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Rumination predicts heightened responding to stressful life events in major depressive disorder and generalized anxiety disorder.
Open accessAbstract
Although studies have documented heightened stress sensitivity in major depressive disorder (MDD) and generalized anxiety disorder (GAD), the mechanisms involved are poorly understood. One possible mechanism is the tendency to ruminate in response to stress. We used ecological momentary assessment to study ruminative thoughts after stressful events in 145 adults with MDD, GAD, comorbid MDD-GAD, or no psychopathology. Diagnosed individuals reported more event-related rumination than controls, even after adjusting for event stressfulness. Rumination was equally common in MDD and GAD and was especially severe among comorbid cases. More rumination immediately after the event predicted poorer affect, more maladaptive behavior, and more MDD and GAD symptoms at the next signal, even when pre-event levels of these variables were controlled. Rumination mediated, but did not moderate, the association of stress with affect and with symptoms. Stress-related rumination was more deleterious for diagnosed than healthy individuals, more intense for more severe clinical cases, and more persistent for cases with a greater temperamental vulnerability for emotional disorders. These results implicate rumination as a mechanism of stress sensitivity and suggest pathways through which it may maintain depression and anxiety in everyday life.
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“Suicidality was not assessed directly, but it may be inferred that reductions in negative affect may reduce suicidality risks.”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [88]
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“Based on results from 37 participants, for the intervention group, she reports significant reductions in overall negative affect, F(1, 1798) = 13.8, P = 0.0002; reduced craving immediately post-meditation, (Group × Assessment Type interaction, F(2, 1796) = 12.3, P = 0.0001); and reduced cigarettes smoked per day over time (Group × Day interaction, F(1, 436) = 5.50, P = 0.01).”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [88]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“contextual CBTs such as mindfulness-based therapy and ACT appear to demonstrate success in treating nicotine addiction and promoting smoking cessation with minimal or no reported increased risk of suicidality.76,78,88”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [88]
Experimental — accuracy not yet measuredIn the citing paper
“which were further worsened by symptom severity and extensive comorbidity”
From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [52]
In the citing paper
“Both clinical samples showed higher levels of rumination in response to stressful situations”
From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [52]
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“rumination significantly mediated the impact of stress on symptoms and affect”
From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [52]
In the citing paper
“higher rumination after a stressful event predicted greater NA and more maladaptive behaviours”
From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [52]
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Citations
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“These behaviors were chosen for their conceptual links with rumination and related forms of perseverative thought and their hypothesized roles as mechanisms through which rumination may influence depression (Nolen-Hoeksema et al., 2008).”
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“Our results align with observations by Nolen-Hoeksema and colleagues (2008) that rumination serves the function of establishing that one’s situation is hopeless, justifying withdrawal, inaction, and avoidant coping.”
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“Its validity was supported by strong associations (both r = .57) with the Ruminative Responses Scale (Nolen-Hoeksema & Morrow, 1991) and the Rumination scale of the Rumination-Reflection Questionnaire (Trapnell & Campbell, 1999).”
Method
Cited by
Sorted by citations
Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination
Watkins, E. R., & Roberts, H. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103573 · Cited by 862
“11 Tanno, 2013, 2014) and to mediate the role of life str ss and negative events in prospectively predicting negative affect and depressive symptoms ver several weeks in both nonclinical (Genet & Siemer, 2012; Moberly & Watkins, 2008b) and clini cal samples (Ruscio et al., 2015) and to moderate the role of life stress…”
BackgroundVachon, H., Viechtbauer, W., Rintala, A., & Myin-Germeys, I. (2019) · Journal of Medical Internet Research · doi:10.2196/14475 · Cited by 252
“Designs vary from 2 [18] to 50 evaluations per day [19], occurring at fixed [20], semirandom [21], or random time intervals [22], for 1 [23] to 150 days [24], using paper-and-pencil [25] or electronic devices [26], Likert scales [27], or visual analogue scales [28], and with questionnaires varying…”
The role of emotion regulation in the characterization, development and treatment of psychopathology
Lincoln, T. M., Schulze, L., & Renneberg, B. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00040-4 · Cited by 234
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Harkness, K. L., & Monroe, S. M. (2016) · Journal of Abnormal Psychology · doi:10.1037/abn0000178 · Cited by 223
“For example, in an experience sampling study of adults with MDD and/or generalized anxiety disorder (GAD), Ruscio et al. (2015) prompted 145 participants eight times per day for one week to rate the ‘stressfulness’ of the most significant event they had experienced since the last signal, as well as…”
BackgroundColombo, D., Fernández-Álvarez, J., Patané, A., Semonella, M., Kwiatkowska, M., García-Palacios, A., Cipresso, P., Riva, G., & Botella, C. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8040465 · Cited by 194
“Ruscio and colleagues investigated the relationship between stressful events and rumination in MDD and GAD patients [52].”
