Rumination and intentional forgetting of emotional material

The tendency to respond to negative life events and negative mood states with ruminative thinking has been linked to emotion dysregulation and to a heightened risk for the onset and maintenance of emotional disorders. To further investigate this maladaptive response style, the present study examined whether rumination is linked to individual differences in the ability to intentionally forget emotional material. In a directed forgetting task, participants were instructed to memorise a list of positive and negative words and were subsequently told to forget these words. Next, participants were told to memorise a new list and, finally, recall was tested for all to-be-forgotten and to-be-remembered words. Our results demonstrate a close relation between rumination and recall in the forget condition but not in the remember condition. Specifically, compared to participants who scored low on the Ruminative Responses Scale (RRS), participants who scored high exhibited reduced forgetting of positive and negative to-be-forgotten words. These results remained stable when depression scores were included as a covariate suggesting that irrespective of depressive symptoms, rumination and intentional forgetting of emotional material are closely related.     

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.     

Emotion regulation in depression: Examining the role of cognitive processes

Sustained negative affect is a hallmark feature of depressive episodes. The ability to regulate emotional responses to negative events may therefore play a critical role in our understanding of this debilitating disorder. Individual differences in cognitive processes such as attention, memory, and interpretation may underlie difficulties in emotion regulation and numerous studies have identified cognitive biases and deficits that characterise depressed people. Few studies, however, have explicitly linked these biases to the difficulties in emotion regulation that are associated with depression. In this paper we discuss relations among cognitive processes and emotion regulation and review the depression literature to identify cognitive biases and deficits that may underlie maladaptive responses to negative events and mood states. Our review suggests that difficulties in the disengagement from negative material, memory biases, and deficits in cognitive control are frequently observed in depressive disorders and may be associated with the use of maladaptive emotion regulation strategies, such as rumination. These biases may also be related to difficulties implementing strategies that are effective for non-depressed people, such as recall of mood-incongruent material and reappraisal. Our review also suggests, however, that empirical studies linking cognitive biases and emotion regulation in depression are still largely missing and would present an important goal for future research in this area.     

Affective Processing and Emotion Regulation in Dysphoria and Depression: Cognitive Biases and Deficits in Cognitive Control

In this article, we take a closer look at the cognitive processing of emotional material in dysphoria and depression and link cognitive biases and deficits to individual differences in emotion regulation, an important risk factor for depression. Specifically, we propose that cognitive biases are associated with individual differences in the initial appraisal and reappraisal of emotion‐eliciting events. In addition, deficits in cognitive control result in prolonged processing of negative, goal‐irrelevant aspects of information as well as in decreased accessibility of mood‐incongruent material. These deficits further affect people’s ability to regulate negative affect by setting the stage for ruminative responses and by interfering with the use of reappraisal after the onset of an emotional response. This article provides a brief summary of findings that support these propositions and outlines implications for future research on the relation among affective processing, cognitive control, and emotion regulation in dysphoria and depression.     

Specificity of parental bonding and rumination in depressive and anxious emotional distress

We examined how different dimensions of rumination may mediate the impact of parental bonding (lack of care and overprotectiveness) on negative emotional symptomatology (anxiety and depression). Survey data from participants were analyzed using structural equation modeling. Results indicated that brooding rumination fully mediated the relationship between maternal care and depressive and anxious symptomatology. These findings suggest that to the extent that maternal caregivers are low in warmth and support, offspring are more likely to develop a brooding style of ruminative thinking associated with heightened emotional distress. This research supports the growing body of evidence suggesting that cognitive variables form a pathway between troublesome parent/child interactions and psychopathology.     

Switching and backward inhibition in major depressive disorder: the role of rumination

Previous studies have demonstrated that individuals with major depressive disorder have difficulties switching attention from one task set to another. In the current study we examined whether ruminative thinking drives the switching deficits of depressed individuals. A secondary, more exploratory, goal of this study was to examine whether state rumination would impair depressed individuals' ability to activate a new task set, to inhibit a no longer relevant task set, or both. Participants underwent either a rumination induction or a distraction induction and then completed a backward inhibition task that measures general switching abilities and the ability to inhibit previous task sets. Although depression was not related to switching ability as a main effect, depressed individuals who were induced to ruminate exhibited poorer switching ability than did both depressed and control individuals who were distracted from ruminating and control participants who were induced to ruminate. These findings suggest that depressed individuals are characterized by switching deficits only if they are ruminating. Moreover, the finding that state rumination did not affect participants' ability to inhibit previous task sets suggests that state rumination primarily impairs noninhibitory task-switching processes. It is interesting that the opposite pattern of results was obtained for trait rumination, which was related to inhibitory deficits during switching, but not to generally poorer switching. Thus, state and trait rumination may be associated with dissociable cognitive deficits.     

