A “Triple W”-Model of Rumination on Sadness: Why Am I Feeling Sad,What’s the Meaning of My Sadness,and Wish I Could Stop Thinking About my Sadness (But I Can’t!)

Depressive rumination has been found to be a critical factor in the onset and maintenance of depression [for a recent review, see Nolen-Hoeksema, In C. Papageorgiou, & A. Wells (Eds.), Depressive rumination: Nature, theory, and treatment (pp. 107–124). Chichester, UK: Wiley, 2004], but an issue still to be resolved is whether some aspects of depressive rumination are more damaging than others. Some studies have found depressive rumination to have a single factor, others describe several dimensions. This study addresses (a) whether a single or multi-factorial model is most appropriate, and if so, (b) which aspect of depressive rumination is the most pathological. In Study One, a measure of depressive rumination, the Rumination on Sadness Scale (RSS; Conway, Csank, Holm, & Blake, Journal of Personality Assessment, 75, 404–425, 2000), was given to 152 students (128 women). Reliability and validity for the RSS was corroborated. The RSS was then used to further investigate the multi-component nature of depressive rumination. Confirmatory Factor Analyses on the RSS revealed a three-factor solution; “ruminating about the reasons for my sadness” (Causal Analysis), “ruminating about the meaning of my sadness” (Understanding), and “uncontrollability of this ruminative thinking on my sadness” (Uncontrollability). In order to strengthen the three subscales, eight new items were added. Four items of the original RSS were deleted. In Study 2, using this extended scale (Leuven Adaptation of the Rumination on Sadness Scale; LARSS), the three-factor model was replicated in a second sample (N = 219). Depressive symptoms and the tendency to suppress negative thinking (Wenzlaff & Luxton, Cognitive Therapy and Research, 27, 293–308, 2003) were associated with Uncontrollability of ruminative thinking. Results confirm the importance of distinguishing different components in depressive rumination and tentatively suggest that the meta-ruminative factor, uncontrollability of rumination, is particularly problematic.     

Negative Cognitive Styles and Stress-Reactive Rumination Interact to Predict Depression: A Prospective Study

Research on cognitive theories of depression has identified negative cognitive styles and rumination in response to depressed mood as risk factors for depressive episodes. In addition, a general self-focusing style has been suggested to increase vulnerability to depression. The present study used a behavioral high-risk paradigm to test whether the interaction of negative cognitive styles and rumination predicted the prospective onset, number, and duration of depressive episodes in a sample of 148 initially nondepressed undergraduates over a 2.5-year follow-up. In addition, rumination was assessed specifically as the tendency to focus on maladaptive self-referential thoughts following stressful events (stress-reactive rumination; SRR). The principal hypotheses tested were (1) the interaction of negative cognitive styles and SRR increases risk for developing depressive episodes as well as longer duration depressive episodes; and (2) this interaction would not be obtained when a trait measure of general self-focus or a measure of rumination in response to depressed mood is used instead of the measure of SRR. After controlling for subsyndromal depressive symptoms and the main effects of negative cognitive styles and SRR, the interaction of negative cognitive styles and SRR was found to predict the prospective onset, number, and duration of major depressive and hopelessness depressive episodes. These interactions were not obtained when other measures of trait self-focus and depressive rumination were used instead of SRR.     

Rumination Reconsidered: A Psychometric Analysis

In an attempt to eliminate similar item content as an alternative explanation for the relation between depression and rumination, a secondary analysis was conducted using the data from S. Nolen-Hoeksema, J. Larson, and C. Grayson (1999). After constructing a measure of rumination unconfounded with depression content, support for a two factor model of rumination was found. These analyses indicate that the 2 components, reflective pondering and brooding, differentially relate to depression in terms of predictive ability and gender difference mediation. The results presented here support the general premise of Nolen-Hoeksema's Response Styles Theory (S. Nolen-Hoeksema 1987) that rumination can contribute to more depressive symptoms and to the gender difference in depression, but suggest important refinements of the theory. Such refinements include the need to differentiate between the reflective pondering component of rumination and the brooding component in rumination research.     