BackgroundAnxiety in the context of cancer: A systematic review and development of an integrated model
Curran, L., Sharpe, L., & Butow, P. N. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.06.003 · Cited by 139
Connolly, S. L., & Alloy, L. B. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.07.006 · Cited by 114
“Whereas previous EMA studies have found rumination to mediate the role of stress in predicting depressedmood (Moberly& Watkins, 2008a; Ruscio et al., 2015), the current work suggests that instead of serving to explain the detrimental effects of stressor occurrence on mood, variability in rumination…”
BackgroundResultInfluentialEffects of rumination and worry on sleep
Tousignant, O. H., Taylor, N. D., Suvak, M. K., & Fireman, G. D. (2019) · Behavior Therapy · doi:10.1016/j.beth.2018.09.005 · Cited by 97
Sep, M. S. C., Steenmeijer, A., & Kennis, M. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.09.029 · Cited by 100
Harkness, K. L., Hayden, E. P., & Lopez‐Duran, N. L. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000041 · Cited by 96
Newman, D. B., & Nezlek, J. B. (2017) · Personality and Individual Differences · doi:10.1016/j.paid.2017.06.039 · Cited by 88
“To our knowledge, only two studies have examined within-person relationships between rumination and positive outcomes, and each found a negative relationship between rumination and positive affect (Pe et al., 2013; Ruscio et al., 2015).”
BackgroundAssociation of opioid misuse with anxiety and depression: A systematic review of the literature
Rogers, A. H., Zvolensky, M. J., Ditre, J. W., Buckner, J. D., & Asmundson, G. J. G. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.101978 · Cited by 93
Rosenkranz, T., Takano, K., Watkins, E. R., & Ehring, T. W. (2020) · PLoS ONE · doi:10.1371/journal.pone.0231783 · Cited by 94
The everyday dynamics of rumination and worry: Precipitant events and affective consequences
Kircanski, K., Thompson, R. J., Sorenson, J., Sherdell, L., & Gotlib, I. H. (2018) · Cognition and Emotion · doi:10.1080/02699931.2017.1278679 · Cited by 76
“…a decrease in positive affect and increase in negative affect were consistent with results reported in previous studies (e.g., Moberly & Watkins, 2008a, 2008b; Ruscio et al., 2015), and underscore the deleterious impact of rumination on subsequent positive and negative affect (Alloy et al., 2000).”
BackgroundMethodResultInfluentialCarpenter, R. W., Wycoff, A. M., & Trull, T. J. (2016) · Assessment · doi:10.1177/1073191116632341 · Cited by 72
“Thus, Ruscio et al. (2015) found support for the hypothesis that rumination plays a role in the effects of stress on mood.”
InfluentialOrvell, A., Vickers, B. D., Drake, B., Verduyn, P., Ayduk, O., Moser, J., Jonides, J., & Kross, E. (2021) · Clinical Psychological Science · doi:10.1177/2167702620951539 · Cited by 63
“…including depression and depressive symptoms, among both clinical and nonclinical populations (Brosschot, Gerin, & Thayer, 2006; Garfenski, Kraaij, & Spinhoven, 2001; Gotlib & Joormann, 2010; Michl, McLaughlin, Shepard, & Nolen-Hoeksema, 2013; M. S. Robinson & Alloy, 2003; Ruscio et al., 2015).”
Adverse life events and the onset of anxiety disorders
Miloyan, B., Joseph Bienvenu, O., Brilot, B., & Eaton, W. W. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.11.027 · Cited by 69
“For example, there may be dispositional traits (e.g., rumination, worry) that predispose individuals to respond more poorly to adverse events and develop mental disorders (Ruscio et al., 2015).”
