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Iannattone S, Mignemi G, Pivetta E, Gatta M, Sica C, Cardi V, Canale N, Spoto A, Bottesi G. Are anxiety, depression, and stress distinguishable in Italian adolescents? an examination through the Depression Anxiety Stress Scales-21. PLoS One 2024; 19:e0299229. [PMID: 38412147 PMCID: PMC10898757 DOI: 10.1371/journal.pone.0299229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
The adolescents' ability to discriminate between different negative emotional states is still under debate. The Depression Anxiety Stress Scales-21 (DASS-21) serves as a useful tool to unravel this issue, yet the literature on its structural validity in young people is ambiguous. Therefore, this study aimed to expand knowledge on the emotional experience of youth by investigating the factor structure and psychometric properties of the DASS-21 in Italian adolescents. Six hundred fifty-five students (60.6% girls) aged 14-18 (M = 16.3 ± 1.29) completed an online survey containing the DASS-21 and Positive and Negative Affect Schedule (PANAS). To evaluate the factor structure of the DASS-21, several alternative models were tested, also adopting an Exploratory Structural Equation Modeling (ESEM) procedure. Measurement invariance, reliability, validity, and latent means differences were addressed. The ESEM model with three correlated factors of Depression, Anxiety, and Stress yielded the best fit to the data, supporting a hierarchical structure of the DASS-21. In addition, this model was invariant across sex and age groups. The Anxiety scale predicted both positive and negative affect, while Depression predicted positive affect only. Finally, girls scored higher than boys on Anxiety and Depression, but no age differences emerged. Overall, our results indicate that anxiety, depression, and stress are distinguishable in Italian adolescents but, simultaneously, share an underlying condition of general distress, which may explain the comorbidity between internalizing problems. Such findings are discussed in terms of clinical and preventive implications for the adolescent population.
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Affiliation(s)
- Sara Iannattone
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giuseppe Mignemi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Erika Pivetta
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Michela Gatta
- Woman and Child's Health Department, Padova University Hospital, Padova, Italy
| | - Claudio Sica
- Department of Health Sciences, University of Firenze, Firenze, Italy
| | - Valentina Cardi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Andrea Spoto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
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Sun Q, Mei Y, Liu Q, Ge S, Wang W, Zhang Z. Trajectories of intrusive and deliberate rumination in young and middle-aged stroke survivors: A growth mixture modeling approach. Nurs Health Sci 2023. [PMID: 38115674 DOI: 10.1111/nhs.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 11/09/2023] [Accepted: 12/03/2023] [Indexed: 12/21/2023]
Abstract
This study aimed to explore the relationship between intrusive and deliberate rumination, to identify distinct trajectories of intrusive and deliberate rumination, and to examine their predictors in young and middle-aged stroke survivors. This study employed a longitudinal design in which 200 young and middle-aged stroke survivors were investigated at 1-week pre-discharge (T0), 1 month (T1), 3 months (T2), and 6 months (T3) post-discharge. The Event-Related Rumination Inventory, Simplified Coping Style Questionnaire, and Perceived Social Support Scale were used for data collection. The results showed that intrusive rumination was positively correlated with deliberate rumination at T0 and T1, and negatively correlated with deliberate rumination at T3. Growth mixture modeling identified three classes of intrusive rumination: Stable-low, Declined, and Elevated group, and two classes of deliberate rumination: High-level and Low-level group. Furthermore, number of children or dysfunctions, type of stroke, family history of stroke, negative coping, and social support were found to predict intrusive rumination. These findings can help healthcare providers timely intervene on survivors in the Elevated and Stable-low intrusive rumination groups, and the Low-level deliberate rumination group.
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Affiliation(s)
- Qianqian Sun
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Qingxuan Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, Texas, USA
| | - Wenna Wang
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Mısır E, Alıcı YH, Kocak OM. Functional connectivity in rumination: a systematic review of magnetic resonance imaging studies. J Clin Exp Neuropsychol 2023; 45:928-955. [PMID: 38346167 DOI: 10.1080/13803395.2024.2315312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/28/2023] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Rumination, defined as intrusive and repetitive thoughts in response to negative emotions, uncertainty, and inconsistency between goal and current situation, is a significant risk factor for depressive disorders. The rumination literature presents diverse findings on functional connectivity and shows heterogeneity in research methods. This systematic review seeks to integrate these findings and provide readers diverse perspectives. METHOD For this purpose, the literature on functional connectivity in rumination was reviewed according to the PRISMA guidelines. Regional connectivity and network connectivity results were scrutinized according to the presence of depression, research methods, and type of rumination. After screening 492 articles, a total of 36 studies were included. RESULTS The results showed that increased connectivity of the default mode network (DMN) was consistently reported. Other important findings include alterations in the connectivity between the DMN and the frontoparietal network and the salience network (SN) and impaired regulatory function of the SN. Region-level connectivity studies consistently show that increased connectivity between the posterior cingulate cortex and the prefrontal cortex is associated with rumination, which may cause the loss of control of the frontoparietal network over self-referential processes. We have seen that the number of studies examining brooding and reflective rumination as separate dimensions are relatively limited. Although there are overlaps between the connectivity patterns of the two types of rumination in these studies, it can be thought that reflective rumination is more associated with more increased functional connectivity of the prefrontal cortex. CONCLUSIONS Although there are many consistent functional connectivity outcomes associated with trait rumination, less is known about connectivity changes during state rumination. Relatively few studies have taken into account the subjective aspect of this thinking style. In order to better explain the relationship between rumination and depression, rumination induction studies during episode and remission periods of depression are needed.
