Induced rumination dampens executive processes in dysphoric young adults

Self-focused, analytical mental rumination constitutes a central process in depression. It has been hypothesized that such rumination depletes executive resources that are necessary for an efficient cognitive regulation of emotion and behavior. However, most of the research supporting this hypothesis is of correlational nature. The present study examined the effects of induced rumination versus distraction on executive capacities in dysphoric and nondsyphoric college students. Executive functioning was measured with the Stroop task. Results indicate that induced rumination decreases inhibition capacities in dysphoric individuals only. The flexibility facet of executive functioning was not affected by induced rumination. However, dysphoric individuals demonstrated a fundamental impairment in this latter capacity, independent of rumination induction. The implications for the facets of executive functioning affected by depression and by rumination are discussed.     

Rumination in posttraumatic stress disorder

Recent studies have shown that rumination is a powerful predictor of persistent posttraumatic stress disorder (PTSD). However, to date, the mechanisms by which rumination maintains PTSD symptoms are little understood. Two studies of assault survivors, a cross-sectional (N = 81) and a 6-month prospective longitudinal study (N = 73), examined several facets of ruminative thinking to establish which aspects of rumination provide the link to PTSD. The current investigation showed that rumination is not only used as a strategy to cope with intrusive memories but it also triggers such memories. Certain characteristics of rumination, such as compulsion to continue ruminating, occurrence of unproductive thoughts, and "why" and "what if" type questions, as well as negative emotions before and after rumination, were significantly associated with PTSD, concurrently and prospectively. These characteristics explained significantly more variance in PTSD severity than the mere presence of rumination, thereby indicating that not all ways of ruminative thinking are equally maladaptive.     

What predicts the trajectory of rumination?: A prospective evaluation

The current report aimed to document individual differences that predict the trajectory of post-event rumination following an evaluative event. In this study, 127 undergraduate students were assessed over a 5-day period preceding and following a mid-term exam. Participants completed measures of anticipatory processing, trait test anxiety, trait tendency to ruminate, negative affect, and post-event rumination. Hierarchical linear modeling was used to examine predictors of post-evaluative rumination. Results suggested that individuals who reported high levels of anticipatory processing and trait test anxiety tended to experience prolonged amounts of rumination following the exam, even when controlling for negative affect, relative to those who scored low on these measures. These results suggest that specific individual difference factors impact the amount and trajectory of rumination beyond levels of general negative affect. Implications for understanding risk factors for heightened rumination are discussed, with particular attention to the larger rumination literature.     

Rumination and vomiting in the developmentally disabled: A critical review of the behavioral, medical, and psychiatric treatment research

Medical and psychiatric research regarding the treatment of vomiting and rumination among developmentally disabled individuals was selectively reviewed. Because of serious methodological flaws which pervade the psychiatric literature, claims for the effectiveness of psychiatric interventions for vomiting and rumination cannot be justified. Medical interventions (e.g., pharmacological and surgical interventions) were found to be effective when rumination was attributable to a specific organic pathology. In the absence of identified organic pathology for rumination, medical interventions are of questionable efficacy and because of the risks and side effects associated with these procedures, are seldom the intervention of first choice for functional rumination. Behavioral procedures for the treatment of vomiting and rumination are described and critically reviewed for their efficacy, side effects, and the generalization and maintenance of their effects. Although methodological weaknesses limit conclusions regarding the efficacy of some behavioral interventions, several procedures have sound experimental support including oral hygiene, differential reinforcement of incompatible behaviors, and food satiation procedures. These behavioral interventions are the treatments of choice when organic causes of rumination cannot be identified. Suggestions for future research and applications are discussed.     

Assessing the relationship between rumination and cortisol: a review

Objective and methodsFor individuals who ruminate, or mentally rehearse past stressful events, the physiological effects of a stressor may be longer lasting. This is well-supported within the cardiovascular domain. In the context of the hypothalamic–pituitary–adrenal (HPA) axis and cortisol, the results are inconsistent. This review summarizes key theoretical and methodological issues that contribute to these mixed findings among the 15 studies to date that have examined the association between rumination and cortisol.ResultsState measures of rumination were consistently linked to increased cortisol concentrations. Stress-related rumination questionnaires were often positively associated with cortisol, whereas depression-related rumination scales predicted lower cortisol concentrations or were unrelated to cortisol. Rumination manipulations in the laboratory (e.g., ruminative self-focused writing tasks compared to distraction writing tasks) influenced cortisol concentrations, but often did not increase cortisol relative to baseline values. Studies that utilized social-evaluative stressor tasks to examine the relationship between rumination and cortisol levels generally showed that rumination predicted greater cortisol reactivity or delayed recovery. Results from studies examining rumination and basal cortisol or the cortisol awakening response were inconsistent.ConclusionThe ways in which researchers conceptualize and assess rumination and the associated cortisol response influences the association between rumination and cortisol. Suggestions for future studies in this area of research are provided.     

