Getting Out of Rumination: Comparison of Three Brief Interventions in a Sample of Youth

Rumination, passively and repetitively dwelling on and questioning negative feelings in response to distress, is a risk factor for the development of psychopathology, especially depression. The ruminative process is difficult to stop once it has begun. The present studies focused on strategies that may help youth disengage from ruminative states. In Study 1, we validated a technique for inducing distress and measuring state rumination. Twenty-six participants (mean age?=?12.21; 62?% girls) underwent a negative mood induction followed by either a rumination or distraction induction. In Study 2, we examined the utility of three different brief interventions for stopping the ruminative process. One hundred-two youth (mean age?=?11.51; 64?% girls) underwent a negative mood induction followed by a rumination induction. Following this, participants were randomly assigned to one of three conditions designed to help them out of the ruminative state (distraction, problem-solving, or mindfulness). In Study 1, participants in the rumination condition reported significantly higher levels of state rumination compared to those in the distraction condition. In Study 2, both distraction and mindfulness helped reduced state rumination compared to problem-solving. Taken together, these data suggest that even a brief period of distraction or mindfulness is helpful in getting youth out of a ruminative state. Clinical implications might include the potential use of mobile device applications to help alleviate rumination.     

Why ruminators are poor problem solvers: clues from the phenomenology of dysphoric rumination

The phenomenology of dysphoric rumination and its consequences for problem solving were explored in 3 studies. In Study 1, self-focused rumination, compared with distraction, led dysphoric participants to rate their own biggest problems as severe and unsolvable and to report a reduced likelihood of actually implementing their solutions. Clues into the mechanisms behind these findings were explored in Study 2. The results showed that dysphoric ruminative thought is characterized by a focus on personal problems combined with a negative tone, self-criticism, and self-blame for problems as well as reduced self-confidence, optimism, and perceived control. Finally, Study 3 revealed a direct relationship between the negatively biased content of ruminative thoughts and reduced willingness to solve one's problems. Implications of these findings for the consequences of self-focused rumination are discussed.     

Can self-compassion improve sleep quality via reduced rumination?

ABSTRACT

Poor sleep quality is highly prevalent in modern societies and can be associated with a multitude of problems for individuals and organizations, and also for society at large. Thus, there is a demand for efficient treatments. We suggest that short self-compassion interventions will improve sleep quality via reducing ruminative thoughts, a key variable associated with poor sleep quality. We ran three studies to test this hypothesis. In Study 1 (correlational data), a positive relationship between self-compassion and sleep quality emerged in students’ self-reports. This effect was mediated by rumination. In Study 2, students in two different self-compassion intervention conditions reported higher sleep quality compared to a control condition. Again, rumination mediated this effect. In Study 3, patients with major depressive disorder reported a significant increase in sleep quality and a significant decrease of ruminative thoughts after one week in a daily self-compassion intervention (compared to patients in a control condition). Limitations and implications for future research, such as the need of placebo control groups, objective sleep quality measures, and person–intervention fit designs are discussed.     

Letting go of unmet goals: Does self-focused rumination impair goal disengagement?

Self-regulation of behavior frequently requires that people disengage from goals that are too difficult to attain. The current studies investigate whether self-focused rumination hinders the execution of this crucial self-regulatory competence. In study one, participants attempted to solve anagrams, some of which were unsolvable, and their predisposition to engage in self-focused rumination was assessed. The tendency to ruminate was associated with getting stuck in the attempt to solve unsolvable anagrams. In study two, ruminative thoughts were manipulated by asking participants to focus on their self, personality, and goals in life, a task frequently employed to induce rumination. Compared to participants undergoing a distraction induction, ruminating participants were more likely to get stuck trying to solve unsolvable anagrams. These results suggest that self-focused rumination hinders disengagement from unattainable goals.     

An experimental analogue study into the role of abstract thinking in trauma-related rumination

Trauma-related rumination has been shown to predict the maintenance of posttraumatic stress disorder (PTSD). However, it is still unclear how rumination can be distinguished from functional forms of thinking about traumatic events. The current study used an analogue design to experimentally test the hypothesis that the abstractness of thinking is responsible for the dysfunctional effects of trauma-related rumination. Eighty-three healthy university students first watched a distressing video and were then randomly assigned to abstract ruminative thinking, concrete thinking or distraction. Abstract thinking was found to lead to a significantly longer maintenance of negative mood and arousal than both concrete thinking and distraction. These results are in line with earlier findings in the context of excessive worry and depressive rumination and support the view that abstractness is a critical factor for the dysfunctional effects of trauma-related rumination. However, results regarding intrusive memories were not supportive of the hypotheses. Unexpectedly, the distraction group showed the highest number of intrusions, whereas the abstract and concrete conditions did not significantly differ. Implications for theoretical models of trauma-related rumination and possible clinical implications are discussed.     

