Ruminative coping with depressed mood following loss

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.

Emotion regulation use in daily-life and its association with success of emotion-regulation, self-efficacy, stress, and state rumination

Introduction

Investigations on emotion regulation strategies (ERS) primarily focus on the influence of instructed emotion regulation (ER) on outcomes. However, recent work has shown that selection of ERS is dependent on, e.g., situational demands and personal resources.

Methods

In this current investigation, we used an online diary to investigate ERS used by free choice and their association with ER-success, stress and rumination. We identified four factors of ERS: cognitive perspective change, cognitive-behavioral problem-solving, suppression-distraction and body-social ERS. Associations of ERS with stress, state-rumination and ER-success were investigated using multilevel-mixed-models, allowing to separate within- and between-subject effects.

Results

Our results show that, on a within-subject level, all adaptive ERS were positively associated with ER-success, while maladaptive ERS as well as higher stress and state rumination were negatively associated with ER-success. On the other hand, only within-subject cognitive ERS were associated with higher self-efficacy. Maladaptive ERS-use was consequently positively associated with stress and state rumination. Surprisingly, only cognitive perspective change ERS were negatively associated with state rumination. Cognitive-behavioral problem-solving was positively associated with stress and success of emotion regulation.

Discussion

We interpret these results in the light of situational constraints of ERS-use and the importance of the assessment of these in future studies.

Patterns of life stress and the development of ruminative brooding in adolescence: A person-centered approach

Research links life stressors, including acute, chronic, and early life stress, to the development of ruminative brooding. However, singular forms of life stress rarely occur in isolation, as adolescents typically encounter stressors that vary on important dimensions (e.g., types, timings, quantities) across development. The current study employs latent profile analysis (LPA) to identify natural clusters of life stress that, over time, may be differently associated with ruminative brooding. Evaluations of episodic, chronic, and early life stress were conducted with community-recruited mid-adolescents (N = 241, Mage = 15.90 years, 53% female) and their parents using the UCLA Life Stress Interview and lifetime adversity portions of the Youth Life Stress Interview. Analyses identified four distinct patterns: low stress, high peer stress, moderate home / family stress, and multifaceted / high school stress. Adolescents in the high peer stress and moderate home / family stress profiles were at highest risk for developing a brooding style over time. Despite high overall levels of stress, teens in the multifaceted / high school stress profile were at not at elevated risk for developing a brooding style. Findings demonstrate the utility of person-centered approaches to identify patterns of stress exposure that heighten risk for brooding over time.

Physical Limitations, Health Rumination/Worry, and Depressive Symptoms: Gender Differences among African Americans

Although studies have documented the relationships between physical health, health rumination/worry, and mental health, few investigations have assessed these linkages within African American communities. Using a community-based sample of residents in historically lower-income, African American communities (N = 306), this study assesses the mediating role of health rumination/worry in the physical limitation-depressive symptom relationship, and the moderating effect of gender on the relationship between health rumination/worry-depressive symptoms. Findings demonstrate that health rumination/worry explains half of the physical limitation-depressive symptom relationship, and the relationship between health rumination/worry and depressive symptoms is stronger for African American men than women. The findings underscore the importance of intersectional research for policy efforts aimed at reducing mental health morbidities within African American communities.

Early Emergence of Rumination has no Association with Performance on a Non-affective Inhibitory Control Task

Rumination is a vulnerability for depression and potentially linked to inhibitory control weaknesses. We aimed to replicate the association observed in adults between inhibitory control and rumination in adolescents, and to examine putative moderating roles of childhood maltreatment and perceived family cohesion in an adolescent sample at risk for depression due to familial/personal history. Ninety adolescents aged 11-17 (M = 14.6, SD = 1.8) completed self-report scales of rumination, maltreatment, and family cohesion, and performed a task assessing inhibitory control. Hierarchical regression models showed no significant relation between inhibitory control and moderator variables on rumination. However, adolescents who reported higher levels of maltreatment and who perceived lower family cohesion tended to indicate higher levels of rumination (BChilhood Maltreatment = 27.52, 95% CIs [5.63, 49.41], BFamily Cohesion = -0.40, 95% CIs [-0.65, -0.15]). These findings demonstrate an alternative understanding of factors that increase depression onset risk and recurrence in adolescents.

From loss to disorder: The influence of maladaptive coping on prolonged grief

Research indicates that post-bereavement coping strategies can be adaptive or maladaptive. Understanding which strategies lead to poorer outcomes is an important clinical and theoretical question with the potential to guide intervention. The Oxford Grief - Coping Strategies scale was developed from interviews with bereaved people with and without prolonged grief disorder (PGD) to assess the frequency of maladaptive cognitive and behavioural strategies after bereavement. Factorial and psychometric validity were assessed using exploratory and confirmatory factor analysis (N = 676). A three-wave cross-lagged panel model (N = 275) was used to assess the predictive validity of the tool in explaining symptoms of PGD. Results supported a four-factor solution (Avoidance, Proximity Seeking, Loss Rumination, Injustice Rumination) with good psychometric properties. The OG-CS predicted prospective symptoms of PGD in the short-term (6-12 months) and long term (12-18 months), controlling for baseline symptoms and autocorrelations. Subscale analyses demonstrated that the use of coping strategies predicted ICD-11 PGD in both the short-term and the long-term. However, avoidance was not predictive of outcomes early in the grieving process. At 6-12 months, avoidance predicted PGD at 12-18 months.

Evaluating the Effects of a Self-Help Mobile Phone App on Worry and Rumination Experienced by Young Adults: Randomized Controlled Trial

BACKGROUND

Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT).

OBJECTIVE

This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being.

METHODS

A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks.

RESULTS

Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI -5.57 to -0.28; P=.03; ηp2=0.02) and worry (mean difference -3.97, 95% CI -6.21 to -1.73; P<.001; ηp2=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point.

CONCLUSIONS

The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1186/s12888-021-03536-0.

