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Davey D, Macdonald-Gagnon G, Bauer BW, Langenecker SA, Ajilore O, Phan KL, Klumpp H. Repetitive negative thinking and suicidal ideation in internalizing psychopathologies: A replication study. Behav Res Ther 2024; 182:104622. [PMID: 39213740 DOI: 10.1016/j.brat.2024.104622] [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: 02/20/2024] [Revised: 07/26/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Abstract
Suicidal ideation (SI), a risk factor for suicide, is prevalent in internalizing psychopathologies, including depression and anxiety. Rumination and worry are well-studied repetitive negative thinking (RNT) constructs implicated in internalizing psychopathologies. These constructs have shared and distinct characteristics. However, the relationship between rumination and worry and their associations with SI are not fully understood in clinical samples. The present study used correlational and regression analysis to evaluate these relationships as a secondary data analysis in treatment-seeking participants with internalizing psychopathologies in two independent samples (Study 1:n = 143; Study 2:n = 133). Results showed about half of the participants endorsed SI (Study 1:n = 79; Study 2:n = 71). Correlations revealed a significant, positive relationship between rumination and worry. Regression results with SI as the dependent variable showed rumination significantly positively corresponded with SI in both studies. Post-hoc partial correlations controlling for symptom severity (depression, anxiety), worry, and age showed the rumination-SI relationship was maintained in both studies. Findings for worry and SI were inconsistent between studies. Findings indicate rumination, but not worry, could be a stable, unique contributor to SI in internalizing psychopathologies. It may be useful to incorporate RNT into suicide risk assessment for individuals with internalizing conditions.
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Affiliation(s)
- Delaney Davey
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | | | - Brian W Bauer
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Scott A Langenecker
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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Le GH, Wong S, Au H, Badulescu S, Gill H, Vasudeva S, Teopiz KM, Rhee TG, Ho R, Kwan ATH, Mansur RB, Rosenblat JD, McIntyre RS. Association between rumination, suicidal ideation and suicide attempts in persons with depressive and other mood disorders and healthy controls: A systematic review and meta-analysis. J Affect Disord 2024; 368:513-527. [PMID: 39303880 DOI: 10.1016/j.jad.2024.09.118] [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: 04/11/2024] [Revised: 09/11/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024]
Abstract
INTRODUCTION Suicidal ideation and behaviors are a leading cause of disability worldwide. Approximately 90 % of suicide completers have a diagnosable mood disorder. Extant literature reports rumination mediates functional impairment across mood disorders. Herein, we report the association between rumination and suicidality amongst persons with psychiatric disorders and healthy controls. METHODS Our systematic review and meta-analysis included relevant articles retrieved from Web of Science, OVID and PubMed from inception to March 20, 2024. Random effects model was used to calculate the correlation between rumination, suicidal ideation and attempt. RESULTS A total of 27 eligible studies were included in our systematic review and meta-analysis. Rumination (r = 0.25 [95 % CI: -0.03, 0.49]), reflection (r = 0.15 [-0.71, 0.83]) and brooding (r = 0.13 [-0.58, 0.73]) were nonsignificantly correlated with suicidal ideation in mood disorders. Suicide attempt history was significantly associated with greater odds of rumination in persons with depressive disorders (OR = 1.13 [0.42, 3.02]). In healthy controls, rumination (r = 0.30 [0.21, 0.38]), reflection (r = 0.23 [0.13, 0.32]) and brooding (r = 0.24 [0.12, 0.36]) were significantly correlated with suicidal ideation. Rumination also predicted lifetime history of suicide attempts in healthy controls (OR = 1.70 [1.16, 2.49]). LIMITATIONS There were inadequate sample sizes of persons with different mood and psychiatric disorders which may have underpowered our ability to detect clinically meaningful associations. DISCUSSION Our study reports a transdiagnostic association between measures of rumination and suicidality. Future research vistas should parse the neurobiological substrates subserving rumination and identify targeted therapies and their association with general cognition and treatment response.