Stress regulation in drug-resistant epilepsy
Kotwas, I., McGonigal, A., Bastien‐Toniazzo, M., Bartoloméi, F., & Micoulaud‐Franchi, J. (2017) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2017.01.025 · Cited by 58
Worry and rumination: do they prolong physiological and affective recovery from stress?
Capobianco, L., Morris, J., & Adrian Wells, A. (2018) · Anxiety Stress & Coping · doi:10.1080/10615806.2018.1438723 · Cited by 54
“Ruscio et al (2015) found that rumination was associated with greater NA and increased symptoms of depression and anxiety following a stressful event.”
BackgroundVidal‐Ribas, P., Benson, B. E., Vitale, A. D., Keren, H., Harrewijn, A., Fox, N. A., Pine, D. S., & Stringaris, A. K. (2019) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2019.05.012 · Cited by 54
“In humans, altered function of frontal regions has been associated with rumination (63, 64), which has been associated with higher reactivity to stressful events (65, 66) and might play a role in the generation of interpersonal stress (67), consequently increasing the likelihood of depression and anxiety.”
BackgroundKhazanov, G. K., Ruscio, A. M., & Swendsen, J. D. (2018) · Behavior Therapy · doi:10.1016/j.beth.2018.05.008 · Cited by 57
“The present study has previously been described (Ruscio et al., 2015).”
Self-citationRumination as a Transdiagnostic Phenomenon in the 21st Century: The Flow Model of Rumination
Wong, S. M. Y., Chen, E. Y. H., Lee, M. C. Y., Suen, Y. N., & Hui, C. L. M. (2023) · Brain Sciences · doi:10.3390/brainsci13071041 · Cited by 48
Webb, C. A., Israel, E. S., Belleau, E. L., Appleman, L., Forbes, E. E., & Pizzagalli, D. A. (2020) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2020.03.010 · Cited by 46
“represents one form of mind-wandering characterized by negatively valenced, past-oriented, and typically selfreferential thoughts, which has been repeatedly shown to predict worse affect.(8,9) In contrast, other forms of mindwandering (eg, related to creative thinking or anticipatory pleasure) may produce positive out…”
BackgroundMethodSánchez-López, Á., Raedt, R. D., van Put, J., & Koster, E. H. W. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.04.005 · Cited by 43
Zeng, M., Chen, S., Zhou, X., Zhang, J., Chen, X., & Sun, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1000109 · Cited by 47
“Numerous studies suggest that rumination was an influential factor in depressive symptoms, anxiety (Candea and SzentagotaiTatar, 2017), perceived stress (Ruscio et al., 2015), and suicidal ideation (Ruscio et al.”
BackgroundStress sensitivity in psychopathology: Mechanisms and consequences.
Hammen, C. L. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000040 · Cited by 45
Adaptive functions of self-focused attention: Insight and depressive and anxiety symptoms
Nakajima, M., Takano, K., & Tanno, Y. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.01.026 · Cited by 43
Longitudinal predictors of depression, anxiety, and alcohol use following COVID‐19‐related stress
Venanzi, L., Dickey, L., Green, H. E., Pegg, S. L., Benningfield, M. M., Bettis, A. H., Blackford, J. U., & Kujawa, A. (2022) · Stress and Health · doi:10.1002/smi.3125 · Cited by 45
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“The majority of events were low in objective intensity, which is consistent with previous EMA studies of life stress (Ruscio et al., 2015); 83.”
BackgroundResultInfluentialHosseinichimeh, N., Wittenborn, A. K., Rick, J., Jalali, M. S., & Rahmandad, H. (2018) · PLoS ONE · doi:10.1371/journal.pone.0204389 · Cited by 38
“Second, this study examines the hypothesis of Ruscio and colleagues, which asserts that rumination prolongs the effects of stressful events by keeping an individual activated [14].”
BackgroundMethodInfluentialEstimating the parameters of system dynamics models using indirect inference
Hosseinichimeh, N., Rahmandad, H., Jalali, M., & Wittenborn, A. K. (2016) · System Dynamics Review · doi:10.1002/sdr.1558 · Cited by 34
“, 2013), the mechanism of rumination’s influence was not known; only one study hypothesized that rumination contributes to depression by keeping stressors alive without testing it (Ruscio et al., 2015).”
