The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review

Rood, Lea; Roelofs, Jeffrey; Bögels, Susan M.; Nolen–Hoeksema, Susan; Schouten, E.G.

doi:10.1016/j.cpr.2009.07.001

Cited by 300 publications

(273 citation statements)

References 82 publications

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“…In turn, evidence suggests that when these challenges are coupled with girls' tendencies to dwell on their emotions, girls are more likely to experience depressive episodes (Hilt et al 2010, Nolen-Hoeksema 1994, Nolen-Hoeksema & Girgus 1994. Supporting these findings, a meta-analysis indicated that girls were more likely to ruminate than boys, and, in turn, rumination predicted more depressive symptoms over time among both children and adolescents (Rood et al 2009). …”

Section: Emergence Of Gender Differences In Depression In Early Adolesupporting

confidence: 55%

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Thinking About Rumination: The Scholarly Contributions and Intellectual Legacy of Susan Nolen-Hoeksema

Lyubomirsky

Layous

Chancellor

et al. 2015

Annu. Rev. Clin. Psychol.

147

106

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Our article reviews and celebrates Susan Nolen-Hoeksema's remarkable contributions to psychological and clinical science, focusing on her vast body of theoretical and empirical work and her influence on colleagues and students. Susan spent her career trying to understand how and why a style of regulating emotions called rumination increases vulnerability to depression and exacerbates and perpetuates negative moods. More broadly, we describe research by Susan and her colleagues on the predictors of depression in childhood and adolescence; gender differences in depression and rumination in adolescence and adulthood; roots, correlates, and adverse consequences of ruminative response styles; and rumination as a transdiagnostic risk factor for not only depression but also a host of psychological disorders, including anxiety, substance abuse, and eating disorders. Susan's intellectual legacy is evident in her impressive publication and citation record, the clinical applications of her work, and the flourishing careers of the students she mentored.

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Section: Emergence Of Gender Differences In Depression In Early Adolesupporting

confidence: 55%

“…Indeed, as previously mentioned, rumination similarly predicts depression among males and females (Rood et al 2009). Accordingly, much of Susan's work later in her career focused on the harmful effects of rumination among both men and women across a wide range of outcomes.…”

Section: Wwwannualreviewsorg • Contributions and Legacy Of Susan Nomentioning

confidence: 51%

Thinking About Rumination: The Scholarly Contributions and Intellectual Legacy of Susan Nolen-Hoeksema

Lyubomirsky

Layous

Chancellor

et al. 2015

Annu. Rev. Clin. Psychol.

147

106

View full text Add to dashboard Cite

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“…Rumination is a potential cognitive vulnerability factor for depressive symptoms among adolescents. 56 High rumination predicts onset of depressive disorder in healthy adolescents. 27,57 Preliminary data from the previous ADAPT RCT suggested that CBT may reduce rumination.…”

Section: Ruminative Responses Scalementioning

confidence: 99%

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

Goodyer

Reynolds

Barrett

et al. 2017

Health Technol Assess

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BackgroundAlthough there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years.ObjectiveTo determine whether or not either of two specialist psychological treatments, cognitive–behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment.DesignObserver-blind, parallel-group, pragmatic superiority randomised controlled trial.SettingA total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London.ParticipantsAdolescents aged 11–17 years withDiagnostic and Statistical Manual of Mental Disorders-Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses.InterventionsIn total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up.Main outcome measuresMean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation.ResultsThere were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up = –0.578, 95% confidence interval (CI) –2.948 to 4.104;p = 0.748]. There were no superiority effects for the two specialist treatments (CBT + STPP) compared with BPI (treatment effect by final follow-up = –1.898, 95% CI –4.922 to 1.126;p = 0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49–52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome.ConclusionsThe three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings.LimitationsNeither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data.Trial registrationCurrent Controlled Trials ISRCTN83033550.FundingThis project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit toThe Lancet.

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“…38 Several explanations for this MDDreducing effect have been proposed: (1) Engaging in activities may distract from ruminating over negative events, and ruminations may worsen or prolong depression. 39,40 (2) A substantial part of MVPA in children consists of play or sports activities, 41 and playing or engaging in sports may bolster self-efficacy and selfesteem in children, which has been suggested to prevent depression. 42,43 (3) Finally, when children are physically active, they tend to be with other children.…”

Section: Mvpa Predicts Fewer Depressive Symptomsmentioning

confidence: 99%

Physical Activity, Sedentary Behavior, and Symptoms of Major Depression in Middle Childhood

2017

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The prospective relation between physical activity and Diagnostic and Statistical Manual of Mental Disorders-defined major depression in middle childhood is unknown, as is the stability of depression. We therefore aimed to (1) determine whether there are reciprocal relations between moderate-to-vigorous physical activity (MVPA) and sedentary behavior, on one hand, and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition defined symptoms of major depressive disorder, on the other and (2) assess the extent of stability in depressive symptoms from age 6 to 10 years. METHODS:A community sample of children living in Trondheim, Norway, comprising a total of 795 6-year-old children was followed up at 8 (n = 699) and 10 (n = 702) years of age. Physical activity was recorded by accelerometry and symptoms of major depression were measured through semistructured clinical interviews of parents and children. Bidirectional relationships between MVPA, sedentary activity, and symptoms of depression were analyzed through autoregressive cross-lagged models, and adjusted for symptoms of comorbid psychiatric disorders and BMI.RESULTS: At both age 6 and 8 years, higher MVPA predicted fewer symptoms of major depressive disorders 2 years later. Sedentary behavior did not predict depression, and depression predicted neither MVPA nor sedentary activity. The number of symptoms of major depression declined from ages 6 to 8 years and evidenced modest continuity.CONCLUSIONS: MVPA predicts fewer symptoms of major depression in middle childhood, and increasing MVPA may serve as a complementary method to prevent and treat childhood depression.

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The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review

Cited by 300 publications

References 82 publications

Thinking About Rumination: The Scholarly Contributions and Intellectual Legacy of Susan Nolen-Hoeksema

Thinking About Rumination: The Scholarly Contributions and Intellectual Legacy of Susan Nolen-Hoeksema

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

Physical Activity, Sedentary Behavior, and Symptoms of Major Depression in Middle Childhood

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