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Affiliation(s)
- Gia Han Le
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Sabrina Wong
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada.
| | - Hezekiah Au
- Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Sebastian Badulescu
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Hartej Gill
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada.
| | - Shreya Vasudeva
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada.
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore; Division of Life Science (LIFS), Hong Kong University of Science and Technology, Hong Kong.
| | - Angela T H Kwan
- Brain and Cognition Discovery Foundation, Toronto, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Rodrigo B Mansur
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada.
| | - Joshua D Rosenblat
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada.
| | - Roger S McIntyre
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
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Huang X, Fan B, Jiang Y, Li Y, Chen Y, Zhao H, Jiang Y, Wang W, Guo L, Chen Y, Liu Y, Li Z, Wong S, McIntyre RS, Han X, Lu C. Associations of rumination with suicidal ideation and suicide attempts amongst individuals with major depressive disorder: A 12-month longitudinal study in China. Compr Psychiatry 2024; 132:152472. [PMID: 38513451 DOI: 10.1016/j.comppsych.2024.152472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/17/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD). METHODS Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations. RESULTS Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01-1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96-1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02-1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82-1.01). CONCLUSION Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small.
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Affiliation(s)
- Xinyu Huang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yingcheng Jiang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yanzhi Li
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ya Chen
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hao Zhao
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yunbin Jiang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wanxin Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan Chen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Zehui Li
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Sabrina Wong
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China.
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China.
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Thompson RJ, Whalen DJ, Gilbert K, Tillman R, Hennefield L, Donohue MR, Hoyniak CP, Barch DM, Luby JL. Preadolescent Suicidal Thoughts and Behaviors: An Intensive Longitudinal Study of Risk Factors. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00184-9. [PMID: 38604472 DOI: 10.1016/j.jaac.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/06/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Dramatic increases in rates of suicidal thoughts and behaviors (STBs) among youth highlight the need to pinpoint early risk factors. This study used intensive longitudinal sampling to assess what the concurrent associations were between risk factors and STB status, how proximal changes in risk factors were related to STB status, and how risk factors prospectively predicted changes in STB status in a preadolescent sample enriched for early childhood psychopathology. METHOD A total of 192 participants were included from the Parent-Child Interaction Therapy-Emotional Development (PCIT-ED) Study, a longitudinal study of children with and without preschool depression. Participants 7 to 12 years of age completed a diagnostic interview, followed by 12 months of intensive longitudinal sampling, assessing experiences of suicidal ideation and 11 psychosocial variables with known links to STBs in adolescents and adults. Preadolescents with STB history (high-risk) received surveys weekly, and those without STB history (lower-risk) received surveys monthly. RESULTS Female sex, elevated depressive symptoms, greater use of expressive suppression and rumination, emotional clarity, and perceived burdensomeness were uniquely concurrently associated with the likelihood of STB endorsement. Within the high-risk group, (1) increases in depression, expressive suppression, rumination, and perceived burdensomeness, and decreases in positive affect from weekt to weekt+1 were associated with a higher likelihood of a positive STB status at weekt+1; and (2) higher expressive suppression, perceived burdensomeness, and caregiver criticism and conflict at weekt compared to participants' mean levels prospectively predicted increases in the likelihood of a positive STB report from weekt to weekt+1. CONCLUSION Psychosocial factors influencing STBs in adolescents and adults also affect preadolescents in day-to-day life. Expressive suppression and perceived burdensomeness consistently emerged as novel risk indicators and potential targets for treatment. In addition, increases in depression, rumination, and caregiver criticism and conflict, as well as decreases in positive affect, might prompt heightened STB screening and assessments for preadolescents with a history of STBs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Joan L Luby
- Washington University in St. Louis, St. Louis, Missouri
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Wang W, Wang X, Duan G. Non-suicidal self-injury and suicidal ideation among Chinese college students of childhood emotional abuse: associations with rumination, experiential avoidance, and depression. Front Psychiatry 2023; 14:1232884. [PMID: 37588028 PMCID: PMC10427149 DOI: 10.3389/fpsyt.2023.1232884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023] Open
Abstract
Background Prior studies have proved the relationships between childhood emotional abuse (CEA) histories and suicidal thoughts or behaviors in adulthood, however, how emotion regulation strategies work as the mediating mechanism is necessary to be investigated. This study aimed to further verify the impacts of rumination, experiential avoidance (EA) and depression on the associations between CEA and non-suicidal self-injury (NSSI) and suicidal ideation (SI) on a sample of Chinese college students. Methods The Childhood Emotional Abuse Questionnaire, the Non-Suicidal Self-Injury Questionnaire, the Symptom Checklist, the Ruminative Response Scale, the Acceptance and Action Questionnaire-II and the Zung Self-Rating Depression Scale were completed by 1,317 college students. Results The rates of NSSI and SI of students with CEA experiences were 31.70 and 7.90% respectively, both higher than those without such experiences. The mediating roles of rumination, EA and depression between CEA and NSSI and SI were significant (p < 0.01). Conclusion The current study shed light on the linking roles of rumination, EA and depression in the relations between CEA and NSSI and SI. It is suggested that developing adaptive emotion-regulating strategies may be helpful to the intervention of suicidal thoughts or behaviors among individuals with CEA experiences.
