Is there a relationship between depression and rumination?

Does depression have anything to do with the tendency to ruminate on the same thought?

¿Is there a relationship between depression and psychological rumination (the tendency to have recurrent thoughts that we can't get out of our heads)? (the tendency to have recurrent thoughts that we cannot get out of our heads)? Several studies have tried to reveal the answer to this question. In this article we bring you a theory that explains in detail the relationship between depression and a ruminative style, the Susan Nolen-Hoeksema theory.

In addition, we turn to a review that analyzes the conclusions of 59 functional neuroimaging studies, and we specify the results they reached on this issue.

Relationship between depression and rumination: the theory of Nolen-Hoeksema

If we look into the group of explanatory theories of depression, we find one of them that establishes a relationship between depression and rumination. This is the response style theory, proposed by Susan Nolen-Hoeksema (1959 - 2013) in 1991. (1959 - 2013) in 1991. Nolen-Hoeksema was an American professor of psychology at Yale University (United States).

Specifically, what Nolen-Hoeksema says in her theory of response styles is that there are certain factors that determine the course of depression; these factors have to do with the way in which the subject responds to the first symptoms of depression.. This response, also called "ruminative style", influences how long the depression lasts and how severe it is.

Thus, further specifying, the author explains that a ruminative response style in depression, maintains or exacerbates the symptoms of depression.

That is, according to this author, the relationship between depression and rumination is the following: the rumination of depressive symptoms chronifies depression, as well as exacerbating its symptoms on certain occasions.. The opposite occurs with an active style based on distraction or problem solving.

Ruminative response style

But, what is a ruminative response style? It consists of the mental process of focusing our attention on the symptoms of the disorder and their implications for us, without doing anything to alleviate these symptoms.

That is to say, it is a process from which coping strategies are not put in place; in simpler words, it is a matter of "thinking about" the symptoms of the disorder and their implications for us, without doing anything to alleviate them, it is a matter of "turning things over", without stopping to think about them, worrying about them, without occupying oneself with them.In simpler terms, it is a matter of "turning things over", worrying about them, without taking care of them or doing anything to change them. It would be like "going into a loop".

On the other hand, the author of the theory that postulates a relationship between depression and rumination, attributes the origin of the ruminative style to a childhood learning by modeling (through models, such as parents, who also display a ruminative style), coupled with socialization practices that do not provide the person with a repertoire of more adaptive behaviors necessary to cope with depression. Thus, these two factors would explain the origin of the ruminative style.

How does rumination influence depression?

S. Nolen-Hoeksema goes further with her theory to understand the relationship between depression and rumination, and proposes a series of mechanisms that would explain the negative effects of ruminative style in depression. What are these mechanisms? There are four of them:

1. vicious circles

The first mechanism that explains why a ruminative style in depression leads to negative effects for the person has to do with the vicious circles, which occur between the depressed mood and the negative cognitions..

Thus, we enter "in a loop" as follows: our mood is depressed, which affects our thinking with more negative cognitions; in turn, these cognitions increase the depressed mood (and both elements feed back on each other).

Failure to generate effective solutions

On the other hand, another mechanism that explains the relationship between depression and rumination is the decrease of effective solutions to everyday problems.

That is to say, we generate less effective solutions to problems (or even none at all), since instead of thinking about these solutions, we think about the problems (ruminative style)..

3. Interference

The fourth of the mechanisms that allow us to understand the relationship between depression and rumination is the following the interference that occurs with instrumental behaviors that would provide positive reinforcement and a sense of control.as well as a sense of control.

That is to say, the ruminative style hinders the appearance of these behaviors (or interferes with their functioning), as well as preventing the feeling of control necessary in depressive disorders and which would allow us to advance within the disorder.

4. Weakening of social support

Finally, there is a weakening of social support, which translates into rejection from the rejection by others, or even criticism of oneself..

This is logical to understand since, when our interpretation of reality and our coping mechanism in the face of life are based on a constant ruminative style, in the end the people around us get tired of these behaviors and move away, because they see that we do nothing to deal with depression (neither seek help, nor relativize things or give them the importance they deserve, nor recognize that we have a problem...).

Research and results

Following Susan Nolen-Hoeksema's theory, which suggests a relationship between depression and rumination, a series of experimental studies on ruminative responses were carried out. The results of these studies were as follows.

Type of attributions

People with a ruminative style make a higher number of negative and global attributions to everything that happens to them (i.e., causal attributions).

2. Accessibility to memories

Accessibility to negative memories in this type of person is greater than in people without a ruminative style.

3. Pessimism

There is a pessimism and a biased negative interpretation of realityThe accessibility of negative memories is greater in people with a ruminative style in the context of depression.

4. Poor interpersonal solutions

Finally, these people generate poorer and therefore less effective interpersonal solutions (e.g. in the face of a conflict with another person).

Scientific review: what does neuroscience have to say?

Beyond S. Nolen-Hoeksema's theory of ruminative style, we have turned, in order to understand a little more about the relationship between depression and rumination, to a scientific review conducted in 2016 by Rayner, Jackson and Wilson, who analyzed the findings of up to 59 functional neuroimaging studies in adults with unipolar depression..

This review also analyzes the relationship between the brain networks involved in cognitive processes during a depressive disorder and the symptoms of the disorder. Specifically, analyzes the relationship between the abnormal functioning of these brain structures and depressive symptoms..

Results

The results of this review indicate that there are two different neurocognitive networks, which can largely explain the symptoms of depression. These two networks are: the autobiographical memory network (AMN) and the cognitive control network (CCN).

Specifically, what was found through this review is that hyperactivity of the first network, the autobiographical memory network, is related to three types of symptoms in depressive patients: rumination, self-blame, and self-blame.The first network, the autobiographical memory network, is related to three types of symptoms in depressive patients: rumination, self-blame, and pathological parenting.

On the other hand, hypoactivation or abnormal functioning of the other network, the cognitive control network, was found to be related to the following symptoms in this type of patients: negative automatic thoughts (Aaron Beck's famous "PAN's"), cognitive distortions and low concentration.

In addition, it should be noted that the configuration of these networks can be modified over time in individuals; this is also related to an increasedThis is also related to a variation in depressive symptoms over time (i.e., a fluctuating course of depression).

Neurocognitive networks and depression

According to this review, we can say that depression, besides being a multifactorial disorder, where biological, social, psychological factors intervene... could also be framed as a disorder of neurocognitive networks, which links neurobiology with psychiatric practice.

This can be of great help to researchers, clinicians, psychologists, etc., and open a path from a neuroscience perspective, which will help us to understand and treat this and more mental disorders in the future.

Bibliographical references:

• American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.
• Belloch, A., Sandín, B. and Ramos, F. (2010). Manual de Psicopatología. Volume I and II. Madrid: McGraw-Hill.
• García Cruz, R, Valencia Ortiz, A.I., Hernández-Martínez, A. and Rocha Sánchez, T.E. (2017). Ruminative thinking and depression among college students: rethinking the impact of gender. Interamerican Journal of Psychology, 51(3): 406-416.
• Rayner, G., Jackson, G. & Wilson, S. (2016). Cognition-related brain networks underpin the symptoms of unipolar depression: Evidence from a systematic review. Neuroscience & Biobehavioral Reviews, 61: 53-65.