Ruminative Thoughts and Their Relation to Depression and Anxiety1

Although past research has shown a correlation between ruminative response style and depression (Nolen-Hoeksema, 1991), the basic relationships among amount of ruminative thoughts, depression, and anxiety has not been established. Scores from the Beck Depression Inventory-Second Edition (BDI-II; Beck, Steer, & Brown, 1996), the Beck Anxiety Inventory (BAI; Beck & Steer, 1993), and the McIntosh and Martin (1992) Rumination Scale were analyzed for 199 participants. The correlation between rumination and depression was .33, between rumination and anxiety was .32, and between depression and anxiety was .56. The partial correlation between rumination and depression (controlling for anxiety level) was .20, and the partial correlation between rumination and anxiety (controlling for depression level) was .17. The finding that rumination is not unique to depression but is also associated with the specific negative affect of anxiety alone might also suggest new treatments of these two prevalent disorders.     

Ruminative self-focus and negative affect: an experience sampling study

The authors conducted an experience sampling study to investigate the relationship between momentary ruminative self-focus and negative affect. Ninety-three adults recorded these variables at quasi-random intervals 8 times daily for 1 week. Scores on questionnaire measures of dispositional rumination were associated with mean levels of momentary ruminative self-focus over the experience sampling week. Concurrently, momentary ruminative self-focus was positively associated with negative affect. Cross-lagged analyses revealed that whereas ruminative self-focus predicted negative affect at a subsequent occasion, negative affect also predicted ruminative self-focus at a subsequent occasion. Decomposition of the dispositional rumination measure suggested that brooding, but not reflective pondering, was associated with higher mean levels of negative affect. Though broadly consistent with Nolen-Hoeksema's (1991) response styles theory, these results suggest that a reciprocal relationship exists between ruminative self-focus and negative affect.     

The Impact of Ruminative Processing on the Experience of Self-Referent Intrusive Memories in Dysphoria

The current study sought to experimentally assess the differential effects of analytical ruminative processing and distraction on the experience of self-referent naturally occurring intrusive memories in a sample of dysphoric (BDI-II ≥ 12) participants. Seventy-seven undergraduate participants completed a memory interview to elicit details about a self-referential intrusion and were randomly assigned to either an analytical rumination or distraction condition. Subsequent to the rumination induction, participants rated their intrusive memory as more negative, more distressing, and more evocative of a negative emotional response compared to participants who were allocated to the distraction induction. Inducing analytical rumination also resulted in participants reporting worse (i.e., more sad) mood relative to those in the distraction condition. The findings align with the suggestion that depressed individuals may get caught up in a ruminative cycle that, due to the documented effects of analytical self-focus, exacerbate the emotional response elicited by intrusions and perpetuate biased attentional focus on them. Directions for future investigations of the cognitive processes that are important in the maintenance of intrusions in depressive disorders are discussed.     

A Kid-Friendly Tool to Assess Rumination in Children and Early Adolescents: Relationships with Mother Psychopathology and Family Functioning

The early identification of ruminative processes in children and early adolescents is particularly important to prevent the development of a stable ruminative style in later stages of development. The present study first aimed at validating a child-friendly tool, Kid Rumination Interview (KRI), to be used in a sample aged 7–12 years (n?=?100; 50% females). Second, we hypothesized that maternal depression, family functioning and participants’ emotion regulation skills would be associated with children’ levels of rumination. Factor analysis on KRI scores yielded two main factors: personal life-related rumination and school-related rumination. Older and female participants showed higher tendencies to ruminate about school issues compared to their younger and male counterparts. A low-to-moderate correlation emerged between school-related rumination and child/early adolescent’s emotion regulation capacities. Mothers’ depressive rumination and mothers’ depressive symptoms were positively associated with children/early adolescents’ rumination about personal life and rumination about school issues. Conversely, an adequate and positive family functioning was negatively correlated with both school-related rumination and rumination about personal life. Hierarchical regression analyses pointed to a crucial role of maternal rumination and familiar rigidity in both types of rumination. Personal life-related rumination was also specifically predicted by maternal depression and family enmeshment, whereas school-related rumination was significantly associated with children/early adolescents’ emotional control and gender. Overall, the KRI appears as a promising tool to assess rumination in children/early adolescents. Results suggests partially different pathways to specific forms of ruminative thoughts.     

