Emotion-related impulsivity and rumination: Unique and conjoint effects on suicidal ideation, suicide attempts, and nonsuicidal self-injury across two samples

Effects of Rumination and Emotional Regulation on Non-Suicidal Self-Injury Behaviors in Depressed Adolescents in China: A Multicenter Study

Objective

Emotion dysregulation is one of the core causes of non-suicidal self-injury (NSSI). However, little is known about the effects of emotion regulation and rumination on NSSI behaviors in adolescents with depressive disorder.

Methods

In total, 1782 depressed adolescents (1464 females and 318 males) completed questionnaires on rumination, emotion regulation, and NSSI, with an average age of 14.85. Participants were recruited from the outpatient and inpatient wards of 14 hospitals across the country.

Results

NSSI behavior frequency was positively correlated with rumination and negatively correlated with emotion regulation. Cognitive reappraisal and expression inhibition play a significant mediating role in the relationship between rumination and NSSI.

Conclusion

Among adolescents with depression, rumination has an impact on the frequency of NSSI behavior, and the relationship between the two is mediated by emotional regulation. The results indicate that intervention with adaptive emotion regulation strategies in adolescent depression patients may reduce the frequency of NSSI, especially in adjusting cognitive evaluation.

Individual Rumination in Adult Cancer Care: A Concept Analysis

OBJECTIVE

To conceptualize rumination in adult cancer care.

METHODS

Walker and Avant's concept analysis method was used to examine rumination in adults with cancer. A systematic search was conducted across psychology, nursing, medicine, and public health disciplines in PsycINFO, PubMed, Web of Science, CINAHL, and Scopus databases from their inception to April 2024. Additional records were identified by manually searching reference lists of relevant studies.

RESULTS

Analysis of 50 articles identified rumination's three defining attributes (intrusions, brooding, instrumentality), antecedents (cancer-related adversity, pre-existing susceptibilities), and consequences (psychophysiological functioning impairments, long-term adaptation). Key features included trait-state duality, internal variability, external cyclicality, and high emotional correlation.

CONCLUSIONS

This concept analysis establishes a preliminary conceptual model of rumination in adult cancer care, integrating its attributes, antecedents, and consequences. The model offers insights into rumination mechanisms, highlighting its complexity and variability, and may inform the development of targeted interventions and theoretical development for cancer population. Further research is needed to validate the model and explore its clinical applications.

IMPLICATIONS FOR NURSING PRACTICE

Understanding rumination in adult cancer care helps nurses identify and support at-risk patients. By recognizing key signs, nurses can implement targeted interventions to improve patients' emotional and psychological well-being, ultimately enhancing their long-term adaptation and quality of life.

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

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.

Contexts of urgency may go beyond emotion

Introduction

Urgency has been defined as the tendency towards rash speech and behavior in the context of emotion. Measures of Urgency have been found to have robust predictive power for psychopathologies and problematic behaviors. In the current study, we question whether emotions are unique drivers of urgency, or if emotions are potent exemplars of contexts that lead to rash speech and behavior. The Emotion Specific model and the Broader Contexts model correspond with these two conceptualizations of urgency, and they frame our pre-registered hypotheses.

Methods

Participants from two well-powered samples (n = 600,n = 588) completed 9 modified items from the Urgency and Positive Urgency scales to assess rash responses in each of four contexts - "Upset," "Excited," "Tired," and "Hungry" - and a fifth "In General" set. After data cleaning, we used principal components analysis to construct a unidimensional, 4-item set that was applied to capture impulsive behavior across the five contexts.

Results

We found that this research tool, called the Contexts of Impulsive Behaviors (CIBS), replicated in the second dataset, and it had adequate internal reliability in both samples. Although the Emotion Specific model was supported by the fact that the Upset context had a greater mean and greater variance than the Tired and Hungry contexts, most results supported the Broader Contexts model. That is, CIBS contexts were highly intercorrelated, and bivariate correlations with psychopathology were not significantly different across contexts. In partial correlations, effects of the Upset and Excited contexts were partially or fully statistically mediated by the Tired and Hungry contexts.

Discussion

These findings suggest that emotions are potent contexts for impulsive behaviors. At the same time, those with high urgency are vulnerable to impulsivity in other contexts, such as fatigue and hunger, that challenge the regulatory functions of the prefrontal cortex. Limitations, future directions, and clinical implications are discussed.

A self-determination theory perspective on the relationship between emotion regulation styles, mindfulness facets, and well-being in adults with self-injury

BACKGROUND

The relevance of emotion regulation (ER) difficulties to nonsuicidal self-injury (NSSI; the deliberate destruction of one's bodily tissue without suicidal intent) has been repeatedly documented. Recently, specific mindfulness facets (i.e., awareness, nonjudging, describing) have been proposed as mechanisms that explain this relationship. The present study sought to extend this line of inquiry by exploring the mediating role of mindfulness facets in the relation between self-determination theory-based ER styles (i.e., integrative ER, suppressive ER, emotion dysregulation) and indices of positive and negative well-being (i.e., subjective vitality, NSSI difficulties), while controlling for gender, in adults with recent NSSI engagement.

METHODS

US adults with a history of more than one occurrence of NSSI within the last year (n = 222) completed online measures of ER styles, mindfulness facets, subjective vitality, and NSSI difficulties.

RESULTS

A mediation model indicated that the effects of ER styles on positive and negative well-being were explained by specific mindfulness facets (i.e., awareness, nonjudging, nonreactivity, describing).

CONCLUSIONS

The present study provides preliminary evidence that facets of dispositional mindfulness may be mechanisms through which ER styles impact positive and negative indices of well-being in adults with lived experience of NSSI.

