The Double-Edged Sword of Reflective Pondering: The Role of State and Trait Reflective Pondering in Predicting Depressive Symptoms Among Women With Breast Cancer

Abstract

Background and Purpose Prior research has debated whether reflective pondering is a more constructive form of rumination than brooding, which is generally considered maladaptive. This study sought to investigate whether reflective pondering predicts depressive symptoms and whether reflective pondering is adaptive under certain conditions. We predicted that the effectiveness of reflective pondering could depend on concurrent coping strategies and the trait–state distinction. Method Women with breast cancer (N = 309; M age = 47.5) were assessed at four waves over 2 years. A time-lagged design was applied, with rumination (i.e., brooding and reflective pondering) and coping (i.e., engagement and disengagement) measured from T1 to T3, predicting depressive symptoms assessed from T2 to T4. These variables were measured by the Ruminative Response Scale, the Brief COPE, and the Hospital Anxiety and Depression Scale. Results Using hierarchical linear modeling, brooding, but not reflective pondering, predicted elevated depressive symptoms at both between- and within-person levels. The relationship between reflective pondering and depression was moderated by the coping strategies. Individual differences in reflective pondering predicted worse depressive symptoms, but higher use of engagement coping mitigated the detrimental effect. Within individuals, the co-occurrence of reflective pondering and disengagement coping predicted a subsequent decrease in depressive symptoms. Conclusions The emerging role of reflective pondering in the face of breast cancer-related stress appears to be a double-edged sword. Its impact on depression may depend on concurrent coping strategies and whether reflective pondering is assessed at state and trait levels.

Greater Post-Surgical Pain Predicts Long-Term Depressed Affect in Breast Cancer Patients

“…Incongruent with findings from previous research, disengagement and engagement coping were not related to depressed affect at 5-year follow-up (Bonnaud-Antignac et al, 2017; Bright & Stanton, 2018; Kim et al, 2020; Kvillemo & Branstrom, 2014; Stanton et al, 2018; A. W. Wang et al, 2020).…”

“…Future longitudinal research should seek to explore whether the current relationships hold in more contemporary samples and after accounting for these additional covariates. Finally, upcoming work should consider using statistical methods that allow for the assessment of coping variability (i.e., latent class analysis; Kim et al, 2020) and/ or control for previous indices of coping to delineate the effect of state versus trait coping responses (A. W. Wang et al, 2020).…”

“…Still, classification of individual coping responses into higher-order categories of disengagement and engagement coping remains ambiguous, as many research groups have utilized different composites to reflect these constructs in various samples (Compas et al, 2006; Hoyt et al, 2014; Merluzzi et al, 2019; Nahlen Bose et al, 2015). Moreover, research investigating the influence of disengagement and engagement coping on physical and psychological symptoms among women with breast cancer has yielded mixed findings, especially with regard to the directionality and longitudinal nature of these effects (Bonnaud-Antignac et al, 2017; Langford et al, 2017; Merluzzi et al, 2019; A. W. Wang et al, 2020).…”

Psychometric Properties of the Chinese Version of the Brief State Rumination Inventory

“…It should be noted that it is useful to distinguish state rumination from trait rumination more precisely in Chinese with this tool and further explore the different functions and neural mechanisms of the two styles of rumination. Some researchers have found that state and trait rumination have different effects on stress and other diseases (17,(57)(58)(59). For instance, state and trait rumination contribute to depression in different ways (58).…”

“…Some researchers have found that state and trait rumination have different effects on stress and other diseases (17,(57)(58)(59). For instance, state and trait rumination contribute to depression in different ways (58). Another research study has shown that the interaction of trait and state rumination shapes the HPA-axis response to stress (59).…”