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.     

On the measurement of rumination: a psychometric evaluation of the ruminative response scale and the rumination on sadness scale in undergraduates

Rumination is considered a specific cognitive vulnerability factor that is thought to play a prominent role in the maintenance of depressive symptoms. The present study investigated the psychometric properties of two measures of rumination, the ruminative response scale (RRS) and the rumination on sadness scale (RSS) in undergraduates (N=331). A joint factor analysis yielded three factors, 'rumination on causes of sadness', 'symptom-based rumination', and 'rumination on sadness'. The internal consistency of the rumination factors was good and the test-retest stability over a 6-month period of time was moderate. Support was also found for the construct validity of the rumination factors. Finally, the 'rumination on the causes of sadness' factor was found to moderate the relation between depression measured at baseline and at 6-month follow-up. More specifically, baseline depression was a strong predictor of future depression but this was particularly true for high ruminating individuals. Implications of the results and directions for future research are provided.     

The impact of anxiety sensitivity, bodily expectations, and cultural beliefs on menstrual symptom reporting: a test of the menstrual reactivity hypothesis

According to the menstrual reactivity hypothesis, certain women report more severe as well as a greater number of menstrual symptoms due to accurate reports of physical symptoms and expectations (e.g., cultural beliefs, sex roles, bodily sensations). To test this hypothesis and to further examine the role that anxiety sensitivity plays in menstrual symptom reporting, women varying in levels of anxiety sensitivity completed measures of sex role socialization, menstrual attitudes, bodily preoccupations, affect, and fear of illness. To assess psychophysiological reactivity and the applicability of response styles theory to individuals varying in anxiety sensitivity, skin conductance was measured as participants engaged in a rumination or distraction task. In addition, participants completed a modified Stroop task consisting of anxiety, menstrual, and neutral words followed by a surprise recognition task. Retrospectively and prospectively, women high in anxiety sensitivity consistently reported more severe menstrual symptoms. High anxiety sensitivity women also reported preoccupation with bodily sensations and more negative attitudes toward illness, but did not differ from low anxiety sensitivity women on measures of menstrual attitudes or sex role socialization. While engaging in a rumination task, high anxiety sensitivity women exhibited more frequent skin conductance responses and greater skin conductance response magnitude than low anxiety sensitivity women. In addition, after the rumination task, high anxiety sensitivity women recognized more anxiety-related words from the Stroop task. Menstrual cycle phase had less of an impact than anxiety sensitivity level on the current results. Implications of these results for the menstrual reactivity hypothesis and rumination are discussed.     

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.     

Internalizing symptoms and rumination: The prospective prediction of familial and peer emotional victimization experiences during adolescence

Adolescence is marked by increases in stressful life events. Although research has demonstrated that depressed individuals generate stress, few studies investigate the generation of emotional victimization. The current study examined the effects of rumination and internalizing symptoms on experiences of peer victimization and familial emotional abuse.Participants were 216 adolescents (M = 14-years-old; 58% female; 47% African–American) who completed two assessments. Results showed that rumination predicted peer victimization and emotional abuse. The effect of rumination on emotional victimization is heightened for those who have higher levels of depression symptoms. That is, individuals who ruminate and who have depression symptoms experience increases in both peer emotional victimization and parental emotional abuse.This study builds upon prior research and indicates that rumination may be a stronger predictor of emotional victimization than symptoms of depression or anxiety. Identifying underlying mechanisms may yield targets for interventions aimed at addressing the chronic nature of depression.     

Cognitive coping strategies and symptoms of depression and anxiety: a comparison between adolescents and adults

The present study focused on comparability of adolescents and adults in the reporting of cognitive coping strategies and their relationship to symptoms of depression and anxiety. Two samples were included: 487 adolescents attending a secondary school and 630 adults from a general practitioners practice. Data were obtained on symptoms of depression and anxiety and the use of nine cognitive coping strategies: acceptance, catastrophizing, other-blame, positive reappraisal, putting into perspective, refocus on planning, positive refocusing, rumination and self-blame.The results showed that all cognitive coping strategies were reported by adolescents to a significantly lesser extent than by adults. Further, it was shown that both in adolescents and adults a considerable percentage of the variance in symptomatology was explained by the use of cognitive coping strategies. Although adolescents and adults differed in relative strength of the relationships, generally speaking, conclusions were the same: in both groups, the cognitive coping strategies self-blame, rumination, catastrophizing and positive reappraisal were shown to play the most important role in the reporting of symptoms of psychopathology, showing the importance of introducing prevention and intervention programmes at an early stage.     

