Cognitive Inflexibility Among Ruminators and Nonruminators

“…to ruminate about their depressive symptoms 1 month after their loss were more severely depressed 6 months after their loss than bereaved people who did not tend to ruminate, even after taking into account initial levels of depressive symptoms at 1 month post-loss (Nolen-Hoeksema et al., 1994).”

“We found that people who score high on our self-report scale of rumination show more perseverative errors on the Wisconsin Card Sort Task than do people who score low on rumination, even after controlling for group differences in levels of depression (Davis & Nolen-Hoeksema, 2000).”

“Davis & Nolen-Hoeksema (2000) reported that ruminators made more errors on the WCST than did nonruminators.”

“For example, Davis and Nolen-Hoeksema (2000) used the Wisconsin Card Sorting Task and found that, compared to non-ruminators, ruminators made more perseverative errors, regardless of their level of depressive symptomatology.”

“In particular, we expected sleep (Fawcett et al. 1990; Durmer & Dinges, 2005; Ferentinos et al. 2009) and concentration (Davis & Nolen-Hoeksema, 2000; Joormann & Gotlib, 2008; Stefanopoulou et al. 2014) to link other symptoms of depression and anxiety symptoms.”

“Davis and Nolen-Hoeksema (2000) showed that people with high ruminative tendencies committed more perseverative errors in the Wisconsin Card Sorting Task.”

“An early study by Davis and Nolen-Hoeksema (2000) showed that ruminators versus non-ruminators committed more perserverative errors on the Wisconsin Card Sorting Task.”

“Attention switching. Research into attention switching, or set-shifting, has historically employed card-sorting ( Davis & Nolen-Hoeksema, 2000; Moritz et al., 2002), trailmaking (Paradisio, Lamberty, Garvey, & Robinson, 1997), dichotic listening (Hughdahl et al., 2003), Stroop (Schatzberg et al., 2000) and dot-probe (…”

“This attentional pattern is known to exacerbate problems such as trauma (Holman & Silver, 1998), rumination (Davis & Nolen-Hoeksema, 2000), and pain (Schutze et al., 2010) among others.”

“…studies suggest ruminators are ineffective in active, interpersonal problem-solving and show an inflexible, perseverative cognitive style on a traditional neuropsychological test of novel problem solving (Davis & Nolen-Hoeksema, 2000; Lyubomirsky & Nolen-Hoeksema, 1995; Watkins & Baracaia, 2002).”

“For example, even after controlling for group differences in depressive symptomatology, Davis and Nolen-Hoeksema (2000) found that trait ruminators were less likely than were nonruminators to be influenced to by negative feedback and more likely to continue to use a no-longer-correct rule to sort cards in the Wisconsi…”

“…of depression, the more an individual depressively ruminates, the more likely he or she is to perseverate on theWisconsin Card Sorting Task (Davis &NolenHoeksema, 2000), These findings have led to the hypothesis that ruminators exhibit ‘‘attentional inflexibility’’ (Davis & Nolen-Hoeksema, 2000).”

“Deffenbacher, J. L., Dahlen, E. R., Lynch, R. S., Morris, C. D., & Gowensmith, W. N. (2000). An application of Beck’s cognitive therapy to general anger reduction.”

“Davis and Nolen-Hoeksema (2000) reported that ruminators made more errors on the Wisconsin Card Sorting Test than did nonruminators.”

“For example, ruminators can switch their attention between nonemotional stimuli if explicitly told to do so (e.g., in a task switching paradigm Whitmer and Banich, 2007) but not if they have to learn on their own from negative feedback that a switch is needed (e.g., WCST; Davis and Nolen-Hoeksema, 2000).”

“In addition, past research suggests that rumination is characterized by an inflexible and perseverative cognitive style (Davis & Nolen-Hoeksema, 2000; Watkins & Brown, 2002) that can interfere with effective problem solving (Lyubomirsky & Nolen-Hoeksema, 1995; Watkins & Baracaia, 2002) and mood…”

“Rumination, a process that has been linked with avoidance, has also been linked to cognitive perseveration (Davis & Nolen-Hoeksema, 2000) and a deficit in inhibiting prior mental sets (Whitmer & Banich, 2007) which may contribute to perseveration in the pursuit of inappropriate approach goals.”

“Future studies would benefit from using more direct, nonaffective, measures of perseverative cognition (e.g., Wisconsin Card Sorting Test; see Davis & Nolen-Hoeksema, 2000) as well as exploring how other forms of rumination are related to affective inflexibility.”

“, 2016), and how disturbances of these abilities might be linked to depressive illness (Davis and Nolen-Hoeksema, 2000; Koster et al., 2011).”

“Davis and Nolen-Hoeksema (2000) reported that ruminators made more errors on the Wisconsin Card Sorting Test (WCST) than did non-ruminators.”

