Extending the recovery window: Effects of trait rumination on subsequent evening cortisol following a laboratory performance stressor

Sex differences in cortisol levels in depression: A systematic review and meta-analysis

Higher prevalence of depression in females might be associated with sex-specific cortisol levels. Evidence exists that cortisol levels differ between healthy females and males, however a sex-specific association in depression has not been systematically assessed. Thus, the current study quantifies the existing literature on different cortisol parameters, i.e., basal cortisol, hair cortisol, cortisol awakening response (CAR), and cortisol stress reactivity comparing depressed females and males as well as sex-specific comparisons with healthy controls. Following an extensive literature research, fifty original articles were included. Depressed females had significantly higher hair cortisol, higher CAR, and lower cortisol stress reactivity compared to depressed males. In comparison with sex-matched controls, female patients had significantly higher evening basal cortisol, higher CAR and lower cortisol stress reactivity, and male patients had significantly higher general, morning and evening basal cortisol. Overall, sex as a fundamental driver of cortisol levels in depression needs to be taken into account.

Hooked on a thought: Associations between rumination and neural responses to social rejection in adolescent girls

Rumination is a significant risk factor for psychopathology in adolescent girls and is associated with heightened and prolonged physiological arousal following social rejection. However, no study has examined how rumination relates to neural responses to social rejection in adolescent girls; thus, the current study aimed to address this gap. Adolescent girls (N = 116; ages 16.95-19.09) self-reported on their rumination tendency and completed a social evaluation fMRI task where they received fictitious feedback (acceptance, rejection) from peers they liked or disliked. Rejection-related neural activity and subgenual anterior cingulate cortex (sgACC) connectivity were regressed on rumination, controlling for rejection sensitivity and depressive symptoms. Rumination was associated with distinctive neural responses following rejection from liked peers including increased neural activity in the precuneus, inferior parietal gyrus, dorsolateral prefrontal cortex, and supplementary motor area (SMA) and reduced sgACC connectivity with multiple regions including medial prefrontal cortex, precuneus and ventrolateral prefrontal cortex. Greater precuneus and SMA activity mediated the effect of rumination on slower response time to report emotional state after receiving rejection from liked peers. These findings provide clues for distinctive cognitive processes (e.g., mentalizing, conflict processing, memory encoding) following the receipt of rejection in girls with high levels of rumination.

Growth mindset and responses to acute stress

Individuals with high levels of growth mindsets believe that attributes are malleable. Although links between acute stress responses and growth mindsets of thought, emotion, and behaviour are central to the conceptualisation of psychological disorders and their treatment, such links have yet to be examined. Undergraduate participants (N = 135) completed a modified Trier Social Stress Test (TSST), and their salivary cortisol and anxiety were assessed throughout the session. Hierarchical linear models revealed that higher growth mindset of behaviour was associated with lower cortisol levels at 25-min after the TSST onset (i.e. peak cortisol stress reactivity) in men, but not in women. Considering one's gender may be critical in understanding the relationship between growth mindset and stress responses.

Effects of Induced Mindfulness at Night on Repetitive Negative Thinking: Ecological Momentary Assessment Study

BACKGROUND

Repetitive negative thinking (RNT) is a cognitive risk factor for various disorders. Although brief mindfulness-based interventions (MBIs; lasting 20-30 minutes or shorter) are effective tools to reduce RNT, the effect of a minimal (5-minute) MBI remains largely unknown.

OBJECTIVE

We investigated the acute changes in RNT induced by a 10-day minimal MBI (body scan before sleeping) using an ecological momentary assessment (EMA) administered during the MBI training phase. In addition, we examined longer-term effects on the postintervention and 2-month follow-up assessments for questionnaire-based RNT and psychological distress.

METHODS

A total of 68 participants (community sample, aged 18-55 years; n=58, 85% women) were randomly allocated to either the intervention group (n=35, 51%) or the no-training control group (n=33, 49%). Both groups completed a 10-day EMA phase of RNT, during which only the intervention group performed a daily 5-minute body scan before sleeping.

RESULTS

The intervention group showed a significantly larger reduction in questionnaire-based RNT than the control group at the follow-up assessment (for growth-curve modeling analysis [GMA], d_GMA=-0.91; P<.001), but this effect was not observed during the EMA phase or at the postintervention assessment. Furthermore, the intervention group showed significantly larger decreases in stress both at the postintervention (d_GMA=-0.78; P<.001) and follow-up (d_GMA=-0.60; P<.001) assessments than the control group. We found no intervention effects on depressive and anxiety symptoms.