Gender and developmental effects on perceived stress, coping, somatic symptoms and psychological disorders among children and adolescents

The aim of this one-year longitudinal study was to investigate gender and developmental effects on perceived stress related to interpersonal stressors, coping strategies, somatic symptoms and psychological disorders. Additionally, associations of perceived stress and coping styles at the first assessment with psychological problems at the second measurement were examined. In total, N = 169 Austrian children and adolescents (ages 10 to 13 years) participated in this self-report study. Compared to male children and adolescents, female counterparts scored higher on perceived stress related to interpersonal stressors and on social support but evaluated a lower amount of distraction. Moreover, girls reported higher levels of somatic symptoms and anxiety/depression. Boys showed a developmental increase in anger control problems and both genders showed developmental increases in antisocial behavior. Low levels of the emotion-focused coping strategies distraction and minimization were related longitudinally to emotional and behavioral disorders. The results support gender-adjusted stress management programs applied in the primary and secondary prevention.     

Rumination and executive function in depression: an experimental study

BACKGROUND: Major depression is associated with cognitive deficits, particularly those requiring central executive functioning. Depressed patients also tend to focus on and think about their symptoms and problems ("ruminate") more than non-depressed controls. Although an association has been found between rumination and impaired performance on a central executive processing task, the causal relation between impaired executive functioning and rumination has not been determined. This study sought to directly manipulate rumination and assess the impact on executive functioning in depression as measured by random number generation. METHODS: Depressed patients (n=14) and non-depressed controls (n=14) were compared on a random number generation task, performed after both a rumination induction and after a distraction induction, with order of inductions counter balanced within each group. RESULTS: Compared with the distraction induction, the rumination induction produced a significant increase in both ruminations and the tendency towards stereotyped counting responses (thought to reflect a failure of inhibitory executive control) in depressed patients but not in controls. However, after distraction, no difference in random number generation or rumination was found between the two groups. CONCLUSIONS: The aspects of executive function involved in random number generation are not fundamentally impaired in depressed patients. In depressed patients, the rumination induction seems to trigger the continued generation of ruminative stimulus independent thoughts, which interferes with concurrent executive processing.     

Turning the pink cloud grey: Dampening of positive affect predicts postpartum depressive symptoms

Objective

Maladaptive response styles to negative affect have been shown to be associated with prospective (postpartum) depression. Whether maladaptive styles to positive affect are also critically involved is understudied, even though anhedonia (a correlate of low positive affectivity) is a cardinal symptom of depression. The present study is the first to investigate the predictive value of cognitive response styles to both negative (depressive rumination) and positive affect (dampening) for postpartum depressive symptoms.

Methods

During the third trimester of pregnancy, 210 women completed self-report instruments assessing depression (symptom severity and current and/or past episodes) and scales gauging the presence of depressive rumination and dampening. Of these women, 187 were retained for postpartum follow-up, with depressive symptoms being reassessed at 12 (n = 171) and 24 (n = 176) weeks after delivery.

Results

Regression analyses showed that higher levels of dampening of positive affect during pregnancy predicted higher levels of depressive symptoms at 12 and 24 weeks postpartum, irrespective of initial symptom severity, past history of depression and levels of rumination to negative affect. Prepartum trait levels of rumination, however, did not predict postpartum symptomatology when controlled for baseline symptoms and history of major depressive episode(s).

Conclusions

The results of this investigation suggest that the way women cognitively respond to positive affect contributes perhaps even more to the development of postpartum depression than maladaptive response styles to negative affect.     

Cyber victimization by peers: Prospective associations with adolescent social anxiety and depressive symptoms

Peer victimization that occurs via electronic media, also termed cybervictimization, is a growing area of concern for adolescents. The current study evaluated the short-term prospective relationship between cybervictimization and adolescents' symptoms of social anxiety and depression over a six-week period. Participants were 839 high-school aged adolescents (14–18 years; 58% female; 73% Hispanic White), who completed measures of traditional peer victimization, cybervictimization, depression, and social anxiety at two time points. Findings supported the distinctiveness of cybervictimization as a unique form of peer victimization. Furthermore, only cybervictimization was associated with increased levels of depressive symptoms over time, and only relational victimization was associated with increased social anxiety over time, after controlling for the comorbidity of social anxiety and depression among youth. Cybervictimization appears to be a unique form of victimization that contributes to adolescents' depressive symptoms and may be important to target in clinical and preventive interventions for adolescent depression.     

Coping measurement and the state effect of depression and anxiety in psychiatric outpatients

The relationship between coping styles and mental health has received considerable attention, but the state effects on coping measures in a clinical sample are not well known. This study investigated changes in scores on the Coping Inventory for Stressful Situations between two treatment phases (acute and remitted phase) in 49 outpatients with major depression or anxiety disorders. Task-oriented coping changed significantly between the treatment phases in both depressive and anxious patients, as analyzed by two-way multivariate analysis of variance. Results from repeated measures of multivariate analysis of covariance indicated that task-oriented coping was influenced by depression and emotion-oriented coping was influenced by anxiety. Avoidance-oriented coping did not change significantly over time in either depressive or anxiety disorders controlled for depressive and anxiety symptoms. The results of this study suggest that depressive or anxiety symptoms and treatment phase affect coping measurement.     

