Depressive rumination reduces specificity of autobiographical memory recall in acquired brain injury.

Individuals with acquired brain injuries (ABI) often experience depression following injury, with estimated rates between 20 and 40% within the first year and up to 50% thereafter (Fleminger et al., 2003). Previous studies with non-brain-injured individuals have identified that rumination is prevalent in both the development and maintenance of depression. The study aimed to explore how depressive rumination may contribute to overgeneral memory recall in ABI patients, by assessing the effects of manipulating ruminative self-focus on autobiographical memory performance across levels of brain injury. Fifty-eight ABI individuals with mild (28) to moderate/severe (30) cognitive impairments were assessed on measures of mood, rumination and autobiographical memory. They were then randomly assigned into matched groups for an intervention (a distraction) or a rumination task. Following intervention, they were re-assessed for autobiographical recall and rumination. Findings indicate that ruminative self-focus reduced specificity of autobiographical memory in individuals with ABI, suggesting that depressive rumination plays a role in the reduced access to autobiographical memories. Higher baseline levels of depression and rumination were also associated with less specificity in recall. These findings indicate the value of identifying and treating depression among this population.     

Brooding rumination as a mediator in the relation between early maladaptive schemas and symptoms of depression and social anxiety in adolescents

Theory states that different cognitive constructs can be included in an integrated sequential model. This 3-wave longitudinal study assessed whether schema domains predict brooding rumination and brooding in turn predict depression and social anxiety symptoms among adolescents. A total of 1170 adolescents (M_age = 13.44 years old, SD_age = 1.30) completed measures of schema domains, brooding rumination, depression and social anxiety symptoms at baseline, 6- and 12-month follow-up (T1, T2, T3, respectively). Results revealed that the Disconnection and Rejection schema domain at T1 predicted prospective depression symptoms at T3 directly but not through brooding rumination. However, this schema domain did not predict social anxiety symptoms. The Other-Directedness schema domain at T1 predicted social anxiety symptoms at T3 both directly and through brooding at T2. Furthermore, this schema domain also predicted depression symptoms at T3 through brooding at T2. Identifying specific schema domains and the mechanisms through which these domains predict psychological symptoms has implications for interventions with adolescents.     

单相与双相抑郁症患者沉思反应及拖延行为的比较

目的:探讨单相与双相抑郁患者沉思反应及拖延行为的差异。方法:对32例单相抑郁(单相组)及31例双相抑郁(双相组)患者分别评定沉思量表(RRS)、一般拖延行为问卷(GPS)和汉密尔顿抑郁量表(HAMD-17)评定;对26名正常对照者(健康组)给予RRS和GPS评定,然后进行组间比较。结果:抑郁组的RRS总分(55.8±9.5)显著高于健康组[(45.8±8.1),P0.01)],抑郁组的GPS总分(57.2±8.9)也显著高于健康组[(49.3±8.4),P0.05];单相组和双相组的RRS总分及GPS总分与HAMD总分及阻滞、绝望感因子分均呈显著正相关(r=0.368~0.491,P0.05或P0.01);单相组与双相组的RRS总分及各因子分和GPS总分差异无统计学意义(P0.05)。结论:抑郁症患者比健康人更易陷入沉思,且也较易采取拖延方式;单相与双相抑郁症患者的沉思反应及拖延行为未见实质性差别,但在临床上需加以关注。     

冗思反应量表中文版在抑郁障碍患者中的运用结果分析

目的 评价冗思反应量表中文版(RRS-C)在抑郁障碍患者中的信、效度.方法 212例抑郁障碍患者完成了RRS-C和流调中心抑郁量表(CES- D),分析RRS-C的Cronbach'sα系数、条目间平均相关系数、总分和各因子的相关系数,并采用验证性因子分析考察其三因子结构.结果 RRS-C总量表的Cronbach's α系数为0.88,三因子的Cronbach's α系数在0.67～0.84;总量表的条目间平均相关系数为0.26,量表总分和各因子间的相关系数在0.71～0.94,各因子条目间平均相关系数在0.29～0.32;验证性因子分析指标(CFI=0.913;GFI=0.905;x2/v＜2;RSMEA=0.072)均符合测量学要求.结论 RRS-C在抑郁障碍患者中有良好的信、效度,可应用于我国抑郁障碍患者冗思特征的测评.     

A seven day actigraphy-based study of rumination and sleep disturbance among young adults with depressive symptoms

Objectives

Trait ruminators exhibit significantly higher levels of sleep disturbance than those without this cognitive vulnerability. However, support for the sleep disruptive effects of state rumination, especially in the pre-sleep period, is rare, and hindered by methodological drawbacks such as self-report and single night assays of sleep. Finally, despite the pervasiveness of the ruminative response style among individuals with depression, the association between rumination and sleep disturbance has not been explored in this population. The present study employed a week-long daily sampling approach to examine the effects of naturally occurring pre-sleep rumination on self-reported and actigraphy-based sleep among individuals with high depressive symptomatology.

Methods

Forty-two university students (19.6 ± 3.2 yo;73.8% female), all of whom reported at least moderate levels of depressive symptoms, completed a short questionnaire after waking each morning for seven days. On this questionnaire, they self-reported sleep indices from the previous night and levels of engagement in pre-sleep rumination. Sleep was also monitored throughout this period via wrist actigraphy. Hierarchical-linear-modeling was used to examine the association between nightly rumination and sleep.

Results

Nightly variations in pre-sleep rumination were predictive of significantly longer actigraphy- and diary-based sleep onset latency (SOL). Notably, a 1 SD increase on the pre-sleep rumination scale was associated with an approximately 7 minute increase in actigraphy-based SOL, even after controlling for baseline sleep disturbance and depressive symptoms.