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Affiliation(s)
- Emre Mısır
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
- Department of Interdisciplinary Neuroscience, Ankara University, Ankara, Turkey
| | - Yasemin Hoşgören Alıcı
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
- Department of Interdisciplinary Neuroscience, Ankara University, Ankara, Turkey
| | - Orhan Murat Kocak
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
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Tichenor SE, Gerwin KL, Walsh B. Repetitive Negative Thinking in Adolescents Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3290-3306. [PMID: 37494925 PMCID: PMC10558142 DOI: 10.1044/2023_jslhr-23-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Repetitive negative thinking (RNT) is the process of engaging in negatively valenced and habitual thought patterns. RNT is strongly associated with mental health conditions and often affects quality of life. This study explored RNT in older school-age children and adolescents who stutter to quantify the relationship between RNT and self-reported anxiety characteristics. An additional aim was to describe how individual differences in an adolescent's goal when speaking influences the frequency they engage in RNT. METHOD Ninety-nine children and adolescents who stutter aged 9-18 years completed a measurement of the frequency/severity of RNT, a screener of anxiety characteristics, and a measure of adverse impact related to stuttering. Children aged 10 years and above also answered questions about their goal when speaking. RESULTS Individual differences in RNT significantly predicted Overall Assessment of the Speaker's Experience of Stuttering (OASES) Total Scores more so than a child or adolescent's age. Higher generalized or social anxiety scores were significantly correlated with more frequent RNT and higher OASES Total Scores. Individual differences in goal when speaking (i.e., whether or not to stutter openly) were found to predict RNT. Finally, 22 children and adolescents (22.2%) also screened positive for generalized anxiety disorder and 32 (32.3%) screened positive for social anxiety disorder. DISCUSSION These data provide strong evidence that (a) many children and adolescents who stutter engage in RNT; (b) children and adolescents who engage more frequently in RNT or who have higher OASES Total Scores may be at increased risk for more characteristics of generalized or social anxiety; and (c) individual differences in goal when speaking can predict the degree to which an adolescent engages in RNT. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23713296.
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Philippi CL, Leutzinger K, Pessin S, Cassani A, Mikel O, Walsh EC, Hoks RM, Birn RM, Abercrombie HC. Neural signal variability relates to maladaptive rumination in depression. J Psychiatr Res 2022; 156:570-578. [PMID: 36368247 PMCID: PMC9817305 DOI: 10.1016/j.jpsychires.2022.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022]
Abstract
Rumination is a common feature of depression and predicts the onset and maintenance of depressive episodes. Maladaptive and adaptive subtypes of rumination contribute to distinct outcomes, with brooding worsening negative mood and reflection related to fewer depression symptoms in healthy populations. Neuroimaging studies have implicated several cortical midline and lateral prefrontal brain regions in rumination. Recent research indicates that blood oxygen level-dependent (BOLD) signal variability may be a novel predictor of cognitive flexibility. However, no prior studies have investigated whether brooding and reflection are associated with distinct patterns of BOLD signal variability in depression. We collected resting-state fMRI data for 79 women with different depression histories: no history, past history, and current depression. We examined differences in BOLD signal variability (BOLDSD) related to rumination subtypes for the following regions of interest previously implicated in rumination: amygdala, medial prefrontal, anterior cingulate, posterior cingulate, and dorsolateral prefrontal cortices (dlPFC). Rumination subtype was associated with BOLDSD in the dlPFC, with greater levels of brooding associated with lower BOLDSD in the dlPFC, even after controlling for depression severity. Depression history was related to BOLDSD in the dlPFC, with reduced BOLDSD in those with current depression versus no history of depression. These findings provide a novel demonstration of the neural circuitry associated with maladaptive rumination in depression and implicate decreased prefrontal neural signal variability in the pathophysiology of depression.
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Affiliation(s)
- Carissa L Philippi
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA.
| | - Katie Leutzinger
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Sally Pessin
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Alexis Cassani
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Olivia Mikel
- Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, Missouri, 63121, USA
| | - Erin C Walsh
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, CB# 7167, Chapel Hill, NC, 27599, USA
| | - Roxanne M Hoks
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI, 53703, USA
| | - Rasmus M Birn
- Department of Psychiatry, University of Wisconsin-Madison, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, WI, 53719, USA
| | - Heather C Abercrombie
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI, 53703, USA
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