Submissive interpersonal style mediates the effect of brooding on future depressive symptoms

Theoretical models and empirical evidence suggest that brooding, the maladaptive sub-component of depressive rumination, is associated with a sub-set of depressogenic interpersonal difficulties characterised by submissive interpersonal behaviours and rejection sensitivity. This study tested whether these cognitive and interpersonal vulnerability factors independently predicted future depression and investigated their interdependence in predicting depression. A heterogeneous adult sample completed self-report measures assessing depressive symptoms, brooding, reflection, rejection sensitivity and maladaptive interpersonal behaviours, at baseline and six months later. When examined separately, brooding and an interpersonal component reflecting submissive, (overly-accommodating, non-assertive, and self-sacrificing) interpersonal behaviours each prospectively predicted increased depressive symptoms six months later, after controlling for baseline depressive symptoms and gender. When examined together, the submissive interpersonal style but not brooding predicted depression, indicating that this maladaptive interpersonal style may mediate the effect of brooding on future depression. Thus, the effects of brooding on depression may in part depend on its association with an interpersonal style characterised by submissiveness.     

Rejection sensitivity prospectively predicts increased rumination

Converging research findings indicate that rumination is correlated with a specific maladaptive interpersonal style encapsulating submissive (overly-accommodating, non-assertive and self-sacrificing) behaviours, and an attachment orientation characterised by rejection sensitivity. This study examined the prospective longitudinal relationship between rumination, the submissive interpersonal style, and rejection sensitivity by comparing two alternative hypotheses: (a) the submissive interpersonal style and rejection sensitivity prospectively predict increased rumination; (b) rumination prospectively predicts the submissive interpersonal style and rejection sensitivity. Currently depressed (n = 22), previously depressed (n = 42) and never depressed (n = 28) individuals completed self-report measures assessing depressive rumination and key psychosocial measures of interpersonal style and behaviours, at baseline and again six months later. Baseline rejection sensitivity prospectively predicted increased rumination six months later, after statistically controlling for baseline rumination, gender and depression. Baseline rumination did not predict the submissive interpersonal style or rejection sensitivity. The results provide a first step towards delineating a potential casual relationship between rejection sensitivity and rumination, and suggest the potential value of clinical assessment and intervention for both rejection sensitivity and rumination in individuals who present with either difficulty.     

Functional connectivity of reflective and brooding rumination in depressed and healthy women

Ruminative thinking is related to an increased risk for major depressive disorder (MDD) and perpetuates negative mood states. Rumination, uncontrollable negative thoughts about the self, may comprise both reflective and brooding components. However, only brooding rumination is consistently associated with increased negativity bias and negative coping styles, while reflective rumination has a less clear relationship with negative outcomes in healthy and depressed participants. The current study examined seed-to-voxel (S2.V) resting-state functional connectivity (FC) in a sample of healthy (HC) and depressed (MDD) adult women (HC: n=50, MDD: n=33). The S2V FC of six key brain regions, including the left and right amygdala, anterior and posterior cingulate cortex (ACC, PCC), and medial and dorsolateral prefrontal cortices (mPFC, dlPFC), was correlated with self-reported reflective and brooding rumination. Results indicate that HC and MDD participants had increased brooding rumination associated with decreased FC between the left amygdala and the right temporal pole. Moreover, reflective rumination was associated with distinct FC of the mPFC, PCC, and ACC with parietal, occipital, and cingulate regions. Depressed participants, compared with HC, exhibited decreased FC between the PCC and a region in the right middle frontal gyrus. The results of the current study add to the understanding of the neural underpinnings of different forms of self-related cognition—brooding and reflective rumination—in healthy and depressed women.     

Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms

Individuals draw on a variety of cognitive strategies—some active, some passive—as a way of coping with stress and dysphoria. Previous research suggests that the impact of rumination—one such strategy—on depression depends on whether rumination takes the passive form of brooding versus the more active form of reflection. This study tests whether brooding and reflection explain the effects of passive versus active coping responses, respectively, on depressive symptoms. In an undergraduate sample (n=284), brooding partially mediated the relationship between passive coping and depressive symptoms, whereas reflection did not. Reflection moderated the relationship between active coping and symptoms, such that low active copers who were high in reflection endorsed more symptoms than those low in reflection. Brooding and reflection may operate within cognitive–behavioural response pathways characterised by an active/passive distinction. Whether reflection is maladaptive likely depends on the active nature of the surrounding coping response.     

Brooding and Reflection as Subtypes of Rumination: Evidence from Confirmatory Factor Analysis in Nonclinical Samples using the Dutch Ruminative Response Scale

Previous research has shown that depressive rumination is an important vulnerability factor for experiencing depressive symptoms. The most widely used measure to assess depressive rumination is the Ruminative Response Scale (RRS). According to Treynor et al. (Cognitive Therapy and Research 27:247–259, 2003), the RRS contains two subscales, reflecting two different rumination subcomponents: brooding and reflection. The present study examined the psychometric properties of the RRS in two samples (N = 432 and N = 407). Based on a confirmatory factor analysis (CFA), results confirmed that a two-dimensional model with brooding and reflection factors provided an adequate fit to the data. Reliability, convergent and discriminant validity of the rumination subcomponents were appropriate. Furthermore, brooding but not reflection predicted depressive symptoms prospectively, even when accounting for concurrent depressive feelings. The results provide the first confirmatory factor-analytical support for the widely assumed two-factor model of the RRS and add to the accumulating body of evidence supporting the multidimensional nature of depressive rumination.     

A Test of the Habit-Goal Framework of Depressive Rumination and Its Relevance to Cognitive Reactivity

The aim of the present study was to test predictions derived from the habit-goal framework of depressive rumination and investigate its relevance to cognitive reactivity—another well-known vulnerability factor to depression. Formerly depressed (FD; n = 20) and never depressed (ND; n = 22) participants completed self-report measures of rumination, cognitive reactivity, and habitual characteristics of rumination (e.g., lack of awareness, control, intent). A standard mood-induction task was also used to measure cognitive reactivity and an outcome-devaluation task to measure general habit vs. goal-directed behavior control. Habitual characteristics of ruminative thoughts were greater in the FD group and were related to depressive brooding and cognitive reactivity, but not reflective pondering. Reliance on habit on the outcome-devaluation task was strongly correlated with number of depression episodes, although group differences were not observed in general habit vs. goal-directed control. Habitual characteristics of rumination (e.g., greater automaticity) may explain reactivity and persistence of negative thoughts in depression. Habitual behavior control may contribute to inflexible responding and vulnerability for depression episodes.     

Social anxiety and depressive symptoms mediate instrumentality and maladaptive interpersonal styles

This study sought to examine the relationships between stereotypically masculine (instrumentality) and feminine (expressiveness) personality traits, social anxiety and depressive symptoms, and three interpersonal styles of relating: destructive overdependence (DO), dysfunctional detachment (DD), and healthy dependence (HD). Based on theories of social anxiety and recent research on social anxiety and close relationships, it is argued that individuals with higher levels of social anxiety would display greater detachment and overdependence in their interpersonal relationships. Students at an Australian university (n = 524) completed a battery of online self-report measures. The findings suggest that low levels of instrumentality are related to social anxiety and depressive symptoms, which both mediate the relationship between instrumentality and the two maladaptive interpersonal styles of relating: DO and DD.     

