting full mediation of the relationship by rumination. Results from the current study suggest a complex relationship between NA and rumination in interpersonal trauma survivors with PTSD, such that a ruminative cognitive coping style may either mitigate or exacerbate PTSD symptoms in the presence of sustained negative emotion. The current findings provide support for a cognitive model of PTSD, within which PTSD symptoms are influenced via negative, ruminative cognitions. Primary implications of these results include (a) the consideration of assessment of rumination in interpersonal trauma survivors with PTSD in clinical settings; (b) the selection of treatment that may address a ruminative cognitive style in this population, given the mediation between subjective distress and PTSD symptoms by rumination; and (c) the necessity for the validation of this mediation model within other traumatized populations.

Measurement Invariance of Three Brief Measures of Rumination in Young Adults With and Without a History of Self-Injury

Abstract. Rumination is central to understanding the onset and maintenance of non-suicidal self-injury. Yet, no study has evaluated whether reported differences in rumination between people with and without a history of self-injury represent genuine group differences. The present study reports an investigation into the measurement invariance of three common measures of rumination in university students with and without a history of self-injury (total N = 1,519). Results revealed configural invariance for the Ruminative Responses Scale (RRS), the Ruminative Thought Style Questionnaire (RTSQ), and the Repetitive Thinking Questionnaire (RTQ). Additionally, the RTSQ and RTQ supported metric invariance, while the RRS supported partial metric invariance. Further, the RTQ demonstrated partial scalar invariance while the RTSQ demonstrated full scalar invariance. The current findings suggest that observed differences using the RTSQ and RTQ reflect genuine differences in rumination between people with and without a history of self-injury, while researchers using the RRS are advised to account for differential item functioning.

Coping With COVID-19: The Benefits of Anticipating Future Positive Events and Maintaining Optimism

In early 2020, the COVID-19 pandemic forced a large portion of the world into quarantine, leading to an extensive period of stress making it necessary to explore regulatory techniques that are effective at stimulating long-lasting positive emotion. Previous research has demonstrated that anticipating positive events produces increases in positive emotion during discrete stressors. We hypothesized that state and trait positive anticipation during the COVID-19 pandemic would be associated with increased positive emotions. We assessed how often participants thought about a future positive/negative/neutral event, activity, or goal through a daily reconstruction method that represented a "day in the life" of people in the United States during the early stages of the COVID-19 pandemic. The results of multi-level modeling and mediational analyses demonstrated that higher optimism, one form of trait positive anticipation, was related to higher state positive anticipation, which was in turn related to higher positive emotions during the current episode, which persisted to the next episode. In addition, both optimism and state positive anticipation were related to adaptive responses to the pandemic. These findings suggest that anticipation of future emotional experiences and hopefulness for the future can be a powerful predictor of positive emotions during global pandemics and perhaps other similar chronic stressors.

Microaggressions and Psychological Health Among College Students: A Moderated Mediation Model of Rumination and Social Structure Beliefs

Racial microaggressions are common experiences for students of color on college campuses. Given prior research connecting microaggressions to negative mental health outcomes, it is important to better understand the social context and process through which microaggressions are associated with poorer mental health. In addition, we put forth a psycho-sociological approach to microaggressions, integrating an attention to both individual psychology and broader social structure. Specifically, the present study investigated whether the indirect association of school/workplace microaggressions and internalizing symptoms (i.e., depression, anxiety, and stress) through problem-focused thoughts (a subset of ruminative thinking) differed as a function of horizontal and vertical dimensions of individualism and collectivism among a racially diverse sample of non-White college students (n = 549) from two universities in the USA. As hypothesized, problem-focused thoughts mediated the associations between school/workplace microaggressions and all three negative mental health symptoms. Furthermore, the indirect effect of school/workplace microaggressions on psychological health through problem-focused thoughts was stronger in students with high levels of vertical individualism (i.e., autonomous but recognize/accept inequality among individuals), compared to students with low or average levels. Our findings suggest that students of color who endorse vertical individualism are at a relatively greater risk of negative mental health outcomes related to school/workplace microaggressions via problem-focused thoughts. Future research is needed to examine additional factors that may buffer or strengthen the pathways between microaggressions and negative mental health in students of color.

The acute effects of alcohol on state rumination in the laboratory

RATIONALE

Rumination is a repetitive, negative, self-focused thinking style associated with various forms of psychopathology. Recent studies suggest that rumination increases craving for alcohol and predicts harmful drinking and alcohol-related problems. However, the acute effects of alcohol on rumination have not been previously studied. It is proposed that alcohol may reduce ruminative thinking through decreasing negative mood.