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.     

Variables associated with frequency of rumination in a boy with profound mental retardation

The relationships between frequency of rumination in a boy with profound mental retardation and a variety of environmental, interpersonal, and temporal variables were investigated by collecting and analyzing data during all waking hours over a 4-week period. Low levels of rumination were associated with periods of special education programming (versus nonschool hours), individual attention (versus group activities and independent play), and time spent with caretakers who like the child (versus those who like him less). The findings also revealed a mealtime effect (decreasing rumination as time elapsed following meals) and a time of day effect (increasing rumination as the day progressed). Directions for future research and possible implications for the environmental management of rumination are discussed.Mennonite Mental Health Services     

Depression and suicidal ideation in pregnancy: exploring relationships with insomnia,short sleep,and nocturnal rumination

BackgroundSleep problems and depression are highly prevalent in pregnancy. Nocturnal rumination has been linked to insomnia and depression in non-pregnant samples, but remains poorly characterized in pregnancy. This study explored relationships of depression and suicidal ideation with insomnia, short sleep, and nocturnal rumination in mid-to-late pregnancy.MethodsIn this study, 267 pregnant women were recruited from obstetric clinics and completed online surveys on sleep, depression, and nocturnal rumination.ResultsOver half (58.4%) of the sample reported clinical insomnia on the Insomnia Severity Index, 16.1% screened positive for major depression on the Edinburgh Postnatal Depression Scale (EPDS), and 10.1% endorsed suicidal ideation. Nocturnal rumination was more robustly associated with sleep onset difficulties than with sleep maintenance issues. Depressed women were at greater odds of sleep onset insomnia (OR = 2.80), sleep maintenance insomnia (OR = 6.50), high nocturnal rumination (OR = 6.50), and negative perinatal-focused rumination (OR = 2.70). Suicidal ideation was associated with depression (OR = 3.64) and negative perinatal-focused rumination (OR = 3.50). A four-group comparison based on insomnia status and high/low rumination revealed that pregnant women with insomnia and high rumination endorsed higher rates of depression (35.6%) and suicidal ideation (17.3%) than good-sleeping women with low rumination (1.2% depressed, 4.9% suicidal). Women with insomnia alone (depression: 3.9%, suicidal: 5.9%) or high rumination alone (depression: 10.7%, suicidal: 7.1%) did not differ from good-sleeping women with low rumination.ConclusionsHigh rumination and insomnia are highly common in mid-to-late pregnancy and both are associated with depression and suicidal ideation. Depression and suicidal ideation are most prevalent in pregnant women with both insomnia and high rumination.ClinicalTrials.gov identifierNCT03596879.     

Mediators of the relationship between social anxiety and post-event rumination

A variety of cognitive and attentional factors are hypothesised to be associated with post-event rumination, a key construct that has been proposed to contribute to the maintenance of social anxiety disorder (SAD). The present study aimed to explore factors contributing to post-event rumination following delivery of a speech in a clinical population. 121 participants with SAD completed measures of trait social anxiety a week before they undertook a speech task. After the speech, participants answered several questionnaires assessing their state anxiety, self-evaluation of performance, perceived focus of attention and probability and cost of expected negative evaluation. One-week later, participants completed measures of negative rumination experienced over the week. Results showed two pathways leading to post-event rumination: (1) a direct path from trait social anxiety to post-event rumination and (2) indirect paths from trait social anxiety to post-event rumination via its relationships with inappropriate attentional focus and self-evaluation of performance. The results suggest that post event rumination is at least partly predicted by the extent to which socially anxious individuals negatively perceive their own performance and their allocation of attentional resources to this negative self-image. Current findings support the key relationships among cognitive processes proposed by cognitive models.     

How Does Rumination Impact Cognition? A First Mechanistic Model

Rumination is a process of uncontrolled, narrowly focused negative thinking that is often self-referential, and that is a hallmark of depression. Despite its importance, little is known about its cognitive mechanisms. Rumination can be thought of as a specific, constrained form of mind-wandering. Here, we introduce a cognitive model of rumination that we developed on the basis of our existing model of mind-wandering. The rumination model implements the hypothesis that rumination is caused by maladaptive habits of thought. These habits of thought are modeled by adjusting the number of memory chunks and their associative structure, which changes the sequence of memories that are retrieved during mind-wandering, such that during rumination the same set of negative memories is retrieved repeatedly. The implementation of habits of thought was guided by empirical data from an experience sampling study in healthy and depressed participants. On the basis of this empirically derived memory structure, our model naturally predicts the declines in cognitive task performance that are typically observed in depressed patients. This study demonstrates how we can use cognitive models to better understand the cognitive mechanisms underlying rumination and depression.