Depressive Rumination and Co-Morbidity: Evidence for Brooding as a Transdiagnostic Process

A sample of 116 patients with unipolar mood disorders referred to a specialist research clinic were assessed to investigate (a) whether rumination is a transdiagnostic process that is related to co-morbid Axis I and II symptoms and diagnosis in depressed patients; (b) whether common findings in the depressive rumination literature could be replicated in a recurrent depressed sample. Consistent with the transdiagnostic hypothesis, rumination was positively associated with both depression and anxiety, brooding was related to co-morbid obsessive-compulsive disorder and generalized anxiety disorder, and rumination was associated with traits associated with borderline personality disorder, most notably self-report of unstable relationships and inconsistent sense of self. As predicted, rumination was equivalent in currently depressed and formerly depressed patients, suggesting that rumination is not simply dependent on mood state or clinical status. As predicted, the brooding subtype most strongly correlated with depressed and anxious symptoms, consistent with previous observations that brooding is the more maladaptive form of rumination. As predicted, rumination was associated with reports of sexual abuse. Inconsistent with previous findings, there was no gender difference in rumination.     

The Role of Attachment Style and Depression in Patients with Hepatitis C

Patients infected with chronic hepatitis C virus (HCV) commonly suffer from the triad of depression, pain and fatigue. This symptom triad in HCV is likely influenced by additional psychological and interpersonal factors, although the relationship is not clearly understood. This retrospective study aimed to characterize the relationship between attachment style and depressive and physical symptoms in the HCV-infected population. Over 18 months, 99 consecutively referred HCV infected patients were assessed with the Hamilton Depression Rating Scale (HDRS), Fatigue Severity Scale, Patient Health Questionnaire-15 for physical symptoms and the Relationship Questionnaire for attachment style. An ANOVA was used to identify differences between attachment styles and Pearson correlations were used to evaluate the association between depression, fatigue and physical symptoms. Approximately 15 % of patients in the sample had a fearful attachment style. Patients with fearful attachment style had significantly higher depressive symptoms compared to a secure attachment style (p = .025). No differences in physical and fatigue symptoms were observed between attachment styles. Further, HDRS scores were significantly associated with fatigue scores (p < .001) and physical symptoms (p < .001), reinforcing the relationship between these symptom domains in HCV-infected patients. Although depressive, physical and fatigue symptoms are inter-related in HCV-infected patients, our study results suggest that only depressive symptoms were influenced by the extremes of attachment style. Screening of relationship styles may identify at-risk HCV-infected individuals for depression who may have difficulty engaging in care and managing physical symptoms.     

The effects of rumination and negative cognitive styles on depression: a mediation analysis

Research on cognitive models of depression has identified negative cognitive styles and rumination as risk factors for depression. The present study examined the hypothesis that rumination mediates the effect of negative cognitive styles on depression. Specifically, we evaluated the differential effects of two aspects of rumination, characterized by brooding and reflection, on the relationship between negative cognitive styles and level of depressive symptoms. A total of 115 college students and 38 patients suffering from depressive disorders completed a battery of questionnaires measuring levels of depressive symptoms, brooding, reflection, and negative cognitive styles. The results support the notion that there exist two distinct dimensions of rumination and that, of the two, it is brooding and not reflection that mediates the relationship between negative cognitive styles and depression and contributes to its negative outcomes.     

Positive emotion dysregulation across mood disorders: How amplifying versus dampening predicts emotional reactivity and illness course

Maladaptive regulation of positive emotion has increasingly been associated with psychopathology. Little is known, however, about how individual strategies used to manage positive emotion predict concurrent emotional responding and prospective illness course across mood disorders. The present study examined the concurrent and prospective influence of amplification and dampening regulation strategies of positive emotion (i.e., self-focused positive rumination, emotion-focused positive rumination, and dampening) among remitted individuals with bipolar I disorder (BD; n = 31) and major depressive disorder (MDD; n = 31). Rumination over positive emotional states concurrently predicted increased positive emotion across both mood disordered groups during an experimental rumination induction. However, dampening positive emotion concurrently predicted increased emotional reactivity (i.e., heart rate and negative affect) and prospective increases in manic and depressive symptoms for the BD group only. This suggests that amplifying positive emotion transdiagnostically increases positive emotion across mood disordered groups, while attempts to dampen positive emotion may paradoxically exacerbate emotional reactivity and illness course in BD. For individuals with BD, negative thinking about one's positive emotion (via dampening) may be particularly maladaptive.     