Neural underpinnings of individual differences in emotion regulation: A systematic review

This review synthesises individual differences in neural processes related to emotion regulation (ER). It comprises individual differences in self-reported and physiological regulation success, self-reported ER-related traits, and demographic variables, to assess their correlation with brain activation during ER tasks. Considering region-of-interest (ROI) and whole-brain analyses, the review incorporated data from 52 functional magnetic resonance imaging studies. Results can be summarized as follows: (1) Self-reported regulation success (assessed by emotional state ratings after regulation) and self-reported ER-related traits (assessed by questionnaires) correlated with brain activity in the lateral prefrontal cortex. (2) Amygdala activation correlated with ER-related traits only in ROI analyses, while it was associated with regulation success in whole-brain analyses. (3) For demographic and physiological measures, there was no systematic overlap in effects reported across studies. In showing that individual differences in regulation success and ER-related traits can be traced back to differences in the neural activity of brain regions associated with emotional reactivity (amygdala) and cognitive control (lateral prefrontal cortex), our findings can inform prospective personalised intervention models.

On assessing trait rumination using the Ruminative Response Scale

Introduction

This study explores the stability of scores on psychometrically validated trait questionnaires over time. We illustrate potential pitfalls through a larger study that used the Ruminative Response Scale (RRS) to categorize participants prior to study inclusion into two groups based on their habitual tendency to ruminate. Surprisingly, when we re-administered the RRS at the start of an experimental session, significant score changes occurred, resulting in participants shifting between the two groups.

Methods

To address this, we modified our recruitment process, aiming to reduce careless responses, including an online RRS assessment a week before the lab appointment. We analyzed the different samples prior to and after changing the recruitment procedure, as well as the total sample regarding the psychometric properties of the RRS. We also explored various indices to identify and predict score changes due to careless responding; however, only a subgroup of participants was successfully identified.

Results

Our findings suggest that Mahalanobis distances are effective for identifying substantial score changes, with baseline state rumination emerging as a marginally significant predictor.

Discussion

We discuss the importance of conducting manipulation checks and offer practical implications for research involving psychometrically validated trait questionnaires.

Associations of rumination, behavioral activation, and perceived reward with mothers' postpartum depression during the COVID-19 pandemic: a cross-sectional study

Introduction

The COVID-19 pandemic has led to increased social isolation for mothers, and rumination exacerbates postpartum depression in mothers with poor social support. Although behavioral activation can help to decrease their depressive symptoms, the mechanism by which behavioral activation reduces postpartum depression remains unclear.

Methods

We examined the effects of rumination and behavioral activation on depression in postpartum women by examining a model mediated by subjective reward perception. A questionnaire was administered to 475 postpartum women (Age: Mean = 30.74 years, SD = 5.02) within 1 year of childbirth using an Internet survey. The measurements included perinatal depression, rumination, and behavioral activation, and we assessed environmental reward. To control for confounding variables, we assessed psychiatric history, social support, parenting perfectionism, and COVID-19 avoidance.

Results

Eighty-four (17.68%) mothers had possible postpartum depression. The covariance structure analysis showed that not only was there a direct positive path from rumination to postnatal depression but also a negative path via reward perception.

Discussion

This finding indicated that the COVID-19 pandemic could have increased depression in many of the mothers. Rumination not only directly relates to postpartum depression, but it could also indirectly relate to postpartum depression by decreasing exposure to positive reinforcers. In addition, having a history of psychiatric illness increases the effect of rumination on postpartum depression. These findings suggest that psychological interventions are needed to reduce rumination and increase contact with positive reinforcements to reduce postpartum depression, especially for high-risk groups.

Mediating Role of Rumination Between Anger and Anxious-Depressive Symptomatology in Family Members of People with Gambling Disorder

Gambling disorder is characterized by a behavioural pattern of dysfunctional gambling that persists despite its negative implications in different areas of people's daily life. One of the most negatively affected areas is the one related to family members. This study aimed, firstly, to study the differences between family members of people with gambling disorder and a general population sample in anger (state, trait, expression-out, expression-in. control-out and control-in), rumination (brooding, reflection and total), and anxiety and depression. The second aim was to analyse the correlation between these variables in the family members of people with gambling disorder, and thirdly, to analyse the mediating role of rumination between anger, anxiety and depression. This study consisted of 170 people, of whom 87 were family members of people with a gambling disorder, and 83 were from the general population. Instruments measuring anger, anxiety, depression, and ruminative responses were administered. Results showed that family members had significantly higher scores in anger (state), depression, anxiety, rumination (total and brooding). Also, results showed that anger correlated positively and significantly with rumination, depression and anxiety, which also correlated positively and significantly with each other. Third, rumination mediated the relationship between the following variables: anger (state) and depression; anger (trait) and anxiety and depression; anger (external expression) and anxiety and depression. A complete mediating effect was found in the latter case and a partial mediating effect in the first two cases. In conclusion, it is found that having a family member with a gambling disorder may increase levels of anger, anxiety, depression and rumination. Furthermore, it is shown that working on rumination may reduce depression and anxiety in family members of gamblers.

Thinking about the consequences: The detrimental role of future thinking on intrapersonal problem-solving in depression

Despite the fact that depressed individuals encounter a multitude of social problems in daily life, research on social problem-solving has largely been dominated by research on interpersonal problems and there is a paucity of research on intrapersonal problems. Intrapersonal problems are linked to one's subjective psychological functioning and involve managing one's own feelings and emotions pertaining to the self. Given that depressed individuals exhibit impaired emotion regulation, it is possible that their ability to solve intrapersonal problems may be impaired, especially in relation to future thinking. The aim of this study was to investigate whether future thinking, in the form of thinking about the consequences of a problem being resolved or remaining unresolved has an impact on intrapersonal problem-solving in depression. Forty-five depressed and fifty-four non-depressed participants completed a modified version of the means end problem-solving task (MEPS). In the task, participants were presented with a series of intrapersonal problems and were asked to generate consequences of the problems being resolved or remaining unresolved. Participants were then presented with a positive resolution to each of the problems and were asked to solve the problem to achieve the positive resolution. Following a delay, participants were asked to recall all of the consequences initially generated. Overall, depressed individuals generated fewer-relevant means and less effective solutions to problems than non-depressed participants. Depressed individuals also demonstrated impaired intrapersonal problem-solving following the generation of resolved and unresolved consequences, compared to a baseline condition, where no consequences were generated. These findings suggest that future thinking impairs intrapersonal problem-solving and indicates that a more nuanced approach to future thinking and social problem-solving in depression is needed across different real-life problem-solving contexts.