BackgroundInfluentialRosenbaum, D., Int-Veen, I., Laicher, H., Torka, F., Kroczek, A., Rubel, J. A., Lawyer, G., Bürger, Z., Bihlmaier, I., Storchak, H., et al. (2021) · Neurobiology of Stress · doi:10.1016/j.ynstr.2021.100344 · Cited by 35
“First evidence for the maladaptive role of rumination in response to stress comes from two studies using ecological momentary assessments (EMA) in students (Connolly and Alloy, 2017) and subjects with MDD and generalized anxiety disorder (Ruscio et al., 2015).”
BackgroundResultSchick, A., Rauschenberg, C., Ader, L., Daemen, M., Wieland, L. M., Paetzold, I., Postma, M. R., Schulte‐Strathaus, J. C. C., & Reininghaus, U. (2022) · Psychological Medicine · doi:10.1017/s0033291722003336 · Cited by 32
A Daily Diary Study of Rumination and Health Behaviors: Modeling Moderators and Mediators
Riley, K. E., Park, C. L., & Laurenceau, J. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay081 · Cited by 34
Mathersul, D. C., & Ruscio, A. M. (2019) · Cognitive Therapy and Research · doi:10.1007/s10608-019-10048-5 · Cited by 42
Self-citationDaily Interpersonal and Noninterpersonal Stress Reactivity in Current and Remitted Depression
Sheets, E. S., & Armey, M. F. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10096-2 · Cited by 33
Hehr, A., Huntley, E. D., & Marusak, H. A. (2023) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2023.01.010 · Cited by 33
Oversampled and undersolved: Depressive rumination from an active inference perspective
Berg, M., Feldmann, M., Kirchner, L., & Κube, T. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104873 · Cited by 36
Rumination, worry and negative and positive affect in prolonged grief: A daily diary study
Eisma, M. C., Franzen, M., Paauw, M., Bleeker, A., & Rot, M. A. H. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2635 · Cited by 36
“…in other samples (for reviews, see Thomsen, 2006; Schubert et al., 2020) and prior studies examining these associations using intensive longitudinal data collection (e.g., Connolly & Alloy, 2017; Moberly & Watkins, 2008a, 2008b; Newman et al., 2019; Ruscio et al., 2015) to the bereaved population.”
BackgroundLangenecker, S. L., Westlund-Schreiner, M., Bessette, K. L., Roberts, H., Thomas, L. R., Dillahunt, A., Pocius, S. L., Feldman, D. A., Jago, D., Farstead, B., et al. (2023) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2023.08.012 · Cited by 36
“The role of the ruminative habit in these fi ndings is that rumination is repetitive, long-lasting, and dif fi cult to control (16 – 18); interferes with effective problem solving (19) and instrumental behavior (20); and prospectively predicts executive functioning impairments among adolescents (21).”
BackgroundRuminative Inertia and Its Association With Current Severity and Lifetime Course of Depression
Bean, C. A. L., Heggeness, L. F., Kalmbach, D. A., & Ciesla, J. A. (2020) · Clinical Psychological Science · doi:10.1177/2167702620949174 · Cited by 34
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“a negative repetitive style of thinking and focus on negative life events) as a maintaining and causal factor for depression [24].”
BackgroundXia, H., Han, X., Jing, C., Liu, D., Wu, Y., & Liu, Y. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.781274 · Cited by 31
“In addition, perceived social support also plays an important role in moderating effect between negative stressful life events and depression and acts as a buffer against stressful events (Ruscio et al., 2015; Miloseva et al., 2017).”
BackgroundRumination is associated with diminished performance monitoring.
Tanovic, E., Hajcak, G., & Sanislow, C. A. (2017) · Emotion · doi:10.1037/emo0000290 · Cited by 31
Bernard, D. L., Halliday, C. A., Are, F. G., Banks, D. E., & Danielson, C. K. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01132-2 · Cited by 34
The grass is not as green as you think: Affect evaluation in people with internalizing disorders
Thompson, R. J., Kircanski, K., & Gotlib, I. H. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.06.006 · Cited by 26
“Thus, levels of should affect were largely transdiagnostic, adding to the studies documenting transdiagnostic factors in MDD, GAD, and MDD-GAD (e.g., Kircanski et al., 2015; Ruscio et al., 2015; Ruscio et al., 2011).”