Impulsive Decision-Making, Affective Experiences, and Parental History of Self-Injurious Thoughts and Behaviors within Parent-Adolescent Dyads

Impulsive decision-making, particularly during states of affective intensity, is associated with greater risk of engagement in self-injurious thoughts and behaviors (SITBs) during adolescence. The proximal (dyadic parent-adolescent affect and impulsivity) and distal (family history of SITBs) risk factors that occur within the family system could be relevant processes at stake in the intergenerational transmission of risk. The current study tests the interdependence of parent-adolescent factors associated with risk for SITBs and probes the extent to which parent-adolescent affective states influence their own (actor-effects) and each other's (partner-effects) impulsive decision-making, and further whether these relationships are moderated by a parent's history of SITBs. Participants included 212 (106 dyads) community parents and their adolescents who completed self-report and behavioral tasks related to positive and negative affective states, impulsive decision-making, and lifetime history of SITBs. Application of the Actor-Partner Interdependence Model (APIM) revealed a partner-effect where greater parent negative affect in the past week was associated with elevated adolescent impulsive decision-making among families with a history of SITBs (Estimate = 0.66, Standard Error = 0.13, p < 0.001). In addition, a significant actor-effect was observed where greater positive affect was associated with decreased impulsive decision-making among adolescents (Estimate = -0.21, Standard Error = 0.10, p = 0.03), however, moderating effects of parent history of SITBs were not detected. Findings from the present study shed light on the interdependence of affect and impulsivity within parent-adolescent dyads, and the extent to which these interactions may be particularly salient for families with known vulnerabilities for SITBs.

Associations of rumination with suicidal ideation and suicide attempts amongst individuals with major depressive disorder: A 12-month longitudinal study in China

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.

Acquired Capability for Suicide: An Evolutionary Concept Analysis

While virtually all suicide attempters experience ideations, not all who think about suicide will attempt or die by suicide. The ideation-to-action framework has led to new theories distinguishing suicide ideators from suicide attempters. The framework suggests that suicide progresses on a spectrum of thoughts and behaviors with different identifiers and explanations. The concept of acquired capability for suicide (ACS), conceptualized by the Interpersonal Psychological Theory of Suicide, is the first to explain the movement from ideation to action. This concept analysis of ACS is timely and relevant for greater clarification of the role ACS has in the movement from ideation to action. Rodgers' evolutionary concept analysis method is used. The six-step evolutionary method highlights the concept's attributes, antecedents, and consequences and provides a basis for further inquiry and development rather than a final definition.

Examining the relationship between subtypes of rumination and non-suicidal self-injury: A meta-analytic review

INTRODUCTION

Non-suicidal self-injury (NSSI) is a highly prevalent maladaptive behavior, often used to cope with intense negative affect. Rumination is an emotion regulation strategy that leads to fixation on and exacerbation of (typically) negative affective states. However, studies examining the relationship between rumination and NSSI have yielded mixed results, showing high degrees of heterogeneity.

METHODS

The present study conducted meta-analyses (k = 50) of the association between overall rumination and NSSI, and independent meta-analyses for each of four subtypes of rumination (general, depressive, brooding, reflection rumination). Potential moderators that may influence the magnitude of these relationships were also examined.

RESULTS

A small-to-moderate positive association between rumination and NSSI was found independent of rumination subtype. Moderating effects included NSSI outcome measure and study design for overall rumination and general rumination, respectively. Race was found to moderate the relationships between both brooding and depressive rumination and NSSI, though in inverse directions. An analysis of effect heterogeneity across studies suggested that undetected moderators may be present.

CONCLUSION

Results of this study support the relationships between rumination subtypes and NSSI and identify factors that may impact these relationships. Continued research is needed to understand this association, particularly in more varied subtypes of rumination and cognitive-affective moderators.

Repetitive negative thinking as a unique transdiagnostic risk factor for suicidal ideation

Repetitive negative thinking (RNT) is a transdiagnostic symptom observed across mood and anxiety disorders and is characterized by frequent, distressing thoughts that are perceived as uncontrollable. Specific forms of RNT have been linked to increased suicide risk. However, most work examining links between RNT and suicide has been conducted within specific disorders and subtypes of RNT (e.g., rumination in individuals with depression). The present study aimed to investigate associations between transdiagnostic RNT and suicidal ideation. We hypothesized RNT would be associated with suicide risk beyond disorder-specific clinical symptoms. Fifty-four participants with mood, anxiety, and/or traumatic stress disorders completed an interview assessing suicidal risk (Columbia-Suicide Severity Rating Scale (C-SSRS)) and self-report questionnaires assessing transdiagnostic RNT, depression, and anxiety. Based on C-SSRS, we divided participants into high or low suicide risk groups. We analyzed the relationship between suicidal risk group and RNT and found that RNT was uniquely associated with suicidal risk group, controlling for depression and anxiety severity. Our results suggest including assessments of RNT may have clinical utility for understanding the degree of suicide risk in individuals and point to the potential utility of including clinical interventions to target this symptom for those at high risk of suicide.

Boredom Proneness and Online Deviant Behaviors: The Mediating Role of Rumination and the Moderating Role of Gender

Online deviant behaviors have received increasing attention. This study examined the association between boredom proneness and online deviant behaviors as well as the mediating role of rumination and the moderating role of gender in the relationship. A sample of 1001 college students (Mage = 20.20 ± 1.52 years, 50.25% female) was recruited to complete a set of questionnaires assessing the main variables. The results show that boredom proneness was positively associated with online deviant behaviors and that rumination played a mediating role in this relationship. Moreover, gender differences were found in the relationship, which was stronger for males than females. Despite several limitations, this study deepens our understanding of the influencing mechanism of boredom proneness on online deviant behaviors, which could provide practical implications for the prevention and intervention of online deviant behaviors.