Co-rumination and conversational self-focus: Adjustment implications of problem talk in adolescents' friendships

Friendships are central relationships during adolescence. Given the increased experience of stress during adolescence, friends are especially critical sources of support at this time. Although experiencing social support is related to well-being, adolescents' experiences sharing problems with friends is not always positive. In this chapter, we consider two forms of problematic talk, co-rumination and conversational self-focus. Co-rumination refers to conversations about problems that is excessive, repetitive, speculative, and focused on negative affect. Conversational self-focus refers to adolescents re-directing conversations about friends' problems to oneself. Both co-rumination and conversational self-focus are associated with depressive symptoms. However, whereas co-rumination draws friends together and is associated with positive friendship quality, adolescents who engage in conversational self-focus are increasingly rejected by friends. Directions for future research and applied implications of studying social support processes between friends are discussed.

Looking back and moving forward: dimensions of coping flexibility divergently predict long-term bereavement outcomes

BACKGROUND AND OBJECTIVES

Bereavement is a serious public health concern. Some people suffer prolonged and debilitating functional impairment after the death of a loved one. Evidence suggests that flexibility in coping approaches predicts resilience after stressful life events, but its long-term effects after the unique experience of bereavement are unknown. Which strategies of coping flexibility predict better-or worse-adjustment over time for bereaved people and at what times?

DESIGN AND METHODS

The present study used path analyses to investigate longitudinal effects of forward-focus and loss-focus coping strategies on symptoms of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder in a spousally bereaved adult sample (N = 248) at three time-points after the loss (∼3 months, ∼14 months, and ∼25 months).

RESULTS

Forward-focus coping demonstrated adaptive utility overall, with sooner effects on PCBD than on depression. By contrast, loss-focus coping demonstrated a delayed-onset, maladaptive pattern.

CONCLUSIONS

The findings contribute to the coping flexibility literature by suggesting that the adaptiveness or maladaptiveness of different coping strategies may depend on the context that requires coping. In particular, forward-focus coping may be substantially more advantageous than loss-focus coping in the context of bereavement. Implications, limitations, and future research directions are discussed.

Association Between Social Networking Site Use Intensity and Depression Among Chinese Pregnant Women: Cross-sectional Study

BACKGROUND

Despite extensive debates about the mental health impacts of the use of social networking sites (SNSs), including WeChat, the association and mechanisms between social interaction of WeChat use intensity and antenatal depression are unclear.

OBJECTIVE

We aimed to test the mediating roles of upward social comparison on social interaction of WeChat and rumination in the association between social interaction of WeChat use intensity and antenatal depression.

METHODS

A cross-sectional survey was conducted in four hospitals with the self-reported measures of social interaction of WeChat use intensity, upward social comparison on social interaction of WeChat, rumination, antenatal depression, and control variables. The mediation analysis was performed through Model 6 from the PROCESS macro 4.0 in SPSS 26.

RESULTS

Results from 2661 participants showed that antenatal depression was unrelated to social interaction of WeChat use intensity (P=.54), but was significantly positively related to the attitude toward social interaction of WeChat (P=.01). The direct effect of attitude toward social interaction of WeChat use on antenatal depression was not statistically significant (β=-.03, P=.05). The results supported an indirect relationship between attitude toward social interaction of WeChat use and antenatal depression via (1) upward social comparison on social interaction of WeChat (indirect effect value=0.04, 95% CI 0.03 to 0.06); (2) rumination (indirect effect value=-0.02, 95% CI -0.04 to -0.01); and (3) upward social comparison on social interaction of WeChat and rumination in sequence (indirect effect value=0.07, 95% CI 0.06 to 0.08).

CONCLUSIONS

Our findings highlight the necessity of focusing on attitudes toward SNS use, and the importance of upward social comparison and rumination in understanding the effect of SNS use on antenatal depression.

The association between subjective cognitive decline and trajectories of objective cognitive decline: Do social relationships matter?

OBJECTIVES

We examine the association between subjective cognitive decline (SCD) and the trajectories of objective cognitive decline (OCD); and the extent to which this association is moderated by social relationships.

METHODS

Data come from waves 10 (2010) through 14 (2018) of the Health and Retirement Study, a nationally representative panel survey of individuals aged 50 and above in the United States. OCD is measured using episodic memory, and overall cognition. SCD is assessed using a baseline measure of self-rated memory. Social relationships are measured by social network size and perceived positive and negative social support. Growth curve models estimate the longitudinal link between SCD and subsequent OCD trajectories and the interactions between SCD and social relationship variables on OCD.

RESULTS

SCD is associated with subsequent OCD. A wider social network and lower perceived negative support are linked to slower decline in memory, and overall cognition. None of the social relationship variables, however, moderate the link between SCD and future OCD.

CONCLUSION

Knowing that SCD is linked to subsequent OCD is useful because at SCD stage, deficits are more manageable relative to those at subsequent stages of OCD. Future work on SCD and OCD should consider additional dimensions of social relationships.

How negative mood hinders belief updating in depression: results from two experimental studies

BACKGROUND

In two experimental studies, we tested the hypothesis that negative mood would hinder the revision of negative beliefs in response to unexpectedly positive information in depression, whereas positive mood was expected to enhance belief updating.

METHODS

In study 1 (N = 101), we used a subclinical sample to compare the film-based induction of sad v. happy mood with a distraction control group. Subsequently, participants underwent a well-established paradigm to examine intra-individual changes in performance-related expectations after unexpectedly positive performance feedback. In study 2, we applied the belief-updating task from study 1 to an inpatient sample (N = 81) and induced sad v. happy mood via film-clips v. recall of autobiographic events.

RESULTS

The results of study 1 showed no significant group differences in belief updating; the severity of depressive symptoms was a negative predictor of belief revision, though, and there was a non-significant trend suggesting that the presence of sad mood hindered belief updating in the subgroup of participants with a diagnosed depressive episode. Study 2 revealed that participants updated their expectations significantly less in line with positive feedback when they underwent the induction of negative mood prior to feedback, relative to positive mood.

CONCLUSIONS

By indicating that the presence of negative mood can hinder the revision of negative beliefs in clinically depressed people, our findings suggest that learning from new experiences can be hampered if state negative mood is activated. Thus, interventions relying on learning from novel positive experiences should aim at reducing state negative mood in depression.