BackgroundVanderhasselt, M., Brose, A., Koster, E. H. W., & Raedt, R. D. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.09.003 · Cited by 26
“Nevertheless, to date, only few studies investigated rumination in relation to stressful events using multiple measurements across time, usually only assessing a general tendency to ruminate (e.g., Robinson and Alloy, 2003), or not including lengthy follow-up assessments (e.g., Ruscio et al., 2015).”
BackgroundSleep disturbances in generalized anxiety Disorder: The central role of insomnia
Xue, Y., Wang, W.-D., Liu, Y., Wang, J., & Walters, A. S. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106545 · Cited by 33
Besharat, M., Khadem, H., Zarei, V., & Momtaz, A. (2020) · Iranian Journal of Psychiatry · doi:10.18502/ijps.v15i1.2442 · Cited by 28
“In patients with generalized anxiety disorder and major depression, sensitivity to stress is higher than normal individuals (18, 20, 21).”
BackgroundZareian, B., Wilson, J., & LeMoult, J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.660062 · Cited by 29
Beddig, T., Reinhard, I., Ebner‐Priemer, U., & Kuehner, C. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103613 · Cited by 27
“For example, momentary rumination predicted subsequent levels of NA in clinical (e.g. Kircanski, Thompson, Sorenson, Sherdell, & Gotlib, 2018; Ruscio et al., 2015) and in community samples (e.”
BackgroundFernandez, C. A., Choi, K. W., Marshall, B. D. L., Vicente, B., Saldivia, S., Kohn, R., Koenen, K. C., Arheart, K. L., & Buka, S. L. (2020) · The British Journal of Psychiatry · doi:10.1192/bjp.2020.88 · Cited by 29
Laicher, H., Int-Veen, I., Torka, F., Kroczek, A., Bihlmaier, I., Storchak, H., Velten-Schurian, K., Dresler, T., Täglich, R., Fallgatter, A. J., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-08579-1 · Cited by 22
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“In addition, rumination was found to mediate the momentary relationship between stress and increases in negative affect (Ruscio et al., 2015).”
BackgroundFernández-Fernández, V., Losada‐Baltar, A., Márquez‐González, M., Paniagua-Granados, T., Vara‐García, C., & Luque-Reca, O. (2020) · International Psychogeriatrics · doi:10.1017/s1041610219002084 · Cited by 27
“Some authors have proposed that ruminative thoughts increase sensitivity to stressful events through a deterioration in affectivity, a variable capable of increasing anxious and depressive symptoms in the face of such events (Ruscio et al., 2015).”
BackgroundInfluentialAssociations of Different Emotion Regulation Strategies with Coping-Efficacy, Rumination and Stress
Rosenbaum, D., Int-Veen, I., Rubel, J. A., Laicher, H., Kroczek, A., Lawyer, G., Fallgatter, A. J., & Ehlis, A. (2022) · Cognitive Therapy and Research · doi:10.1007/s10608-022-10307-y · Cited by 24
Liu, Q., Wangqing, P., Baima, Y., Wang, S., Shen, Z., Zhou, J., Song, H., Liu, Y., Liu, X., Luo, P., et al. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.783687 · Cited by 22
“One psychological mechanism suggests that rumination mediates the longitudinal relationship between stressful life events and comorbid depressive and anxiety symptoms (38), while the genetic mechanism suggests that stressful life events may change mitochondrial DNA and telomere length to cause depression (39).”
BackgroundBeute, F., & de Kort, Y. A. W. (2018) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12128 · Cited by 23
Pawluk, E. J., Koerner, N., Kuo, J. R., & Antony, M. M. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102478 · Cited by 23
Chang, X., Guo, C., Heng, Z., & Liu, L. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04572-8 · Cited by 24
“This is in line with earlier studies, which have shown that the more ruminant a person is, the more anxious he/she is, and the opposite is true [24, 25].”