Ruminative and mindful self-focused processing modes and their impact on problem solving in dysphoric individuals

A mindful experiential rather than an analytical ruminative mode of information processing is beneficial in depression. However studies have not taken into account people’s trait mindfulness or trait rumination. This study aimed to examine the effects of state and trait analytical rumination and experiential mindfulness on affect and social problem solving (SPS). Participants filled in the trait mindfulness and trait rumination questionnaires. After mood induction, dysphoric participants with and without a history of depression were assessed for SPS and affect before and after induction of mindful (experiential) or ruminative (analytic) processing modes. Results showed trait mindfulness was negatively correlated with the BDI and trait rumination was positively correlated with the BDI. There was no significant difference between groups after the induced experiential mindful or analytical ruminative processing modes. However, participants who scored high on trait rumination showed significant improvement in SPS after induced mindfulness processing. No such effect was found on trait mindfulness. These findings suggest a useful way to prevent high trait ruminators from developing depressive symptoms or depression. Experiential mindful processing may help reduce the risk of developing depressive symptoms by increasing social problem solving ability in those with low mood and high levels of trait rumination.     

A meta‐mood model of rumination and depression: Preliminary test in a non‐clinical population

Depressive rumination and trait meta‐mood (emotional attention, emotional clarity and emotional repair) have been suggested as vulnerability factors leading to depression, but less is known about the associations among them. In this study, we examined the relationships between trait meta‐mood, rumination and depressive symptomatology. Using structural equation analysis in a large sample of a non‐clinical population we found a preliminary test of the role of trait meta‐mood dimensions in rumination and depressive symptomatology. Results indicated that attention to feelings has two pathways in its relation with rumination and depressive mood. On the one hand, emotional attention was associated with emotional clarity, and emotional clarity with emotional repair, which was related to lower depressive symptomatology, in part, by reducing rumination. On the other hand, emotional attention was directly associated with ruminative thoughts which, in turn, were related to higher depressive mood. Findings are discussed in terms of the implications of beliefs about emotions in the treatment of depression.     

Ruminative Inertia,Emotion Regulation,and Depression: A Daily-Diary Study

Emotional suppression and cognitive reappraisal are emotion regulation strategies that have been linked to the severity of depression. Recent research has shown that greater ruminative inertia (i.e., rumination that is more resistant to change across time) is also associated with higher levels of depressive symptoms in clinical samples. However, it is unknown how tendencies to use suppression or reappraisal might be related to the inertia of rumination from day to day. After completing a baseline assessment of depressive symptoms and trait emotional suppression and cognitive reappraisal use, undergraduates (n = 94) completed daily-diary questionnaires assessing rumination for two weeks. Both higher depressive symptoms and greater tendencies to use suppression predicted stronger ruminative inertia, while tendencies to use reappraisal were unrelated to ruminative inertia. These results suggest that maladaptive emotion regulation strategies may contribute to a pattern of rumination that is more resistant to change over time. They also provide the first evidence that ruminative inertia is positively associated with depressive symptoms in a nonclinical sample.     

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.     

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.     

Responses to Positive Affect in Daily Life: Positive Rumination and Dampening Moderate the Association Between Daily Events and Depressive Symptoms

Depressive rumination has been strongly linked to the development and maintenance of depression; however, less attention has been paid to ruminative processes in response to positive affect, and fewer have examined these processes in daily life. The current study sought to address these gaps by exploring depressive rumination and two forms of responses to positive affect, dampening and positive rumination, under ecologically valid conditions using daily diary methodology. One hundred fifty-seven young adults completed 14-day end-of-day diaries assessing positive affect and depressive symptoms in relation to depressive rumination, responses to positive affect, and daily positive and negative events. Daily depressive rumination predicted stronger associations between negative events and daily depressive symptoms. Higher daily dampening was associated with higher daily depressive symptoms and decreased positive affect and predicted lower associations between daily positive events and improvements in mood (including reduced daily positive affect and increased daily depressive symptoms). Higher daily positive rumination was negatively associated with daily depressive symptoms and interacted with daily positive events such that positive rumination had a greater impact on depressed mood on days when positive experiences were low. Results indicate that both depressive rumination and responses to positive affect play a role in influencing daily mood and depressive symptoms.     

Sticky thoughts: depression and rumination are associated with difficulties manipulating emotional material in working memory

Cognitive inflexibility may play an important role in rumination, a risk factor for the onset and maintenance of depressive episodes. In the study reported here, we assessed participants' ability to either reverse or maintain in working memory the order of three emotion or three neutral words. Differences (or sorting costs) between response latencies in backward trials, on which participants were asked to reverse the order of the words, and forward trials, on which participants were asked to remember the words in the order in which they were presented, were calculated. Compared with control participants, depressed participants had higher sorting costs, particularly when presented with negative words. It is important to note that rumination predicted sorting costs for negative words but not for positive or neutral words in the depressed group. These findings indicate that depression and rumination are associated with deficits in cognitive control.     

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.     

Dampening of positive affect prospectively predicts depressive symptoms in non-clinical samples

Past research has convincingly shown that a ruminative response style to negative affect (NA) predicts concurrent and prospective levels of depressive symptoms. Recent findings suggest that how people respond to positive affect (PA) might also be involved in the development of depressive symptoms, although this has heretofore not been tested prospectively. Participants from two non-clinical samples (total N=487) completed measures of depressive symptoms, response styles to NA (negative rumination) and response styles to PA (positive rumination and mood dampening) at two assessments separated by a 3-month (Sample 1) and 5-month period (Sample 2). Results in both samples showed that increased dampening responses to PA predict depressive symptoms at follow-up, even when taking into account baseline depressive symptoms and ruminative responses to NA. The results suggest that (dampening) responses to PA add useful information above and beyond (ruminative) responses to NA in predicting depression symptoms prospectively.     

