Psychometric properties of the 10-item ruminative response scale in Chinese university students

The effect of acceptance and commitment therapy on work-related rumination and job fatigue of medical emergency and accident management center staff: an experimental study

BACKGROUND

Working in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran.

METHODS

This study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis.

RESULTS

The findings showed that the average job fatigue reached 16.78[Formula: see text] 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue.

CONCLUSION

Treatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel's mental health and the quality of services provided to patients.

CLINICAL TRIAL NUMBER

Not applicable.

Semantic inhibition impairment in college students with depressive states as evidenced by EEG and pupillometry during the hayling task

In this study we tested whether depression is associated with impaired semantic inhibition, resulting in symptoms of rumination and anhedonia. For this purpose and using the Beck Depression Inventory II (BDI-II) college students with depressive states (DEP) and matched controls (CTL) performed a Hayling's task, while EEG and pupillometry measures were recorded. Participants were asked to complete sentential contexts with either a highly associated word (initiation) or a non-related word (inhibition), in response to randomly presented trial-by-trial cues. The DEP group, compared to the CTL group, showed lower performance, and reduced frontal negativity (N450) in inhibition trials. Source analyses revealed greater activation for inhibition trials than for initiation trials in bilateral orbitofrontal cortex for the CTL group, but the difference was reduced and more left lateralized for the DEP group. In addition, the DEP group showed more pupil size reactivity to inhibition trials than the CTL group, indicating higher cognitive effort during semantic inhibition. Finally, self-reported rumination and anhedonia correlated with N450 in inhibition trials, and rumination correlated with pupil dilation. Overall, this research contributes to understanding the neural underpinnings of impaired semantic inhibition in individuals with depression, with potential clinical applications.

Linking Self-Esteem to Problematic Mobile Phone Use: A Moderated Mediation Model of Fear of Missing Out and Ruminative Subtypes

Low self-esteem has been identified as a risk factor for problematic mobile phone use (PMPU). However, the magnitude of self-esteem's effect on PMPU varied across different studies. Drawing on the Interaction of Person-Affect-Cognition-Execution model and the response styles theory, this study developed a moderated mediation model to investigate the mediating role of fear of missing out (FoMO) and the moderating roles of ruminative subtypes (i.e., brooding and reflection) in the relationship between self-esteem and PMPU. We conducted a cross-sectional survey among 806 undergraduate students (Mage = 19.35 years, SD = 1.18) using the convenience sampling method. Results showed that self-esteem was negatively associated with PMPU. Mediation analysis revealed that the association between self-esteem and PMPU was mediated by FoMO. Furthermore, moderated mediation analyses revealed that the mediating effect of FoMO was moderated by both brooding and reflection, such that the indirect effect became stronger for individuals with higher levels of brooding/reflection. These findings add to previous research by shedding light on how (i.e., mediation) and under what conditions (i.e., moderation) self-esteem is associated with PMPU and have implications for early prevention and intervention of individual PMPU.

The Association Between Intolerance of Uncertainty and Mobile Phone Addiction Among Overseas Chinese Students During COVID-19: The Mediating Roles of Perceived Stress and Rumination

Purpose

This study investigated the mechanism underlying the association between intolerance of uncertainty and mobile phone addiction among Chinese overseas students during the COVID-19 pandemic by examining the mediating roles of perceived stress and rumination.

Patients and Methods

An online questionnaire survey was distributed via social media platforms popular in mainland China. The items collected demographic information and assessed intolerance of uncertainty, perceived stress, rumination, and mobile phone addiction. A total of 249 respondents completed the questionnaire.

Results

The findings suggest a considerably high risk of mobile phone addiction in the study period among overseas Chinese students, as three-fourths of the participants may have been susceptible to mobile phone addiction according to the suggested cut-off point of the Chinese version of the Smartphone Addiction Scale-Short Form. Intolerance of uncertainty showed a significant positive direct effect on mobile phone addiction. The mediation analyses suggest that intolerance of uncertainty affected mobile phone addiction mainly through three pathways: the mediating effect of perceived stress, the mediating effect of rumination, and the chain mediating effect of perceived stress and rumination.

