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‘All these negative thoughts come flooding in’: how young people with depression describe their experience of rumination

Published online by Cambridge University Press:  23 July 2015

Jeremy Oliver*
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK Doctorate in Clinical Psychology, Royal Holloway, University of London, Egham, UK
Patrick Smith
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Eleanor Leigh
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
*
*Author for correspondence: J. Oliver, Doctorate in Clinical Psychology, Royal Holloway, University of London, Egham, TW20 0EX, UK (email: jeremy.oliver.2013@live.rhul.ac.uk).

Abstract

Rumination, or dwelling repeatedly on negative thoughts about the past, can prolong depression and make it worse. When treating clients with depression, it can be important to consider the behavioural, cognitive and emotional impact of rumination on their life. Previous research has examined adult experience of rumination, but the current study was the first to examine how young people with depression experience rumination. Seven young people with depression were interviewed about the cognitive content of their rumination episodes, the associated feelings, and any behavioural start and stop triggers. Interview transcripts were analysed using interpretative phenomenological analysis (IPA). Participants reported experiencing rumination as a disorientating cognitive battle, in which they felt under attack. The process elicited sadness predominantly, but also anger and anxiety, with mood and rumination often maintaining each other. Interpersonal interaction played a key role in starting and stopping rumination episodes. CBT-based interventions specifically targeting the ruminative process may be important for young people with depression, particularly interventions which consider the impact of family members or other systemic factors on rumination behaviour.

Type
Original Research
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Recommended follow-up reading

Nolen-Hoeksema, S, Wisco, BE, Lyubomirsky, S (2008). Rethinking rumination. Perspectives on Psychological Science 3, 400424.CrossRefGoogle ScholarPubMed
Smith, JA (2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology 1, 3954.Google Scholar
Watkins, ER (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin 134, 163206.CrossRefGoogle ScholarPubMed

