Brooding and reflective rumination among suicide attempters: Cognitive vulnerability to suicidal ideation

Previous research suggests that the brooding subtype of rumination is associated with increased suicidal ideation, but findings are inconsistent with respect to reflection, considered to be the more adaptive form of rumination. This study investigated the circumstances under which reflective rumination might be associated with increased suicidal ideation by examining whether a suicide attempt history moderated the relationship between the ruminative subtypes and current suicidal ideation. Thirty-seven young adults who reported a past suicide attempt and fifty-nine young adults without a suicide attempt history completed measures of rumination and depression symptoms in an initial study session. They then completed a measure of suicidal ideation and hopelessness during a second study session. Overall, brooding was associated with higher self-reported suicidal ideation, whereas reflection was not significantly associated with ideation. However, reflection - but not brooding - interacted with suicide attempt history to statistically predict suicidal ideation, even after adjusting for symptoms of depression and hopelessness, whereas brooding no longer predicted ideation after adjusting for these symptoms. These findings qualify earlier suggestions that reflection is a more adaptive form of rumination by indicating that among vulnerable individuals - in particular those with a history of a suicide attempt - a higher degree of reflective rumination is associated with increased suicidal ideation.     

The durability of beneficial health effects associated with expressive writing

Abstract

This study examined the durability of benefits associated with expressive writing. Sixty-eight college undergraduates completed measures of physical and psychological health at the beginning of their first year and were then randomized to either an expressive writing or a control writing condition. Changes in physical health, psychological health (i.e., depression, stress, and anxiety), and academic performance were assessed two, four, and six months later. Findings indicated that participants assigned to the expressive writing condition reported less depression symptom severity at the two-month follow-up assessment relative to participants assigned to the control condition. However, these symptom reductions were not observed at any of the subsequent follow-up assessments. No significant changes were reported for physical health complaints, stress symptoms, anxiety symptoms, or academic performance. These findings suggest that, among first-year college students, expressive writing may provide some short-term relief for certain symptoms.     

高中生强迫思考与抑郁状态：压力知觉的中介作用及不反应的调节作用

青少年时期是抑郁的高发时期,也是抑郁预防的重要时间窗口。为探讨强迫思考倾向和抑郁状态的关系及其作用机制,采用问卷法对501名高中生进行调查。结果发现：（1）高中生强迫思考倾向完全通过压力知觉正向预测抑郁状态;（2）不反应在强迫思考倾向与压力知觉之间起调节作用,当不反应水平较高时,强迫思考倾向通过压力知觉预测抑郁状态的作用较弱。研究结果有助于揭示强迫思考倾向对高中生抑郁状态的影响及作用机制,对积极预防高中生抑郁具有一定的启示。     

Rumination and suicidal ideation: The moderating roles of hope and optimism

The current study aimed to investigate whether the correlation between rumination and suicidal ideation is moderated by the presence of hope and optimism. It was hypothesized that both hope and optimism would moderate (weaken) the relationship between rumination and suicidal ideation. Two hundred and ninety-eight participants completed self-report measures of hope, optimism, rumination (brooding and reflection), and depression. Results demonstrated that both hope and optimism weakened the relationship between rumination and suicidal ideation, as well as the relationships between both subscales of rumination and suicidal thinking. These results were found when controlling for symptoms of depression. Results suggest that a ruminative thinking style may be most harmful when an absence of hope or optimism is also present.     

Temporal Associations Between Posttraumatic Stress Symptoms and Depression in Response to Online Expressive Writing Interventions in a Hispanic Sample

Some expressive writing (EW) interventions targeting posttraumatic stress symptoms (PTSS) may reduce both PTSS and comorbid depression symptoms. The temporal associations between PTSS and depression symptom levels in response to EW interventions are unknown. This study examined the directionality of PTSS and depression symptom levels from baseline to 1-week, 1-month, and 3-month follow-ups of two online EW interventions in a Hispanic sample with diverse trauma experiences. Participants (n = 70) completed either emotion-focused or fact-focused writing for 3 consecutive days online. A manifest autoregressive model with cross-lagged effects and treatment condition was analyzed. All but one first-order autoregressive path were statistically significant, with later PTSS and depression scores significantly predicted by those scores at preceding time points. The cross-lagged effects findings suggest that earlier PTSS levels influenced later depression levels, but earlier depression did not influence later PTSS, demonstrating a unidirectional temporal association. Severe PTSS may hinder EW treatment gains in depression. Superior outcomes for emotion-focused writing relative to fact-focused writing were also found.     