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Affiliation(s)
- Wan Wang
- Department of Child Development and Behavior, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xi Wang
- College of Computer Science and Electronic Engineering, Hunan University, Changsha, China
| | - Guiqin Duan
- Department of Child Development and Behavior, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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6
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Rosario-Williams B, Miranda R. Prospective Relation between Ruminative Subtypes and Suicide Ideation: Moderating Role of Problem Solving. COGNITIVE THERAPY AND RESEARCH 2023; 47:574-586. [PMID: 38152613 PMCID: PMC10751028 DOI: 10.1007/s10608-023-10373-w] [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] [Accepted: 04/07/2023] [Indexed: 12/29/2023]
Abstract
Background Although reflection has been characterized as a more adaptive subtype of rumination than brooding, evidence suggests that reflection is associated with suicide ideation. The present longitudinal study investigated the mediating role of hopelessness and depressive symptoms and the moderating role of problem solving in explaining why reflection may lead to suicide ideation. Methods Two hundred ninety-four undergraduates participated in the study and were followed up every 6 months over 18 months. Participants completed measures of brooding and reflection, hopelessness, depressive symptoms, problem solving, and suicide ideation. Results Results revealed that after adjusting for baseline suicide ideation, the serial mediation path from brooding (but not reflection) to suicide ideation via hopelessness and depressive symptoms was significant. Baseline reflection predicted suicide ideation 18 months later through depressive symptoms at 12 months for people average in passive problem solving, and for those low or average in active problem solving. Brooding predicted suicide ideation through depressive symptoms, regardless of problem-solving. Conclusions Reflection may result in suicide ideation via depressive symptoms among people with poor problem-solving skills. Clinical and theoretical implications are discussed.
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Affiliation(s)
| | - Regina Miranda
- The Graduate Center, City University of New York
- Hunter College, City University of New York
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Wong SMY, Chen EYH, Lee MCY, Suen YN, Hui CLM. Rumination as a Transdiagnostic Phenomenon in the 21st Century: The Flow Model of Rumination. Brain Sci 2023; 13:1041. [PMID: 37508974 PMCID: PMC10377138 DOI: 10.3390/brainsci13071041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Rumination and its related mental phenomena share associated impairments in cognition, such as executive functions and attentional processes across different clinical conditions (e.g., in psychotic disorders). In recent decades, however, the notion of rumination has been increasingly narrowed to the "self-focused" type in depressive disorders. A closer review of the literature shows that rumination may be construed as a broader process characterized by repetitive thoughts about certain mental contents that interfere with one's daily activities, not only limited to those related to "self". A further examination of the construct of rumination beyond the narrowly focused depressive rumination would help expand intervention opportunities for mental disorders in today's context. We first review the development of the clinical construct of rumination with regard to its historical roots and its roles in psychopathology. This builds the foundation for the introduction of the "Flow Model of Rumination (FMR)", which conceptualizes rumination as a disruption of a smooth flow of mental contents in conscious experience that depends on the coordinated interactions between intention, memory, affect, and external events. The conceptual review concludes with a discussion of the impact of rapid technological advances (such as smartphones) on rumination. Particularly in contemporary societies today, a broader consideration of rumination not only from a cognition viewpoint, but also incorporating a human-device interaction perspective, is necessitated. The implications of the FMR in contemporary mental health practice are discussed.