OBJECTIVES

In the present study, we aimed to test the previously unexplored effects of acute alcohol consumption on rumination in a hazardous drinking population.

METHODS

We conducted a randomised placebo-controlled laboratory study to examine the effect of low (0.4 g kg^-1) and high doses (0.8 g kg^-1) of alcohol on state rumination compared to placebo. Participants completed a rumination induction task prior to receiving drinks. We then measured state rumination and mood at repeated time points; 30 min, 60 min and 90 min post-drinks consumption.

RESULTS

We found a significant decrease in state rumination in the low-dose alcohol group compared to placebo at 30 min post-alcohol consumption, but no difference was observed between the high-dose alcohol and placebo groups. Mediation analysis provided evidence for an indirect effect of alcohol on state rumination through concurrent changes in negative mood.

CONCLUSIONS

These findings suggest that acute alcohol consumption can regulate negative mood and concurrently rumination, providing preliminary evidence for the role of rumination in alcohol use disorders. Rumination may be a treatment target in alcohol use disorders.

Cortical midline structures associated with rumination in women with PTSD

Elevated rumination, characterized by repetitive, negative self-focused cognition, is common in posttraumatic stress disorder (PTSD) and has been shown to predict the onset and maintenance of the disorder. Neuroimaging research has implicated cortical midline brain structures, including the rostral anterior cingulate cortex (rACC), posterior cingulate cortex (PCC), and isthmus cingulate (IsthCing), in rumination in healthy and depressed populations. While past research has revealed dysfunction in cortical midline regions in PTSD, no studies have yet investigated the structural and functional neural mechanisms underlying rumination in women with PTSD. In the current study, we used structural MRI and resting-state fMRI to examine relationships between rumination and brain volume, as well as resting-state functional connectivity (rsFC) of cortical midline structures in women with PTSD due to interpersonal trauma (N = 71). We performed multiple linear regression analyses to relate brain volume in rACC, PCC, and IsthCing regions to self-reported rumination, after controlling for age and total intracranial volume. We also conducted standard seed-based voxelwise rsFC analyses for significant regions identified in the structural analysis. We found a significant relationship between greater rumination and volume in the left IsthCing (p = .025). Results from the rsFC analyses revealed a significant relationship between greater rumination and diminished rsFC between the left IsthCing and left precuneus (p_FWE < .05). These findings provide novel support for alterations in the neural substrates of ruminative thought in women with PTSD. More broadly, we discuss clinical implications for targeted interventions to reduce rumination through psychotherapy or non-invasive brain stimulation.

Rumination in posttraumatic stress disorder: A systematic review

Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.

Phenomenology of counterfactual thinking is dampened in anxious individuals

Counterfactual thinking (CFT), or simulating alternative versions of occurred events, is a common psychological strategy people use to process events in their lives. However, CFT is also a core component of ruminative thinking that contributes to psychopathology. Though prior studies have tried to distinguish adaptive from maladaptive CFT, our study provides a novel demonstration that identifies phenomenological differences across CFT in participants with varying levels of trait anxiety. Participants (N = 96) identified negative, regretful memories from the past 5 years and created a better counterfactual alternative (upward CFT), a worse counterfactual alternative (downward CFT), or simply recalled each memory. Participants with high levels of trait anxiety used more negative language when describing their mental simulations, reported lower ratings of composition during upward CFT, and reported more difficulty in imagining the emotion they would have felt had negative events turned out to be better. Additionally, participants with high anxiety thought that upward CFT was less likely to occur relative to individuals with low anxiety. These results help to clarify how mental simulations of aversive life events are altered in anxiety and serve as a stepping stone to future research uncovering the mechanisms of ruminative thought patterns.

Residential greenspace is associated with mental health via intertwined capacity-building and capacity-restoring pathways

BACKGROUND

Experiences afforded by natural settings promote health by helping people to build new adaptive capacities and to restore existing capacities. The aim of this study was to examine relations among restorative experience, mindfulness, rumination and psychological resilience in pathways linking residential greenspace to anxiety and depression symptoms.

METHODS

We sampled 529 university students residing in Plovdiv, Bulgaria. Residential greenspace was measured in terms of the Normalized Difference Vegetation Index (NDVI) and tree cover density for different buffer sizes. Symptoms of anxiety and depression were measured with the Generalized Anxiety Disorder scale (7-item) and Patient Health Questionnaire (9-item), respectively. The following mediators were assessed by self-report: perceived greenspace, restorative quality of the neighborhood, dispositional mindfulness, rumination, and psychological resilience. Structural equation modelling techniques were used to test the theoretically-indicated relations among the variables.