Conclusion

This study enhances understanding of mobile phone addiction among Chinese overseas students and suggests the mediating roles of rumination and perceived stress in the relationship between intolerance of uncertainty and mobile phone addiction. The study also provides suggestions for interventions among Chinese students overseas.

Depressive symptoms, sleep-wake features, and insomnia among female students: The role of rumination

Depression symptoms are prevalent among nursing students, especially those in Asia. This study assessed the association between rumination and depression symptoms among female nursing students (N = 148) and the chain mediation role of sleep-wake indexes and insomnia symptoms. The data were collected from a battery of questionnaires and consecutive 7-day actigraphy data for analyzing sleep-wake indexes. About 54.1% of the participants had either mild or moderate depression symptoms. Most students (89.2%) had a delayed circadian phase, and circadian activity rhythm (CAR) was not ideal. The path mediation model underwent analysis using the PROCESS macros. The results showed that rumination in students is directly positively correlated with depressive symptoms (b = 4.831). Moreover, the association between rumination and depressive symptoms is sequent (moderating effect = 0.12, 95% CI [0.017, 0.410]). The proposed model in this study provides a foundation for improving educational programs on sleep hygiene and promoting mental wellness.

Bridge symptoms between parenting styles and proximal psychological risk factors associated with adolescent suicidal thoughts: a network analysis

BACKGROUND

Parenting styles and the associated proximal psychological factors are suggested to increase suicidal risks in adolescents. However, how the two factors interact and confer risks on the emergence of adolescent suicidal thoughts remains unclear. Herein, we used a network approach to investigate their interrelationship and explore whether the network properties predict adolescent suicidal thoughts.

METHODS

Self-report questionnaires were completed by 1171 students aged 12-16. Network analyses were performed by Gaussian graphical models estimating the adolescent psychosocial network structure of parenting styles and psychological variables including depression, anxiety, affective lability, rumination, and resilience. Furthermore, we re-examined the network by adding a variable measuring active suicidal thoughts. Moreover, we conducted linear regressions to examine the predictive utility of bridge symptoms for adolescent suicidal thoughts.

RESULTS

Resilience, Afraid, Rumination, Concentration, and affective lability (Anger) had the highest bridge strengths in the adolescent psychosocial network. Among the identified bridge symptoms, Resilience was negatively correlated with active suicidal thoughts (regularized edge weights = -0.181, bootstrapped 95% CIs: [-0.043, -0.155]), whereas affective lability (from Anxiety to Depression, Anger), Rumination, and Afraid were positively correlated with active suicidal thoughts, with edge weights (bootstrapped 95% CIs) ranging from 0.057 (0.001, 0.112) to 0.081(0.026, 0.136). Regression analysis showed that bridge strength was significantly correlated with active suicidal thoughts (R2 = 0.432, P = 0.001).

CONCLUSION

Negative parenting styles may drive and maintain suicidal thoughts by modifying the key proximal psychological variables. Our findings highlight the important role of bridge symptoms, which may serve as vital targets for triggering adolescent suicide.

tDCS efficacy and utility of anhedonia and rumination as clinical predictors of response to tDCS in major depressive disorder (MDD)

BACKGROUND

Anhedonia and rumination are mental disorders' transdiagnostic features but remain difficult to treat. Transcranial direct current stimulation (tDCS) is a proven treatment for depression, but its effects on anhedonia and rumination and whether anhedonia and rumination can be used as a predictive biomarker of treatment response is not well known. This study aimed to investigate the tDCS efficacy and identify the predictive role of anhedonia and rumination in response to tDCS in patients with MDD.

METHODS

182 patients received 10 tDCS sessions delivered at 2 mA to left (anode) dorsolateral prefrontal cortex (DLPFC). Hamilton Rating Scale for Depression (HRSD-17), Snaith-Hamilton Pleasure Scale (SHAPS), and the 10-item Ruminative Response Scale (RRS-10) was administered to patients with MDD before treatment, following it, and after two weeks of tDCS.