Conclusions

These data offer compelling evidence for the impact of pre-sleep rumination on sleep onset, providing insight into one potential mechanism that triggers sleep disturbance among individuals with depressive symptoms.     

Increased involvement of the parahippocampal gyri in a sad mood predicts future depressive symptoms

Behavioral studies suggest a relationship between autobiographical memory, rumination and depression. The objective of this study was to determine whether remitted depressed patients show alterations in connectivity of the posterior cingulate cortex (PCC, a node in the default mode network) with the parahippocampal gyri (PHG, a region associated with autobiographical memory) while intensively recalling negative memories and whether this is related to daily life symptoms and to the further course of depression. Sad mood was induced with keywords of personal negative life events in participants with remitted depression (n = 29) and matched healthy controls (n = 29) during functional magnetic resonance imaging. Additionally, daily life assessments of mood and rumination and a 6-month follow-up were conducted. Remitted depressed participants showed greater connectivity than healthy controls of the PCC with the PHG, which was even stronger in patients with more previous episodes. Furthermore, patients with increased PCC–PHG connectivity showed a sadder mood and more rumination in daily life and a worsening of rumination and depression scores during follow-up. A relationship of negative autobiographical memory processing, rumination, sad mood and depression on a neural level seems likely. The identified increased connectivity probably indicates a ‘scar’ of recurrent depression and may represent a prognostic factor for future depression.     

The cyclical nature of depressed mood and future risk: Depression,rumination, and deficits in emotional clarity in adolescent girls

Deficits in emotional clarity, the understanding and awareness of one's own emotions and the ability to label them appropriately, are associated with increased depressive symptoms. Surprisingly, few studies have examined factors associated with reduction in emotional clarity for adolescents, such as depressed mood and ruminative response styles. The present study examined rumination as a potential mediator of the relationship between depressive symptoms and changes in emotional clarity, focusing on sex differences. Participants included 223 adolescents (51.60% female, Mean age = 12.39). Controlling for baseline levels of emotional clarity, initial depressive symptoms predicted decreases in emotional clarity. Further, rumination prospectively mediated the relationship between baseline depressive symptoms and follow-up emotional clarity for girls, but not boys. Findings suggest that depressive symptoms may increase girls' tendencies to engage in repetitive, negative thinking, which may reduce the ability to understand and label emotions, a potentially cyclical process that confers vulnerability to future depression.     

Distinguishing worry from rumination in older people: a preliminary investigation

Anxiety and depression are common mental health problems in later life. Since worry and rumination are thought to underpin the respective primary cognitive processes in anxiety and depression, we developed a measure to distinguish worry from rumination in later life. The Ruminative Response Scale was adapted to include items that characterise the cognitive features of worry. We examined its properties using 92 clinical and non-clinical participants, aged over 65. Factor analysis demonstrated a three-factor structure: brooding, reflection and worry with internal consistencies of alpha = 0.72, alpha = 0.67 and alpha = 0.55 respectively. We found no evidence for concurrent validity of these factors using the Penn State Worry Questionnaire. Modest but significant associations between reflection and brooding (r = 0.36) and reflection and worry (r = 0.2) were found. Brooding and worry sub-scales remained unrelated. We suggest that it is possible to distinguish worry from rumination in older people and that differentiating between their key underlying characteristics in the assessment of mood problems may enhance the targeting and evaluation of cognitive-behavioural therapy for anxiety and depression in later life. Future research with a substantial clinical sample is needed to explore the underlying dimensions and correlates of worry in later life.     

Pretreatment levels of rumination predict cognitive-behavioral therapy outcomes in a transdiagnostic sample of adults with anxiety-related disorders

Increasing research has implicated rumination in the development and maintenance of many types of psychopathology, including anxiety-related disorders. A few studies have explored the impact of rumination during cognitive-behavioral therapy (CBT) for anxiety-related disorders (which relies heavily on exposure-based interventions), with mixed results. The present study assessed levels of (trait) rumination before starting treatment for predicting outcomes in 147 adults seeking CBT for anxiety-related disorders in an open treatment clinic. Results revealed that pretreatment levels of rumination significantly predicted (lower) quality of life at the end of treatment, after accounting for baseline variance in quality of life. This finding remained robust when also accounting for demographics, depression, general anxiety, and diagnosis. This result was not observed for self-reflection (a construct related to, but distinguishable from, rumination). Nevertheless, a follow-up (receiver-operator characteristic) analysis showed that pretreatment rumination did not reliably distinguish participants who showed clinically meaningful gains in quality of life during treatment from those who did not. Theoretical and clinical implications of these findings are discussed. We propose that rumination may impede emotional processing during CBT for anxiety, and warrants further attention and treatment. However, more advanced methods (e.g., multivariate modeling) are needed to improve the prognostic utility of rumination.     

The influence of rumination and distraction on depressed and anxious mood: a prospective examination of the response styles theory in children and adolescents

The present study sought to test predictions of the response styles theory in a sample of children and adolescents. More specifically, a ratio approach to response styles was utilized to examine the effects on residual change scores in depression and anxiety. Participants completed a battery of questionnaires including measures of rumination, distraction, depression, and anxiety at baseline (Time 1) and 8–10 weeks follow-up (Time 2). Results showed that the ratio score of rumination and distraction was significantly associated with depressed and anxious symptoms over time. More specifically, individuals who have a greater tendency to ruminate compared to distracting themselves have increases in depression and anxiety scores over time, whereas those who have a greater tendency to engage in distraction compared to rumination have decreases in depression and anxiety symptoms over time. These findings indicate that a ratio approach can be used to examine the relation between response styles and symptoms of depression and anxiety in non-clinical children and adolescents. Implications of the results may be that engaging in distractive activities should be promoted and that ruminative thinking should be targeted in juvenile depression treatment.