Neural correlates of rumination in depression

Rumination, or recursive self-focused thinking, has important implications for understanding the development and maintenance of depressive episodes. Rumination is associated with the worsening of negative mood states, greater affective responding to negative material, and increased access to negative memories. The present study was designed to use fMRI to examine neural aspects of rumination in depressed and healthy control individuals. We used a rumination induction task to assess differences in patterns of neural activation during ruminative self-focus as compared with a concrete distraction condition and with a novel abstract distraction condition in 14 participants who were diagnosed with major depressive disorder and 14 healthy control participants. Depressed participants exhibited increased activation in the orbitofrontal cortex, subgenual anterior cingulate, and dorsolateral prefrontal cortex as compared with healthy controls during rumination versus concrete distraction. Neural activity during rumination versus abstract distraction was greater for depressed than for control participants in the amygdala, rostral anterior cingulate/medial prefrontal cortex, dorsolateral prefrontal cortex, posterior cingulate, and parahippocampus. These findings indicate that ruminative self-focus is associated with enhanced recruitment of limbic and medial and dorsolateral prefrontal regions in depression. Supplemental materials for this article may be downloaded from http://cabn.psychonomic-journals.org/content/supplemental.     

Imagery and verbal thought during rumination and distraction: Does imagery amplify affective response?

Rumination has long been considered a verbal thought process, though emerging evidence suggests that some individuals dwell on maladaptive imagery. This series of studies evaluated imagery and verbal thought during experimentally induced rumination and distraction. In Study 1, imagery and verbal thought during rumination resulted in similar increases in negative affect. Greater imagery during distraction, on the other hand, was associated with greater decreases in negative affect while verbal thought was not related to affect change. Given that greater verbal thought was reported in the rumination condition and greater imagery was reported in the distraction condition, Study 2 evaluated whether the rumination/distraction induction was confounded by concurrent induction of imagery or verbal thought. The rumination prompts induced both rumination and verbal thought and the distraction prompts induced both distraction and imagery. Using a revised induction, Study 3 tested whether imagery and verbal thought during rumination and distraction impacted affective response. Rumination maintained negative affect and distraction relieved negative affect, regardless of the degree to which imagery or verbal thought was experienced. This paper provides evidence that imagery-based rumination is just as impairing as verbally-based rumination and highlights imagery-based distraction as a potentially effective alternative to rumination.     

The association between ruminative thinking and negative interpretation bias in social anxiety

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction (post-event processing by self-report questionnaire and social rumination by experience sampling method) and negative interpretation bias (via two separate tasks) in a student sample (n?=?51) screened for high (HSA) and low social anxiety (LSA). Results support the hypothesis that group differences in negative interpretations of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing.     

Rumination and symptom reports in children and adolescents: Results of a cross-sectional and experimental study

This study explores the relationship between a ruminative response style and symptom reports in children and adolescents of grades 5, 7 and 9 from German secondary schools. Questionnaires were used to assess rumination and symptom reports. A group of children and adolescents (N?=?140) were asked to think first about the items before responding to them (increased attention condition), while a second group (N?=?260) served as control group (standard condition). The assumption was that rumination and also additional attention to the symptoms by instruction would increase the reported frequency of experiencing somatic and psychological symptoms. The results showed significant relations between symptom reports and rumination, which increased with grade. There were sex differences for somatic symptom reports with increased symptom frequencies in girls, which were mediated by rumination. Moreover, instructing participants to think first about the items led to an increase in reported symptoms. It is concluded that an increased attention to symptoms of distress increases symptom reports, which may be induced momentarily by instruction and also more generally by a ruminative response style. Conclusions regarding prevention and concerning instructions in symptom report questionnaires are outlined.     