Examination of the Response Styles Theory in a Community Sample of Young Adolescents

This study examined the Response Styles Theory in a large, racially and ethnically diverse sample (N = 722) of 6th, 7th, and 8th graders. We examined the role of response styles (rumination, distraction, and problem-solving) as predictors of changes in depressive symptoms over a seven-month period. Higher levels of rumination and lower levels of problem-solving and distraction were associated with increases in depressive symptoms over time. Response style ratio scores (rumination scores divided by the sum of distraction and problem-solving scores) also predicted increases in depressive symptoms over time. Girls reported greater depressive symptoms compared to boys, and both rumination and response style ratio score statistically accounted for the gender difference in depressive symptoms. Clinical implications include the importance of problem-solving training and rumination reduction techniques in preventive interventions.     

Rumination, experiential avoidance, and dysfunctional thinking in eating disorders

The majority of research in eating disorders (ED) has investigated the content of disorder-specific thoughts, while few studies have addressed underlying cognitive-affective processes. A better understanding of processes underpinning ED may have important implications for treatment development. Two studies were conducted that investigated levels of rumination, beliefs about rumination, experiential avoidance, and aspects of schematic thinking in individuals with eating pathology. The latter was assessed with a newly designed ED-Sentence Completion Task (ED-SCT). Study 1 (N = 177) examined relations between ED psychopathology and these variables in a student population. Extending this, Study 2 (N = 26) assessed differences between patients with anorexia nervosa and healthy control participants. The results showed that ED psychopathology was related to disorder-specific cognitions, experiential avoidance as well as ruminative brooding but not reflection. A follow-up of anorexia nervosa patients indicated that changes in ED psychopathology were associated with changes in dysfunctional attitudes and maladaptive cognitive-affective processes. These findings highlight cognitive processes that may play an important role in the maintenance of eating pathology.     

Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The current study sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N = 198). All patients completed a battery of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety. Results showed that in subsequent analyses, rumination and worrying both mediated the relation between neuroticism and depression and anxiety. When rumination and worrying were simultaneously entered in the mediation analysis, only rumination was found to mediate the relation between neuroticism and symptoms of anxiety and depression. Two components of rumination (i.e., brooding and reflection) were also analyzed in the mediational analysis. Both reflection and brooding were significant mediators with respect to depressive symptoms, whereas brooding was the only significant mediator in relation to anxiety symptoms. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and suggestions for future research are provided.     

Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms

Worry, social anxiety, and depressive symptoms are dimensions that have each been linked to heterogeneous problems in interpersonal functioning. However, the relationships between these symptoms and interpersonal difficulties remain unclear given that most studies have examined diagnostic categories, not accounted for symptoms’ shared variability due to general distress, and investigated only interpersonal problems (neglecting interpersonal traits, interpersonal goals, social behavior in daily life, and reports of significant others). To address these issues, students (Study 1; N = 282) endorsed symptoms and interpersonal circumplex measures of traits and problems, as well as event-contingent social behaviors during one week of naturalistic daily interactions (N = 184; 7,036 records). Additionally, depressed and anxious patients (N = 47) reported symptoms and interpersonal goals in a dyadic relationship, and significant others rated patients’ interpersonal goals and impact (Study 2). We derived hypotheses about prototypical interpersonal features from theories about the functions of particular symptoms and social behaviors. As expected, worry was uniquely associated with prototypically affiliative tendencies across all self-report measures in both samples, but predicted impacting significant others in unaffiliative ways. As also hypothesized, social anxiety was uniquely and prototypically associated with low dominance across measures, and general distress was associated with cold-submissive tendencies. Findings for depressive symptoms provided less consistent evidence for unique prototypical interpersonal features. Overall, results suggest the importance of multimethod assessment and accounting for general distress in interpersonal models of worry, social anxiety, and depressive symptoms.     