Mindfulness for the self-management of negative coping, rumination and fears of compassion in people with cancer: An exploratory study

BACKGROUND

Cancer and its treatments have the potential to significantly impact mental health, provoking feelings of anxiety, depression, and distress, which can last long after treatment is over. One of the most rapidly emerging influences in the healthcare field is mindfulness-based interventions (MBIs), which are designed to cultivate present moment awareness, attentional flexibility, compassion and acceptance, to reduce physical and psychological distress. However, there is limited research into the efficacy of MBIs or disease specific MBIs in shifting negative coping, ruminative thinking and fears of compassion as primary outcomes in individuals with cancer.

AIMS

This exploratory study was designed to evaluate inter- and intra-individual change in the management of negative coping, rumination and fears of compassion, following a cancer-specific mindfulness-based intervention.

METHODS AND RESULTS

A single group, non-experimental, repeated measures study of 22 participants across six cancer care centres explored the efficacy of an 8-week Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca) course. The Reliable Change Index (RCI) examined reliable clinical improvement, deterioration, or no change in individuals on the Mental Adjustment to Cancer Scale (MACS), the Ruminative Responses Scale (RRS) and the Fears of Compassion Scale (FCS). About 82% of participants (n = 18) saw an improvement in at least one measure. A significant decrease in primary outcome scores was observed in negative coping, ruminating and fears of self-compassion. There were significant correlations between the fear of self-compassion and depressive ruminating, fear of accepting compassion from others and showing it to others pre and post intervention.

CONCLUSION

Our findings indicate that the MBCT-Ca programme may significantly reduce negative coping, ruminating and fears of self-compassion improving psychological health and wellbeing in cancer survivors.

Relationship Between Negative Life Events and Depressive Symptoms for Chinese College Students: The Mediating Role of Rumination and Moderating Role of Perceived Social Support and Psychological Capital

Objective

External events affect individuals through their cognitive process, a model on how and when negative life events are associated with depressive symptoms was tested by considering individuals' internal and external factors based on the conservation of resource theory (COR).

Methods

We conducted a survey to test our hypotheses. Participants were college students who were selected with the cluster sampling method and were asked to complete the scales measuring negative life events, perceived social support, psychological capital (PsyCap), rumination, and depressive symptoms in the classroom with a unit of class. A total of 764 questionnaires were distributed and returned, and 703 valid data were obtained finally.

Results

The present study found that (1) the relationship between negative life events and depressive symptoms was moderated by perceived social support negatively, such that the relationship was stronger with low perceived social support; (2) the relationship between negative life events and depressive symptoms was mediated by rumination; (3) the relationship between rumination and depressive symptoms was moderated by PsyCap negatively, such that the relationship was stronger with low PsyCap; (4) the indirect relationship between negative life events and depressive symptoms through rumination was moderated by PsyCap negatively, such that the indirect relationship got stronger with low PsyCap.

Conclusion

Rumination is an essential process for negative life events to affect depressive symptoms, PsyCap and perceived social support help alleviate the detrimental effect of negative life events from internal and external perspectives, respectively. Our research conclusion has a theoretical and practical implementation for reducing depressive symptoms in college students.

Psychological Resilience: An Affect-Regulation Framework

Exposure to adversity (e.g., poverty, bereavement) is a robust predictor of disruptions in psychological functioning. However, people vary greatly in their responses to adversity; some experience severe long-term disruptions, others experience minimal disruptions or even improvements. We refer to the latter outcomes-faring better than expected given adversity-as psychological resilience. Understanding what processes explain resilience has critical theoretical and practical implications. Yet, psychology's understanding of resilience is incomplete, for two reasons: (a) We lack conceptual clarity, and (b) two major approaches to resilience-the stress and coping approach and the emotion and emotion-regulation approach-have limitations and are relatively isolated from one another. To address these two obstacles,we first discuss conceptual questions about resilience. Next, we offer an integrative affect-regulation framework that capitalizes on complementary strengths of both approaches. This framework advances our understanding of resilience by integrating existing findings, highlighting gaps in knowledge, and guiding future research.

The Change of Suicidal Ideation Over a 12-Week Naturalistic Treatment of Depression: Comparison Between Young People and Older Adults

OBJECTIVE

We investigated the differences in suicidality between young people and older adults with depression over the course of 12-week naturalistic treatment with antidepressants.

METHODS

A total of 565 patients who had moderate to severe depression (Hamilton Depression Rating Scale [HAM-D] score ≥14) and significant suicidal ideation (Beck Scale for Suicide Ideation [SSI-B] score ≥6) were recruited from 18 hospitals. Participants were classified into two groups: the younger group (13-24 years of age, n=82) and the older group (≥25 years of age, n=483). Total scores over time on the SSI-B, HAM-D, and Hamilton Anxiety Rating Scale (HAM-A) were assessed and compared between the two groups.

RESULTS

At baseline, the younger group had lower HAM-D scores (21.0 vs. 22.2; p=0.028) but higher SSI-B scores (19.4 vs. 15.6; p<0.001) compared with the older group. The overall 12-week proportion of patients with resolved suicidality was 44.1% in the younger group and 69.2% in the older group. Although the improvement in the HAM-D and HAM-A scores did not differ between the groups, suicidal ideation in the younger group remained more severe than in the older group throughout the treatment. The ratio of the subjects who achieved HAM-D remission or response but did not achieve SSI-B remission was significantly higher in the younger group than in the older group.

CONCLUSION

These data suggest that in depressed youths, suicide risk is a serious concern throughout the course of depression even when favorable treatment outcomes are obtained.

How Daily Mindfulness Predicts Life Satisfaction: From the Perspective of Mindfulness Coping Model

Previous studies have explored the effect of mindfulness on life satisfaction, but the mechanism has not been explored in terms of daily mindfulness. Therefore, based on the mindfulness coping model, this study uses a daily diary method to examine whether individuals' daily mindfulness could predict life satisfaction and whether this relationship was mediated by rumination. In this study, 178 adults who had not received mindfulness training completed the same diary for continuous 14 days, in which their mindfulness and rumination at state level were measured. Besides, mindfulness, rumination, and life satisfaction at dispositional level were measured before and after the daily reporting process. Hierarchical linear models showed that daily mindfulness is a significant predictor of daily rumination. In addition, both the latent growth curve model and structural equation model showed that the change of daily mindfulness can influence life satisfaction through the change of rumination, and this relationship was also confirmed at the dispositional level. These findings are not only valuable for understanding how mindfulness is linked to rumination and life satisfaction according to the mindfulness coping model, but also contribute to the development of psychological intervention programs aimed at improving individual life satisfaction.