RESULTS

Across different buffer sizes, higher greenspace was consistently associated with reduced scores on the anxiety and depression scales. This effect was partially mediated via several pathways. Specifically, higher NDVI _500-m was associated with higher perceived greenspace, and in turn, with higher restorative quality, and then with higher mindfulness, lower rumination, and greater resilience to stress, and consequently, with better mental health.

CONCLUSIONS

Our findings affirm the potential of greenspace for building psychological resilience and promoting health by offsetting dysfunctional rumination and facilitating mindfulness as components of intertwined capacity-building and capacity-restoring pathways.

Depressive symptoms, ruminative thinking, marijuana use motives, and marijuana outcomes: A multiple mediation model among college students in five countries

BACKGROUND

Previous studies have evidenced that rumination and drinking motives may mediate the association between depressive symptoms and alcohol outcomes. The present study cross-culturally examined whether a similar mediation model may extend to marijuana. Specifically, we tested distinct rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and marijuana use motives (social, coping, expansion, conformity, enhancement) as double-mediators of the paths from depressive symptoms to marijuana outcomes (use and consequences).

METHOD

A comprehensive mediation path model was tested in a cross-sectional sample of college student marijuana users (n = 1175) from five countries (U.S., Argentina, Uruguay, Spain, Netherlands). Multi-group models were tested to determine if the proposed mediational model was invariant across sex and different cultures/countries.

RESULTS

Depressive symptoms and marijuana outcomes were indirectly associated through ruminative thinking and marijuana motives. Specifically, higher depressive symptoms were associated with higher problem-focused thoughts; which in turn were associated with: a) higher endorsement of coping motives which in turn was associated with higher marijuana use and related consequences and b) lower endorsement of enhancement motives which in turn was associated with lower marijuana use and related consequences. The multi-group analyses showed that the model was invariant across sex and the five countries.

CONCLUSIONS

The present research supports the existence of a universal (i.e., cross-national invariant) negative affect regulation pathway to marijuana use/misuse similar to those previously found with alcohol. Additional research is needed to confirm the role of enhancement motives in the associations of depression, rumination and marijuana outcomes.

Ruminating in English, Ruminating in Spanish

Abstract. The present study aimed to adapt and validate a Spanish version of the Ruminative Thought Style Questionnaire (RTSQ) and test for measurement invariance of the RTSQ across college students in the US, Spain, and Argentina ( n = 1,632). Additionally, we examined/compared across these countries, criterion-related (i.e., concurrent) validity of RTSQ factors (i.e., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) on constructs theoretically-associated with rumination. Consistent with previous findings, we found that a 15-item 4-factor RTSQ provided a more adequate model compared to single-factor CFA models (15- and 20-item versions) in every country. The reliability and validity of the subscales for the Spanish version were satisfactory-to-good in Spain and Argentina. Using multigroup confirmatory factor analyses, we found the 15-item 4-factor version of the RTSQ to be invariant across countries and sex. Bivariate correlations provided evidence for the criterion-related validity of the 4-factor RTSQ across the countries. Our findings suggest that self-report items of the RTSQ convey the same meaning, and that responses to those items load onto the same set of factors, across languages and cultures of administration. Taken together, our findings serve as a foundation for future cross-cultural work testing models in which rumination is a central facet.

The association between perseverative cognition and resting heart rate variability: A focus on state ruminative thoughts

OBJECTIVE

Two studies were conducted to shed light on the associations between trait and state rumination and worry and a time-domain metric of heart rate variability, the root mean square of successive differences (RMSSD) of cardiac interbeat-interval (IBI).

METHOD

Study 1 involved 130 healthy adults (118 females; mean age = 23.4 ± 3.59 years), while 72 healthy participants (58 females; mean age = 22.2 ± 1.79 years) were involved in Study 2. RMSSD was calculated from a 5-min baseline recording and state ruminative thoughts were assessed during measurement. Trait perseverative cognitions were measured using self-reported questionnaires.

RESULTS

In Study 1, we found that a higher level of state but not trait ruminative thoughts showed weak negative association with lnRMSSD. In Study 2, we replicated the results of Study 1 and we found that trait reflection moderated the relationship between state rumination and lnRMSSD.

CONCLUSION

State rumination may reflect actual cardiovascular activity better than trait preservative cognitions, although trait reflection could be a protective factor.