“…much work has focused on the important role of prefrontal cortex (PFC) for emotion processing and emotion regulation(Banich et al., 2009; Beckwé et al., 2014; Bernblum & Mor, 2010; Davis & Nolen-hoeksema, 2000; Goodkind et al., 2015; Kahl, Winter, & Schweiger, 2012; Ochsner et al., 2004).”

“In particular, based on a number of relevant findings (e.g., Davis & Nolen-Hoeksema, 2000; Lyubomirsky et al., 1998; Lyubomirsky & Nolen-Hoeksema, 1995), it seemed likely that ruminators’ memories of past failures and gloomy predictions for the future, coupled with a cognitive tendency to perseverate, may all contribu…”

“…to dysphoric mood that is characterized by recurrent thoughts focusing on the causes, symptoms, and implications of one’s depressive mood (Nolen-Hoeksema, 1991), was found to be related to attentional inflexibility (Davis & Nolen-Hoeksema, 2000) and inhibitory deficits (Whitmer & Banich, 2007).”

“, the Wisconsin card sorting task) than those who do not [44, 45].”

“…intensify negative emotions (e.g., Lyubomirsky & Nolen-Hoeksema, 1993, 1995; Nolen-Hoeksema, McBride, & Larson, 1997) and can cause impairments in cognitive abilities as well as in cognitive flexibility (e.g., Beckmann, 1994; Davis & Nolen-Hoeksema, 2000; Lyubomirsky, Kasri, & Zehm, 2003).”

“This interpretation runs counter to the findings of Davis and Nolen-Hoeksema (2000), who have found that depressive ruminators show an inflexible cognitive style in the Wisconsin Card Sort Test.”

“…study found that individuals with a ruminative style made more perseverative errors on the Wisconsin Card Sorting Test, a task that requires cognitive flexibility and set shifting, and took more time on a measure of psychomotor speed, than did nonruminators (R. N. Davis & Nolen-Hoeksema, 2000).”

“…suggests that perseveration and cognitive inflexibility are closely linked to rumination and provides an important first step towards investigating the relationship between underlying cognitive processes and rumination, Davis and Nolen-Hoeksema (2000) did not measure inhibitory processes directly.”

“…thoughts (rumination) about one’s symptoms, and the causes and consequences of those symptoms, interfere with adaptive problem-solving and enhance negative thinking (Davis & Nolen-Hoeksema, 2000; Nolen-Hoeksema, 1991; Nolen-Hoeksema & Davis, 1999; Nolen-Hoeksema, Grayson, & Larson, 1999).”

“Depressive rumination is associated with deficits in inhibiting prior mental sets on the WCST [177] and a switching task [178].”

“…in working memory (WM), a system that provides temporary access to a select set of representations in the service of current cognitive processes (Cowan, 1999; Miyake & Shah, 1999), underlie ruminative responses in depression (Davis & Nolen-Hoeksema, 2000; Joormann, 2010; Joormann & Gotlib, 2008).”

“The RS has good reliability and acceptable convergent and predictive validity ( Davis & Nolen-Hoeksema, 2000 ).”

“The absence of valence-specific shifting impairments is in line with previous research showing shifting impairments in the context of non-emotional material (Davis & Nolen-Hoeksema, 2000; Whitmer & Banich, 2007).”

“For instance, in a recent study, Davis and Nolen-Hoeksema (2000) showed that dysphoric ruminators cannot inhibit off-goal thoughts and fail to maintain productive lines of reasoning.”

“…significant negative correlations between working memory or setshifting and rumination (Altamirano, Miyake, & Whitmer, 2010; Bernblum & Mor, 2010; Davis & Nolen-Hoeksema, 2000; De Lissnyder, Koster, Derakshan & De Raedt, 2010, 2012; Dickson, 2015; Foxworth, 2014; Wagner, Alloy, & Abramson, 2015;…”

“…to greater insensitivity to contextual demands (e.g., impeding awareness of the punishing effects of rumination) and therefore inhibiting flexibility of cognition, affect, and behavior (e.g., Connolly et al., 2014; Davis & Nolen-Hoeksema, 2000; Koster et al., 2011; Whitmer & Gotlib, 2012, 2013).”

“…function is an important aspect of cognition that is compromised in a number of neuropsychological disorders such as depression (Channon, 1996; Davis & Nolen-Hoeksema, 2000; Harvey et al., 2004), schizophrenia (Berman et al., 1995; Daniel et al., 1991; Egan et al., 2001; Monchi et al., 2004),…”

“…with depression (Ingram, 1990; Nolen-Hoeksema, 1991 ; APA, 1994) may be characterized, and perhaps even prolonged, by an inflexible cognitive style or an inability to inhibit prior mental sets (Davis & Nolen-Hoeksema, 2000 ; Whitmer & Banich, 2007 ; de Lissnyder et al. 2010 ; Koster et al. 2011).”