BackgroundResultWebb, C. A., Murray, L., Tierney, A. O., & Gates, K. M. (2023) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000830 · Cited by 20
Ruminative Variability Predicts Increases in Depression and Social Anxiety
Bean, C. A. L., & Ciesla, J. A. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10451-z · Cited by 20
“The experience of stressful everyday events often leads to increases in rumination, which mediates the intraday relations between stress and increases in negative affect and symptoms of depression and anxiety (Kircanski et al., 2018; Ruscio et al., 2015).”
Rumination and dissociation: The mediating role of poor sleep quality and presleep cognitions.
Vannikov‐Lugassi, M., & Soffer‐Dudek, N. (2017) · Psychology of Consciousness Theory Research and Practice · doi:10.1037/cns0000128 · Cited by 20
“…Martinez-Tabaos, 1991; Wise, Mann, & Sheridan, 2000, for dissociation), (b) pathological worry/ generalized anxiety disorder (see Dar & Iqbal, 2015; Ruscio et al., 2015; van Rijsoort, Emmelkamp, & Vervaeke, 2001, for rumination, and Muris, Merckelbach, & Peeters, 2003, for dissociation), and (c)…”
Feneberg, A. C., Mewes, R., Doerr, J. M., & Nater, U. M. (2021) · Scientific Reports · doi:10.1038/s41598-021-03374-w · Cited by 20
Altered Task-Evoked Corticolimbic Responsivity in Generalized Anxiety Disorder
Kim, N., & Kim, M. J. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22073630 · Cited by 19
“Indeed, GAD patients report higher levels of stress from daily life events compared to healthy individuals [3], and, conversely, stress reduction programs effectively reduce anxiety symptoms in GAD [4].”
BackgroundLeno, V. C., Wright, N., Pickles, A. R., Bedford, R., Zaidman‐Zait, A., Kerns, C. M., Mirenda, P., Zwaigenbaum, L., Duku, E., Bennett, T. A., et al. (2022) · Autism · doi:10.1177/13623613211061932 · Cited by 21
“…rumination after SLE exposure predicts poorer outcomes and more mental health symptoms, even when adjusting for severity of pre-SLE symptoms (Ruscio et al., 2015), and emotional control and cognitive shifting moderate the association between exposure to community violence and anxiety…”
BackgroundRuminative Inertia, Emotion Regulation, and Depression: A Daily-Diary Study
Bean, C. A. L., Heggeness, L. F., & Ciesla, J. A. (2021) · Behavior Therapy · doi:10.1016/j.beth.2021.04.004 · Cited by 25
Schneider, B. C., Veckenstedt, R., Karamatskos, E., de Pinho, L. G., Morgado, B., da Fonseca, C. J. V., Moritz, S., & Jelinek, L. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1153377 · Cited by 21
“Moreover, in a study utilizing ecological momentary assessment, rumination mediated longitudinal relationships between stress and both negative affect and depressive symptoms for stressful events occurring in daily life (Ruscio et al., 2016).”
BackgroundPace, U., D’Urso, G., Passanisi, A., Mangialavori, S., Cacioppo, M., & Zappulla, C. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01547-w · Cited by 17
Preoccupied with the body: mild stress amplifies the relation between rumination and interoception
Schlinkert, C., Herbert, B. M., Baumann, N., & Koole, S. L. (2020) · Cognition & Emotion · doi:10.1080/02699931.2020.1746242 · Cited by 17
Martínez, R., Senra, C., Fernández-Rey, J., & Merino, H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17165716 · Cited by 12
“Available research supports the notion that MDD and GAD are the most comorbid emotional disorders [41,42].”
MethodGriffioen, N., Lichtwarck‐Aschoff, A., van Rooij, M. M. J. W., & Granic, I. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.789302 · Cited by 18
Emotional and cognitive correlates of hating among adolescents: An exploratory study
Pace, U., Passanisi, A., & D’Urso, G. (2018) · Journal of Adolescence · doi:10.1016/j.adolescence.2018.08.002 · Cited by 15
Daily Emotion Regulation in Major Depression and Borderline Personality Disorder
Zetsche, U., Bürkner, P., Bohländer, J., Renneberg, B., Roepke, S., & Schulze, L. (2023) · Clinical Psychological Science · doi:10.1177/21677026231160709 · Cited by 15
“The latter finding was confirmed by an experience-sampling study that assessed spontaneous rumination (Ruscio et al., 2015).”