CONCLUSIONS

A 5-minute body scan before sleeping reduces RNT and stress when continued for at least 10 days; however, the results suggest that this effect only appears with some time lag because no acute changes during and immediately after the intervention emerged for RNT.

Implicit theories shape responses to social-evaluative threat

It is important to understand factors that make one more or less vulnerable to the harmful effects of social threat. This study focuses on the role of implicit theories (also referred to as mindsets) in shaping responses to a potent form of social threat, namely social-evaluative threat (SET). 124 individuals participated in an experimental study in which they were induced to have an incremental theory or an entity theory about their social skills. Next, they were exposed to SET in the laboratory. Psychological and physiological responses were assessed including social self-esteem, rumination, spontaneous mentions of concerns about one's social skills, and heart-rate variability. Compared to those induced to have entity theories, those induced to have incremental theories were buffered from the typical harmful effects of SET on social self-esteem, rumination, and concerns about their social skills. The association between implicit theories and heart-rate variability fell just short of significance.

Adolescent effects on mothers’ bedtime cortisol: Cognitive interference as a mediating mechanism

Prior studies have shown that parent and adolescent cortisol are associated across days and that this covariation may be adolescent-driven. This study extends this literature by (a) testing whether parents' cognitive interference (i.e., distracting and ruminative thoughts potentially due to worry) mediates the linkages between adolescent and next-day parent cortisol and (b) whether these linkages were moderated by parent gender or warmth. Daily diary data, including bedtime cortisol, were collected on two samples of employees and their adolescent-aged children (N = 318 dyads, M_{youth age}  = 13.18 years, 74% mothers). We tested mediation with autoregressive cross-lagged models. Moderated mediation by parent gender was found in our bedtime cortisol models. Higher adolescent bedtime cortisol levels were associated with higher next-day levels of mothers' cognitive interference. In turn, higher levels of mothers' cognitive interference were linked to higher mothers' same-day bedtime cortisol levels. These linkages were not significant for fathers. Cognitive interference did not mediate the associations between child and parent area under the curve or cortisol awakening response. No moderation was evident for parental warmth. Results suggest that mothers' cognitions play a key role in the transmission of elevated bedtime cortisol levels from adolescents to their mothers.

Stressed in afterthought: Neuroendocrine effects of social self-threat during physical effort are counteracted by performance feedback after stress exposure

Social self-threat during physical stress, such as exposure to the cold pressor test and isometric handgrip test, has been shown to induce activation of the HPA axis, in addition to autonomic responses. However, previous research has suggested that dysfunctional post-event processing may play a major role in neuroendocrine reactivity at initial as well as subsequent social stress exposure. In the present study, we investigated how the interplay of context (i.e. performance feedback) with state (i.e., self-esteem) as well as trait-like factors (i.e., ruminative tendencies) affects stress responses to repeated, short bouts of physical activity. On two sessions, 1 week apart, 53 participants (27 women) performed an isometric handgrip task for 3 min, during which they were exposed to social-evaluative threat. In addition, participants received fake feedback on their performance immediately after the task, labeling it as either 'above' (positive) or 'below average' (negative). In addition to neuroendocrine (cortisol), cardiovascular (heart rate, blood pressure) and subjective stress reactivity, performance-related and social dimensions of state self-esteem were assessed before and after stress induction. Substantial increases in cardiovascular parameters were found on both days, regardless of feedback condition. However, positive feedback led to significantly diminished neuroendocrine responses on day 1, whereas baseline cortisol on session 2 was significantly higher in the negative feedback group. Conversely, social self-esteem decreased after stress induction on both days only for participants who had received negative feedback. Changes in self-esteem reported on day 1 were associated with increased baseline cortisol at the second session, while interindividual differences in self-reported (trait) rumination were associated with cortisol reactivity at session 1. Taken together, the results suggest that effects of social evaluation during short periods of physical stress rely on post-event processing and might be counteracted by positive appraisal directly after stress exposure. Post-hoc framing (in terms of success vs. failure) may predict subsequent stress-related hormonal effects better than task demands per se, which should be considered as a potential moderator in future acute stress research, but might also be relevant to many practical applications in fields ranging from sports/performance to health psychology.

