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Cognitive Therapy and Research

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01.06.2011 | Original Article

Rumination in Clinical Depression: A Type of Emotional Suppression?

verfasst von: Gabrielle I. Liverant, Barbara W. Kamholz, Denise M. Sloan, Timothy A. Brown

Erschienen in: Cognitive Therapy and Research | Ausgabe 3/2011

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Abstract

This study examined the relationship between rumination and the use of other emotion-regulation strategies in a depressed sample. Sixty outpatients diagnosed with unipolar depression completed questionnaires and participated in a sad mood induction. The mood induction was used to investigate the relationship between the use of rumination and each of two theoretically relevant emotion-regulation strategies—suppression and acceptance. Findings demonstrated that rumination was positively associated with other types of suppression and negatively related to acceptance. Results offer tentative support for the conceptualization of rumination as a maladaptive, cognitive emotion-regulation strategy utilized by depressed individuals in an attempt to suppress their experience of negative emotion. Findings also suggest a potential mechanism of action for efficacious mindfulness and acceptance-based treatments for depression.

The rates of anxiety disorder comorbidity in our sample (i.e., 83% of the sample had at least one comorbid anxiety disorder diagnosis) are consistent with published research demonstrating high rates of comorbidity between mood and anxiety disorder diagnoses in outpatient settings (e.g., Brown et al. 2001a). This suggests that the study sample is representative of individuals with unipolar depression, and findings from this study are generalizable to the wider population. Nonetheless, to examine the potential effects of anxiety disorder comorbidity on study findings, Independent samples t-tests were conducted to investigate the relation between the presence/absence of a comorbid anxiety disorder diagnosis and use of suppression (WBSI scores from the questionnaire packet and ERS-S scores during the mood induction), rumination (RSS scores from the questionnaire packet and SRQ scores during the mood induction), as well as self-reported negative affect (PANAS) and sadness (ERM ratings) during the mood induction. Results from all of these analyses were not significant, suggesting that the presence of a comorbid anxiety disorder did not contribute significantly to study findings.

A 4 (Time) × 2 (Film) mixed model ANOVA was conducted to investigate the effectiveness of the mood induction in eliciting sadness and to explore the presence of differential responding to the two film clips used as mood induction stimuli. ERM sadness ratings from four time points (baseline, anticipation, exposure, and recovery periods) were used in this analysis. Mauchly’s test of sphericity was conducted, and results demonstrated that the assumption of sphericity was not met. As a result, multivariate tests were interpreted, and the Greenhouse-Geisser correction was utilized to adjust degrees of freedom and assess statistical significance. Interpretation of multivariate tests found a significant effect for Time, F(3, 56) = 12.88, P < .001, η² = .41, and did not find a significant Time × Film interaction. Tests of within-subjects effects also demonstrated a significant effect for Time, F(2.61, 148.68) = 17.51, P < .001, η² = .24, while the interaction of Time × Experimental Group was again not significant. Inspection of estimated marginal means demonstrated that overall mean sadness remained relatively stable between the baseline (M = 39.00, SD = 3.94) and anticipation (M = 38.15, SD = 4.05) periods, increased during the exposure period (M = 54.47 SD = 3.81) and declined during the recovery period (M = 41.51, SD = 4.11). Consistent with previous validation studies, these results suggest that the mood induction stimuli used in this study effectively elicited the discrete emotion of sadness. In addition, the two films elicited similar intensities and patterns of sadness responding.

A Chi squared test was conducted to investigate the presence of gender differences between the two film assignments. Results of this test were not significant.

To examine whether rumination was related to suppression due to comorbid anxiety in the sample, we conducted a Pearson correlation to examine the relation between the DASS-Anxiety subscale and the use of suppression during the mood induction. The relationship between DASS-Anxiety subscale scores and use of suppression was not significant. In addition, we used partial correlation analysis to examine the relationship between use of rumination and suppression when controlling for DASS-Anxiety subscale scores. The results of this analysis were significant (r = .36, P < .006). Taken together, these findings suggest that comorbid anxiety did not explain the observed correlation between rumination and suppression.

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Titel: Rumination in Clinical Depression: A Type of Emotional Suppression?
verfasst von: Gabrielle I. Liverant
Barbara W. Kamholz
Denise M. Sloan
Timothy A. Brown
Publikationsdatum: 01.06.2011
Verlag: Springer US
Erschienen in: Cognitive Therapy and Research / Ausgabe 3/2011
Print ISSN: 0147-5916
Elektronische ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-010-9304-4

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