The DOI matches its Crossref record; 54 of the 55 references it cites were found in a registry or an index.
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]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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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]
In the citing paper
“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
Cites
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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).”
BackgroundResultInfluentialNolen-Hoeksema, S., & Morrow, J. (1991) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.61.1.115 · Cited by 3,276 · cited 2×
“…around the time of a stressor report higher levels of depressive symptoms over the following weeks and months, even after accounting for pre-stressor levels of depressive symptoms (NolenHoeksema, McBride, & Larson, 1997; Nolen-Hoeksema & Morrow, 1991; NolenHoeksema, Parker, & Larson, 1994).”
BackgroundMethodThe role of rumination in depressive disorders and mixed anxiety/depressive symptoms.
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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.”
BackgroundResultConstructive and unconstructive repetitive thought
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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
Liu, D. Y., & Thompson, R. J. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.07.004 · Cited by 220
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…”
Background
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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