Rumination: One Construct, Many Features in Healthy Individuals, Depressed Individuals, and Individuals with Lupus

Rumination has been associated with depression and negative health effects. Yet measures of rumination appear to index multiple constructs that may be differentially related to clinical phenomena. To clarify this literature, we explored convergence and divergence among self-report measures of rumination in 349 undergraduates, 59 depressed adults, 81 healthy adults, and 15 never-depressed adults with Systemic Lupus Erythematosis (SLE). Results suggested there are separate constructs labeled rumination with different relationships to depression. Yet, aggregate measures index a central construct. Depressed individuals ruminated more, across measures, than individuals with SLE, who ruminated more than healthy individuals; this relationship was mediated by dysphoria. Thus, administering multiple rumination measures and attending to constructs assessed by rumination measures appears important in clinical studies.     

Ruminating and Distracting: The Effects of Sequential Tasks on Depressed Mood

Response styles theory (Nolen-Hoeksema, 1987)provided the impetus for recent research effortsinvestigating the effects of rumination and distractionon depressed mood. This study elaborates on previous research by examining the sequential effects ofengaging in ruminating and distracting tasks. Resultsfrom two studies indicated that initially engaging in aruminating task maintained postinduction levels of dysphoric mood, whereas initially engagingin a distracting task reduced levels of dysphoric mood.More important, however, were the effects of task orderon mood. When participants engaged in a distracting taskfollowing aruminating task, dysphoric mood, which had been maintainedwith a ruminating task, was reduced to premoodinductionlevels. Of equal importance, individuals who ruminatedafter distracting maintained their current mood and did not report an increase in depressedmood. In the second study, engaging in sequentialrumination tasks further prolonged depressed mood,whereas engaging in sequential distraction tasks reduceddepressed mood. The results suggest that, althoughengaging in a rumination task maintains depressed moodand engaging in a distraction task reduces it, the orderin which these tasks are performed is also important. The implications of these results for responsestyles theory are discussed.     

Dysfunctional Attitudes,Dependency, and Self-Criticism as predictors of depressive mood states: A 12-month longitudinal study

The Dysfunctional Attitude Scale (DAS) and the Dependency and Self-Criticism scales from the Depressive Experiences Questionnaaire (DEQ) have been identified as possible markers for vulnerability to depressive mood states (Blatt, 1974; Weissman & Beck, 1978). Sixty-six undergraduate women were tested with the DAS, the DEQ, and the Beck Depression Inventory (BDI). Approximately 12 months later, 46 subjects were successfully contacted and retested with those scales. In addition, they rated the severity of their worst period of dysphoria during the 12-month interval using a retrospective version of the BDI and measures of anaclitic and introjective state depression. All three vulnerability measures displayed acceptable temporal stability. After controlling for initial levels of depression, the DAS predicted the BDI measure of worst period depression. Dependency predicted anaclitic state depression, and Self-Criticism predicted introjective state depression. The majority of both dependent and self-critical subjects' worst periods involved interpersonal events. The results added to the evidence that stable cognitive and personality variables confer vulnerability to depressive mood states.     

Dysphoria and Hostile Cognition: The Relationship Depends on Levels of Trait Anger

Previous research has found that persistent hostility was associated with a different pattern of attributions than persistent sadness in dysphoric episodes (W. D. Scott, R. E. Ingram, & W. G. Shadel, 2003). In the present study, we attempted to extend these findings by examining another cognitive correlate of hostility in dysphoria: hostile cognition. Measures of dysphoria, trait anger, and hostile cognition were administered to college students. We found that the relationship between dysphoria and hostile cognition depended on the level of trait anger. Specifically, the presence of high trait anger in dysphoria was associated with high levels of hostile cognition whereas low trait anger in dysphoria was not associated with elevated hostile cognition. Moreover, the relationship between trait anger and hostile cognition was stronger among dysphoric participants. This finding adds to existing evidence of affective confounds in clinical research and suggests that discrete moods should be taken into account when assessing cognitive correlates in dysphoria.     