RESULTS

There was an overall significant improvement in anhedonia from pre- to post-treatment. Regression analyses revealed that responders had higher baseline anhedonia and rumination (reflective pondering) scores. We found that the reduction in HRSD scores after tDCS was significantly associated with anhedonia's baseline values while no relation was found between baseline rumination and tDCS treatment response.

CONCLUSION

These results provide new evidence that pronounced anhedonia may be a significant clinical predictor of response to tDCS. Patients with severe or low baseline rumination had an equal chance of achieving clinical response. Prospective tDCS studies are necessary to validate the predictive value of the derived model.

An open-label pilot trial assessing tolerability and feasibility of LSD microdosing in patients with major depressive disorder (LSDDEP1)

BACKGROUND

Globally, an estimated 260 million people suffer from depression [1], and there is a clear need for the development of new, alternative antidepressant therapies. In light of problems with the tolerability and efficacy of available treatments [2], a global trend is emerging for patients to self-treat depression with microdoses of psychedelic drugs such as lysergic acid diethylamide (LSD) and psilocybin [3]. Beyond anecdotal reports from those who self-medicate in this way, few clinical trials have evaluated this practice. In our recently published phase 1 study in healthy volunteers [4], we determined that LSD microdosing was relatively safe and well tolerated in that cohort. Furthermore, the data demonstrated that conducting such microdosing trials is broadly feasible, with excellent adherence and compliance to the regimen observed. In this open-label pilot trial of patients with major depressive disorder (LSDDEP1), we will test the tolerability and feasibility of an 8-week regimen of LSD microdosing in this patient group prior to a larger subsequent randomised controlled trial (LSDDEP2).

METHODS

Twenty patients meeting the DSM-5 criteria for major depressive disorder will receive an 8-week LSD microdosing treatment regimen. The treatment protocol will use a sublingual formulation of LSD (MB-22001) delivered twice per week under a titration schedule using a dose of 5-15 µg. Tolerability will be assessed by quantifying the percentage of participants who withdraw from the trial due to adverse events attributable to the treatment regimen, while feasibility will be assessed by quantifying the percentage of attended clinic visits once enrolled. To determine whether there is any antidepressant response to the LSD microdosing regimen, MADRS scores will be assessed at baseline and 2, 4, 6, and 8 weeks after the commencement of the regimen.

DISCUSSION

The results of LSDDEP1 will provide valuable information regarding the tolerability and feasibility of a proposed LSD microdosing regimen in patients with MDD. Such information is critically important to optimise trial design prior to commencing a subsequent and more resource-intensive randomised controlled trial.

TRIAL REGISTRATION

ANZCTR, ACTRN12623000486628. Registered on 12 May 2023.

Feasibility and efficacy of an at-home, smart-device aided mindfulness program in people with Multiple Sclerosis

BACKGROUND

Multiple Sclerosis (MS) is a chronic disease with a high prevalence of neuropsychiatric symptoms. Mindfulness is a practice that encourages individuals to cultivate a present-focused, acceptance-based approach for managing psychological distress. Its positive effect on MS has been demonstrated, but learning such technique is expensive and time-consuming. In this study, we investigated the feasibility and efficacy of an 8-week, at-home, smart-device aided mindfulness program in a cohort of MS patients. Specifically, we explored the role of a brain-sensing headband providing real-time auditory feedback as supportive tool for meditation exercises.

METHODS

The study included two visits, one at baseline and another after the mindfulness program. We measured adherence to the proposed mindfulness treatment and its effect on questionnaires investigating different psychological domains, cognition, fatigue, quality of life and quantitative EEG parameters. All participants received a smart biofeedback device to be used during the therapeutic program consisting of daily meditative exercises.

RESULTS

Twenty-nine patients were recruited for the present study. Among them, 27 (93%) completed the entire program and 17 (63%) completed more than 80% of the scheduled sessions. We observed a statistically significant reduction of the Ruminative Response Scale score and a significant increase of the Digit Span Backward. Regarding neurophysiological data, we found a significant reduction of the whole-scalp beta and parieto-occipital theta power post intervention.