Assessing post-event processing after social situations: a measure based on the cognitive model for social phobia

In their cognitive model of social phobia, Clark and Wells (1995) described a process called post-event processing that is characterized by prolonged ruminative and negative thinking about a past social event. Referring to this concept, Rachman and colleagues (2000) developed a questionnaire that has been used in several studies subsequently (Post-Event Processing Questionnaire (PEPQ)). Our aim was to examine a German version of the PEPQ and, where necessary, modify this measure. In Study 1 (N=130 students), we inspected the psychometric properties of the German version of the PEPQ. According to the item analyses, problematic items were identified and eliminated or reformulated. To map aspects of post-event processing that were missing in the original questionnaire, new items were developed. In Study 2, the psychometric properties of the revised instrument were analyzed in a sample of students (N=268).The revised instrument showed excellent internal consistency and a meaningful pattern of correlations with anxiety, depression, and dysfunctional self-consciousness. With regard to the factorial structure of the construct, our data suggest that a four-factorial model may be more appropriate than the one-dimensional structure proposed by Rachman and colleagues.     

The roles of sex, gender, and coping in adolescent depression

This study investigated the roles of coping and masculinity in higher rates of depressive symptoms among adolescent girls, as compared to boys. A model was designed and tested through path analysis, which involved the variables of sex, gender, problem-focused coping, rumination, and distraction. The Reynolds Adolescent Depression Scale and the Bem Sex Role Inventory, as well as a measure of coping with general stressors was completed by 246 adolescents. Results showed that adolescent girls were more depressed than boys, and that girls used more emotion-focused and ruminative coping than did boys. Greater degrees of ruminative coping were related to high levels of depressive symptoms. Problem-focused and distractive coping were positively correlated with masculinity and negatively associated with depression. Surprisingly, girls were more likely to use problem-focused coping. Problem-focused and distractive coping were found to mediate the negative relationship between masculinity and depression.     

Rumination and overgeneral autobiographical memory

Two studies investigated the effects of rumination on the retrieval of autobiographical memories in high-depressed and low-depressed individuals. Experiment 1 administered either a rumination or distraction task prior to a cued autobiographical memory task. High-depressed participants recalled more overgeneral memories following rumination relative to distraction, whereas experimental inductions did not influence low-depressed participants. Experiment 2 administered either a positive or negative rumination task prior to a cued autobiographical memory task. Negatively valenced rumination led high-depressed participants to recall more overgeneral memories than positively valenced rumination; this effect was not observed in low-depressed participants. These findings accord with the proposal that rumination is a mediating mechanism in the retrieval of overgeneral memories, and extends this proposal by indicating that negatively valenced ruminative content is particularly instrumental in inducing overgeneral retrieval.     

Perfectionism Cognitions, Rumination, and Psychological Distress

The current study examined the extent to which dimensions of perfectionism are associated with a ruminative response orientation and the experience of cognitive intrusions in response to stressful events. Our main goal was to test the hypothesis that individuals characterized by frequent automatic thoughts involving perfectionistic themes would also be characterized by a ruminative response orientation when distressed and they would report intrusive thoughts and images following the experience of a stressful event. A sample of 65 students completed several measures, including the Perfectionism Cognitions Inventory, the Multidimensional Perfectionism Scale, the Response Styles Questionnaire, the Impact of Events Scale, and indices of depression and anxiety. Correlational analyses confirmed that high scores on the Perfectionism Cognitions Inventory were correlated with a ruminative response orientation and the reported experience of intrusive thoughts and images following the experience of a stressful event. High levels of perfectionism cognitions, socially prescribed perfectionism, and rumination were also correlated with measures of depression and anxiety representingthe tripartite model. The results support the view that there is a salient cognitive aspect to perfectionism and the experience of frequent perfectionistic cognitions and related forms of rumination contribute to levels of psychological distress.     

Rumination, reflection, intrusive thoughts, and hallucination-proneness: Towards a new model

Although rumination has been proposed to play an important role in the creation of hallucinations, direct empirical tests of this proposal have not yet been performed. Employing a distinction between ruminative and reflective self-consciousness, we set out to test a new model of the relations among rumination, reflection, intrusive thoughts, thought suppression, social anxiety, and hallucination-proneness. This model proposed that rumination would be related to hallucination-proneness through the mediating variable of intrusive thoughts, but that reflection would not be related to hallucination-proneness. The model was tested in a student population (N = 296) using path analyses. A modified version of the model was found to be a good fit to the data, once a direct path from reflection to hallucination-proneness had been added. As hypothesized, rumination was related to hallucination-proneness only indirectly, through the mediating variable of intrusive thoughts. Implications for interventions and future directions for research are considered.     

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.