Group rumination-focused cognitive-behavioural therapy (CBT) <i>v.</i> group CBT for depression: phase II trial

Hvenegaard, Morten; Møeller, Stine Bjerrum; Poulsen, Stig; Gondan, Matthias; Grafton, Ben; Austin, Stephen F.; Kistrup, Morten; Rosenberg, Nicole Gremaud; Howard, Henriette; Watkins, Edward

doi:10.1017/s0033291718003835

Cited by 73 publications

(38 citation statements)

References 36 publications

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“…However, the indirect effects in the structural equation model showed that that kind of rumination, when used to think and talk about past events, can have a positive mood-enhancement effect. Although previous research has shown that concrete rumination can be used to reduce depression [43], the current results suggest that abstract rumination may be used to gain insight about experiences needed for planning for present and future behaviors (directive function) and communication/sharing with others (social function). However, these results must be taken with caution as participants in the current study were not drawn from a clinical population and so may differ in the contents and duration of rumination as compared to clinical groups.…”

Section: Plos Onecontrasting

confidence: 73%

Ruminative and mood associations for age differences in social and directive reasons to think and talk about life experiences

et al. 2020

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Reminiscing, or thinking and talking about our past experiences, can have mood enhancing effects. Rumination is implicated in reminiscence and yet has been shown to have negative effects on mood, with important differences between age groups. However, age differences in the effects of reminiscing on mood, and particularly the effects of rumination within reminiscence, are less explored. Two different age groups completed self-report measures of the positive directive (planning for present and future behaviors) and social (communication) uses of autobiographical memory, as well as maladaptive rumination and depression symptom severity. Young participants (Mean age: 21.82) ruminated more and reported greater frequency of using the directive and social functions of thinking and talking about past experiences than older adults (Mean age: 71.82). These reminiscence processes were also differentially associated with depression symptoms between age groups when tested in structural equation models. In older participants, but not young participants, the directive function was negatively associated with depression severity; in young participants, but not old participants, the social function was negatively associated with depression severity. Furthermore, although depressive and abstract rumination was directly positively related to depression scores in both samples, this association was inverted when the effect of rumination on depression was calculated through functions of reminiscence. The implications of these results for intervention development in older versus young adults, is discussed.

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Section: Plos Onecontrasting

confidence: 73%

Ruminative and mood associations for age differences in social and directive reasons to think and talk about life experiences

et al. 2020

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“…Unfortunately, it is unclear whether existing interventions can successfully improve rumination (Watkins, 2015). A recently developed intervention, Rumination‐Focused Cognitive Behavioral Therapy (RFCBT), showed its efficacy for depressive patients but requires twelve sessions to complete (Hvenegaard et al, 2020; Watkins et al, 2011). CBT requires patients to be conscious of their maladaptive ruminative thinking, so then they will be able to learn how to control it.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it may be useful to visualize one's internal state of mind outside of one's awareness and to use that information to facilitate one's self‐control. Also, these studies investigating the efficacy of RFCBT (Hvenegaard et al, 2020; Watkins et al, 2011) were not designed to determine what aspect of RFCBT contributes to reducing ruminations. Thus, it is necessary to identify and determine any underlying brain dysfunctions related to rumination.…”

Section: Introductionmentioning

confidence: 99%

Prevent breaking bad: A proof of concept study of rebalancing the brain's rumination circuit with real‐time fMRI functional connectivity neurofeedback

Tsuchiyagaito

Misaki

Investigators

et al. 2020

Human Brain Mapping

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Rumination, repetitively thinking about the causes, consequences, and one's negative affect, has been considered as an important factor of depression. The intrusion of ruminative thoughts is not easily controlled, and it may be useful to visualize one's neural activity related to rumination and to use that information to facilitate one's self‐control. Real‐time fMRI neurofeedback (rtfMRI‐nf) enables one to see and regulate the fMRI signal from their own brain. This proof‐of concept study utilized connectivity‐based rtfMRI‐nf (cnf) to normalize brain functional connectivity (FC) associated with rumination. Healthy participants were instructed to brake or decrease FC between the precuneus and the right temporoparietal junction (rTPJ), associated with high levels of rumination, while engaging in a self‐referential task. The cnf group (n = 14) showed a linear decrease in the precuneus‐rTPJ FC across neurofeedback training (trend [112] = −0.180, 95% confidence interval [CI] −0.330 to −0.031, while the sham group (n = 14) showed a linear increase in the target FC (trend [112] = 0.151, 95% CI 0.017 to 0.299). Although the cnf group showed a greater reduction in state‐rumination compared to the sham group after neurofeedback training (p < .05), decoupled precuneus‐rTPJ FC did not predict attenuated state‐rumination. We did not find any significant aversive effects of rtfMRI‐nf in all study participants. These results suggest that cnf has the capacity to influence FC among precuneus and rTPJ of a ruminative brain circuit. This approach can be applied to mood and anxiety patients to determine the clinical benefits of reduction in maladaptive rumination.

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“…Rumination-focused cognitive behaviour therapy (RfCBT) was designed to teach patients how to interrupt the mental habit of rumination, and to shift into a more constructive style of thinking, characterized by more concrete and experiential processing. In clinical trials, RfCBT has been shown to reduce depression and prevent relapse in medication-refractory residual depression (Watkins et al, 2011) when added to anti-depressant medication, and in depressed patients relative to CBT (Hvenegaard et al, 2019). However, to date, RfCBT has not been investigated in patients who are currently experiencing a chronic episode of major depression, lasting longer than 1 year that has not responded to at least two trials of anti-depressant medication.…”

Section: Introductionmentioning

confidence: 99%

Rumination-focused cognitive behaviour therapy for non-responsive chronic depression: an uncontrolled group study

Møeller

Austin

Hvenegaard

et al. 2019

Behav. Cogn. Psychother.

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Background:One-third of patients with depression do not respond satisfactorily to treatment, and approximately 20% of all patients treated for depression develop a chronic depression. One approach to more effective treatment of chronic and treatment-resistant depression is to target rumination – an underlying mechanism implicated in the development and maintenance of depression.Aim:The purpose of this uncontrolled group study was to investigate the feasibility of individual rumination-focused cognitive behavioural therapy (RfCBT) for patients with chronic and treatment-resistant depression.Method:A total of 10 patients with chronic and treatment-resistant depression were offered 12–16 individual sessions of RfCBT. The primary outcome was depressive symptoms as measured by Hamilton Depression Scale at pre-, post- and 3-month follow-up. Secondary symptoms measured included self-reported rumination and worry.Results:There was a significant reduction in depressive symptoms (p < 0.05), rumination (p < 0.01) and worry (p < 0.5) from pre- to post-treatment. Half of the participants (n = 5) showed significant reliable change on levels of depressive symptoms post-treatment. The reduction in depressive symptoms, rumination and worry were maintained at follow-up.Conclusions:RfCBT was associated with significant reductions in depressive symptoms in a small sample with chronic and treatment-resistant depression. Despite limitations of being a small uncontrolled study with limited follow-up, these results are promising in a difficult to treat population. RfCBT warrants further systematic evaluation.

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Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial

Cited by 73 publications

References 36 publications

Ruminative and mood associations for age differences in social and directive reasons to think and talk about life experiences

Ruminative and mood associations for age differences in social and directive reasons to think and talk about life experiences

Prevent breaking bad: A proof of concept study of rebalancing the brain's rumination circuit with real‐time fMRI functional connectivity neurofeedback

Rumination-focused cognitive behaviour therapy for non-responsive chronic depression: an uncontrolled group study

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