Repetitive Thought and Emotional Distress: Rumination and Worry as Prospective Predictors of Depressive and Anxious Symptomatology

Repetitive thought processes have been implicated in vulnerability to both anxiety and depression. The present study used a prospective design to examine the ability of worry and rumination to predict these two forms of emotional distress over time. Participants were 451 college students (273 females) who completed self-report measures of rumination, worry, depression, and anxiety at two time points separated by 6–8 weeks. Results indicated that both worry and rumination prospectively predicted anxiety, whereas neither thought process prospectively predicted depressive symptomatology. Although females reported elevated levels of worry and rumination compared to males, gender did not moderate any of these effects. Based on these findings, it appears that repetitive thought in the form of both worry and rumination contributes to anxiety, whereas neither thought process contributed to the development of depressive symptomatology in the present sample. Post-hoc analyses raise the possibility that previously documented associations between rumination and depression may have been partially driven by criterion contamination between measures of these constructs (see J. E. Roberts, E. Gilboa, & I. H. Gotlib, 1998).

Labile Self-Esteem, Life Stress, and Depressive Symptoms: Prospective Data Testing A Model of Vulnerability

Recent theory and research suggests that labile self-esteem (SE) is an important dimension of vulnerability to depression (Butler, Hokanson, & Flynn, 1994; Roberts & Monroe, 1992, 1994, in press). In the present study, participants completed seven daily ratings of SE from which we derived a measure of lability. The interaction between labile SE and life stress predicted increases in depressive symptoms across a two-month prospective interval, particularly in participants who were initially low in depression and who had more severe worst lifetime episodes of depressive symptomatology. Interactions between life stress and labile SE were stronger for life stress measures that were based on the subjective appraisal of stress than for those that were based on raw life event counts. In contrast to predictions, depletions in self-esteem failed to mediate the synergistic effects of labile SE and life stress.     

Metacognitive Beliefs and Rumination: A Longitudinal Study

High prevalence and costs of depression underline the importance of understanding and treating vulnerability factors of depression such as rumination. Given the role of rumination in predicting the onset of new depressive episodes, it is important to learn why previously healthy people start to ruminate. One explanation is provided by the metacognitive model of depression, which assumes that positive beliefs about rumination initiate rumination. However previous research has been predominantly cross-sectional in nature. We investigated the effect of positive beliefs about rumination on engagement in rumination in a longitudinal design and tested the indirect effect of positive beliefs about rumination on depressive symptoms in 60 healthy university students. A hierarchical regression revealed a significant effect of Time 1 (T1) positive beliefs about rumination on Time 2 rumination, even after controlling for T1 rumination. Additionally, an indirect effect of positive beliefs about rumination on depressive symptoms via rumination was confirmed using a multiple regression and a Sobel test.     

Cognitive Vulnerability,Lifetime Risk,and the Recurrence of Major Depression in Graduate Students

The main purpose of this study was to determine the contribution of cognitive risk variables for previous episodes of major depression and for the recurrence of the disorder in a sample of university graduate students (n = 97). Participants were diagnosed with at least one prior episode of major depression and were assessed again 16 months later (n = 77). Consistent with previous findings (Alloy et al., 2000. Journal of Abnormal Psychology, 109, 403–418), cognitive measures including dysfunctional attitudes and a negative attributional style were associated with a greater number of previous episodes of depression, controlling for mood, neuroticism, rumination, sociotropy, and autonomy. Cognitive vulnerability in the achievement domain as well as neuroticism and sociotropy were uniquely related to a greater number of previous episodes of depression. Negative attributions and autonomy predicted the recurrence of the disorder, controlling for past history of depression and all other variables. These findings suggest that the autonomous personality style and negative attributions are particularly pernicious for the recurrence of depression in graduate students. The cognitive variables were not related to anxiety diagnoses, but did predict Axis 2 disorders.     

An Examination of Integrated Cognitive-Interpersonal Vulnerability to Depression: The Role of Rumination,Perceived Social Support,and Interpersonal Stress Generation

This research examined an integration of cognitive and interpersonal theories of depression by investigating the prospective contribution of depressive rumination to perceptions of social support, the generation of interpersonal stress, and depressive symptoms. It was hypothesized that depressive ruminators would generate stress in their relationships, and that social support discontent would account for this association. Further, depressive rumination and dependent interpersonal stress were examined as joint and unique predictors of depressive symptoms over time. Participants included 122 undergraduate students (M age = 19.78 years, SD = 3.54) who completed assessments of depressive rumination, perceptions of social support, life stress, and depressive symptoms across three waves, each spaced 9 months apart. Results revealed that social support discontent accounted for the prospective association between depressive rumination and dependent interpersonal stress, and that both depressive rumination and dependent interpersonal stress contributed to elevations in depressive symptoms over time. These findings highlight the complex interplay between cognitive and interpersonal processes that confer vulnerability to depression, and have implications for the development of integrated depression-focused intervention endeavors.     