Depressive symptomatology and alcohol misuse among treatment-seeking military veterans: Indirect associations via ruminative thinking

BACKGROUND

Veterans are particularly vulnerable to experiencing concurrent issues related to depression and alcohol misuse. Despite this well-established susceptibility, research explicating targetable mechanisms that can account for this comorbidity remains limited. The present study sought to examine the explanatory role of ruminative thought processing within the depression and alcohol misuse relationship.

METHOD

The sample included 230 veterans presenting to a general mental health clinic at a large Veterans Affairs (VA) hospital (83% male, 58% African American, M_age = 50.61, SD_age = 13.79). As part of their intake evaluation, veterans completed a brief battery of self-report questionnaires to assist with diagnostic clarification and treatment planning.

RESULTS

A significant total effect was observed between depression and alcohol misuse. An indirect effect between depression and alcohol misuse via rumination was also found. Notably, when examining two subtypes of rumination, an indirect effect between depression and alcohol misuse via reflective pondering but not brooding was evinced.

CONCLUSIONS

Findings suggest that ruminative thought processing may be an explanatory risk factor within the depression and alcohol misuse relationship. By testing the simultaneous indirect effects of brooding rumination and reflective pondering, the present study also offers novel insights concerning the circumstances under which reflection may become a maladaptive process.

Goal-directed rumination and its antagonistic effects on problem solving: a two-week diary study

BACKGROUND

The tendency to repetitively and intrusively think about a particular negative event, goal failure, or problem (i.e., goal-directed rumination) is generally associated with impairments in well-being, thus decreasing performance in solving this failure. However, rumination is also associated with higher levels of resources invested in problem solving, likely leading to an improvement in performance.

OBJECTIVES

The current study thus examines the indirect effect of rumination via various mediators on subjective problem-solving performance in the everyday context.

DESIGN

Over a period of two weeks, 147 students completed a brief survey each evening (i.e., diary study).

METHODS

Data were analyzed by means of a multiple mediation model in the multilevel structural equation modeling (MSEM) framework.

RESULTS

The analyses revealed that perceived stress and negative mood negatively mediated the relationship between rumination and problem solving, while attention and effort positively mediated this relationship. Finally, both a negative direct and total effect of rumination on problem solving was observed.

CONCLUSIONS

Conclusively, goal-directed rumination exerted a negative indirect effect on subjective problem solving via perceived stress and negative mood, whereas it positively affected problem solving via attention and effort. Possible limitations and implications are discussed.

Academic performance: A longitudinal study on the role of goal-directed rumination and psychological distress

BACKGROUND

In this research, we examine the relationship between goal-directed rumination, psychological distress, and performance. Although previous research has largely contributed to our understanding of how these constructs are related, the direction of their relationships remains unclear.

OBJECTIVES

We argue that goal-directed rumination and psychological distress (conceived as perceived stress and strain) are reciprocally related, and that goal-directed rumination has a positive effect on performance when controlling for the negative effect of psychological distress.

DESIGN

We explored these relationships in a longitudinal field study, drawing on multiple sources: self-reports of 147 students on goal-directed rumination and psychological distress and objective ratings of academic performance.

METHOD

Based on structural equation modelling, we employed a random-intercept cross-lagged panel model and hierarchical regressions to examine our hypotheses.

RESULTS

We demonstrated that goal-directed rumination predicted perceived stress one week later but not vice versa, while its relationship to strain was less clear. Furthermore, goal-directed rumination positively predicted academic performance when we controlled for psychological distress.

CONCLUSIONS

We found evidence for a unidirectional relationship between goal-directed rumination and psychological distress, especially for perceived stress. Additionally, we observed that psychological distress diminishes the beneficial effect of goal-directed rumination on academic performance.

