CoChat
Sign Up
Cited by 230Posttraumatic Stress Disorder ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

The Role of Rumination and Reduced Concreteness in the Maintenance of Posttraumatic Stress Disorder and Depression Following Trauma

Open access
Ehring, Thomas, Frank, Silke, Ehlers, Anke·2008·Cognitive Therapy and Research
DOI 10.1007/s10608-006-9089-7PMC PMC2908437
Open this paper in CoChat — free accountOpen PDF

Abstract

Rumination has been linked to posttraumatic stress disorder (PTSD) and depression following trauma. A cross-sectional (N = 101) and a prospective longitudinal study (N = 147) of road traffic accident survivors assessed rumination, PTSD and depression with self-report measures and structured interviews. We tested the hypotheses that (1) rumination predicts the maintenance of PTSD and depression and (2) reduced concreteness of ruminative thinking may be a maintaining factor. Rumination significantly predicted PTSD and depression at 6 months over and above what could be predicted from initial symptom levels. In contrast to the second hypothesis, reduced concreteness in an iterative rumination task was not significantly correlated with self-reported rumination frequency, and did not consistently correlate with symptom severity measures. However, multiple regression analyses showed that the combination of reduced concreteness and self-reported frequency of rumination predicted subsequent PTSD better than rumination frequency alone. The results support the view that rumination is an important maintaining factor of trauma-related emotional disorders.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s10608-006-9089-7

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Worry is associated with PTS.

    “Worry and rumination are regulatory strategies which have been found to be associated with PTS in prior research (Ehring, Frank, & Ehlers, 2008;Spinhoven, Penninx, Krempeniou, van Hemert, & Elzinga, 2015)”

    From Experiential acceptance and trait‐mindfulness as predictors of analogue post‐traumatic stress. (2018) · cites this paper as Ehring, Frank, & Ehlers, 2008

    The Discussion (page unavailable) reports that trauma-related rumination was significantly correlated with PTSD symptom severity and predicted later symptoms. It discusses worry as a related but distinct form of thinking; it does not report that worry itself was associated with posttraumatic stress symptoms. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Rumination is associated with PTS.

    “Worry and rumination are regulatory strategies which have been found to be associated with PTS in prior research (Ehring, Frank, & Ehlers, 2008;Spinhoven, Penninx, Krempeniou, van Hemert, & Elzinga, 2015)”

    From Experiential acceptance and trait‐mindfulness as predictors of analogue post‐traumatic stress. (2018) · cites this paper as Ehring, Frank, & Ehlers, 2008

  • These findings accord with prior evidence (Breslau & Schultz, 2013; Ehring et al., 2008; Spinhoven et al., 2015).

    “These findings accord with prior evidence (e.g., Breslau & Schultz, 2013;Ehring et al., 2008;Spinhoven et al., 2015).”

    From Experiential acceptance and trait‐mindfulness as predictors of analogue post‐traumatic stress. (2018) · cites this paper as Ehring et al., 2008

    The Results (Self-report rumination measures) report associations between rumination and PTSD and depression symptoms, and the Method (Participants) reports comorbidity. But the citing sentence does not say what “these findings” are, so it is not possible to determine whether they accord with the evidence in this paper. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 66 · Cited by 230