CONCLUSION

Our results show that an at-home, smart-device aided mindfulness program is feasible for people with MS. The efficacy in terms of reappraisals of stress, cognitive and emotional coping responses is also supported by our neurophysiological data. Further studies are warranted to better explore the role of such approaches in managing the psychological impact of MS diagnosis.

The relationship between physical exercise and mobile phone addiction among Chinese college students: Testing mediation and moderation effects

Background

During the COVID-19 pandemic, suspensions of activities and long periods of self-isolation led to a sharp increase in excessive use of mobile phones, which sparked public concern about mobile phone addiction (MPA). In recent years, more and more attention has been paid to physical exercise as a protective effect of MPA. However, more studies are needed to reveal this relationship and the exact mechanisms, based on which this study tested the mediating and moderating roles of self-control, rumination, psychological distress, and loneliness between physical exercise and MPA.

Methods

In this cross-sectional study, primary data was collected by questionnaire from 1,843 college students (19.75 ± 1.3) from five universities in Sichuan Province in Mainland China. Mobile Phone Addiction Tendency Scale (MPATS), Physical Activity Rating Scale-3 (PARS-3), Self-Control Scale (SCS), Ruminative Response Scale (RRS), Depression Anxiety Stress Scale-21 (DASS-21), and UCLA Loneliness Scale (UCLA-20) were investigated. The mediating models were examined using SPSS PROCESS macro 3.3 software, in which the mediation variables were self-control, rumination, and psychological distress, and the moderation was loneliness. Gender, major, and grade were included as control variables.

Result

Self-control, rumination, and psychological distress played a simple mediating role between physical exercise and MPA. Moreover, not only self-control and rumination but also self-control and psychological distress played the chain mediating roles between physical exercise and MPA. The chain pathways were moderated by loneliness. Specifically, the effect was more substantial among college students with higher loneliness.

Conclusion

The conclusions corroborate and clarify that self-control, rumination, and psychological distress mediated the association between physical exercise and MPA, and the mediation effects were moderated via loneliness. This present study advanced our understanding of how and when college students’ physical exercise was related to MPA. It also illustrates that educators and parents should pay more attention to college students’ physical exercise.

Longitudinal bifactor modeling of anxiety, depression and schizotypy - The role of rumination as a shared mechanism

A bifactor model with a general (p) factor reflecting shared variance and specific factors reflecting additional variance in individual symptoms has been introduced to explain common co-occurrence among anxiety, depression and schizotypy. However, longitudinal evidence is lacking and the validity of bifactor modeling is debatable. The current study aimed to examine the presence of the p factor together with specific factors in accounting for relationships between anxiety, depression and schizotypy both cross-sectionally and longitudinally, and to investigate the relationship between these factors and rumination. A validated sample of university students were surveyed on levels of anxiety, depression, schizotypy and rumination at baseline (N = 2291), one year (N = 1833) and two years (N = 1656). Models were estimated using exploratory structural equation modeling (ESEM) and compared at each time point. Longitudinal invariance of the best-fitting model was examined and all potential within- and between-factor stability pathways were tested in an SEM framework. A bifactor model with a p factor and four specific factors (representing residual information of composite anxiety and depression, cognitive-perceptual, interpersonal and disorganized schizotypy respectively) consistently outperformed a correlated-factors model. The bifactor structure appeared longitudinally stable. Within-factor stabilities were moderate, and between-factor pathways reflected a few significant interactions, mostly involving the p factor. Rumination was independently associated with p and four specific factors at each time point. Therefore, there is a p factor accounting for concurrent and sequential co-occurrence of anxiety, depression and schizotypy. Rumination explained partly the p and specific factors. Transdiagnostic interventions should target rumination.

Expressive suppression and rumination mediate the relationship between frailty and depression among older medical inpatients

OBJECTIVE

Frailty is common among older medical inpatients and has been found to be an independent risk factor for depression. However, few studies have explored the underlying mechanisms of the frailty-depression relationship. The present study was aimed to examine emotional regulation strategies as mediators in the frailty-depression relationship based on the process model of emotional regulation.

