Rumination: brooding, pondering, mindfulness, hypersensitivity, concreteness, writing - raising as many questions as answers
Last updated on 17th January 2013
Probably most cogntive-behavioural therapists subscribe to the general comment that rumination is a bad for depression. And it is, but as Oscar Wilde said "The truth is rarely pure and never simple". Smith & Alloy, in their 2009 paper "A roadmap to rumination: a review of the definition, assessment, and conceptualization of this multifaceted construct", stated "Rumination has been widely studied and is a crucial component in the study of cognitive vulnerabilities to depression. However, rumination means different things in the context of different theories, and has not been uniformly defined or measured. This article aims to review models of rumination, as well as the various ways in which it is assessed. The models are compared and contrasted with respect to several important dimensions of rumination."
I'd like to use this blog post to touch on eight points about rumination that I find interesting. I'm aiming to raise at least as many questions as answers. It's an opportunity for me to glance around this intriguing, developing field. The eight points I want to mention are rumination's links to anxiety as well as depression, various ways of assessing rumination, the important distinction between ruminative brooding and reflective pondering, some of the links between mindfulness, rumination & depression, rumination & rejection hypersensitivity, the recently developed rumination-targeting concreteness training, and the way expressive writing effects the tendency to ruminate.
So first rumination's links to anxiety as well as depression. I tend to see rumination as primarily past-focused and associated with depression, while I see worry as future-focused and associated with anxiety. This is largely true, but it's interesting to note that in their recent paper "Rumination as a transdiagnostic factor in depression and anxiety", McLaughlin & Nolen-Hoeksema wrote "The high rate of comorbidity among mental disorders has driven a search for factors associated with the development of multiple types of psychopathology, referred to as transdiagnostic factors. Rumination is involved in the etiology and maintenance of major depression, and recent evidence implicates rumination in the development of anxiety. The extent to which rumination is a transdiagnostic factor that accounts for the co-occurrence of symptoms of depression and anxiety, however, has not previously been examined. We investigated whether rumination explained the concurrent and prospective associations between symptoms of depression and anxiety in two longitudinal studies: one of adolescents (N=1065) and one of adults (N=1317). Rumination was a full mediator of the concurrent association between symptoms of depression and anxiety in adolescents ... and was a partial mediator of this association in adults ... In prospective analyses in the adolescent sample, baseline depressive symptoms predicted increases in anxiety, and rumination fully mediated this association ... In adults, baseline depression predicted increases in anxiety and baseline anxiety predicted increases in depression; rumination fully mediated both of these associations ... These findings highlight the importance of targeting rumination in transdiagnostic treatment approaches for emotional disorders."
More to follow ...