Episodic Counterfactual Thinking

Our tendency to engage in episodic counterfactual thinking—namely, imagining alternative ways in which past personal events could have occurred but did not—is ubiquitous. Although widely studied by cognitive and social psychologists, this autobiographically based variety of counterfactual thought has been connected only recently to research on the cognitive and neuroscientific basis of episodic memory and mental simulation. In the current article, we offer an empirical characterization of episodic counterfactual thinking by contrasting it with related varieties of mental simulation along three dimensions: temporal context, degree of episodic detail, and modal profile (i.e., perceived possibility or impossibility). In so doing, we offer a practical strategy to navigate the nascent literature on episodic counterfactual thinking within the context of other mental simulations, and we argue that the evidence surveyed strongly indicates that although connected along the aforementioned dimensions, episodic counterfactual thinking is a psychological process different from episodic memory, episodic future thinking, and semantic counterfactual thinking.

Depressive symptoms, ruminative thinking, drinking motives, and alcohol outcomes: A multiple mediation model among college students in three countries

BACKGROUND

Recent research suggests that ruminative thinking (specifically problem-focused thoughts) may explain why individuals engage in drinking to cope (DTC) when dealing with depressive symptoms; which in turn leads to increased negative alcohol-related consequences. Cross-cultural studies addressing these phenomena are scarce.

OBJECTIVES

The present study cross-culturally tested whether four rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) uniquely mediate the relationships between depressive symptoms and drinking motives/alcohol outcomes in a multicultural sample of college student drinkers (n=1429) from Spain, Argentina, and the U.S.

METHOD

Structural equation modeling was conducted to test the models, controlling for sex. Further, we conducted invariance testing to determine whether our models were culturally-specific or culturally-universal.

RESULTS

Within both proposed models, no rumination facet uniquely mediated the relationship between depressive symptoms and drinking motives. However, an exploratory model with a second-order latent factor of ruminative thinking did significantly mediate these associations (exception was conformity motives). Further, there were two significant double-mediated associations that suggested that increased depressive symptoms is associated with increased ruminative thinking, which is associated with higher DTC motives, which in turn is associated with higher alcohol consumption and negative alcohol-related consequences. All models were found to be invariant across countries and sex, suggesting that these associations may be relatively universal.

CONCLUSIONS

Rumination is relevant to understand the increased vulnerability of college drinkers to exhibit greater alcohol consumption and negative consequences via DTC motives when dealing with depressive symptoms.

Neural activity associated with repetitive simulation of episodic counterfactual thoughts

When people revisit past autobiographical events they often imagine alternative ways in which such events could have occurred. Often these episodic counterfactual thoughts (eCFT) are momentary and fleeting, but sometimes they are simulated frequently and repeatedly. However, little is known about the neural differences between frequently versus infrequently repeated eCFT. The current study explores this issue. In a three-session study, participants were asked to simulate alternative ways positive, negative, and neutral autobiographical memories could have occurred. Half of these eCFT were repeatedly re-simulated while the other half were not. Immediately after, participants were asked to simulate all these eCFT again while undergoing fMRI. A partial least squares analysis on the resultant fMRI data revealed that eCFT that were not frequently repeated preferentially engaged brain regions including middle (BA 21) and superior temporal gyri (BA 38/39), middle (BA 11) and superior frontal gyri (BA 9), and hippocampus. By contrast, frequently repeated eCFT preferentially engaged regions including medial frontal gyri (BA 10), anterior cingulate cortex, insula, and inferior parietal lobule (BA 40). Direct contrasts for each type of eCFT were also conducted. The results of these analyses suggest differential contributions of regions traditionally associated with eCFT, such as BA 10, anterior cingulate cortex, and hippocampus, as a function of kind of eCFT and frequency of repetition. Consequences for future research on eCFT and rumination are considered.

Cross-Cultural Validity of the Ruminative Responses Scale in Argentina and the United States

Although frequently used in the United States, the Ruminative Response Scale (RRS) has not been extensively studied in cross-cultural samples. The present study evaluated the factor structure of Treynor et al.'s 10-item version of the RRS in samples from Argentina (N = 308) and the United States (N = 371). In addition to testing measurement invariance between the countries, we evaluated whether the maladaptive implications of rumination were weaker for the Argentinians than for the U.S. group. Self-critical perfectionism was the criterion in those tests. Partial scalar invariance supported an 8-item version of the RRS. There were no differences in factor means or factor correlations in RRS dimensions between countries. Brooding and Reflection were positively correlated with self-critical perfectionism in both countries, with no significant differences in the sizes of these relations between the two samples. Results are discussed in terms of psychometric and cross-cultural implications for rumination.

PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology

A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment.

New DSM-5 PTSD guilt and shame symptoms among Italian earthquake survivors: Impact on maladaptive behaviors

Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster.