Reciprocal Relations of Worry, Rumination, and Psychopathology Symptoms After Loss: A Prospective Cohort Study

Bereavement can precipitate symptoms of depression, prolonged grief disorder, and posttraumatic stress disorder. Targeting repetitive negative thought (i.e., worry, rumination) in treatment may help reduce post-loss psychopathology. Yet, evidence on longitudinal associations of depressive rumination and worry with post-loss psychopathology symptoms has been mixed and the directions of effects are still unclear. Recently bereaved adults (78% female) completed questionnaires assessing depressive rumination (brooding), worry, and depression, prolonged grief and posttraumatic stress symptoms 11 times in 1.5 month intervals. We applied random-intercept cross-lagged panel models (RICLPMs) to examine reciprocal within-person associations between worry and psychopathology symptoms, between rumination and these symptoms, and between worry and rumination. Main findings were that worry showed reciprocal relationships with psychopathology symptoms (although worry did not consistently predict prolonged grief symptoms). Depressive rumination was predicted by psychopathology symptoms, but not vice versa. Worry showed reciprocal relations with depressive rumination. Findings suggest that worry may be part of a downward spiral, enhancing psychopathology symptoms following loss, whereas depressive rumination is solely a consequence of such symptoms.

Reward sensitivity modulates the brain reward pathway in stress resilience via the inherent neuroendocrine system

In the previous 10 years, researchers have suggested a critical role for the brain reward system in stress resilience. However, no study has provided an empirical link between activity in the mesostriatal reward regions during stress and the recovery of cortisol stress response. Moreover, although reward sensitivity as a trait has been demonstrated to promote stress resilience, it remains unclear whether it modulates the brain reward system in stress resilience and how this effect is achieved by the inherent neuroendocrine system. To investigate these uncertainties, 70 young adults were recruited to participate in a ScanSTRESS task, and their brain imaging data and saliva samples (for cortisol assay) were collected during the task. In addition, we assessed reward sensitivity, cortisol awakening response, and intrinsic functional connectivity of the brain in all the participants. We found that left putamen activation during stress exposure positively predicted cortisol recovery. In addition, reward sensitivity was positively linked with activation of the left putamen, and this relationship was serially mediated by the cortisol awakening response and right hippocampus-left inferior frontal gyrus intrinsic connectivity. These findings suggest that reward sensitivity modulates reward pathways in stress resilience through the interplay of the diurnal stress response system and network of the hippocampus-prefrontal circuitry. Summarily, the current study built a model to highlight the dynamic and multifaceted interaction between pertinent allostatic factors in the reward-resilience pathway and uncovered new insight into the resilience function of the mesostriatal reward system during stress.

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Cortisol recovery can be predicted by activation of the left putamen in stress.

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Activation of the left putamen was positively linked with reward sensitivity.

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This relationship was serially mediated by the cortisol awakening response and right hippocampus-left inferior frontal gyrus intrinsic coupling.

Early indicators of vulnerability to depression: The role of rumination and heart rate variability

BACKGROUND

Despite the evidence of increased levels of rumination and reduced heart rate variability (HRV) in depression, whether these measures can be considered early indicators of vulnerability to depression has yet to be investigated. Therefore, the present study aimed to investigate both levels of rumination and resting HRV in individuals with familial risk for depression that is the most reliable risk factor for the disorder.

METHODS

Rumination and vagally-mediated HRV were assessed using the Ruminative Response Scale and a smartphone-based photoelectric volumetric pulse wave assay, respectively, in 25 individuals who had family history of depression (but did not report current depressive symptoms), 15 individuals who reported depressive symptoms (but had no family history of depression), and 25 controls (without depressive symptoms and family history of depression).

RESULTS

Individuals with depressive symptoms and those with a family history of depression were characterized by higher levels of rumination and lower cardiac vagal control than controls.

LIMITATIONS

Given the small sample size, this study should be used to design larger confirmatory studies; the cross-sectional nature of the study does not allow discussing the results in terms of cause-effect relationships.

CONCLUSIONS

Our findings suggested that individuals at risk of developing depression, also in absence of depressive symptoms, are defined by defective self-regulation capacity that may lead to future depression episodes. Increased ruminative thoughts and reduced HRV may represent early indicators of vulnerability to depression. Effective prevention programs designed to reduce rumination and/or increase HRV may reduce the risk of developing a full-blown depressive episode.

Melting COVID-frozen goals: How goal disengagement supports well-being during the COVID-19 pandemic

The current research addresses dynamics of the COVID-19 pandemic's disruption to goal pursuit. Specifically, we examined the effects of disengaging from frozen goals (goals for which progress had been disrupted due to COVID-19). In May 2021, we asked participants (N = 226) what percentage of their goals were COVID-frozen goals and asked them to report their engagement in one such goal (vs. an active goal): the degree to which they think about the goal, ruminate about the goal, and are committed to the goal. Participants also reported on two facets of their recent well-being: psychological distress (stress, depressive symptoms, anxiety) and life satisfaction. As expected, percentage of COVID-frozen goals was positively associated with psychological distress (stress, depressive symptoms, and anxiety). Moreover, frozen goal rumination (but not thought frequency or commitment) was negatively associated with life satisfaction and positively associated with psychological distress (stress, depressive symptoms, and anxiety; even when controlling for active goal rumination). Furthermore, individual differences in the capacity to disengage and reengage in alternatives were negatively associated with frozen goal rumination, positively associated with life satisfaction, and negatively associated with psychological distress (stress, depressive symptoms, and anxiety). These results highlight the adaptive function of disengagement in goal pursuit. We discuss implications for the goal disengagement literature and for coping with COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11031-022-09959-w.

The Effects of Bereavement Time on the Relationship Between Coping Strategies and Psychological Distress

The purpose of this study was to investigate the relationship between bereaved individuals' coping patterns, mental health, and time post-loss. A questionnaire using the Coping with Bereavement Scale (CBS) and the Kessler Psychological Distress Scale (K6) was completed by 173 family members of individuals who died from cancer between August 2013 and March 2016. Confirmatory factor analysis revealed a three-factor solution for the CBS comprised of "life orientation," "avoidance," and "retaining ties" with the deceased. Scores on retaining ties were significantly but weakly correlated with K6 scores; however, the intensity of this relationship increased with more time post-bereavement, and individuals who retained strong ties with the deceased for two years or more demonstrated poorer mental health. Although retaining ties with the deceased might be an adaptive psychological process following bereavement, in this study, long-term persistence with that coping strategy was associated with greater overall psychological distress. Further research is needed to identify optimal coping methods to address evolving needs during the bereavement process.