The prediction of intrusions following an analogue traumatic event: peritraumatic cognitive processes and anxiety-focused rumination versus rumination in response to intrusions

Intrusions are often considered the hallmark of posttraumatic stress disorder (PTSD). Despite this, relatively little is known about factors that give rise to intrusions. Cognitive models of PTSD highlight the importance of pre-existing cognitive vulnerabilities, cognitive processing and anxiety during a traumatic event, as well as negative responses to trauma sequelae. However, few studies have examined multiple forms of peritraumatic processes, and rumination in response to trauma intrusions using analogue trauma tasks, and none have examined whether broader anxious ruminative processes contribute to intrusion development. In addition, little work has investigated the role of post-state anxiety in intrusions, and anxiety may be related to both peritraumatic processing and rumination. The current study employed a distressing film paradigm to examine key tenets of cognitive models of PTSD. Ninety-one female university students completed measures of anxiety, rumination in response to anxious symptoms, peritraumatic dissociation, data driven processing, lack of self referent processing, intrusions, and rumination in response to intrusions of the distressing film. Results revealed that peritraumatic dissociation, data driven processing, and self referent processing were associated with intrusion development, with lack of self referent processing being a strong predictor of intrusion development. Post-state anxiety and rumination in response to intrusions also predicted intrusion development. Discussion focuses on implications of cognitive processes and anxiety in theories of intrusion development.     

心理动力性心理治疗合并药物治疗对焦虑障碍患者防御方式的影响

目的 了解心理动力性心理治疗合并药物治疗对焦虑障碍患者防御方式的影响.方法 本研究26例符合DSM- IV诊断标准的焦虑障碍患者进行6个月的心理动力性心理治疗合并药物治疗,对患者进行治疗前后防御方式问卷(DSQ)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评定及比较.结果 6个月重测时HAMD(4.79±5.86)和HAMA(5.42±7.204)均较治疗前(17.88±11.01)、(19.67±8.35)明显降低(t1=6.143,t2=6.989,P＜0.000).6个月后不成熟防御方式的评分下降显著(t=2.17,P=0.04);成熟型防御机制的评分增高显著(t=-4.84,P＜0.000);中间型防御机制评分下降显著(t=2.24,P=0.035).HAMA减分率与不成熟因子分下降率呈正相关(r=0.426,P=0.038).结论 心理动力性心理治疗合并药物治疗对焦虑障碍患者的焦虑和抑郁症状均有改善,并在改变症状的同时减少了不成熟防御机制的使用.心理动力性心理治疗合并药物治疗较单纯药物治疗更有助于焦虑症患者康复.     

Bully victimization and emotional problems in adolescents: Moderation by specific cognitive coping strategies?

Objective

Relationships between bully victimization and symptoms of depression/anxiety were examined. In addition, it was studied whether this relationship was moderated by specific cognitive coping strategies.

Methods

Participants were 582 secondary school students who filled out online self-report questionnaires on bully victimization, cognitive coping, and depression/anxiety. (Moderated) Multiple Regression analysis was performed.

Results

Strong relationships were found between bully victimization and symptoms of depression and anxiety. On top of that, two cognitive coping strategies moderated the relationship between bullying and depression, i.e. rumination (strengthening) and positive refocusing (reducing). Cognitive coping strategies that moderated the effect of bullying on anxiety symptoms were rumination, catastrophizing (strengthening) and positive reappraisal (reducing).

Conclusion

The results provide possible targets for intervention: when helping adolescents who have been bullied, maladaptive cognitive coping strategies could be assessed and challenged, while more adaptive strategies could be acquired.     

Continuity and Change in,and Child Predictors of,Caregiver Reported Anxiety Symptoms in Young People with Autism Spectrum Disorder: A Follow-Up Study

Little is known about continuity, change and predictors of anxiety in ASD. This follow-up study investigated changes in caregiver-reported anxiety in 54 non-referred youth with ASD after 10–19 months. Earlier child predictors of later anxiety were also examined. Anxiety scores were generally stable. Time 1 ASD repetitive behavior symptoms, but not social/communication symptoms, predicted Time 2 total anxiety scores, over and above child age, gender and adaptive functioning scores, but this predictive relationship was fully mitigated by Time 1 anxiety scores when these were included as a covariate in the regression model. Exploring bi-directionality between autism and anxiety symptomatology, Time 1 anxiety scores did not predict Time 2 ASD symptoms. Preliminary clinical implications and possible future directions are discussed.     