Research works printed but not linked: 34

  1. Baker S. P. O’Neil B. Haddon W. J. E. A. Long W. B. The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care Journal of Trauma 1974 14 187 196 10.1097/00005373-197403000-00001 4814394 · DOI
  2. Borkovec T. D. Davey G. C. L. Tallis F. The nature, functions, and origins of worry Worrying: Perspectives on theory, assessment and treatment 1994 Chichester, UK Wiley 5 33
  3. Clohessy S. Ehlers A. PTSD symptoms, response to intrusive memories and coping in ambulance service workers The British Journal of Clinical Psychology 1999 38 251 265 10.1348/014466599162836 10532147 · DOI
  4. Davey G. C. L. Jubb M. Cameron C. Catastrophic worrying as a function of changes in problem-solving confidence Cognitive Therapy and Research 1996 20 333 344 10.1007/BF02228037 · DOI
  5. Davey G. C. L. Levy S. Catastrophic worrying: Personal inadequacy and a perseverative iterative style as features of the catastrophizing process Journal of Abnormal Psychology 1998 107 576 586 10.1037/0021-843X.107.4.576 9830245 · DOI · Paper page
  6. Davey G. C. L. Levy S. Internal statements associated with catastrophic worrying Personality and Individual Differences 1999 26 21 32 10.1016/S0191-8869(98)00162-7 · DOI
  7. Ehring, T., Ehlers, A., & Glucksman, E. (in preparation). A prospective longitudinal study of posttraumatic stress disorder, phobia, and depression after road traffic accidents. PMC2672053 18377119
  8. Evans, C., Ehlers, A., Mezey, G., & Clark, D. M. (in press). Intrusive memories and ruminations related to violent crime among young offenders: Phenomenological characteristics. Journal of Traumatic Stress. 17427909
  9. Foa E. B. Kozak M. J. Emotional processing of fear: Exposure to corrective information Psychological Bulletin 1986 99 20 35 10.1037/0033-2909.99.1.20 2871574 · DOI · Paper page
  10. Greenberg M. A. Cognitive processing of traumas: The role of intrusive thoughts and reappraisals Journal of Applied Social Psychology 1995 25 1262 1296 10.1111/j.1559-1816.1995.tb02618.x · DOI
  11. Hackmann A. Ehlers A. Speckens A. Clark D. M. Characteristics and content of intrusive memories in PTSD and their changes with treatment Journal of Traumatic Stress 2004 17 231 240 10.1023/B:JOTS.0000029266.88369.fd 15253095 · DOI · Paper page
  12. Halligan S. L. Clark D. M. Ehlers A. Cognitive processing, memory, and the development of PTSD symptoms: Two experimental analogue studies Journal of Behavior Therapy and Experimental Psychiatry 2002 33 73 89 10.1016/S0005-7916(02)00014-9 12472172 · DOI
  13. Harvey A. G. Greenall E. Catastrophic worry in primary insomnia Journal of Behavior Therapy and Experimental Psychiatry 2003 34 11 23 10.1016/S0005-7916(03)00003-X 12763390 · DOI
  14. Holman E. A. Silver R. C. Getting “stuck” in the past: Temporal orientation and coping with trauma Journal of Personality and Social Psychology 1998 74 1146 1163 10.1037/0022-3514.74.5.1146 9599436 · DOI
  15. Joseph S. Williams R. Yule W. Understanding post-traumatic stress: A psychosocial perspective on PTSD and treatment 1997 Chichester, UK Wiley
  16. Lyubomirsky S. Tkach C. Papageorgiou C. Wells A. The consequences of dysphoric rumination Depressive rumination: Nature, theory and treatment 2004 Chichester, UK Wiley 21 41
  17. Mayou R. A. Bryant B. M. Ehlers A. Prediction of psychological outcomes one year after a motor vehicle accident The American Journal of Psychiatry 2001 158 1231 1238 10.1176/appi.ajp.158.8.1231 11481156 · DOI
  18. McNally R. J. Bryant R. A. Ehlers A. Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest 2003 4 45 79 10.1111/1529-1006.01421 26151755 · DOI · Paper page
  19. Michael T. Ehlers A. Halligan S. Clark D. M. Unwanted memories of assault: What intrusion characteristics predict PTSD? Behaviour Research and Therapy 2005 43 613 628 10.1016/j.brat.2004.04.006 15865916 · DOI
  20. Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (in press). Rumination in posttraumatic stress disorder. Depression and Anxiety. 17041914
  21. Murray J. Ehlers A. Mayou R. A. Dissociation and posttraumatic stress disorder: Two prospective studies of motor vehicle accident survivors The British Journal of Psychiatry 2002 180 363 368 10.1192/bjp.180.4.363 11925361 · DOI · Paper page
  22. Nolen-Hoeksema S. Papageorgiou C. Wells A. The response styles theory Depressive rumination: Nature, theory and treatment 2004 Chichester, UK Wiley 107 123
  23. O’Donnell M. L. Creamer M. Pattison P. Atkin C. Psychiatric morbidity following injury The American Journal of Psychiatry 2004 161 507 514 10.1176/appi.ajp.161.3.507 14992977 · DOI
  24. Paivio A. Mental representation: A dual coding approach 1986 New York Oxford University Press
  25. Papageorgiou C. Wells A. Depressive rumination: Nature, theory and treatment 2004 Chichester Wiley
  26. Provencher M. D. Freeston M. H. Dugas M. J. Ladouceur R. Catastrophizing assessment of worry and threat schemata among worriers Behavioural and Cognitive Psychotherapy 2000 28 211 224 10.1017/S1352465800003027 · DOI
  27. Speckens, A. E. M., Ehlers, A., Hackmann, A., Ruths, F., & Clark, D. M. (submitted). Intrusive memories and rumination in patients with posttraumatic stress disorder: A phenomenological comparison. 17454662
  28. Startup H. M. Davey G. C. L. Mood as input and catastrophic worrying Journal of Abnormal Psychology 2001 110 83 96 10.1037/0021-843X.110.1.83 11261404 · DOI
  29. Startup H. M. Davey G. C. L. Inflated responsibility and the use of stop rules for catastrophic worrying Behaviour Research and Therapy 2003 41 495 503 10.1016/S0005-7967(02)00245-0 12643971 · DOI
  30. Steil R. Ehlers A. Dysfunctional meaning of posttraumatic intrusions in chronic PTSD Behaviour Research and Therapy 2000 38 537 558 10.1016/S0005-7967(99)00069-8 10846804 · DOI
  31. Stöber J. Worry, problem elaboration and suppression of imagery: The role of concreteness Behaviour Research and Therapy 1998 36 751 756 10.1016/S0005-7967(98)00027-8 9682529 · DOI
  32. Stöber J. Borkovec T. D. Reduced concreteness of worry in generalized anxiety disorder: Findings from a therapy study Cognitive Therapy and Research 2002 26 89 96 10.1023/A:1013845821848 · DOI
  33. Watkins E. Adaptive and maladaptive ruminative self-focus during emotional processing Behaviour Research and Therapy 2004 42 1037 1052 10.1016/j.brat.2004.01.009 15325900 · DOI
  34. Watkins E. Mason A. Mood as input and rumination Personality and Individual Differences 2002 32 577 587 10.1016/S0191-8869(01)00058-7 · DOI