Dampening of positive affect prospectively predicts depressive symptoms in non-clinical samples

Past research has convincingly shown that a ruminative response style to negative affect (NA) predicts concurrent and prospective levels of depressive symptoms. Recent findings suggest that how people respond to positive affect (PA) might also be involved in the development of depressive symptoms, although this has heretofore not been tested prospectively. Participants from two non-clinical samples (total N=487) completed measures of depressive symptoms, response styles to NA (negative rumination) and response styles to PA (positive rumination and mood dampening) at two assessments separated by a 3-month (Sample 1) and 5-month period (Sample 2). Results in both samples showed that increased dampening responses to PA predict depressive symptoms at follow-up, even when taking into account baseline depressive symptoms and ruminative responses to NA. The results suggest that (dampening) responses to PA add useful information above and beyond (ruminative) responses to NA in predicting depression symptoms prospectively.     

Mood-as-input and depressive rumination

This article describes a test of mood-as-input theory predictions as applied to a rumination task in a nonclinical population. An experimenter-controlled interview was used to allow participants to reflect on a personal period of depression while in an experimentally-induced mood state (either negative or positive) or while deploying a specific stop rule for the task (either an “as many as can” or “feel like continuing” stop rule). As predicted by mood-as-input theory, persistence at the rumination task was greatest in the group experiencing negative mood while deploying an “as many as can” stop rule, and this suggests a mechanism that may contribute to perseverative depressive rumination. It is argued that the variables that contributed to perseveration in this study are already known to be characteristic of ruminative thinkers (e.g. negative mood and positive metacognitive beliefs about rumination that will command the deployment of “as many as can” stop rules for rumination). It is also argued that mood-as-input processes may provide a common mechanism for perseverative rumination and perseverative worry, and this common mechanism may account for many of the similarities between these two functionally-distinct activities.     

Trauma‐related rumination mediates the effect of naturally occurring depressive symptoms but not momentary low mood on trauma intrusions

Comorbid depression is known to contribute to the maintenance of posttraumatic stress disorder (PTSD) including distressing intrusive trauma memories. It is theorised that depression is a risk factor for persistent PTSD through preventing optimal habituation of distress provoked by trauma memories and reminders, but the underlying cognitive mechanisms responsible are uncertain. The present study investigated trauma‐related rumination as a possible mediator for the effect of depression on trauma intrusions. Participants received a low mood induction or control procedure. Following viewing an analogue trauma film, frequency of film‐related intrusions and associated distress levels were measured and at 1‐week follow‐up. Between the two occasions, participants rated their levels of rumination about the film. Existing depression symptoms but not induced momentary sad mood predicted frequency of film intrusions and associated distress at 1‐week follow‐up. Some evidence was found that ruminative trauma processing mediated the relationship between baseline depressive symptoms and later intrusion frequency and associated distress. Future research is warranted to better understand the role of rumination in the depression–intrusion relationship, which may shed light on the clinical applicability of rumination‐targeted intervention for PTSD and comorbid depression.     

Effects of Rumination and Mindful Self-Focus Inductions During Daily Life in Patients With Remitted Depression: An Experimental Ambulatory Assessment Study

Rumination has been proposed as an important risk factor for depression, whereas mindful attention is considered a protective form of self-focusing. Experimental studies have demonstrated differential effects of these modes when induced in the lab. However, their impact on daily life processes is poorly understood, particularly in individuals vulnerable to depressive relapses. The aim of our study was to examine short- and longer-term effects of repeated brief rumination and mindful self-focus inductions during daily life on momentary mood, cognitions, and cortisol in patients with remitted depression (rMDD) as well as in healthy individuals, and to identify their potential differential effects in these groups. The study involved repeated short ambulatory inductions of a ruminative or a mindful self-focus during daily life with additional assessments of momentary mood, rumination, self-acceptance, and cortisol over 4 consecutive days in a sample of patients with rMDD (n = 32, ≥2 lifetime episodes, age 19–55 years) and matched healthy controls (n = 32, age 21–54 years). Multilevel models revealed differential immediate effects of the two induction modes on all momentary mood and cognitive outcomes (all p’s < .001), but not on cortisol. Detrimental effects of rumination over mindful self-focus inductions were particularly strong for cognitions in the patient group. Longer-term effects of the inductions over the day were lacking. This study underlines immediate deteriorating effects of an induced ruminative compared to a mindful self-focus on momentary mood and cognitions during daily life in patients with rMDD and in healthy individuals. The observed stronger rumination-related reactivity in patients suggests heightened cognitive vulnerability. Understanding rumination- and mindfulness-based mechanisms of action in real-life settings can help to establish mechanism-based treatment options for relapse prevention in depression.