METHODS

Older medical inpatients (N=684) completed questionnaires and tests on frailty, emotional regulation strategies, and depressive symptoms.

RESULTS

Structural equation models showed that expressive suppression and rumination, but not cognitive reappraisal, mediated the relationship between frailty and depressive symptoms (RMSEA = 0.059, CFI = 0.963, TLI = 0.957).

CONCLUSIONS

Frail older medical inpatients habitually use expressive suppression and rumination in their daily lives, which may lead to more psychological disturbance. Interventions targeting expressive suppression and rumination might be effective in reducing the detrimental effect of frailty on psychological well-being among older medical inpatients.

Passive and active suicidal ideation among left-behind children in rural China: An evaluation of intrapersonal and interpersonal vulnerability and resilience

OBJECTIVE

Although theoretical conceptualizations of suicide hold that passive and active suicidal ideation are etiologically distinct, existing research observing this distinction is modest, with most prior studies focusing exclusively on active ideation. Understanding processes associated with passive ideation is clinically important insofar as passive ideation may precede active ideation, and thus serve as an earlier intervention target prior to potential onset of suicidal behavior. We aimed to evaluate intrapersonal and interpersonal vulnerability and resilience factors for passive ideation and differentiating passive from active ideation.

METHOD

Left-behind adolescents in rural China (n = 371) were assessed for passive and active ideation, depressive symptoms, rumination, grit, peer support, and peer victimization.

RESULTS

Overall, 15.9% of the sample endorsed passive ideation without active ideation, and 17.8% endorsed active ideation. In multivariate analyses, rumination and grit differentiated left-behind children with passive ideation from those with no ideation. Depressive symptom severity predicted active ideation among adolescents with passive ideation.

CONCLUSIONS

The current findings suggest that rumination and grit may characterize passive ideation. Although passive and active ideation may differ modestly in vulnerability and resilience factors, depressive symptoms may be important to monitor among those with passive ideation and have not yet experience active ideation.

Cross-cultural and gender invariance of emotion regulation in the United States and India

BACKGROUND

The ability to effectively regulate one's emotions has been established as an important transdiagnostic mechanism in the development and maintenance of psychopathology. To date, much of the research on emotion regulation (ER) has been conducted in Western, educated, industrialized, rich, and democratic (WEIRD) samples. Specifically, there is a dearth of cross-cultural construct equivalence studies on measures of ER. Establishing measurement equivalence is an important first step to facilitate future research on ER in culturally diverse samples.

METHODS

The present study sought to validate the latent structures of three commonly used ER measures: the Emotion Regulation Questionnaire (ERQ), Ruminative Responses Scale (RRS-10), and Acceptance subscale of the Five-Facet Mindfulness Questionnaire (FFMQ-AS). Measurement equivalence was examined across 123 American and 121 Indian participants (M_age = 36.60) and across gender.

RESULTS

Cross-cultural confirmatory factor analyses revealed configural equivalence (i.e., same factor structures) in both cultural groups across all three measures. The RRS-10 met weak invariance across cultures; however, factor loadings were not equal across the two samples for all items on the ERQ or FFMQ-AS. Consequently, a partial invariance solution was identified, and all measures subsequently met criteria for Level 2 strict cross-cultural invariance. Across gender, full invariance was found on all measures except the FFMQ-AS.

CONCLUSION

Findings suggest that the structure of ER processes is largely invariant across these two cultural groups, with a few notable exceptions, pointing to the importance of continued work in this area.

The relations between childhood experience of negative parenting practices and nonsuicidal self-injury in Chinese adolescents: The mediating roles of maladaptive perfectionism and rumination

BACKGROUND

Nonsuicidal self-injury (NSSI) is a highly prevalent and serious public health concern among adolescents worldwide, and family experiences are influential in its development. However, the potential mediating mechanisms underlying the relations between childhood experience of negative parenting practices and NSSI are not fully understood. This study tested a mediating model to examine the roles of maladaptive perfectionism and rumination in these relations.

METHODS

A total of 5,619 Chinese adolescents (54.7 % males; mean age = 15.92 years, SD = 0.73) participated in this study and completed self-report measures of negative parenting practices, maladaptive perfectionism, rumination, and NSSI.