The association between temperament and depressive symptoms in adolescence: Brooding and reflection as potential mediators

This study examined whether rumination subtypes (brooding and reflection) mediated prospective associations between temperament (negative emotionality and positive emotionality) and depressive symptoms in a community sample of 423 adolescents. Effortful control and sex were examined as potential moderators of the mediated pathway. Youth self-reported negative emotionality (NE), positive emotionality (PE), and effortful control (EC) at age 12; brooding and reflection subtypes of rumination at age 14; and depressive symptoms at ages 12, 14, and 15. Hierarchical linear regression analyses indicated that, controlling for initial levels of depressive symptoms, high NE, but not low PE, predicted increases in depressive symptoms from age 12 to age 15. Brooding, but not reflection, mediated the association between NE and depressive symptoms. Neither sex nor EC moderated either indirect pathway in the mediated model. The results confirm and extend previous findings on the association between affective and cognitive vulnerability factors in predicting depressive symptoms in adolescence.     

How do Rumination and Social Problem Solving Intensify Depression? A Longitudinal Study

In order to examine how rumination and social problem solving intensify depression, the present study investigated longitudinal associations among each dimension of rumination and social problem solving and evaluated aspects of these constructs that predicted subsequent depression. A three-wave longitudinal study, with an interval of 4 weeks between waves, was conducted. Japanese university students completed the Beck Depression Inventory-Second Edition, Ruminative Responses Scale, Social Problem-Solving Inventory-Revised Short Version, and Interpersonal Stress Event Scale on three occasions 4 weeks apart (n = 284 at Time 1, 198 at Time 2, 165 at Time 3). Linear mixed models were analyzed to test whether each variable predicted subsequent depression, rumination, and each dimension of social problem solving. Rumination and negative problem orientation demonstrated a mutually enhancing relationship. Because these two variables were not associated with interpersonal conflict during the subsequent 4 weeks, rumination and negative problem orientation appear to strengthen each other without environmental change. Rumination and impulsivity/carelessness style were associated with subsequent depressive symptoms, after controlling for the effect of initial depression. Because rumination and impulsivity/carelessness style were not concurrently and longitudinally associated with each other, rumination and impulsive/careless problem solving style appear to be independent processes that serve to intensify depression.     

Brooding rumination and attentional biases in currently non-depressed individuals: an eye-tracking study

Both rumination and attentional biases have been proposed as key components of the RDoC Negative Valence Systems construct of Loss. Although theorists have proposed that rumination, particularly brooding rumination, should be associated with increased sustained attention to depression-relevant information, it is not clear whether this link would be observed in a non-depressed sample or whether it is specific to brooding versus reflective rumination. To address these questions, the current study examined the link between brooding rumination and attentional biases in a sample of non-depressed individuals (n?=?105). Attentional biases were assessed using eye tracking during a passive viewing task in which participants were presented with 2?×?2 arrays of angry, happy, sad, and neutral faces. In line with predictions, higher levels of brooding rumination were associated with greater sustained attention to sad faces and less sustained attention to happy faces. These results remained significant after controlling for participants’ prior history of major depression and current nonclinical level of depressive symptoms, suggesting that the link between brooding rumination and attentional biases is at least partially independent of current or past depression.     

The association between temperament and depressive symptoms in adolescence: brooding and reflection as potential mediators

This study examined whether rumination subtypes (brooding and reflection) mediated prospective associations between temperament (negative emotionality and positive emotionality) and depressive symptoms in a community sample of 423 adolescents. Effortful control and sex were examined as potential moderators of the mediated pathway. Youth self-reported negative emotionality (NE), positive emotionality (PE), and effortful control (EC) at age 12; brooding and reflection subtypes of rumination at age 14; and depressive symptoms at ages 12, 14, and 15. Hierarchical linear regression analyses indicated that, controlling for initial levels of depressive symptoms, high NE, but not low PE, predicted increases in depressive symptoms from age 12 to age 15. Brooding, but not reflection, mediated the association between NE and depressive symptoms. Neither sex nor EC moderated either indirect pathway in the mediated model. The results confirm and extend previous findings on the association between affective and cognitive vulnerability factors in predicting depressive symptoms in adolescence.