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Cognitive Therapy and Research, Vol. 27, No. 3, June 2003 ( C 2003), pp. 243–245

Rumination and Depression: Advancesin Theory and Research

Costas Papageorgiou 1,2,4 and Greg J. Siegle 3

The tendency to engage in repetitive negative thinking, in the form of rumina-tion, has attracted considerable empirical interest from researchers working in theeld of depression. The recognition of rumination as a key cognitive characteristic of dysphoria and depression (Ingram, 1984; Martin & Tesser, 1989; Nolen-Hoeksema,1987; Teasdale & Barnard, 1993; Wells & Matthews, 1994) has motivated this re-search along with its resemblance to other maladaptive styles of thinking such asworry (Molina, Borkovec, Peasley, & Person, 1998; Papageorgiou & Wells, 1999a,1999b; Segerstrom, Tsao, Alden, & Craske, 2000). Rumination has also been as-sociated with numerous deleterious outcomes linked to depression including pro-longed and more severe negative affect and depressive symptoms, negatively biasedthinking, poor problem solving, impaired motivation and inhibition of instrumen-

tal behavior, impaired concentration and cognition, and increased stress/problems(Lyubomirsky & Tkach,2003) as well as preliminary data suggesting a link to delayedrecovery from major depressive disorder in cognitive–behavioral therapy (Siegle,Sagratti, & Crawford, 1999). Thus, further knowledge of ruminative thinking has thepotential to aid our understanding of mechanisms of depression as well as aspects of itsonset,maintenance, andrecurrence or relapse. Thispotentialhas ledto thecurrentspecial issue of Cognitive Therapy and Research on rumination and depression.

A number of other factors make the topic particularly timely. A search of ar-ticles in the PsychInfo database suggests that interest in depressive rumination isincreasing. Eighty-eight publications with “rumination” in the title (i.e., referring tocognitive rumination and not a regurgitation disorder) appeared in or after 1984;

these increased almost linearly over the past 17 years, r = . 88, p < . 0005. These pub-lications have appeared not only in journals associated with clinical psychology butalso in outlets for a variety of other subdisciplines of psychology. For example, a

1University of Manchester, Manchester, United Kingdom.2Department of Clinical Psychology, Manchester Mental Health and Social Care Trust, Manchester,United Kingdom.

3Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh,Pennsylvania.

4Correspondence should be directed to Costas Papageorgiou, Institute for Health Research, AlexandraSquare, Lancaster University, Lancaster LA1 4YT, United Kingdom; e-mail: [email protected].

2430147-5916/03/0600-0243/0 C 2003 Plenum Publishing Corporation

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244 Papageorgiou and Siegle

number of social psychologists have been interested in rumination in contrast tomore interpersonal ways of dealing with stressful situations (e.g., Philippot & Rime,1998). Health psychologists have been interested in the link between ruminationand specic negative health consequences such as increased time to recovery from

coronary incidents (Fritz, 1999). As might be expected, these perspectives have leadto a considerable variety of methods for dening, eliciting, and assessing ruminationin depression.

This special issue, therefore, highlights a broad spectrum of recent trends in ru-mination research, as they apply to understanding depression, in hopes of stimulatingfurther research on this topic and providing an entry-point for integrating the eld’sdiverse perspectives. The included papers employ a variety of orientations towardsthe nature of depressive rumination, ranging from Thayer et al.’s fairly broad notionof rumination as persistent thinking, to Rodriguez et al.’s decomposition of subdi-mensions of symptom-focused rumination. They also take advantage of a varietyof approaches to measuring rumination, ranging from self-report to physiologicalassessment, and experimental designs from Robinson and Alloy’s prospective studyto Vickers and Vogeltanz-Holm’s use of a laboratory-based rumination inductionprocedure.

Each contribution’s unique approach to examining the intimate relationshipbetween ruminative processing and depression thus leads to conclusions that varyfrom intuitions about the mechanisms and time-course of rumination to its conse-quences for depression. Three papers examine the nature of depressive rumination.Treynor, Gonzolez, and Nolen-Hoeksema consider subdimensions of rumination.Papageorgiou and Wells outline a clinical metacognitive model of rumination anddepression and present empirical evidence supporting the model. Thayer and col-

leagues use data supporting gender differences in rumination to promote a model of its potential neurobiological substrates. Three papers examine cognitive and physi-ological correlates of depressive rumination. Lyubomirsky, Kasri, and Zehm reportevidence in support of thenotionthat dysphoric rumination impairs concentration onacademic tasks. Siegle, Steinhauer, Carter, and Thase examine relationships betweenrumination and sustained pupil dilation, a correlate of cognitive load, in response toemotional information in depression. Vickers and Vogeltanz-Holm describe othercognitive and physiological correlates of rumination induction. The nal two papersprospectively examine relationships between rumination and depressive symptoma-tology. Robinson andAlloy reporta prospective study showing that the interaction of negative cognitive styles and stress-reactive rumination predict depression. Wenzlaff and Luxton report a study providing a longitudinal test of the prediction that thecombination of thought suppression and stress can promote depressive rumination.