Gaze-fixation and pupil dilation in the processing of emotional faces: The role of rumination

Sustained attentional processing of negative information plays a significant role in the development and maintenance of depression. The present study examines the relationships between rumination, a relevant factor in information processing in depression, and the attentional mechanisms activated in individuals with different levels of depression severity when attending to emotional information (i.e., sad, angry and happy faces). Behavioural and physiological indicators of sustained processing were assessed in 126 participants (39 dysphoric and 87 non-dysphoric) using eye-tracking technology. Pupil dilation and total time attending to negative faces were correlated with a global ruminative style in the total sample once depression severity was controlled. Furthermore, in dysphoric participants the brooding component of rumination was specifically associated with the total time attending to sad faces. Finally, bootstrapping analyses showed that the relationships between global rumination and pupil diameter to emotional faces were accounted by total time attending to emotional faces, specifically for participants reporting lower levels of depression severity. The results support the idea that sustained processing of negative information is associated with a higher ruminative style and indicate differential associations between these factors at different levels of depressive symptomatology.     

Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity

The current study assessed main effects and moderators (including emotional expressiveness, emotional processing, and ambivalence over emotional expression) of the effects of expressive writing in a sample of healthy adults. Young adult participants (N=116) were randomly assigned to write for 20 minutes on four occasions about deepest thoughts and feelings regarding their most stressful/traumatic event in the past five years (expressive writing) or about a control topic (control). Dependent variables were indicators of anxiety, depression, and physical symptoms. No significant effects of writing condition were evident on anxiety, depressive symptoms, or physical symptoms. Emotional expressiveness emerged as a significant moderator of anxiety outcomes, however. Within the expressive writing group, participants high in expressiveness evidenced a significant reduction in anxiety at three-month follow-up, and participants low in expressiveness showed a significant increase in anxiety. Expressiveness did not predict change in anxiety in the control group. These findings on anxiety are consistent with the matching hypothesis, which suggests that matching a person's naturally elected coping approach with an assigned intervention is beneficial. These findings also suggest that expressive writing about a stressful event may be contraindicated for individuals who do not typically express emotions.     

Perfectionism and psychological distress: evidence of the mediating effects of rumination

Three studies investigated the role of ruminative tendencies in mediating the effects of multidimensional perfectionism (Hewitt & Flett, 1991) on psychological distress. Study 1 (Sample 1, N = 279; Sample 2, N = 224) and Study 2 (N = 205) found evidence, cross‐sectionally and prospectively, that brooding ruminative response style either fully or partially mediated the effects of socially prescribed and self‐oriented perfectionism on psychological distress, depression and hopelessness levels. In addition, Study 3 (N = 163) confirmed these mediation effects for socially prescribed perfectionism in relation to depression and hopelessness, 2 months later, after initial levels of distress were controlled. Overall, these findings provide evidence that brooding ruminative response style is an important mechanism that can explain, in part, the relationship between perfectionism and distress. Copyright © 2006 John Wiley & Sons, Ltd.     

Procrastination and Depression from a Cognitive Perspective: An Exploration of the Associations Among Procrastinatory Automatic Thoughts,Rumination, and Mindfulness

Extensive research indicates that procrastination is associated with many maladaptive outcomes including diminished performance and greater psychological distress, but the specific factors and mechanisms associated with the vulnerability of procrastinators still need to be identified. The current study examined the associations among procrastination, ruminative brooding, mindfulness, and self-compassion. Procrastination was measured in terms of academic procrastination as well as a cognitive measure of procrastination examining the frequency of procrastination-related automatic thoughts. In addition to the main focus on the vulnerability of procrastinators, the question of whether students with multiple vulnerabilities would be particularly at risk for depression was also assessed. A sample of 214 undergraduate students completed measures of academic procrastination, procrastination-related automatic thoughts, rumination, mindfulness, self-compassion, and depression. Correlational analyses showed that both procrastination measures were associated with ruminative brooding as well as reduced mindfulness and self-compassion. Moderator-effect tests yielded no significant interactions. Overall, our findings highlight the relevance of cognitive factors in explaining procrastination and depression. Elevated levels on measures tapping cognitive risk factors (ruminative brooding and procrastination-related automatic thoughts) or a low level of protective, self-relevant cognitive factors associated with resilience (mindfulness and self-compassion) were related to a high level of procrastination and depression. These results imply that procrastinators might be vulnerable to depression due to the joint presence of these cognitive risk and resilience factors.     

The differential impact of brooding and reflection on the relationship between perceived stress and suicide ideation

This study investigated whether brooding and reflection moderated the relationship between perceived stress and suicide ideation. It was hypothesized that brooding, but not reflection, would strengthen the effect of perceived stress on suicide ideation above and beyond depression symptoms. Hypotheses were supported. Results suggest the assessment of a brooding response style may help identify clients who are more likely to contemplate suicide when confronted with life stress.     