Changes in the quality of life of persons with epilepsy, after the implementation of an occupational therapy intervention with drama activities

PURPOSE

Epilepsy is a chronic disorder that affects all domains of daily living. Especially, in the case of drug resistance, it is usually associated with impairment of quality of life (QOL). The opportunity to self-express is crucial for maintaining mental health. Therefore, many non-pharmaceutical interventions have been utilized to relieve psychiatric symptoms, such as fear, anxiety, and depression in persons with epilepsy. In this study, we aimed to investigate the effect of the occupational therapy program with drama activities (ODTA) on the QOL of patients with epilepsy.

METHODS

In total, 15 patients with epilepsy from the region of Thrace, Greece, were enrolled in a 3-month OTDA program focusing on the relief of anxiety symptoms and self-regulation. Each patient's QOL was measured using the Quality of Life in Epilepsy Inventory (QOLIE-31) mean scores. The reliability change index was calculated and the Wilcoxon paired test was used to determine QOL changes post-intervention compared to pre-intervention.

RESULTS

Statistically significant improvements were observed in fear of having a seizure (p =.004), overall quality (p =.001), emotional well-being (p =.004), energy fatigue (p =.014), and total QOLIE (p =.001) score after the intervention. The changes in the QOLIE score were more prominent among female individuals (male vs female: p =.028 vs p =.008).

CONCLUSION

This study highlights the importance of providing an ODTA program in patients with epilepsy and proposes its broader combined application as a complementary intervention in such patients.

Metacognitions and brooding predict depressive symptoms in a community adolescent sample

Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16-20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.

Facing the Pandemic in Italy: Personality Profiles and Their Associations With Adaptive and Maladaptive Outcomes

The negative impact of the COVID-19 pandemic on individuals' psychosocial functioning was widely attested during the last year. However, the extent to which individual differences are associated with adaptive and maladaptive outcomes during quarantine in Italy remains largely unexplored. Using a person-oriented approach, the present study explored the association of personality profiles, based on three broad individual dispositions (i.e., positivity, irritability, and hostile rumination) and two self-efficacy beliefs in the emotional area (i.e., expressing positive emotions and regulating anger emotion), with adaptive and maladaptive outcomes during the first Italian lockdown (March-June 2020). In doing so, we focused also on how different age groups (i.e., young adults and adults) differently faced the pandemic. The study was conducted through an online survey from May to June 2020 and included 1341 participants living in Italy, divided into two groups: 737 young adults aged 18-35 and 604 adults aged 36-60 years old. Latent Profile Analysis identified three personality profiles: resilient, vulnerable, and moderate. A subsequent path analysis model showed that the resilient profile was positively associated with prosocial behavior as an indicator of adaptive outcome, and negatively associated with three maladaptive outcomes: interpersonal aggression, depressive symptoms, and anxiety problems. Contrarily, the vulnerable profile resulted negatively associated with prosocial behavior and positively associated with the three maladaptive outcomes. Finally, regarding age group differences, young adults belonging to the vulnerable profile showed a greater association especially with interpersonal aggression, depression, and anxiety problems, as compared to adults belonging to the same profile. Overall, the results of the present study highlighted the importance to analyze individual functioning during an isolation period by using a person-oriented approach. Findings evidenced the existence of three different profiles (i.e., Resilient, Vulnerable, and Moderate) and subsequent path analysis revealed, especially for the vulnerable profile and young adults, a greater maladaptive consequence of the quarantine. The practical implications will be discussed.

Impulsivity and Depressive Brooding in Internet Addiction: A Study With a Sample of Italian Adolescents During COVID-19 Lockdown

This contribution presents a study conducted on a sample of Italian adolescents (n = 411) in the period of the first COVID-19 lockdown. The study investigated the role and predictive weight of the impulsivity and depressive brooding variables on Internet addiction, using a hierarchical regression analysis. The participants were administered the Uso-Abuso e Dipendenza da Internet [Internet Use-Abuse and Addiction] (UADI-2), the Barratt Impulsiveness Scale-11 (BIS-11), and the Ruminative Response Scale (RRS). In terms of percentage distribution, 28% of the participants were in the full dependency range, while 34.7% demonstrated Internet abuse behavior. The results highlighted not only the predictive value of impulsiveness (β = 0.323) and ruminative thinking (β = 0.258), but also the role of gender (β = -0.205) on Internet addiction. Thus, male participants showed higher levels of Internet addiction, with higher scores on impulsiveness and brooding way of thinking. The study shows that the issue in question is significantly present among adolescents; in addition, not only targeted awareness programmes but also psycho-educational and clinical interventions to promote greater emotional and cognitive control would be necessary as a preventive and mitigating measure. Psychological interventions can help increase self-awareness, develop emotional regulation and impulse control, and correct maladaptive cognitions which in adolescents are mostly driven by a ruminative cognitive style.

Relationship between depression, prefrontal creatine and grey matter volume

BACKGROUND

Depression and low mood are leading contributors to disability worldwide. Research indicates that clinical depression may be associated with low creatine concentrations in the brain and low prefrontal grey matter volume. Because subclinical depression also contributes to difficulties in day-to-day life, understanding the neural mechanisms of depressive symptoms in all individuals, even at a subclinical level, may aid public health.

METHODS

Eighty-four young adult participants completed the Depression, Anxiety and Stress Scale (DASS) to quantify severity of depression, anxiety and stress, and underwent 1H-Magnetic Resonance Spectroscopy of the medial prefrontal cortex and structural magnetic resonance imaging (MRI) to determine whole-brain grey matter volume.

RESULTS/OUTCOMES

DASS depression scores were negatively associated (a) with concentrations of creatine (but not other metabolites) in the prefrontal cortex and (b) with grey matter volume in the right superior medial frontal gyrus. Medial prefrontal creatine concentrations and right superior medial frontal grey matter volume were positively correlated. DASS anxiety and DASS stress scores were not related to prefrontal metabolite concentrations or whole-brain grey matter volume.

