Depressive Rumination and Co-Morbidity: Evidence for Brooding as a Transdiagnostic Process
Open accessAbstract
A sample of 116 patients with unipolar mood disorders referred to a specialist research clinic were assessed to investigate (a) whether rumination is a transdiagnostic process that is related to co-morbid Axis I and II symptoms and diagnosis in depressed patients; (b) whether common findings in the depressive rumination literature could be replicated in a recurrent depressed sample. Consistent with the transdiagnostic hypothesis, rumination was positively associated with both depression and anxiety, brooding was related to co-morbid obsessive-compulsive disorder and generalized anxiety disorder, and rumination was associated with traits associated with borderline personality disorder, most notably self-report of unstable relationships and inconsistent sense of self. As predicted, rumination was equivalent in currently depressed and formerly depressed patients, suggesting that rumination is not simply dependent on mood state or clinical status. As predicted, the brooding subtype most strongly correlated with depressed and anxious symptoms, consistent with previous observations that brooding is the more maladaptive form of rumination. As predicted, rumination was associated with reports of sexual abuse. Inconsistent with previous findings, there was no gender difference in rumination.
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NSRP occurs in high-functioning individuals ('worried well') and across many disorders ('transdiagnostically').
“Even in its dysfunctional forms, NSRP is seen in people with relatively high functioning (i.e., “the worried well”) as well as in many disorders (i.e., “transdiagnostically”).”
From What, me worry and ruminate about dsm-5 and rdoc? The importance of targeting negative self-referential processing (2013) · cites this paper as Watkins, 2009
The Discussion (page unavailable) supports a transdiagnostic role for rumination: it reports associations with anxiety and depression, and links brooding to co-morbid OCD and GAD. The Introduction mentions studies using non-clinical samples, but the paper does not establish that dysfunctional rumination occurs in relatively high-functioning people or the “worried well.” Its findings concern rumination rather than NSRP as a whole. (LLM, conf=0.85)
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- Authors
- Watkins, E. R.
- Affiliations
- University of Exeter (GB)
- Corresponding author
- Watkins, Edward R.
- ORCID
- Watkins, Edward R.
- Venue
- Journal of Rational-Emotive & Cognitive-Behavior Therapy
- Published
- 2009-08-07
- Volume
- 27
- Issue
- 3
- Pages
- 160-175
- ISSN
- 0894-9085 (ISSN-L)
- 1573-6563
- PMC
- PMC2731158
- OpenAlex
- W2136574827
- Cited by
- 182
- References
- 53
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 16 · 2023: 11 · 2022: 12 · 2021: 11 · 2020: 15 · 2019: 19 · 2018: 7 · 2017: 9 · 2016: 10 · 2015: 7 · 2014: 15 · 2013: 12 · 2012: 5
- FWCI
- 7.62
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Rational-Emotive & Cognitive-Behavior Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion)
- Funders
- Wellcome Trust (08099/Z/06/Z)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- depressive rumination, brooding, transdiagnostic mechanisms, depression, anxiety, obsessive-compulsive disorder, generalized anxiety disorder, borderline personality disorder, comorbidities, recurrent depression, sexual abuse, gender differences
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