The Temporal Development of Mood, Cognitive, and Vegetative Symptoms in Recurrent SAD Episodes: A Test of the Dual Vulnerability Hypothesis

Recent literature on seasonal affective disorder (SAD) has begun to focus on diathesis–stress models, including Young and colleagues’ dual vulnerability hypothesis. The dual vulnerability hypothesis posits that individuals must possess both a biological vulnerability to developing vegetative symptoms and a psychological vulnerability to developing mood symptoms in order to develop SAD episodes. However, few studies have directly tested this model until very recently. Research has demonstrated a temporal relation between mood and vegetative symptoms, with vegetative symptoms having an earlier onset than mood symptoms supporting the idea that separate factors related to the two symptom clusters exist. The current study represents a longitudinal assessment of vegetative and mood symptoms, as well as cognitive factors (i.e., rumination, automatic thoughts) that may represent part of the psychological vulnerability shared by SAD sufferers. Furthermore, the present study represents only the second to assess state levels of cognitive factors that may impact recurrent SAD episode severity. Fifty-one individuals participated in the study across two groups, individuals with a history of SAD, and with no history of depression or SADs. Findings supported the dual vulnerability hypothesis, with an early vegetative symptom onset than mood symptom evident for the individuals with a history of SAD. Participants with a history of SAD also reported more ruminative responses and negative automatic thoughts about the seasons. Findings are generally supportive of Young and colleagues’ dual vulnerability hypothesis and directions for future research are suggested.     

Influence of Rumination and Distraction on the Therapeutic Process in Cognitive-Behavioral Therapy for Depression

The response styles theory by Nolen-Hoeksema (J Abnorm Psychol 100:569–582, 1991) suggests that rumination in response to depressed mood exacerbates and prolongs depression, while distraction ameliorates it. In addition, research has shown that rumination is associated with several undesirable interpersonal outcomes, including greater interpersonal problems and less satisfying social support. In a sample of depressed patients (n = 67) receiving cognitive-behavioral therapy, the current study investigated whether patients’ use of ruminative and distractive responses to depressed mood influences the therapeutic alliance and the patients’ receptivity to therapeutic interventions. Ruminative responses were neither predictive of the therapeutic alliance nor of patients’ receptivity. However, the more the patients reported distractive responses to depressed mood, the better therapists judged their receptivity in therapy and the better they evaluated the therapeutic alliance. In the course of therapy, distractive responses were also associated with patients’ ratings of the alliance. Implications for future research and psychotherapeutic practice are discussed.     

The Effects of Rumination and Distraction Tasks on Psychophysiological Responses and Mood in Dysphoric and Nondysphoric Individuals

Prior experimental manipulations of ruminative and distractive response style have not included psychophysiological measures or investigated the statistical relation between rumination and the conceptually-related constructs of worry and neuroticism. Dysphoric (n =84) and nondysphoric participants (n =86) were randomly assigned to either a rumination task (i.e., self-focused attention) or a distraction task. Results supported prior findings that distraction and rumination differentially impact depressed mood in dysphoric individuals; dysphoric ruminators reported significantly higher levels of postexperiment depressed mood than did dysphoric distractors, even after neuroticism, worry, or response style were included in the empirical model. However, post- rumination worry ratings were significantly higher than postdistraction worry ratings, regardless of initial dysphoria status. Of the psychophysiological responses measured, a significant difference in postrumination systolic blood pressure was found between nondysphoric men (M = 119.88; SE = 1.29) and nondysphoric women (M = 114.88; SE = 1.20). The implications of these results for future response style studies are discussed     

Stress-Related Symptoms and Suicidal Ideation: The Roles of Rumination and Depressive Symptoms Vary by Gender