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Affiliation(s)
- Stephanie M Y Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Michelle C Y Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christy L M Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
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Dauvermann MR, Schmaal L, Colic L, van Velzen LS, Bellow S, Ford TJ, Suckling J, Goodyer IM, Blumberg HP, van Harmelen AL. Elevated cognitive rumination and adverse life events are associated with lower cortical surface area and suicidal ideation in adolescents with major depressive disorder. J Affect Disord 2023; 325:93-101. [PMID: 36584707 DOI: 10.1016/j.jad.2022.12.087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/25/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Suicide is the second most common cause of death among young people. Structural brain alterations, rumination, and recent stressful experiences contribute to suicidal thoughts and behaviors (STBs). METHODS Here, we employed structural equation modeling (SEM) to examine the unique and combined relationships of these risk factors with STBs in a sample of young people with major depressive disorder (MDD) from the Magnetic Resonance-Improving Mood with Psychoanalytic and Cognitive Therapies (MR-IMPACT) study (N = 67, mean age = 15.90; standard deviation ± 1.32). RESULTS Whereas increased rumination and lower surface area of brain regions, that have been previously reported to be involved in both STBs and rumination, were associated with each other (Beta = -0.268, standard error (SE) = 0.114, Z = -2.346, p = 0.019), only increased rumination was related to greater severity of suicidal ideation (Beta = 0.281, SE = 0.132, Z = 2.134, p = 0.033). In addition, we observed that recent stress was associated with lower surface area in the suicidal ideation model without covariate only (Beta = -0.312, SE = 0.149, Z = -2.089, p = 0.037). For the attempt models, no associations were found between any of the risk factors and suicide attempts. LIMITATIONS We emphasize that these findings from this secondary analysis are hypothesis-forming and preliminary in nature given the small sample size for SEM analyses. CONCLUSION Our findings suggest that neither lower surface area nor recent stress are directly associated with youth suicidal ideation or attempt. However, lower surface area is related to recent stress and increased rumination, which predicted greater severity of suicidal ideation in young people with MDD.
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Affiliation(s)
- Maria R Dauvermann
- Institute for Mental Health, School of Psychology, University of Birmingham, UK; McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Psychiatry, University of Cambridge, UK
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Lejla Colic
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (CIRC), Jena, Germany
| | - Laura S van Velzen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sophie Bellow
- Department of Psychiatry, University of Cambridge, UK
| | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, UK
| | - Ian M Goodyer
- Department of Psychiatry, University of Cambridge, UK
| | | | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Anne-Laura van Harmelen
- Department of Psychiatry, University of Cambridge, UK; Institute of Education and Child Studies, Leiden University, the Netherlands.
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Li X, Qin F, Liu J, Luo Q, Zhang Y, Hu J, Chen Y, Wei D, Qiu J. An insula-based network mediates the relation between rumination and interoceptive sensibility in the healthy population. J Affect Disord 2022; 299:6-11. [PMID: 34818518 DOI: 10.1016/j.jad.2021.11.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals sometimes continuously centered their attention on the same thoughts. When such process tends to be negative and self-referential, we delineated this mental state as rumination, which may undermine body's perception of endogenous signal, but little is known about the certainly relationship and the potential neural mechanisms. METHODS Rumination and interoceptive sensibility were measured by questionnaires, then insula-related network of rumination dimensions were examined by the whole brain resting-state functional connectivity (FC) in 479 college students, and whether the insula-based network mediate the relationship between rumination and interoceptive sensibility were tested. RESULTS Rumination (including brooding reflective pondering) and interoceptive sensibility showed positive correlations. The neural mechanisms of brooding and reflective pondering were all related to the insula-networks, to be specific, brooding was positively correlated with the FC between the left posterior insula (PI) and left parahippocampal gyrus/ hippocampus (PHG), reflective pondering were positively correlated with the FC between the insula subregion and the dorsolateral prefrontal cortex. Moreover, the relationship between brooding and interoceptive sensibility was mediated by the FC between left PI and left PHG. LIMITATIONS We just tested the relationship between rumination and interoceptive sensibility at a cross-sectional level, but it is unclear that whether the longitudinal relationship would be predicted by the related network. CONCLUSIONS Our findings provided new insights into neural mechanisms of brooding and reflective pondering, also the integration of brooding and interoceptive sensibility. The insula-related networks may contribute crucially to rumination and interoception.