Authors
Ehring, T., Frank, S., & Ehlers, A.
Affiliations
King's College London (GB)
Corresponding author
Ehlers, Anke
ORCID
Venue
Cognitive Therapy and Research
Publisher
Springer Science and Business Media LLC
Published
2007-03-28
Volume
32
Issue
4
Pages
488-506
ISSN
  • 0147-5916 (ISSN-L)
  • 1573-2819
DOI
10.1007/s10608-006-9089-7
PMC
PMC2908437
OpenAlex
W2128927430
Cited by
230
References
66
Citations by year
2026: 4 · 2025: 10 · 2024: 8 · 2023: 6 · 2022: 12 · 2021: 20 · 2020: 17 · 2019: 13 · 2018: 15 · 2017: 14 · 2016: 12 · 2015: 20 · 2014: 17 · 2013: 13 · 2012: 24
FWCI
5.82
Type
journal article
Language
en
Open access
Licence
Locations
  • Cognitive Therapy and Research (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Open access LMU (Ludwid Maxmilian's Universitat Munchen) (acceptedVersion)
  • UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
  • Research Portal (King's College London) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
  • Wellcome Trust (069777)
  • King's College London
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
rumination, post-traumatic stress disorder, depression, trauma, traffic accidents, ruminative thinking, symptom maintenance

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review