Development and Validation of a Chinese Language Version of the Ruminative Thought Styles Questionnaire

The Ruminative Thought Styles Questionnaire (RTS) conceptualizes rumination as repetitive, recurrent, intrusive, and uncontrollable thinking. This article outlines the development and validation of a Chinese language version of the RTS, the RTS-CH. Following independent translation, back translation, and final translation checking, the factor structure, convergent and divergent validity, and item-level congruence of the RTS-CH was examined and improved. The resultant scale showed equivalence to the RTS and had attractive psychometric properties. The RTS-CH is the first Chinese language rumination measure that does not have inherently negative or depressive content.

The Dimensions of Ruminative Thinking: One for All or All for One

The Ruminative Thought Scale (RTS) was developed to measure the ruminative thinking style, presumably common to various psychopathological disorders. However, prior factor-analytic research was inconclusive regarding unidimensionality versus multidimensionality of the RTS. The present study was conducted on a large, heterogeneous Serbian sample ( N = 838). A subsample was retested 6 months later providing information about symptoms of depression and various anxiety symptoms. Results showed that a bifactor model of the RTS (representing one general and four group factors) had a better fit than the second-order and one-factor models. The subscale scores were not prospective predictors of symptoms of depression and anxiety, over and above the contribution of the total score. The RTS is a reliable transdiagnostic measure of repetitive thinking. Although there is some clustering of more homogeneous items, there is not enough evidence to support interpretation of the subscales.

Assessing maladaptive repetitive thought in clinical disorders: A critical review of existing measures

Rumination and worry have recently been grouped under the broader transdiagnostic construct of repetitive thought (Watkins, 2008). The purpose of this review is to provide an overview of scales used to assess repetitive thinking across a broad range of contexts: depression, anxiety, trauma, stress, illness, interpersonal difficulties, positive affect, and so forth. We also include scales developed or adapted for children and adolescents. In the extant literature, measures of repetitive thinking generally show small-to-moderate correlations with measures of psychopathology. This review highlights problems with the content validity of existing instruments; for example, confounds between repetitive thought and symptomatology, metacognitive beliefs, and affect. This review also builds on previous reviews by including newer transdiagnostic measures of repetitive thinking. We hope that this review will help to expand our understanding of repetitive thinking beyond the mood and anxiety disorders, and suggest ways forward in the measurement of repetitive thinking in individuals with comorbid conditions.

Psychological Distress and Non-Suicidal Self-Injury: The Mediating Roles of Rumination, Cognitive Reappraisal, and Expressive Suppression

This study sought to explore the relationships between depression, anxiety, stress, and non-suicidal self-injury (NSSI), and the mediating roles of rumination and emotion regulation in this relationship. The sample comprised 1,586 Australian university students who completed a self-report questionnaire assessing the relevant variables. Of the sample, 8.9% engaged in NSSI in the 4 weeks prior to the survey. Depression, anxiety, and stress each exerted a direct effect on NSSI, and each relationship was mediated by cognitive reappraisal. The relationship between stress and NSSI was also mediated by expressive suppression. The results imply intervention efforts aimed at teaching adaptive emotion regulation strategies for students experiencing high levels of psychological distress may reduce the frequency of NSSI.

Drinking to Cope With Depressive Symptoms and Ruminative Thinking: A Multiple Mediation Model Among College Students

BACKGROUND

Understanding the potential psychosocial mechanisms that explain (i.e., mediate) the associations between depressive symptoms and alcohol-related problems can improve interventions targeting college students.

OBJECTIVES

The current research examined four distinct facets of rumination (e.g., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and drinking to cope motives as potential explanatory mechanisms by which depressive symptoms are associated with increased alcohol-related problems.

METHOD

Participants were undergraduate students from a large, southeastern university in the United States that consumed at least one drink per typical week in the previous month (n = 403). The majority of participants were female (n = 291; 72.2%), identified as being either White, non-Hispanic (n = 210; 52.1%), or African American (n = 110; 27.3%), and reported a mean age of 21.92 (SD = 5.75) years.

RESULTS

Structural equation modeling was conducted examining the concurrent associations between depressive symptoms, rumination facets, drinking to cope motives, and alcohol-related problems (i.e., cross-sectional). There was one significant double-mediated association that suggested that increased depressive symptoms is associated with increased problem-focused thoughts, which is associated with higher drinking to cope motives and alcohol-related problems. Conclusions/Importance: Our results suggests that problem-focused thoughts at least partially explains the associations between depression and maladaptive coping (i.e., drinking to cope), which in turn is related to problematic drinking among college students. Limitations and future directions are discussed.