Rumination about discrimination mediates the unique association between anger and collective action intentions

People are more willing to engage in collective action when they feel anger about collective disadvantage (van Zomeren, Postmes, & Spears, 2008). However, anger is often a fleeting emotion, whereas collective action is deliberate and sustained. Moreover, people cannot always engage in collective action on demand. We propose that rumination, or repetitive thoughts about negative emotions and experiences, may constitute a mechanism by which anger about collective disadvantage is sustained, and through it the motivation to engage in collective action. In three separate samples (128 students of color, 155 women, and 150 sexual minorities), we measured group-based anger about discrimination, group efficacy, group identification, rumination about discrimination, and collective action intentions. In all samples, rumination mediated the unique association between group-based anger and collective action intentions, controlling for group efficacy and group identification. Further, in an experimental study with 117 undergraduate women, we found that rumination, compared to distraction, sustained anger about collective disadvantage over a short period of time, and this sustained level of anger mediated the relationship between rumination and collective action intentions. These results lend support to conceptualizing collective action as a form of coping with collective disadvantage, and highlight the potential role of emotion regulation strategies like rumination in understanding intergroup relations.

Towards an integration of recovery and restoration theories

The attempts to balance between the actual and preferred states of activation or relaxation has been studied from a recovery and a restoration perspective. There are many noticeable parallels between restoration and recovery. Both traditions depart from understanding the need for the individual to regain finite resources that has been used to meet and handle external demands. There is some disagreement of the phenomena, and the terminology may differ as well as the implied meaning of the underlying concepts. Both traditions although consider resource use on one hand, and the processes to return to a state where these resources are replenished, on the other hand. To integrate the recovery and restoration traditions a tentative model is proposed, recognizing that both traditions departs from an interactive process perspective, where the need to replenish resources are consciously perceived.

HPA axis responses to psychological challenge linking stress and disease: What do we know on sources of intra- and interindividual variability?

Stress is an ubiquitous phenomenon with significant impact on human physiology when it lasts too long, when it is too intense, or when it hits vulnerable individuals. Examining the mechanisms linking stress exposure with health and disease is an important endeavor in psychoneuroendocrine research. Empirical evidence so far revealed large intra- as well as inter-individual variability in hypothalamic-pituitary-adrenal (HPA) axis responses to acute psychosocial stress, showing that the HPA axis is a highly adaptive system. Thus, the characterization of intra- und inter-individual patterns of HPA axis reactivity is of high scientific interest and forms the basis on which mechanistic links between stress response (dys)regulation and health impairments can be examined. To date, basic knowledge has been, and still is, accumulated on demographic, biological (including genetic and epigenetic) factors, lifestyle behavioral variables, consumption of substances and medication, psychological and personality factors, as well as on methodological aspects. Besides this, there is also very recent progress in respect to the development of laboratory stress paradigms that can be applied in virtual reality or inside an MRI-scanner. In sum, the present review updates our current knowledge on moderating and intervening factors as sources of intra- und inter-individual variability in human cortisol stress responses and offers recommendations for future research designs.

Depressive Symptoms, Rumination, and Emotion Reactivity Among Youth: Moderation by Gender

The emotion context-insensitivity hypothesis (ECI; Rottenberg et al., 2005) posits that depressive symptoms are associated with blunted emotional reactivity and is supported by the results of a meta-analysis (Bylsma et al., 2008). Yet it remains unclear how strongly ECI holds across emotional response domains, whether ECI operates similarly in male and female individuals, and whether this pattern of underreactivity is observed in youth. In contrast, rumination, a cognitive style strongly associated with depressive symptoms, may be associated with heightened reactivity. We assessed the effects of youth's depressive symptoms and rumination on subjective and physiological emotion reactivity (N = 160; M_age = 12.67, SD_age = 1.12; 48% female; 94% non-Hispanic). State sadness and respiratory sinus arrhythmia were assessed during a baseline activity (nature video) and a sad mood induction. As hypothesized, depressive symptoms predicted less subjective emotional reactivity, whereas rumination predicted more subjective reactivity. Exploratory analyses revealed that associations for physiological reactivity differed by child gender. ECI may be stronger in terms of subjective rather than physiological emotional reactivity.