There is a growing body of literature suggesting that reactions to stressful life events, such as intrusive thoughts, physiological hyperarousal, and cognitive/behavioral avoidance (i.e., stress-related symptoms) may increase risk for thinking about and attempting suicide. Cognitive vulnerability models have identified rumination (i.e., perseverating on a negative mood) as a maladaptive response that may increase risk for suicidal behavior, as it has also been linked to depression. The present study examined the direct and indirect effects of stress-related symptoms on suicidal ideation through rumination and depressive symptoms. Participants were 1375 young adults, primarily non-White (78 %) females (72 %), recruited from a public university in the Northeastern U.S., who completed measures of stress-related symptoms (as a response to a stressful event), rumination, depressive symptoms, and suicidal ideation. The relation between stress-related symptoms and suicidal ideation was accounted for by the brooding subtype of rumination and depressive symptoms among females. Depressive symptoms, but not rumination, better accounted for suicidal ideation among males. These findings suggest that the role of brooding and depressive symptoms in the relationship between stress-related symptoms and suicidal ideation may vary by gender.     

Dysphoria and Self-Esteem Following an Achievement Event: Predictive Validity of Goal Orientation and Personality Style Theories of Vulnerability

B. M. Dykman (1998) proposed a goal orientation model of depression in which striving to prove self-worth in goal pursuits conferred depression vulnerability. This study replicated and extended the findings of B. M. Dykman (1998) by comparing goal orientation against 2 personality variables: autonomy and sociotropy. In a series of sessions around an achievement event, college students completed goal orientation, autonomy/sociotropy, and measures of dysphoria and self-esteem. For participants who were dissatisfied with the achievement outcome, a greater validation seeking goal orientation predicted increased dysphoria and decreased self-esteem. No such effects were found for autonomy or sociotropy. These findings provide support for the contention that the goal of validating self-worth confers vulnerability to dysphoria and self-esteem loss.     

Sociotropy,Body Dissatisfaction and Perceived Social Disapproval in Dieting Women: A Prospective Diathesis-Stress Study of Dysphoria

A 4-week prospective study (N = 138), using an expanded version of Becks (1983, 1987) cognitive diathesis-stress model, examined the moderating and mediating relationships between personality vulnerability, perceived dieting stress, interpersonal appraisals, and increases in dysphoria among actively dieting university women. Results from regression and path analyses indicated that actively dieting women who were highly sociotropic and who perceived social disapproval reported greater increases in dysphoria. Heightened dysphoria was also related to elevated levels of perceived social disapproval and low levels of dieting success/satisfaction. However, the impact of low dieting success on elevated dysphoria was fully mediated by perceptions of social disapproval. Low dieting success, however, did not significantly interact with cognitive vulnerability as predicted by a cognitive diathesis-stress model. The findings did provide strong evidence for the role of social appraisals in their relation to dysphoria among young women who are vulnerable to body shape/weight-preoccupation and dieting experiences.     

Social, Achievement, and Control Dimensions of Personality-Life Event Vulnerability to Depression

This study investigated whether Sociotropy and the subscales of Autonomy (i.e., Perfectionistic/Self-critical, Need for Control, and Defensive Separation) would show differential patterns of vulnerability to dysphoria in both retrospective and prospective designs. Each of these scales showed a predicted pattern of association with life goals and impact ratings for negative events in a retrospective design. In a prospective design, the scales showed differential associations with goal obtainment and cognitive-affective responses to life events but did not predict follow-up dysphoria independently of baseline dysphoria. These results are discussed in terms of the multidimensionality of personality vulnerability and depressogenic negative life events along social, achievement, and control dimensions.

Effects of Rumination and Initial Severity on Remission to Cognitive Therapy for Depression

Trait rumination, a tendency to focus on depressive symptoms and negative information, is associated with longer and more severe episodes of depression. This study examined whether trait rumination was also associated with initial remission from unipolar depression in Cognitive Therapy, which we hypothesized would target this coping style. Eighty one patients completed measures of depressive severity and rumination before and after 16–20 sessions of procedurally determined Cognitive Therapy. Pre-treatment rumination and severity were generally associated with later initial remission and lower odds of achieving remission. Limited evidence also suggested that for the most severe patients, rumination was associated with earlier initial remission and greater odds of achieving initial remission. Cognitive Therapy was associated with significant reductions in both rumination and severity. Results suggest that (1) pre-treatment assessment of rumination and severity could help to plan treatment course and (2) Cognitive Therapy is associated with changes in cognitive coping styles.