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Affiliation(s)
- Xianrui Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Facai Qin
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Jiahui Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Qian Luo
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Yi Zhang
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Jun Hu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Yulin Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China
| | - Dongtao Wei
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University (SWU), Chongqing 400715, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University.
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Cho GY, Waite EE, Ammerman BA, Dixon-Gordon KL. Testing the Influence of Brooding and Anger Rumination on the Association Between Suicidal Outcomes and BPD Features in Undergraduate Students. Arch Suicide Res 2022; 26:290-303. [PMID: 32329411 DOI: 10.1080/13811118.2020.1755920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Borderline personality disorder (BPD) symptoms and suicidal behaviors are prevalent among undergraduate students. Although rumination contributes to self-destructive behaviors in BPD, less research examines the role of rumination in distinct suicidal outcomes among individuals with BPD features instead focusing more on self-destructive behaviors as a latent variable. The present study examined the main and interactive effects of BPD features and two forms of rumination (brooding and anger) in the prediction of suicide-related outcomes (ideation and attempts) among college students. Participants (N = 181 undergraduate students, overrecruited for BPD features; 55.2% female) reported their lifetime suicide risk, brooding rumination, anger rumination, and BPD features. Brooding rumination and BPD features were associated with suicidal ideation. Anger rumination was not associated with suicide-related outcomes. Findings suggest that brooding rumination is a potential intervention target for suicidal ideation in undergraduate students whereas further research is required to determine the association between anger rumination and suicidal ideation and attempts.
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Teismann T, Forkmann T, Michalak J, Brailovskaia J. Repetitive Negative Thinking About Suicide: Associations With Lifetime Suicide Attempts. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e5579. [PMID: 36398103 PMCID: PMC9667229 DOI: 10.32872/cpe.5579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background Repetitive negative thinking has been identified as an important predictor of suicide ideation and suicidal behavior. Yet, only few studies have investigated the effect of suicide-specific rumination, i.e., repetitive thinking about death and/or suicide on suicide attempt history. On this background, the present study investigated, whether suicide-specific rumination differentiates between suicide attempters and suicide ideators, is predictive of suicide attempt history and mediates the association between suicide ideation and suicide attempts. Method A total of 257 participants with a history of suicide ideation (55.6% female; Age M = 30.56, Age SD = 11.23, range: 18-73 years) completed online measures on suicidality, general and suicide-specific rumination. Results Suicide-specific rumination differentiated suicide attempters from suicide ideators, predicted suicide attempt status (above age, gender, suicide ideation, general rumination) and fully mediated the association between suicide ideation and lifetime suicide attempts. Conclusion Overall, though limited by the use of a non-clinical sample and a cross-sectional study design, the present results suggest that suicide-specific rumination might be a factor of central relevance in understanding transitions to suicidal behavior.