Taken together, these papers suggest as much conuence as divergence in theeld. Multiple types of measurement and designs converge on an idea of rumina-tion as a broadly inuential process tied longitudinally and cross-sectionally to bothgross and subtle aspects of depression. Rumination is placed squarely at the heart of cognitive, metacognitive, and physiological aspects of depression.

In the short-term, the papers in this special issue have the potential to en-courage more precise measurement and better specication of the constructs cur-rently referred to broadly as rumination, to assist in understanding how rumination

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Rumination and Depression 245

is prospectively related to aspects of depression, and to create a better picture of cognitive and physiological consequences of rumination for depressed and nonde-pressed individuals. In the longer-term, these insights could lead to interventions fordepression that specically target rumination and its substrates as well as a better

understanding of the extent to which there are cognitive subtypes of depression. Itis our hope and belief that the papers in this special issue can serve as a springboardfor such bold advances in the conceptualisation and treatment of depression in thenear future.

ACKNOWLEDGMENTS

We thank Rick Ingram for his help and support in preparing this special issue.We are also grateful to all of the reviewers of the special issue for their timely andhighly constructive comments. Thanks to Katy Gleditsch for help in preparation of this introduction.

REFERENCES

Fritz, H. L. (1999). The role of rumination in adjustment to a rst coronary event . Unpublished doctoraldissertation, Carnegie Mellon University, Pittsburgh, PA.

Ingram, R. E. (1984). Toward an information-processing analysis of depression. Cognitive Therapy andResearch , 8, 443–478.

Lyubomirsky, S., & Tkach, C. (2003). The consequences of dysphoric rumination. In C. Papageorgiou &A. Wells (Eds.), Depressive rumination: Nature, theory, and treatment . Chichester, UK: Wiley.

Martin, L. L., & Tesser, A. (1989). Toward a motivational and structural theory of ruminative thought. InJ. S. Uleman & J. A. Bargh (Eds.), Unintended thought (pp. 306–326). New York: Guilford Press.

Molina, S., Borkovec, T. D., Peasley, C., & Person, D. (1998). Content analysis of worrisome streams of thought in anxious and dysphoric participants. Cognitive Therapy and Research , 22, 109–123.

Nolen-Hoeksema, S. (1987). Sex differences in unipolar depression: Evidence and theory. Psychological Bulletin , 101, 259–282.

Papageorgiou, C., & Wells, A. (1999a). Process and meta-cognitive dimensions of depressive and anxiousthoughts and relationships with emotional intensity. Clinical Psychology and Psychotherapy , 6, 156–162.

Papageorgiou, C., & Wells, A. (1999b, November). Dimensions of depressive rumination and anxiousworry: A comparative study . Paper presented at the 33rd Annual Convention of the Association forAdvancement of Behavior Therapy, Toronto, Canada.

Philippot, P., & Rime, B. (1998). Social and cognitive processing in emotion: A heuristic for psychopathol-ogy. In W. F. Flack & J. D. Laird (Eds.), Emotions in Psychopathology (pp. 114–130). New York:Oxford University Press.

Segerstrom, S. C., Tsao, J. C. I., Alden, L. E., & Craske, M. G. (2000). Worry and rumination: Repetitivethought as a concomitant and predictor of negative mood. Cognitive Therapy and Research , 24,671–688.

Siegle, G. J., Sagrati, S., & Crawford, C. E. (1999, November). Effects of rumination and initial severity onresponse to cognitive therapy for depression. Paper presented at the 33rd annual Convention of theAssociation for Advancement of Behavior Therapy, Toronto, Canada.

Teasdale, J. D., & Barnard, P. J. (1993). Affect, cognition and change: Re-modelling depressive thought .Hove, UK: Erlbaum.

Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective . Hove, UK: Erlbaum.

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