Cognitive reactivity mediates the relationship between neuroticism and depression

Although neuroticism has long been established as an important risk factor for depression, the mechanisms through which this temperamental predisposition translates into the occurrence of symptoms are still relatively unclear. This study investigated cognitive reactivity, i.e. the ease with which particular patterns of negative thinking are reactivated in response to mild low mood, as a potential mediator. Individuals with (N = 98) and without a previous history of depression (N = 83) who had provided neuroticism scores six years previously were assessed for cognitive reactivity and current symptoms of depression using self-report questionnaires. Tendencies to respond to mild low mood with ruminative thinking mediated the relation between neuroticism and current symptoms of depression in both groups. Reactivation of hopelessness and suicidal thinking occurred as an additional mediator only in those with a history of previous depression. The results suggest that neuroticism predisposes individuals to depression by generally increasing the likelihood of ruminative responses to low mood. In those with a history of depression in the past, neuroticism additionally increases risk of recurrence by facilitating reactivation of previously associated patterns such as suicidal thinking and hopelessness. These findings suggest potential targets for interventions to help preventing the occurrence, or recurrence of depression in those who due to their temperamental predisposition are at an increased risk.     

Cognitive aspects of chronic depression

Previous research on chronic depression has focused on its link with other mood disorders and Axis II personality disorders. However, there are few data examining whether the cognitive perspective applies to this condition. In this cross-sectional study, 42 outpatients with chronic depression were compared with 27 outpatients with nonchronic major depressive disorder and 24 never psychiatrically ill controls on cognitive variables thought to be related to vulnerability to depression (e.g., dysfunctional attitudes, attributional style, a ruminative response style, and maladaptive core beliefs). Both depressed groups were more elevated than a never-ill comparison group. However, chronically depressed individuals were generally more elevated on measures of cognitive variables than those with major depressive disorders even after controlling for mood state and personality disorder symptoms.     

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.     

How brooding minds inhibit negative material: An event-related fMRI study

Depressive brooding – a passive ruminative focus on one’s problems, negative mood and their consequences – is a thinking style that places individuals at a greater risk to develop future psychopathology. In this study, we investigated whether inter-individual differences in depressive brooding are related to neural differences underlying the inhibition of a dominant response towards negative information in favor of the concurrent (positive) response. To exclude the possibility that information processes would be confounded by sustained negative mood or enhanced stress responses, a sample of thirty never-depressed healthy individuals was selected. The Cued Emotional Control Task (CECT) was used to index the ability to enhance cognitive control when encountering a negative stimulus associated with an incompatible stimulus–response mapping. Individual brooding scores were not related to behavioral performances on the CECT. On the other hand, whole brain analyses demonstrated that trait depressive brooding scores were positively associated with activation in the posterior parts of the dorsal anterior cingulate cortex (pdACC) while successfully inhibiting a response to negative relative to positive information. These findings demonstrate that brooding minds need to recruit more pdACC activation when inhibiting a dominant response towards negative information (in favor of a response towards positive), although they are performing similarly as low brooders at the behavioral level. Future research should investigate whether and how these brooding related neural adjustments in healthy volunteers are related to future psychopathology.     

Healthy brooders employ more attentional resources when disengaging from the negative: an event-related fMRI study

Depressive brooding is considered a maladaptive ruminative-thinking style that has been shown to be highly correlated with major depression. The present study in healthy participants employed event-related fMRI to uncover the neural underpinnings of emotional disengagement as it relates to depressive brooding. Thirty-four healthy, never depressed individuals performed an emotional go/no-go task with a rapid presentation of emotional faces. We focused on the contrast of inhibiting sad (happy/no-go) versus inhibiting happy (sad/no-go) information. This contrast allowed us to assess possible difficulties in disengaging from emotionally negative, as compared with emotionally positive, faces. At the behavioral level, only in high brooders were higher self-reported brooding scores correlated with more errors when sad information was inhibited, relative to happy information. At the neural level, across all participants, brooding scores were positively correlated with activity in the right dorsolateral prefrontal cortex (DLPFC; BA 46), implying that high brooders show higher DLPFC involvement when successfully disengaging from a series of negative stimuli. These results may suggest that healthy individuals who report a high brooding thinking style need to recruit more attentional control in order to disengage successfully from negative information, in a way that may be related to emotion regulation strategies. These mechanisms might protect them from developing depressive symptoms.     