“The Response Styles Questionnaire—Short Form (Short RSQ; Davis & Nolen-Hoeksema, 2000; Nolen-Hoeksema, personal communication) measured partici-pants’ruminative tendencies in negative situations (e.g., “I think about how alone I feel”).”

“The WCST has been used previously as a measure of cognitive inflexibility and has been found to distinguish dysphoric from nondysphoric individuals,[9] and also individuals high in rumination from those low in rumination.[20] ANXIETY AND MOOD DISORDER DIAGNOSES AND DEPRESSIVE SYMPTOMS.”

“…tendencies might themselves reflect persistent EF deficits (and perhaps specifically, shifting deficits; e.g., see Bredemeier et al., 2011, Davis & Nolen-Hoeksema, 2000, and De Lissnyder et al., 2012) and promote/exacerbate suicidal thinking (see Miranda et al., 2007, 2013 and Marzuk et…”

“…would be consistent with considerable research evidence showing that depressed affect is related to a compromised shifting or switching abilities on executive control tasks (Channon, 1996; Davis & Nolen-Hoeksema, 2000; Grant, Thase, & Sweeney, 2001; Merriam, Thase, Haas, Keshavan, & Sweeney, 1999).”

“The negative effects of reflection may stem not only from an overly abstract level of cognition (Watkins, 2008), but also from rumination’s impact on executive processing and cognitive flexibility (e.g., Davis & Nolen-Hoeksema, 2000; Lyubomirsky & Nolen-Hoeksema, 1993; 1995; Watkins & Brown, 2002).”

“For example, clinical research has linked increased susceptibility to recollecting negative events with both symptom severity and cognitive impairment in emotional disorders such as depression and PTSD (e.g., Davis and Nolen-Hoeksema, 2000; Rubin et al., 2008).”

“On the other hand, there are studies showing that the tendency to experience PC is associated with reductions in objectively assessed cognitive flexibility (Davis & Nolen-Hoeksema, 2000).”

“Other studies have shown a positive correlation between the tendency to ruminate and the number of perseverative errors on shifting tasks using non-emotional material (Davis & Nolen-Hoeksema, 2000; Whitmer & Banich, 2007).”

“Furthermore, by statistically controlling for correlations with BDI scores, Davis and Nolen-Hoeksema (2000) found WCST differences associated with the tendency to ruminate.”

“In these paradigms, positive emotion reduces perseveration (Dreisbach & Groschke, 2004) while negative emotional states reduce the tendency to give up unsuccessful cognitive strategies (Davis & Nolen-Hoeksema, 2000; Gasper, 2003).”

“Together with the notion that recurring ruminative thoughts may be a manifestation of general mental inflexibility in trait ruminators (Davis & Nolen-Hoeksema, 2000; Whitmer & Banich, 2007), the current results highlight the importance of not equating the effects of experimentally induced…”

“Davis and Nolen-Hoeksema (2000) found that individuals who scored high on trait rumination showed more cognitive inflexibility, exhibited by greater perseverative errors on the Wisconsin Card Sorting Test (Heaton et al., 1993), compared to individuals who scored low on trait rumination.”

“This scale is often extracted from the RSQ for use in studies relating to rumination (e.g., Davis & Nolen-Hoeksema, 2000; Papageorgiou & Wells, 2003; Watkins & Baracaia, 2002)).”

“…disengaging from a previously established conceptual frame can be viewed as a form of rigid rule reiteration (Zelazo et al., 2008), possibly leading to cognitive styles that are characteristic of individuals with depressive and anxiety problems (Britton et al., 2010; Davis & Nolen-Hoeksema, 2000).”

“For example (see 1a in Figure 1), there is an ample evidence that depressive disorders are associated with deficits in attentional functions, executive control, lowered cognitive flexibility [87], verbal learning, memory [88], and interpretation biases [89–92].”

“Cross-sectional (Davis & Nolen-Hoeksema, 2000; Joormann, 2006; Joormann & Gotlib, 2010) as well as prospective studies (Connolly et al., 2014; Demeyer, De Lissnyder, Koster, & De Raedt, 2012; Zetsche & Joormann, 2011) have consistently linked rumination to impaired cognitive control (for a review,…”

“This also confirmed the expectations and is comparable to earlier studies, which indicated rumination as a risk factor for developing psychopathology (Carver et al., 1989; Davis & Nolen-Hoeksema, 2000; Garnefski, Boon et al., 2003; Garnefski, Van den Kommer et al., 2002; Garnefski, Legerstee et al., 2002; Garnefski et…”