CONCLUSIONS/INTERPRETATIONS

This study provides preliminary evidence from a representative group of individuals who exhibit a range of depression levels that prefrontal creatine and grey matter volume are negatively associated with depression. While future research is needed to fully understand this relationship, these results provide support for previous findings, which indicate that increasing creatine concentrations in the prefrontal cortex may improve mood and well-being.

Predictors of health behaviors during a college national championship sports event: A daily diary study

Objective: Few studies have examined relations between college sporting events and maladaptive health behaviors among non-athlete college students. Participants: 97 college students. Methods: Completed nightly surveys (alcohol, eating, physical activity, sexual risk taking, smoking) for 11 days around a National Championship game. Results: Baseline stress and rumination was related to worse health behavior; mindfulness was related to better health behavior. Hierarchical linear modeling showed that all maladaptive health behaviors significantly increased the day of the sporting event compared to individuals' baseline levels. Rumination significantly predicted a spike in alcohol use and sexual risk taking behavior on the day of the Championship game. Conclusions: Risk factors for maladaptive health behaviors include stress and rumination, while mindfulness is protective. Interventions may work to make sports events on campus safer for students (e.g., condoms, reminder emails, mindfulness interventions for at risk groups); more research is needed.

Reducing worry and rumination in young adults via a mobile phone app: study protocol of the ECoWeB (Emotional Competence for Well-Being in Young Adults) randomised controlled trial focused on repetitive negative thinking

BACKGROUND

Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety.

METHOD/DESIGN

The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16-24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored.

DISCUSSION

This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT04950257 . Registered 6 July 2021 - Retrospectively registered.

Metacognition, rumination and suicidal ideation: An experience sampling test of the self-regulatory executive function model

A relationship between rumination and suicidal ideation is well-evidenced. A role for thought suppression has also been suggested but under-explored. The present study assessed the relative contribution of rumination and a range of thought control strategies in the understanding of suicidal ideation, within the theoretical framework of the self-regulatory executive function (S-REF) model (Wells & Matthews, 2015). Twenty-four participants who had experienced suicidal ideation in the last two months completed trait-level measures of metacognitive beliefs and momentary sampling measures of thought control strategy use, rumination and suicidal ideation over six days. Maladaptive thought control strategy use (worry and punishment), alongside rumination, predicted suicidal ideation. Adaptive strategies (distraction, social control and reappraisal) emerged as negative predictors. Metacognitive beliefs about the need to control thoughts predicted the use of punishment- but not worry-based thought control strategies. Thought control strategy use is as important in the development of suicidal ideation as rumination. The S-REF model represents a promising new approach to understanding these processes in the development of suicidal ideation.

Rumination and worry as putative mediators explaining the association between emotional disorders and alcohol use disorder in a longitudinal study

INTRODUCTION

The high rate of comorbidity between alcohol use and emotional disorders is well demonstrated, but the mechanisms underlying their relationship remain largely unidentified. One possibility is maladaptive responding to negative affect, such as worry and rumination. The present study sought to examine worry and rumination as putative mediators explaining the link between emotional disorders and alcohol use disorders. Methods Mediational analyses were conducted using a sample (n = 232) derived from a larger late adolescence/early adulthood longitudinal dataset (Youth Emotion Project; Zinbarg et al., 2010). Results A significant indirect effect was observed for emotional disorder severity on alcohol use disorder severity via rumination, but not via worry or the shared variance between worry and rumination. Conclusions These findings suggest that rumination may specifically confer risk for the development of alcohol use disorder for individuals with emotional disorders. Further, ruminative thinking may serve as a specific treatment target to reduce vulnerability to alcohol use disorder.

Hypostability in the default mode network and hyperstability in the frontoparietal control network of dynamic functional architecture during rumination

The neural underpinnings of rumination can be characterized by its specific dynamic nature. Temporal stability is the stable and consistent representation of information by a distributed neural activity and connectivity pattern across brain regions. Although stability is a key feature of the brain's functional architecture, its profiles supporting rumination remain elusive. We characterized the stability of the whole-brain functional architecture during an induced, continuous rumination state and compared it with a well-constrained distraction state as the control condition in a group of healthy participants (N = 40). We further examined the relationship between stability in regions showing a significant effect on the rumination vs. distraction contrast and rumination traits. The variability of dynamic functional connectivities (FCs) among these regions was also explored to determine the potential coupling regions that drove the altered stability pattern during rumination. The results showed that rumination was characterized by a similar but altered stability profile compared with distraction and resting states. Comparison between rumination and distraction revealed that key regions of the default mode network (DMN), such as the medial prefrontal cortex (MPFC) and bilateral parahippocampal gyrus (PHG), which showed decreased stability while frontoparietal control network (FPCN) regions, including the inferior parietal lobule (IPL) and dorsal lateral prefrontal cortex (DLPFC), showed significantly enhanced stability in rumination compared with distraction. Additionally, stability in the MPFC and IPL was related to individual differences in rumination traits. Exploratory analysis of the variation in dynamic FCs suggested that higher stability in the IPL may be related to its less variable FCs with the PHG. Together, these findings implicated that rumination may be supported by the dissociated dynamic nature of hypostability in the DMN and hyperstability in the FPCN.

Acting against your own interests: The tension between emotion regulation preference and efficacy and its implications for individuals with depressive symptoms

The aim of this study was twofold: first, to compare individuals' strategy choices in low and high intensity conditions and the actual efficacy of these strategies; second, to assess whether and how perceived intensity levels of aversive situations moderate the relationship between depressive symptoms and a strategies' efficacy. In Experiment 1A (N = 58), we replicated previous results, showing that individuals prefer distraction in high- and reappraisal in low-intensity conditions, irrespective of depressive symptom levels. Experiment 1B (N = 50) assessed the efficacy of distraction and reappraisal strategies in aversive conditions with low and high intensity. Contrary to our prediction, reappraisal was more effective than distraction, independent of the intensity of the aversive conditions. In Experiment 2 (N = 113), we tested the interactive relationship between perceived intensity levels and depression on the relative effectiveness of reappraisal and distraction. We found that while in perceived low-intensity situations the advantage of distraction over reappraisal increased as depressive symptoms increased, no such relationship was found in high-intensity situations. The results suggest that while all individuals prefer to apply reappraisal in both low- and high-intensity conditions, for those with high level of depressive symptoms, such a preference acts against their own interests. The study highlights the need to distinguish between emotion regulation preferences and their actual efficacy, while illuminating possible implications for individuals with depressive symptoms.