A two-year longitudinal study of gender differences in responses to positive affect and depressive symptoms during middle adolescence

This study aimed to analyze the prospective associations during adolescence between depressive symptoms and response styles to positive affect and to examine gender differences. A longitudinal study was conducted with three waves separated by 1 year each to assess a non-clinical sample of 622 Spanish adolescents who were 13 and 14 years old (50.2% boys, 49.8% girls). The participants completed self-report measures of depressive symptoms and responses to positive affect (emotion-focused positive rumination, self-focused positive rumination and dampening of positive emotion). The results showed that the increase in depressive symptoms was associated with an increase in dampening and decreases in emotion-focused and self-focused positive rumination. Furthermore, girls presented more depressive symptoms, as well as higher dampening and lower self-focused positive rumination, than boys. The conclusions highlight the need to consider responses to positive affect in explaining gender differences in depressive symptoms during mid-adolescence, as well as in designing prevention programs.     

Parent Psychopathology and Youth Internalizing Symptoms in an Urban Community: A Latent Growth Model Analysis

The present study examined the developmental trajectories of youth depression and anxiety symptoms from 6th through 12th grade in a low-income, urban sample (N = 141; mean age = 11.75 years; 88.7% African American). The study also tested the independent contribution of parent mood disorders, anxiety disorders, and substance use disorders assessed in early childhood to initial levels and rate of change in depression and anxiety symptoms from 6th through 12th grade. Possible gender differences in symptom course and strength of parent psychopathology predictors were examined using multiple-group analysis. Results indicated that depression symptoms declined over time for males, whereas depression symptoms initially declined, but then increased for females. In contrast, male and female adolescents each showed a decline in anxiety symptoms throughout adolescence. Findings also indicated that parent mood disorders were the only predictor of youth depression and anxiety symptoms for male and female adolescents in 6th grade. Parent anxiety disorders uniquely predicted the rate of change in depression symptoms among male adolescents. These results underscore the importance of targeting parents with mood and anxiety disorders in urban families in order to reduce the risk for internalizing difficulties in their adolescent youth.     

Intolerance of uncertainty,worry, and rumination in major depressive disorder and generalized anxiety disorder

Intolerance of uncertainty (IU) can be defined as a cognitive bias that affects how a person perceives, interprets, and responds to uncertain situations. Although IU has been reported mainly in literature relating to worry and anxiety symptoms, it may be also important to investigate the relationship between IU, rumination, and depression in a clinical sample. Furthermore, individuals who are intolerant of uncertainty easily experience stress and could cope with stressful situations using repetitive thought such as worry and rumination. Thus, we investigated whether different forms of repetitive thought differentially mediate the relationship between IU and psychological symptoms. Participants included 27 patients with MDD, 28 patients with GAD, and 16 patients with comorbid GAD/MDD. Even though worry, rumination, IU, anxiety, and depressive symptoms correlated substantially with each other, worry partially mediated the relationship between IU and anxiety whereas rumination completely mediated the relationship between IU and depressive symptoms.     

Cross-situational coping with peer and family stressors in adolescent offspring of depressed parents

Offspring of depressed parents are faced with significant interpersonal stress both within their families and in peer relationships. The present study examined parent and self-reports of adolescents' coping in response to family and peer stressors in 73 adolescent children of parents with a history of depression. Correlational analyses indicated that adolescents were moderately consistent in the coping strategies used with peer stress and family stress. Mean levels of coping were similar across situations, as adolescents reported greater use of secondary control coping (i.e., acceptance, distraction) than primary control coping (i.e., problem solving, emotional expression) or disengagement coping (i.e., avoidance) with both types of stress. Regression analyses indicated that fewer symptoms of self-reported anxiety/depression and aggression were related to using secondary control coping strategies in response to family stress and primary control coping in response to peer stress. Implications for understanding the characteristics of effective coping with stress related to living with a depressed parent are highlighted.     

Brief report: “I can’t talk about it:” Sexuality and self-silencing as interactive predictors of depressive symptoms in adolescent dating couples

This longitudinal study examined sexual intercourse within adolescent romantic relationships as a couple-level moderator of the association between adolescent individual characteristics and depressive symptoms. Two hundred nine middle- and older-adolescent dating couples (aged 14-17 and 17-21, respectively) reported on their own self-silencing, depressive symptoms, and sexual behaviors. At Time 1, frequency of sexual intercourse significantly moderated the relationship between self-silencing and depressive symptoms, such that adolescents higher in self-silencing engaging in more frequent sex were at risk for clinically significant levels of depression. Adolescents who were low in self-silencing were not at increased risk for depression, regardless of frequency of sex. Self-silencing also significantly predicted increases in depressive symptoms from Time 1 to Time 2. Implications include the possibility that frequent sex in highly self-silencing adolescents exacerbates psychological depletion believed to link self-silencing to depressive symptoms, and that this depletion compounds over time.