The Role of Rumination and Reduced Concreteness in the Maintenance of Posttraumatic Stress Disorder and Depression Following Trauma (original) (raw)
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Rumination in posttraumatic stress disorder: A systematic review
Clinical Psychology Review, 2020
Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, a systematic review of the empirical literature was conducted on rumination in posttraumatic stress disorder (PTSD). Six subgroups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identify key methodological limitations which limit causal inferences. This review points to important areas of future research to advance knowledge on rumination in PTSD.
Posttraumatic Rumination: Content, Correlates, and Processes
Journal of Clinical Psychology, 2016
Trauma-related rumination (i.e., repetitive and recurrent thinking about trauma and its consequences) has shown to predict the development and maintenance of posttraumatic stress disorder symptoms, though little is known about its characteristics. The purpose of this study was to examine trauma-related ruminative content, correlates, and processes during a trauma-specific repetitive thinking interview. Method: A total of 63 female survivors of violence completed questionnaires assessing trauma-related pathology and participated in a trauma-specific repetitive thinking interview, which was qualitatively coded. Results: Most participants expressed problematic (i.e., assimilated and overaccommodated) trauma beliefs during the interview, which were associated with baseline posttraumatic sequelae. Reexperiencing symptoms mediated the relation between a brooding response style and expressed problematic trauma beliefs. State negative emotions were associated with ruminative processes during the interview and predicted negative emotions after the interview. Conclusion: Maladaptive trauma-related rumination is characterized by perseveration on problematic trauma beliefs. Implications for treatment are discussed.
European journal of psychotraumatology, 2014
Trauma-related rumination has been suggested to be involved in the maintenance of posttraumatic stress disorder (PTSD). This view has empirically been supported by extensive evidence using cross-sectional, prospective, and experimental designs. However, it is unclear why trauma survivors engage in rumination despite its negative consequences. The current study aimed to explore the hypothesis that low emotion regulation ability underlies trauma-related rumination. Emotion regulation ability and trauma-related rumination were assessed in 93 road traffic accident survivors 2 weeks post-trauma. In addition, symptom levels of PTSD were assessed at 2 weeks as well as 1, 3, and 6 months follow-up. Emotion regulation ability was significantly related to trauma-related rumination as well as levels of PTSD symptoms. In addition, the association between low emotion regulation ability and PTSD was mediated by rumination. The findings support the view that rumination is used as a dysfunctional e...
Journal of Experimental Psychopathology, 2017
Trauma-related rumination is considered one cognitive process that underlies the maintenance of posttraumatic stress. However experimental findings for the effect of trauma-related rumination have been inconclusive and a moderating role of trait rumination has been speculated. Further, existing depression may also interact with trauma-related rumination to increase posttraumatic stress symptoms. The roles of trauma-related rumination, trait rumination and existing depression were therefore investigated. Healthy female participants watched an analogue trauma film and completed either film-related rumination or control inductions involving a distraction and free-thinking task in the first and second experiments, respectively. Participants' frequency of film-related intrusions and associated distress levels were assessed within the initial experimental session, over 1-week after the film and at 1-week follow-up. Induced rumination resulted in greater intrusion-related distress in t...
The relationship between rumination, PTSD, and depression symptoms
Journal of Affective Disorders, 2015
Background: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are highly comorbid (Elhai et al., 2008. J. Clin. Psychiatry, 69, (4), 597-602). Rumination is a cognitive mechanism found to exacerbate and maintain both PTSD and MDD (Elwood et al., 2009. Clin. Psychol. Rev. 29, (1), 87-100; Olatunji et al., 2013. Clin. Psychol.: Sci. Pract. 20, (3), 225-257). Aims: Assess whether four rumination subtypes moderate the relationship between comorbid PTSD and MDD symptoms. Method: We consecutively sampled patients (N ¼45) presenting to a mental health clinic using selfreport measures of PTSD and MDD symptoms, and rumination in a cross-sectional design. Results: Repetitive rumination moderates the relationship between PTSD and MDD symptoms at one standard deviation above the mean (β ¼ .044, p¼ .016), while anticipatory rumination moderates the relationship between PTSD and MDD symptoms at mean levels and higher levels of anticipatory rumination (mean β¼.030, p ¼.042; higher β¼.060, p ¼.008).
2011
The present study replicates results of a previous pilot intervention (Sezibera et al., 2009). The objectives consist in evaluating the effectiveness of a Rumination Focused Cognitive and Behavioural Therapy (RFCBT) in treating PTSD and comorbid depression in a randomized controlled trial (RCT) conducted with young multitraumatized from the 1994 genocide against Tutsi in Rwanda. Participants (N=38) were randomly assigned to treatment group (n=19) and control group (n=19). Treatment protocol included exposure monitoring and challenging negative rumination exercises, stress management skills, and social sharing exercises. Results demonstrate significant decrease in PTSD and depression symptoms in the treatment group at posttreatment, while no changes were observed in the control group. Improvement in PTSD is a function of the improvement in rumination, social sharing and loneliness. Regarding rumination mode, decrease in analytic “WHY” thinking rumination is the best predictor of the ...
Posttraumatic stress disorder (PTSD) is a severe mental disorder causing high individual and societal costs. The use of maladaptive emotion regulation (ER) strategies has been identified as a potential contributing factor. This meta-analysis aimed to quantify the associations between PTSD symptoms and rumination, thought suppression and experiential avoidance. The systematic literature search resulted in 4486 studies, 44 of which were included in the analysis. From those eligible studies 135 effect sizes were obtained. For symptoms of posttraumatic stress, large effects were found for associations with rumination (r = .53) and experiential avoidance (r = .47), whereas a medium effect size was found for thought suppression (r = .27). With respect to different PTSD symptom clusters, associations ranged between r = .35 and r = .38 for associations with intrusive re-experiencing, between r = .39 and r = .40 for associations with avoidance, between r = .48 and r = .56 for associations wi...