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Affiliation(s)
- Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Johannes Michalak
- Department of Clinical Psychology and Psychotherapy, Universität Witten-Herdecke, Witten, Germany
| | - Julia Brailovskaia
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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Tang H, Xiong T, Shi J, Chen Y, Liu X, Zhang S, Wang H, Lu Q, Yao Z. Global and reflective rumination are related to suicide attempts among patients experiencing major depressive episodes. BMC Psychiatry 2021; 21:117. [PMID: 33637053 PMCID: PMC7908759 DOI: 10.1186/s12888-021-03119-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent attention has focused on the role of rumination in suicidality, with evidence indicating that rumination may be positively related to suicidal ideation. There remains disagreement on the nature of the relationship between rumination and suicide attempts, especially in major affective disorders. This study was designed to identify whether rumination is a risk factor for attempted suicide. METHODS A total of 309 patients with major depressive episodes were recruited for this study, including 170 patients with major depression and 139 patients with bipolar disorder. All participants were categorized into two groups based on a series of clinical assessments: suicide attempters (n = 87) and non-suicide attempters (n = 222). Rumination was evaluated with the Ruminative Responses Scale. A binary logistic regression analysis was carried out to evaluate the relationship between rumination and suicide attempts. RESULTS Both global ruminative levels and the two subtypes of rumination, brooding and reflection, were significantly higher in the suicide attempters than the non-suicide attempters. After controlling for age, current depression and anxiety symptoms, and episode frequency, it was found that global rumination and reflection (but not brooding) were positively associated with suicide attempts. CONCLUSION These results suggest that rumination may be a risk factor for suicide attempts and highlight the maladaptive nature of reflection in patients with major depressive episodes.
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Affiliation(s)
- Hao Tang
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029 Jiangsu China
| | - Tingting Xiong
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029 Jiangsu China
| | - Jiabo Shi
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029 Jiangsu China
| | - Yu Chen
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029 Jiangsu China
| | - Xiaoxue Liu
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029 Jiangsu China
| | - Siqi Zhang
- grid.263826.b0000 0004 1761 0489School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou Road, Nanjing, 210096 Jiangsu China ,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
| | - Huan Wang
- grid.263826.b0000 0004 1761 0489School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou Road, Nanjing, 210096 Jiangsu China ,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou Road, Nanjing, 210096, Jiangsu, China. .,Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China.
| | - Zhijian Yao
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China. .,School of Biological Sciences & Medical Engineering, Southeast University, No. 2 Sipailou Road, Nanjing, 210096, Jiangsu, China. .,Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China.
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13
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Crowe M, Porter R, Douglas K, Inder M, Lacey C, Jordan J, Wells H. Patients' experiences of cognitive functioning in recurrent depression: A qualitative study. J Psychiatr Ment Health Nurs 2020; 27:321-329. [PMID: 31981272 DOI: 10.1111/jpm.12603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Recurrent depressive episodes involve significant morbidity, suicide risk and recurrent hospitalizations. In both major depressive disorder and bipolar disorder, there are significant impairments in functioning following resolution of acute symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper provides an in-depth qualitative understanding of the subjective experience of cognitive impairment following a depressive episode in a recurrent mood disorder. It identifies descriptions of two types of experience (being stuck and being preoccupied with one's thoughts) that led to impairments in concentration, memory, organization and decision-making. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses need to develop an awareness of the impact of cognitive difficulties in the process of recovery from recurrent mood disorders. Mental health nurses need to provide knowledgeable reassurance, information and interventions to people who experience cognitive difficulties to provide a framework of understanding that promotes recovery. ABSTRACT: Introduction People who experience recurrent depressive episodes often have ongoing cognitive problems that impact on their functional recovery. These cognitive difficulties have been identified as impacting on social, interpersonal and occupational functioning and can result in vulnerability to relapse. Aim The aim of this qualitative study was to explore participants' subjective experiences of cognitive impairment after discharge from mental health services following treatment for recurrent depression. Methods The study was designed as a qualitative study in order to best capture participants' subjective experiences. Data were collected by semi-structured interviews and were analysed using a process of thematic analysis. Results Twenty participants took part in this study. All participants described experiences of either 1) "being stuck"; or 2) "being preoccupied with own thoughts"; however, all participants described the experiences in the third theme: "it stops you living to your potential." Implications for practice In order to promote recovery in a meaningful way, mental health nurses need to provide information about and strategies for managing cognitive difficulties associated with recurrent mood disorders.
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Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Maree Inder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Hayley Wells
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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