Rumination, worry and negative and positive affect in prolonged grief: A daily diary study

After bereavement, a significant minority experiences severe, persistent, and disabling grief, termed prolonged grief or complicated grief. Prolonged grief treatments may be enhanced by improving understanding of malleable risk factors in post‐loss psychological adaptation. Repetitive negative thought (e.g., rumination, worry) constitutes such a risk factor. Rumination and worry are both theorized to be maladaptive through interrelations with affect, yet this assumption has not been systematically investigated in the bereaved. We aimed to fill this gap in knowledge with a baseline survey and 10‐day daily diary investigation among a bereaved sample. Survey between‐subject analyses (N = 113) demonstrated that trait rumination and worry, trait negative affect and prolonged grief symptoms are positively related to each other and negatively related with trait positive affect. Within‐subject multilevel analyses of diaries (N = 62) demonstrated that trait rumination and trait worry relate positively to daily negative affect and negatively to daily positive affect. Daily rumination and worry showed similar relationships with daily negative and positive affect. A stronger relationship emerged between daily rumination and daily negative affect in people with higher prolonged grief symptom levels. Findings consistently support interrelations between repetitive negative thought, affect, and prolonged grief symptoms. Rumination appears particularly detrimental in people with severe grief reactions. Results align with research demonstrating the effectiveness of targeting repetitive negative thought in prolonged grief treatments. Additionally, our study demonstrates the potential feasibility and usefulness of using daily diaries to study behaviours of relevance to post‐loss adaptation in everyday life.

Depression and Creativity During COVID-19: Psychological Resilience as a Mediator and Deliberate Rumination as a Moderator

Purpose: The pandemic of coronavirus disease 2019 (COVID-19), which has had a significant impact on people’s lives, has apparently increased the incidence of depression. Although the topic of how depression affects creativity is contested, previous research has revealed a significant relationship between the two. The purpose of this study is to further investigate the relationship and the mechanisms that operate between depression and creativity.

Methods: A total of 881 students at an independent college in China completed a questionnaire consisting of the Self-Reported Depression Scale, Runco Ideational Behavior Scale, Psychological Resilience Scale, Deliberate Rumination Scale and demographic information. Among the respondents, 317 (36.0%) were male and 564 (64.0%) were female, all of whom were from the same grade. Correlation analyses were conducted, and then the researchers carried out mediation analysis and developed a moderated mediation model.

Results: The results indicated that (a) depression was positively related to creativity (r = 0.085, p < 0.05); (b) psychological resilience mediated the relationship between depression and creativity; specifically, psychological resilience was negatively related to depression (r = −0.462, p < 0.01), which in turn was positively related to creativity (r = 0.198, p < 0.01); and (c) deliberate rumination moderated the relationship between depression and psychological resilience, showing a significant negative correlation with depression (r = 0.138, p < 0.01), psychological resilience (r = 0.078, p < 0.05), and creativity (r = 0.288, p < 0.05); specifically, higher levels of deliberate rumination strengthened the negative correlation between psychological resilience and depression.

Conclusion: The results suggest that depression is a positive predictor of creativity and may promote creativity to some extent. Further, individuals with greater psychological resilience are more creative than those with less psychological resilience, as it is a question of whether they can and to what extent they can effectively use depression as an emotional resource. Last, an individual’s level of deliberate rumination moderates the mediating process, especially at the stage where depression is associated with psychological resilience. These findings advance understanding of the mechanisms that operate between depression and creativity.

Emotion regulation therapy for social anxiety disorder: a single case series study

BACKGROUND

Despite the vast majority of evidence indicating the efficacy of traditional and recent cognitive behaviour therapy (CBT) therapies in treating social anxiety disorder (SAD), some individuals with SAD do not improve by these interventions, particularly when co-morbidity is present.

AIMS

It is not clear how emotion regulation therapy (ERT) can improve SAD co-morbid with symptoms of generalized anxiety disorder (GAD) and depression. This study investigated this gap.

METHOD

Treatment efficacy was assessed using a single case series methodology. Four clients with SAD co-occurring with GAD and depression symptoms received a 16-session version of ERT in weekly individual sessions. During the treatment, self-report measures and clinician ratings were used to assess the symptom intensity, model-related variables, and quality of life, work and social adjustment of participants every other week throughout the treatment. Follow-up was also conducted at 1, 2 and 3 months after treatment. Data were analysed using visual analysis, effect size (Cohen's d) and percentage of improvement.

RESULTS

SAD clients with depression and GAD symptoms demonstrated statistically and clinically significant improvements in symptom severity, quality of life, work, social adjustment and model-related measures (i.e. negative emotionality/safety motivation, emotion regulation strategies). The improvements were largely maintained during the follow-up period and increased for some variables.

CONCLUSION

These findings showed preliminary evidence for the role of emotion dysregulation and motivational factors in the aetiology and maintenance of SAD and the efficacy of ERT in the treatment of co-morbid SAD.

Distinguishing Transdiagnostic versus Disorder-Specific Pathways between Ruminative Brooding and Internalizing Psychopathology in Adolescents: A Latent Variable Modeling Approach

Rumination is correlated with diverse types of internalizing problems, but the extent to which it relates to a higher-order internalizing spectrum versus disorder-specific pathology is unclear. Using a quantitative model of the internalizing dimension, we compared the strength of transdiagnostic versus diagnosis-specific pathways from brooding-the most depressogenic component of rumination-to major depressive disorder (MDD) in adolescents. Community-recruited mid-adolescents (N = 241, M_age = 15.90 years, 53% female) completed semi-structured interviews of anxiety and depressive conditions and a self-report brooding measure. Confirmatory factor analysis revealed good fit for a one-factor model of internalizing conditions. Results revealed a large, significant factor correlation between brooding and the internalizing factor (r = 0.55), with some evidence for a more modest specific link between brooding and the unique component of the MDD diagnosis (r = 0.17; approximately one-third as large as the transdiagnostic pathway). These cross-sectional associations were generally consistent across two assessment waves separated by 19 months. We concluded that brooding is better conceptualized as a common characteristic of all internalizing problems in adolescence, rather than a specific feature of MDD. Preregistered hypotheses, data analysis code, and correlation matrices for this study are posted at https://osf.io/dax7u/ .