The cortisol reactivity threshold model: Direction of trait rumination and cortisol reactivity association varies with stressor severity

Various internalizing risk factors predict, in separate studies, both augmented and reduced cortisol responding to lab-induced stress. Stressor severity appears key: We tested whether heightened trait-like internalizing risk (here, trait rumination) predicts heightened cortisol reactivity under modest objective stress, but conversely predicts reduced reactivity under more robust objective stress. Thus, we hypothesized that trait rumination would interact with a curvilinear (quadratic) function of stress severity to predict cortisol reactivity. Evidence comes from 85 currently non-depressed emerging adults who completed either a non-stressful control protocol (n = 29), an intermediate difficulty Trier Social Stress Test (TSST; n = 26), or a robustly stressful negative evaluative TSST (n = 30). Latent growth curve models evaluated relationships between trait rumination and linear and quadratic effects of stressor severity on the change in cortisol and negative affect over time. Among other findings, a significant Trait Rumination x Quadratic Stress Severity interaction effect for cortisol's Quadratic Trend of Time (i.e., reactivity, B = .125, p = .017) supported the hypothesis. Rumination predicted greater cortisol reactivity to intermediate stress (r_p = .400, p = .043), but blunted reactivity to more robust negative evaluative stress (r_p = -0.379, p = 0.039). Contrasting hypotheses, negative affective reactivity increased independently of rumination as stressor severity increased (B = .453, p = 0.044). The direction of the relationship between an internalizing risk factor (trait rumination) and cortisol reactivity varies as a function of stressor severity. We propose the Cortisol Reactivity Threshold Model, which may help reconcile several divergent reactivity literatures and has implications for internalizing psychopathology, particularly depression.

More than a feeling: A unified view of stress measurement for population science

Stress can influence health throughout the lifespan, yet there is little agreement about what types and aspects of stress matter most for human health and disease. This is in part because "stress" is not a monolithic concept but rather, an emergent process that involves interactions between individual and environmental factors, historical and current events, allostatic states, and psychological and physiological reactivity. Many of these processes alone have been labeled as "stress." Stress science would be further advanced if researchers adopted a common conceptual model that incorporates epidemiological, affective, and psychophysiological perspectives, with more precise language for describing stress measures. We articulate an integrative working model, highlighting how stressor exposures across the life course influence habitual responding and stress reactivity, and how health behaviors interact with stress. We offer a Stress Typology articulating timescales for stress measurement - acute, event-based, daily, and chronic - and more precise language for dimensions of stress measurement.

Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults

Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (M_age = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes.

Do psychosocial predictors affect the following days' cortisol awakening response? Expanding the temporal frame with which to explore morning cortisol

Much of the extant cortisol awakening response (CAR) literature posits that CAR is an anticipatory response to perceived demands later that same day. However, expanding and switching the temporal order of cortisol and psychosocial influences may motivate more flexible approaches to understanding the dynamic relationship between mind and body, including cumulative strain on the HPA axis. This study was novel because we used two models to explore the effects of one day's emotion regulation and cortisol levels on cortisol and CAR the following day in 100 mildly stressed adults aged 50-81 years old, which contrasts with the more common CAR-anticipatory-response design. In the first model, High negative-affect-variation on day 1 predicted a higher risk of having a flat CAR the next day, relative to the moderate-affect-variation group (RR = 10.10, p < .05). In the second model, higher bedtime cortisol on day 1 was positively associated with waking cortisol (β = .293, p < .01) and flatter CAR slopes on day 2 (β = -.422, p < .001). These results show that morning cortisol intercepts and slopes may be associated with previous days' affect variability and levels of bedtime cortisol. These results also suggest that anticipation of demands may extend to the previous day, rather than just the morning of the demand, indicating a broader temporal framework for the study of CAR.

Trait and state rumination interact to prolong cortisol activation to psychosocial stress in females

There is a growing realization that cognitive processes associated with stress coping, such as rumination and distraction, can impact the hypothalamic-pituitary-adrenal-axis (HPA-axis). Yet, little is known about what aspects of the HPA-axis stress response (rate of activation, duration of activation, rate of recovery) is impacted by such cognitive processes. This study examines the impact of both ruminative trait tendencies and experimentally induced rumination on salivary cortisol responses to a social evaluative stress task. Participants (n=71) were exposed to the Trier Social Stress Test (TSST) and were then randomized to complete either a rumination or distraction task. Trait rumination was also assessed at baseline. Results showed no main effects of either trait rumination or experimental condition, but they interacted to predict the cortisol response. Specifically, participants high in trait rumination had prolonged duration of cortisol activation in the rumination condition, compared to those in the distraction condition. In contrast, cortisol responses of participants with low trait rumination did not differ by condition. Notably, our interaction effect was only significant in females. Our findings highlight the complex relationship between rumination and HPA-axis activity, suggesting an interaction of trait and state rumination in shaping HPA-axis responses to stress, and call attention to sex differences in this relationship.