RESULTS

There were significant positive correlations among negative parenting practices, maladaptive perfectionism, rumination, and NSSI. In the mediation analyses, all negative parenting practices were indirectly related to NSSI via maladaptive perfectionism, while rumination only mediated the relation of maternal overprotection to NSSI. In addition, among all negative parenting practices, maternal rejection was the most closely associated with maladaptive perfectionism.

CONCLUSION

The findings of the study expand our understanding of the influences of negative parenting practices on NSSI. Clinicians may pay special attention to maternal rejection and focus on adolescents' maladaptive perfectionism and rumination when interacting with individuals with NSSI.

Mobile phone addiction and psychological distress among Chinese adolescents: The mediating role of rumination and moderating role of the capacity to be alone

BACKGROUND

With the increasing incidence of mobile phone addiction, mobile phone addiction has been considered to be related to adolescents' psychological distress. However, the underlying mechanisms of this relation were still unclear. The present study tested the mediating role of rumination and the moderating role of the capacity to be alone in the relation between mobile phone addiction and psychological distress.

METHODS

754 middle school students were recruited to complete measures of mobile phone addiction, rumination, the capacity to be alone, psychological distress and demographic variables.

RESULTS

Mobile phone addiction was significantly and positively associated with psychological distress, and this link could be mediated by rumination. Moreover, the direct effect of mobile phone addiction on psychological distress and the indirect effect of rumination in this link were moderated by the capacity to be alone. Both these two effects were stronger for adolescents with lower capacity to be alone.

LIMITATIONS

The present study is limited in terms of its sample selection, cross-sectional design, and self-reported instruments.

CONCLUSIONS

The present study advances our understanding of how and when or for whom mobile phone addiction is related to serious psychological distress. Education professionals and parents should pay special attention to the psychological distress of adolescents suffering from mobile phone addiction, particularly for those with lower capacity to be alone.

Psychometric Properties of the Chinese Version of the 10-Item Ruminative Response Scale Among Undergraduates and Depressive Patients

Objective: Rumination is considered as a key process in the mechanism of depression. Assessing rumination is important for both research and clinical practice. The Ruminative Response Scale (RRS) is a widely-used instrument to measure rumination. This study aimed to examine the psychometric properties of the Chinese 10-item Ruminative Response Scale (RRS-10) in a large sample of Chinese undergraduates and depressive patients. Methods: A total of 1,773 university students and 286 clinical patients with major depressive disorder finished the Chinese version of the RRS10, State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). A confirmatory factor analysis (CFA) was performed to examine the two-factor structure (reflection and brooding) of the RRS-10. The correlations among RRS-10, STAI, and BDI were explored in two samples. In addition, the measurement invariance of the RRS-10 across gender, time, and groups with and without depressive symptoms were further investigated. The internal consistency and test-retest reliability were also evaluated. Results: Confirmatory Factor Analysis revealed that the two-factor structure of RRS-10 fitted reasonably both in undergraduates (CFI = 0.933, TLI = 0.905, RMSEA = 0.071, SRMR = 0.035) and depressive patients (CFI = 0.941, TLI = 0.910, RMSEA = 0.077, SRMR = 0.057). The results of the multi-group confirmatory factor analysis supported the full strict invariance across genders and across groups (undergraduates and depressive patients). The full strong invariance over time was also supported by MGCFA. Besides, the RRS-10 showed acceptable internal consistency and good stability. Conclusions: The RRS-10 has good reliability and validity in different samples and over time, which demonstrated that RRS-10 is a valid measurement instrument to assess rumination.

Childhood emotional abuse and adolescent nonsuicidal self-injury: The mediating role of identity confusion and moderating role of rumination

OBJECTIVE

According to Nock's (2009) integrated model, nonsuicidal self-injury (NSSI) is caused by the interplay of distal environmental and proximal intrapersonal risk factors. Based on this theory, the current study tested a moderated mediation model of family and individual characteristics to investigate how they impact adolescent NSSI. Specifically, we examined whether identity confusion mediated the association between childhood emotional abuse and NSSI, and whether this indirect effect was moderated by rumination.