References

Angold, A, Costello, EJ (1987). Mood and feelings questionnaire (MFQ). Durham: Developmental Epidemiology Program, Duke University.Google Scholar
Blakemore, SJ, Choudhury, S (2006). Development of the adolescent brain: implications for executive function and social cognition. Journal of Child Psychology and Psychiatry 47, 296312.CrossRefGoogle ScholarPubMed
Brewin, CR, Wheatley, J, Patel, T, Fearon, P, Hackmann, A, Wells, A, Fisher, P, Myers, S (2009). Imagery rescripting as a brief stand-alone treatment for depressed patients with intrusive memories. Behaviour Research and Therapy 47, 569576.CrossRefGoogle ScholarPubMed
Calmes, CA, Roberts, JE (2008). Rumination in interpersonal relationships: does co-rumination explain gender differences in emotional distress and relationship satisfaction among college students? Cognitive Therapy and Research 32, 577590.CrossRefGoogle Scholar
Carver, CS, Scheier, ME (1981). Attention and Self-regulation: A Control-theory Approach to Human Behavior. New York: Springer-Verlag.CrossRefGoogle Scholar
Daviss, W, Birmaher, B, Melhem, NA, Axelson, DA, Michaels, SM, Brent, DA (2006). Criterion validity of the Mood and Feelings Questionnaire for depressive episodes in clinic and non-clinic subjects. Journal of Child Psychology and Psychiatry 47, 927934.CrossRefGoogle ScholarPubMed
Garber, J, Weersing, VR (2010). Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clinical Psychology 17, 293306.Google ScholarPubMed
Hammen, C (2006). Stress generation in depression: reflections on origins, research, and future directions. Journal of Clinical Psychology 62, 10651082.CrossRefGoogle ScholarPubMed
Harrington, JA, Blankenship, V (2002). Ruminative thoughts and their relation to depression and anxiety. Journal of Applied Social Psychology 32, 465485.CrossRefGoogle Scholar
Hilt, LM, Pollak, SD (2013). Characterizing the ruminative process in young adolescents. Journal of Clinical Child & Adolescent Psychology 42, 519530.CrossRefGoogle ScholarPubMed
Holmes, EA, Lang, TJ, Deeprose, C (2009). Mental imagery and emotion in treatment across disorders: Using the example of depression. Cognitive Behaviour Therapy 38 (S1), 2128.CrossRefGoogle ScholarPubMed
Jose, PE, Wilkins, H, Spendelow, JS (2012). Does social anxiety predict rumination and co-rumination among adolescents? Journal of Clinical Child & Adolescent Psychology 41, 8691.CrossRefGoogle ScholarPubMed
Kuyken, W, Watkins, E, Holden, E, Cook, W (2006). Rumination in adolescents at risk for depression. Journal of Affective Disorders 96, 3947.CrossRefGoogle ScholarPubMed
Lyubomirsky, S, Nolen-Hoeksema, S (1993). Self-perpetuating properties of dysphoric rumination. Journal of Personality and Social Psychology 65 339349.CrossRefGoogle ScholarPubMed
Meiser-Stedman, R, Dalgleish, T, Yule, W, Smith, PA (2012). Intrusive memories and depression following recent non-traumatic negative. Journal of Affective Disorders 137, 7078.CrossRefGoogle ScholarPubMed
Merikangas, KR, He, JP, Burstein, M, Swanson, SA, Avenevoli, S, Cui, L, Benjet, C, Georgiades, K, Swendsen, J (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry 49, 980989.CrossRefGoogle ScholarPubMed
Leigh, E, Smith, P, Milavic, G, & Stringaris, A (2012). Mood regulation in youth: research findings and clinical approaches to irritability and short-lived episodes of mania-like symptoms. Current Opinion in Psychiatry, 25 (4), 271276.CrossRefGoogle ScholarPubMed
NICE (2015). Depression in children and young people. Identification and management in primary, community and secondary care. London: National Institute for Health and Care Excellence.Google Scholar
Nolen-Hoeksema, S (2004). The response styles theory . In Depressive rumination: nature, theory and treatment (ed. Papageorgiou, C. & Wells, A.), pp. 107124. New York: Wiley.Google Scholar
Nolen-Hoeksema, S, Wisco, BE, Lyubomirsky, S (2008). Rethinking rumination. Perspectives on Psychological Science 3, 400424.CrossRefGoogle ScholarPubMed
Papageorgiou, C, Wells, A (2003). An empirical test of a clinical metacognitive model of rumination and depression. Cognitive Therapy and Research 27, 261273.CrossRefGoogle Scholar
Park, RJ, Goodyer, IM, Teasdale, JD (2004). Effects of induced rumination and distraction on mood and overgeneral autobiographical memory in adolescent major depressive disorder and controls. Journal of Child Psychology and Psychiatry 45, 9961006.CrossRefGoogle ScholarPubMed
Patel, T, Brewin, CR, Wheatley, J, Wells, A, Fisher, P, Myers, S (2007). Intrusive images and memories in major depression. Behaviour Research and Therapy 45, 25732580.CrossRefGoogle ScholarPubMed
Paus, T (2005). Mapping brain maturation and cognitive development during adolescence. Trends in Cognitive Sciences 9, 6068.CrossRefGoogle ScholarPubMed
Pearson, M, Brewin, CR, Rhodes, J, McCarron, G (2008). Frequency and nature of rumination in chronic depression: a preliminary study. Cognitive Behaviour Therapy 37, 160168.CrossRefGoogle ScholarPubMed
Rood, L, Roelofs, J, Bögels, SM, Nolen-Hoeksema, S, Schouten, E (2009). The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: a meta-analytic review. Clinical Psychology Review 29, 609616.CrossRefGoogle ScholarPubMed
Sarin, S, Abela, JRZ, Auerbach, RP (2005). The response styles theory of depression: a test of specificity and causal mediation. Cognition & Emotion 19, 751761.CrossRefGoogle Scholar
Silverstein, LB, Auerbach, CF, Levant, RF (2006). Using qualitative research to strengthen clinical practice. Professional Psychology: Research and Practice 37, 351358.CrossRefGoogle Scholar
Smith, JA (2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology 1, 3954.Google Scholar
Smith, JA (2011). Evaluating the contribution of interpretative phenomenological analysis. Health Psychology Review 5, 927.CrossRefGoogle Scholar
Smith, JA, Jarman, M, Osborn, M (1999). Doing interpretative phenomenological analysis . In: Qualitative Health Psychology: Theories and Methods (ed. Murray, M. & Chamberlain, K.), pp. 218240. London: Sage.CrossRefGoogle Scholar
Spasojevic, J, Alloy, LB (2001). Rumination as a common mechanism relating depressive risk to depression. Emotion 1, 2537.Google Scholar
Stringaris, A, Maughan, B, Copeland, WS, Costello, EJ, Angold, A (2013). Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study. Journal of the American Academy of Child & Adolescent Psychiatry 52, 831840.CrossRefGoogle ScholarPubMed
Treynor, W, Gonzalez, R, Nolen-Hoeksema, S (2003). Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research 27, 247259.CrossRefGoogle Scholar
Waller, EM, Rose, AJ (2010). Adjustment trade-offs of co-rumination in mother-adolescent relationships. Journal of Adolescence 33, 487497.CrossRefGoogle ScholarPubMed
Waller, JM, Silk, JS, Stone, LB, Dahl, RE (2014). Co-rumination and co-problem solving in the daily lives of adolescents with Major Depressive Disorder. Journal of the American Academy of Child & Adolescent Psychiatry 53, 869878.CrossRefGoogle ScholarPubMed
Watkins, ER (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin 134, 163206.CrossRefGoogle ScholarPubMed
Watkins, E, Moulds, M (2005). Distinct modes of ruminative self-focus: impact of abstract versus concrete rumination on problem solving in depression. Emotion 5, 319328.CrossRefGoogle ScholarPubMed
Watkins, E, Moulds, M, Mackintosh, B (2005). Comparisons between rumination and worry in a non-clinical population. Behaviour Research and Therapy 43, 15771585.CrossRefGoogle Scholar
Watkins, ER, Mullan, E, Wingrove, J, Rimes, K, Steiner, H, Bathurst, N, Eastman, R, Scott, J (2011). Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised control trial. British Journal of Psychiatry 199, 317322.CrossRefGoogle Scholar
Watkins, E, Teasdale, JD (2001). Rumination and overgeneral memory in depression: effects of self-focus and analytic thinking. Journal of Abnormal Psychology 110, 353.CrossRefGoogle ScholarPubMed
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