ResultSchneider, B. C., Veckenstedt, R., Karamatskos, E., Ahlf-Schumacher, J., Gehlenborg, J., Schultz, J., Moritz, S., & Jelinek, L. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.10.118 · Cited by 20
Rosenbaum, D., Int-Veen, I., Laicher, H., Woloszyn, L., Wiegand, A., Ladegast, S., Eßer, U., Kroczek, A., Sippel, D., Menkor, S., et al. (2024) · Neurobiology of Stress · doi:10.1016/j.ynstr.2024.100640 · Cited by 14
Zawadzki, M. J., Sliwinski, M. J., & Smyth, J. M. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay009 · Cited by 14
“For example, for participants with generalized anxiety disorder and/or major depressive disorder, engaging in rumination after a stressful event explained the relationship between the stressful event and poorer affect, more mood disorder symptoms, and greater anxiety in a subsequent measure [25].”
BackgroundHummel, K. V., Trautmann, S., Venz, J., Thomas, S., & Schäfer, J. (2021) · BMC Psychology · doi:10.1186/s40359-021-00696-2 · Cited by 12
Humor Styles Moderate the Relationship Between Rumination and Mental Health in Community Residents
Chuang, S. P., Wu, J. Y., & Wang, C. S. (2021) · SAGE Open · doi:10.1177/21582440211054477 · Cited by 13
“, 2012), especially in the clinical population (Hanssen et al., 2018; Ruscio et al., 2015).”
BackgroundRumination and Overrecruitment of Cognitive Control Circuits in Depression
Park, H., Kuplicki, R., Paulus, M. P., & Guinjoan, S. M. (2024) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2024.04.013 · Cited by 13
Yaroslavsky, I., Napolitano, S. C., & France, C. M. (2019) · Journal of Clinical Psychology · doi:10.1002/jclp.22839 · Cited by 12
Zuo, B., Wang, Q., Qiao, Y., Ding, Y., & Wen, F. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.600533 · Cited by 13
Zhao, S., Ren, R., & Chen, W. (2023) · Scientific Reports · doi:10.1038/s41598-023-28626-9 · Cited by 14
Gepty, A. A., Lambert, S. F., & Ialongo, N. S. (2023) · Journal of Youth and Adolescence · doi:10.1007/s10964-023-01805-7 · Cited by 11
“For example, rumination has been found to be link between stress and depression among adolescents (Ruscio et al., 2015).”
BackgroundWebb, C. A., Hilt, L. M., Swords, C. M., Bolt, D. M., Fisher, H., & Goldberg, S. B. (2025) · Journal of Medical Internet Research · doi:10.2196/69297 · Cited by 13
“These items were also created in line with previous research [71,72].”
The ecological validity of trait-level rumination measures among women with binge eating symptoms
Smith, K. E., Schaumberg, K., Reilly, E. E., Anderson, L. M., Schaefer, L. M., Dvorak, R. D., Crosby, R. D., & Wonderlich, S. A. (2020) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-019-00838-x · Cited by 12
Briki, W., & Dagot, L. (2020) · Current Psychology · doi:10.1007/s12144-020-00652-0 · Cited by 11
Rogers, M. L., Law, K. C., Lawrence, O. C., & Mandel, A. A. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104524 · Cited by 10
Brain Mechanisms of Rumination and Negative Self-Referential Processing in Adolescent Depression
Murray, L., Jaffe, N. M., Tierney, A. O., Pidvirny, K., Balkind, E. G., Abbasi, B., Brown, M., & Webb, C. A. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.114 · Cited by 15
Gepty, A. A., Hamilton, J. L., Abramson, L. Y., & Alloy, L. B. (2019) · Journal of Youth and Adolescence · doi:10.1007/s10964-019-01150-8 · Cited by 11
Qian, S., Lim, V. K. G., & Gao, Y. (2022) · Career Development International · doi:10.1108/cdi-11-2021-0280 · Cited by 12
Remote Monitoring for Understanding Mechanisms and Prediction in Psychiatry
Gillett, G., & Saunders, K. (2019) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-019-00176-3 · Cited by 12
Schricker, I. F., Nayman, S., Reinhard, I., & Kuehner, C. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.09.001 · Cited by 12
Exploring personalized psychotherapy for depression: A system dynamics approach
Wittenborn, A. K., & Hosseinichimeh, N. (2022) · PLOS ONE · doi:10.1371/journal.pone.0276441 · Cited by 9
Within Your Control? When Problem Solving May Be Most Helpful
Sarfan, L. D., Gooch, P., & Clerkin, E. M. (2018) · Behavior Modification · doi:10.1177/0145445517726300 · Cited by 7
“Given the important role that rumination is thought to play in maintaining psychopathology such as depression (e.g., Nolen-Hoeksema et al., 2008) and anxiety (Ruscio et al., 2015), the factors that buffer rumination’s maladaptiveness merit further exploration.”