METHODS

949 Chinese adolescents anonymously filled out questionnaires regarding emotional abuse, identity confusion, rumination, and NSSI.

RESULTS

The results revealed that childhood emotional abuse was positively associated with NSSI, and this association was mediated by identity confusion. Rumination intensified the association between childhood emotional abuse and identity confusion, as well as the association between childhood emotional abuse and NSSI.

CONCLUSIONS

These findings highlight the need to consider family and individual factors simultaneously when evaluating risks associated with adolescent NSSI and have important implications for the prevention and intervention of NSSI.

Cognitive Mechanisms in Adolescent and Young Adult Cancer Patients and Survivors: Feasibility and Preliminary Insights from the Cognitions and Affect in Cancer Resiliency Study

This cross sectional pilot study assesses the feasibility of conducting online research into cognitive mechanisms in adolescent and young adult cancer populations. Twenty-one participants, aged 18-39 years, answered questionnaires about mental defeat, rumination, cancer worry, anxiety, and experience participating in such research. Seven participants scored in the clinical range for anxiety. Cancer-related worry was common. Rumination and mental defeat were positively associated with anxiety. The participants reported the length and type of questions to be appropriate and not distressing. Findings may inform future research into cognitive mechanisms, which could aid the development of psychosocial interventions for young cancer patients.

Examining the Relationship Between Daily Co-Rumination and Rumination in Response to Negative Events Among Adolescents Using Ecological Momentary Assessment

Introduction: Rumination and co-rumination are related processes characterized by repetitive focus on negative feelings and problems, with current theory suggesting that co-rumination fosters the use of intrapersonal rumination over time. Additionally, both rumination and co-rumination are related to the occurrence of depressive symptoms during adolescence.

Method: The current study utilized an ecological momentary design to examine the temporal relationship between daily co-rumination and rumination in response to negative events within a sample of young adolescents (N = 150).

Results: Hierarchical linear models indicated that co-rumination in response to a negative event significantly, positively predicted the use of rumination the following day, whereas use of rumination did not predict engagement in co-rumination the following day.

Discussion: Results of the current study support the hypothesis that co-rumination influences the tendency to ruminate individually, which may indirectly result in depressive symptoms over time.

The impact of depression and culture on responses to intrusive autobiographical memories: Cognitive appraisals, cognitive avoidance, and brooding rumination

OBJECTIVES

Those with depression ascribe more negative appraisals to intrusive autobiographical memories and use maladaptive strategies to regulate intrusive memory distress. However, it is unknown whether these patterns extend to East Asian samples. This study investigated the influence of culture and depression on intrusive remembering.

DESIGN

The study used a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design, with an online intrusive memory diary.

METHODS

European Australian (n = 46) and East Asian (n = 45) participants living in Australia, with and without depression, reported two intrusive memories in real-time and completed self-report measures indexing their appraisals of the memories, and their use of cognitive avoidance and brooding rumination in response to the memories.

RESULTS

East Asian participants reported significantly greater negative, control, and responsibility appraisals than European Australian participants. Regardless of cultural group, depressed participants endorsed greater maladaptive memory appraisals and brooding compared to controls. Additionally, among East Asian participants, those with depression cognitively avoided memories significantly more than controls. When comparing the two depressed groups, East Asians reported significantly greater brooding and avoidance in response to intrusive memories than Australians.

CONCLUSIONS

The findings suggest that depression may be associated with some similar maladaptive responses to intrusive autobiographical memories across cultural groups. Clinical interventions targeting unhelpful responses may, therefore, be beneficial for those with depression, regardless of cultural background.

PRACTITIONER POINTS

Across both European Australian and East Asian cultures, depressed participants endorsed higher maladaptive intrusive memory appraisals and brooded more in response to memories. Clinical interventions targeting appraisals and emotion regulation in response to intrusive memories may be beneficial for those with depression across both cultural groups. Language and acculturation may have impacted findings, as measures were administered in English and in Australia. Replication using a cross-country design and larger sample would be beneficial to confirm findings.