Rumination

Several theoretical perspectives have advanced our current understanding of rumination and its role in depression. Rumination can be conceptualized as a symptom of the depressive state itself (Robinson & Alloy, 2003) or as a reaction to the onset of a depressed mood state (Nolen-Hoeksema, 1991). As a symptom of depression, research has suggested that rumination in this context precedes the onset of a depressed mood. As a coping response, rumination is thought to occur in response to the onset of a depressed mood. It is rumination as a

response to mood that is of interest in the present study.

Ruminative coping, according to Response Styles Theory (RST; Nolen-Hoeksema, 1987), refers to a particular response strategy. The RST posits that the ways in which people respond to a depressed mood may exacerbate the

symptoms of depression and prolong the negative mood state. Rumination in response to a depressed mood (experimenter induced or naturally occurring) has been associated with increased depressive symptoms over time

(Nolen-Hoeksema & Davis, 1999; Nolen-(Nolen-Hoeksema, Larson, & Grayson, 1999),

prolonged depressed mood state (Nolen-Hoeksema & Morrow, 1993), the onset of a future depressive episode (Just & Alloy, 1997; Roberts, Gilboa, & Gotlib, 1998), and prediction of further deterioration of the course of a depressive disorder (Kuehner & Weber, 1999). These effects have been demonstrated through correlational and experimental investigation. However, an important caveat is the measurement issues associated with several studies on rumination and depression.

Rumination has typically been assessed using the Ruminative Responses Questionnaire (RRS), a self-report subscale of the Response Styles Questionnaire (RSQ). The RRS is a 22-item inventory believed to represent those thoughts and behaviours indicative of ruminative coping. Some research suggested that rumination, as it is defined by and measured with the RRS, embodies a gender stereotype indicative of how women and girls are expected to behave (Strauss, Muday, McNall, & Wong, 1997). Others have suggested that rumination, as measured by the RRS, is actually tapping depressive phenomenology itself because of the overlap of items from the RRS and measures of depression (e.g., Conway, Csank, Holm, and Blake, 2000; Cox, Enns, & Taylor, 2001). As is often the case, studies of rumination and depression have used the Beck Depression

Inventory (BDI) to assess depressive symptoms and as a result of large correlations between the BDI and RRS, which make findings vulnerable to

misinterpretation due to multicollinearity. The correlation between RRS and BDI items has been reported to be between .48 and .56 (Butler & Nolen–Hoeksema, 1994; Nolen-Hoeksema, 2000).

The RRS has also undergone extensive psychometric analysis (Bagby &

Parker, 2001; Cox, Enns, & Taylor, 2001). For example, Bagby and Parker (2001) used factor analysis to extract two distinct factors, self-focus and symptom focus, suggesting a two-component model of rumination. Further, Bagby, Rector, Bachiochi, and McBride (2004) investigated the stability of the RRS

two-component model and found that both the self-focus and symptom-focus aspects of the RRS were stable measures of “a reliable individual difference variable that prolongs and exacerbates depressed mood” (p. 534). However, the RRS captures behavioural aspects of rumination (e.g., sharing one’s feelings with friends) that far extend the construct beyond the internal realm central to the concept of mental control.

Conway, Csank, Holm, and Blake (2000) developed the Rumination on Sadness Scale (RSS) that seems to fit with the concept of mental control as a cognitive rather than behavioural entity. In three studies assessing the

psychometric properties of the RSS compared to the RRS, Conway et al. provided evidence for the reliability and validity of the RSS (see Luminet, 2004 for a

complete review). Rumination was redefined as “recurrent thoughts concerning

one’s present distress and the circumstances surrounding the sadness” (Conway et al., 2000, p.404). Subsequent use of the RSS reveals that the tenets of RST of depression appear to hold, at least for adult populations (e.g., Conway,

Mendelson, Giannopoulos, Csank, & Holm, 2004). Before reviewing the literature on rumination, it is important to consider the definition of rumination in terms of its relationship to other related constructs (e.g., worry).

Rumination can be distinguished from other cognitive constructs such as worry, negative automatic thoughts, and mental problem-solving activities.

Several features characterize worry and worrisome thoughts: a) worries involve thinking about and anticipating pending threat whether real or imagined; b) worries are more akin to mental images; c) worries contain more verbal content;

and d) worries are of shorter duration. In contrast, ruminative thoughts are usually focused on the past and are of longer duration (e.g., Nolen-Hoeksema, 2004; Papageorgiou & Wells, 2004). This suggests that ruminators focus attention on events already stored in memory rather than anticipating events to come.

Nolen-Hoeksema and her colleagues (1993) suggested that worriers tend to take action against pending threat, whereas ruminators may think about their

situation but they fail to act in any way to alter the outcome.

Nolen-Hoeksema (2004) also distinguished between Beck’s negative automatic thoughts and rumination. According to Nolen-Hoeksema (2004), negative automatic thoughts are a set of distorted cognitions, whereas rumination is a set of behaviours and thoughts representative of a particular

style or response to mood. Nolen-Hoeksema (2004) referred to rumination as an attentional style that focuses on the negative aspects of self. While negative automatic thoughts may be the by-product of rumination and other cognitive events, they remain distinct phenomena. In addition, rumination is a passive process. That is to say that there is no active thought or behaviour on the part of the ruminator to change his or her current situation. In contrast, the problem-solving process is viewed as an active process in which a person engages with the intent to resolve a given problem or situation.

Papageorgiou and Wells (2004) suggested that rumination, while sharing a number of features with worry and negative automatic thoughts, is different from other constructs on a number of dimensions (e.g., duration, content, and time frame focus). As well, normal ruminative thinking can be differentiated from the more pathological forms of rumination such as depressive rumination (Papageorgiou & Wells, 2004). This is evidenced in the research findings of Nolen-Hoeksema and Morrow (1993), who found that rumination in the absence of depressed mood state has virtually no negative impact on aspects of mood (i.e., no exacerbation of mood). Would the same be true of the effect that rumination has on an individual’s ability to forget? To answer this question, attention is now drawn to the literature on rumination and memory.