BackgroundThe Effects of Worry and Relaxation on Flexibility During Cognitive Restructuring
Stevens, E. S., Jendrusina, A. A., Legrand, A. C., Nahin, E. R., Kaufman, M., Borkovec, T., & Behar, E. (2018) · Behavior Modification · doi:10.1177/0145445517732272 · Cited by 4
“Cognitive models of worry (e.g., Hirsch & Mathews, 2012) conceptualize cognitive inflexibility in worry as being due in part to information processing biases and in part to difficulty shifting attention away from worry content.”
BackgroundInfluentialAffective flexibility and generalized anxiety disorder: valence-specific shifting difficulties
Wen, A., LeMoult, J., McCabe, R. E., & Yoon, K. L. (2019) · Anxiety Stress & Coping · doi:10.1080/10615806.2019.1638684 · Cited by 10
“Hence, difficulty switching from the emotional aspect of negative information is related to a tendency to engage in rumination that is prevalent in GAD (e.g., McLaughlin & Nolen-Hoeksema, 2011; Ruscio et al., 2015).”
BackgroundHouben, M., Kalokerinos, E. K., Koval, P., Erbaş, Y., Mitchell, J., Pe, M. L., & Kuppens, P. (2023) · Clinical Psychological Science · doi:10.1177/21677026231203662 · Cited by 11
“Ruscio et al. (2015) found that people with depression reported higher levels of rumination after the occurrence of an event in daily life, which was related to a stronger subsequent increase in NE. Pasyugina et al. (2015) showed that average level of rumination but not the impact of rumination use…”
Funk, J., Takano, K., Babl, M., Goldstein, R., Oberwestersberger, R., Kopf‐Beck, J., Rohleder, N., & Ehring, T. W. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104547 · Cited by 8
“…momentary levels of RNT and negative affect was found to be stronger in individuals with heightened depressive symptoms (Moberly & Watkins, 2008; Ruscio et al., 2015), lending further support for RST. Additionally, a strong bi-directional relationship between RNT and negative affect was shown…”
Metadata
- Authors
- Ruscio, A. M., Gentes, E. L., Jones, J. D., Hallion, L. S., Coleman, E. S., & Swendsen, J.
- Affiliations
- University of Pennsylvania (US)
- Université de Bordeaux (FR)
- Venue
- Journal of Abnormal Psychology
- Published
- 2015-02
- Volume
- 124
- Issue
- 1
- Pages
- 17-26
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- PMC
- PMC4332541
- OpenAlex
- W2137352759
- Cited by
- 228
- References
- 55
- Citations by year
- 2026: 12 · 2025: 29 · 2024: 20 · 2023: 37 · 2022: 20 · 2021: 26 · 2020: 24 · 2019: 17 · 2018: 14 · 2017: 17 · 2016: 9 · 2015: 3
- FWCI
- 21.59
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Sponsor name not included (K01 MH076162, R01 MH094425)
- University Research Foundation
- 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 › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Keywords
- rumination, stress sensitivity, major depressive disorder, generalized anxiety disorder, comorbidities, life events, affect, maladaptive behavior, mediation
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Life Change Events, Male, Middle Aged, Psychiatric Status Rating Scales, Stress, Psychological, Thinking, Young Adult
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