Dampening and brooding jointly link temperament with depressive symptoms: A prospective study

Integrated affective-cognitive models of depression suggest that the effects of trait temperament (low positive affectivity (PA) and high negative affectivity (NA)) on depressive symptoms may be mediated by maladaptive cognitive strategies. Research and theory suggest that the effect of NA on depression is mediated by brooding and the effect of PA on depression is mediated by dampening. Despite correlations among these constructs, no studies have examined joint contributions of PA, NA, brooding, and dampening on depression. The present study examined the effects of NA and PA on prospective increases in depressive symptoms, and whether effects were mediated by brooding and dampening. Hypotheses were tested in an eight-week study of 333 young adults; depressive symptoms were assessed at weeks one and eight. Participants reported their use of dampening and brooding in response to ideographically identified weekly events in weeks two through seven. Results suggest that the effect of PA on increases in depressive symptoms was mediated by use of dampening and the effect of NA on increases in depressive symptoms was mediated by use of both brooding and dampening. Future research should consider temperament traits and cognitive strategies jointly to understand the development and maintenance of depression.     

Temperament and Risk for Depressive Symptoms in Adolescence: Mediation by Rumination and Moderation by Effortful Control

The present study examined the relations between temperament, ruminative response style and depressive symptoms both cross-sectionally and prospectively (1 year follow-up) in a community sample of 304 seventh- through tenth-graders. First, higher levels of negative affectivity (NA), lower levels of positive affectivity (PA) and lower levels of effortful control (EC) were found to be associated with higher levels of depressive symptoms. Second, the association between NA and PA on the one hand and depressive symptoms on the other was significantly moderated by level of EC (low PA and high NA are associated with depressive symptoms only if EC is low) and these relations were moderated by sex in the cross-sectional data. In the prospective data, T1 depressive symptoms and PA predicted T2 depressive symptoms; with EC approaching significance. Third, rumination also predicted T1 as well as T2 depressive symptoms. Finally, support was found for a model of moderated mediation: higher levels of NA were associated with higher levels of ruminative response style, which was in turn related to more depressive symptoms but only in individuals with low EC and this was true for the cross-sectional as well as the prospective data albeit with noteworthy differences in pattern. These findings confirm and extend previous findings on the associations between temperament, response styles and depression in adolescence and, as such, add to the growing body of research providing support for the applicability of cognitive vulnerability theories to depression in younger populations.

Take Some Time to Feel This Over: Relations Between Mood Responses,Indecision, and Creativity

Previous characterizations of rumination do not account for why a reflective style of ruminative response to negative mood, as opposed to a brooding style, is linked with greater creativity—especially when indecision is high. Moreover, less is known about ruminative responses to positive mood. The purpose of this investigation is to demonstrate the utility of a new conceptualization of rumination styles that explains their differential effects across negative and positive moods. Using tenets from psychological self-distance theory, reflective and brooding styles were respectively characterized as self-distant and self-immersed, and they were measured with the Ruminative Responses Scale (RRS), a commonly used indicator of ruminative responses to negative mood. Self-distant and self-immersed responses to positive mood were measured with an RRS adaptation. In this sample, only a self-immersed response to positive mood predicted creativity when indecision was high. Results demonstrate contrasting links between creativity and self-perspectives when responding to negative and positive moods.     

Benefits of expressive writing in lowering rumination and depressive symptoms

Depression-vulnerable college students (with both elevated prior depressive symptoms and low current depressive symptoms) wrote on 3 consecutive days in either an expressive writing or a control condition. As predicted, participants scoring above the median on the suppression scale of the Emotion Regulation Questionnaire (Gross & John, 2003) showed significantly lower depression symptoms at the 6-month assessment when they wrote in the expressive writing versus the control condition. Additional analyses revealed that treatment benefits were mediated by changes in the Brooding but not the Reflection scale of the Ruminative Response Scale (Nolen-Hoeksema & Morrow, 1991). A "booster" writing session predicted to enhance treatment benefits failed to have a significant effect.     

Randomized trial of a brief depression prevention program: an elusive search for a psychosocial placebo control condition

This trial compared a brief group cognitive-behavioral (CBT) depression prevention program to a waitlist control condition and four placebo or alternative interventions. High-risk adolescents with elevated depressive symptoms (N=225, M age=18, 70% female) were randomized to CBT, supportive-expressive group intervention, bibliotherapy, expressive writing, journaling, or waitlist conditions and completed assessments at baseline, termination, and 1- and 6-month follow-up. All five active interventions showed significantly greater reductions in depressive symptoms at termination than waitlist controls; effects for CBT and bibliotherapy persisted into follow-up. CBT, supportive-expressive, and bibliotherapy participants also showed significantly greater decreases in depressive symptoms than expressive writing and journaling participants at certain follow-up points. Findings suggest there may be multiple ways to reduce depressive symptoms in high-risk adolescents, although expectancies, demand characteristics, and attention may have contributed to the observed effects.