Brooding and reflection: rumination predicts suicidal ideation at 1-year follow-up in a community sample.

The cognitive processes underlying suicidal thinking and behavior are not well understood. The present study examined brooding and reflection, two dimensions of rumination, as predictors of suicidal ideation among a community sample of 1134 adults. Participants completed self-report measures of rumination and depression, and a semi-structured clinical interview that included an assessment of suicidal ideation, at baseline and 1-year follow-up. Brooding was more strongly related to degree of ideation at baseline than was reflection. However, both brooding and reflection predicted whether an individual thought about suicide at 1-year follow-up, even after adjusting for baseline suicidal ideation. Symptoms of depression mediated the relationship between brooding and ideation but not that between reflection and ideation. Implications for the nature of thought processes that result in suicidal thinking are discussed.

[1]  S. Nolen-Hoeksema,et al.  A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. , 1991, Journal of personality and social psychology.

[2]  E. Watkins,et al.  Distinct modes of ruminative self-focus: impact of abstract versus concrete rumination on problem solving in depression. , 2005, Emotion.

[3]  T. Joiner Why People Die by Suicide , 2005 .

[4]  S. Lyubomirsky,et al.  Effects of self-focused rumination on negative thinking and interpersonal problem solving. , 1995, Journal of personality and social psychology.

[5]  D. Fergusson,et al.  Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood , 2000, Psychological Medicine.

[6]  S. Nolen-Hoeksema,et al.  Rumination Reconsidered: A Psychometric Analysis , 2003, Cognitive Therapy and Research.

[7]  Cynthia L. Turk,et al.  Distinct and Overlapping Features of Rumination and Worry: The Relationship of Cognitive Production to Negative Affective States , 2002, Cognitive Therapy and Research.

[8]  A. Beck,et al.  Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. , 1997, Behaviour research and therapy.

[9]  R A Steer,et al.  Scale for Suicide Ideation: psychometric properties of a self-report version. , 1988, Journal of clinical psychology.

[10]  P. Lewinsohn,et al.  Psychosocial risk factors for future adolescent suicide attempts. , 1994, Journal of consulting and clinical psychology.

[11]  R. Brown,et al.  Rumination and executive function in depression: an experimental study , 2002, Journal of neurology, neurosurgery, and psychiatry.

[12]  L. Abramson,et al.  Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: multiple pathways to self-injurious thinking. , 2006, Suicide & life-threatening behavior.

[13]  S. Nolen-Hoeksema,et al.  Explaining the gender difference in depressive symptoms. , 1999, Journal of personality and social psychology.

[14]  A. Beck,et al.  Prediction of eventual suicide in psychiatric inpatients by clinical ratings of hopelessness. , 1989, Journal of consulting and clinical psychology.

[15]  Eric Stice,et al.  Reciprocal relations between rumination and bulimic, substance abuse, and depressive symptoms in female adolescents. , 2007, Journal of abnormal psychology.

[16]  R. N. Davis,et al.  Cognitive Inflexibility Among Ruminators and Nonruminators , 2000, Cognitive Therapy and Research.

[17]  S. Nolen-Hoeksema,et al.  The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. , 2000, Journal of abnormal psychology.

[18]  L. Abramson,et al.  Childhood maltreatment and college students' current suicidal ideation: a test of the hopelessness theory. , 2001, Suicide & life-threatening behavior.

[19]  C. Keyes,et al.  Women and Depression: A Handbook for the Social, Behavioral, and Biomedical Sciences , 2006 .

[20]  R A Steer,et al.  Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. , 2000, Journal of consulting and clinical psychology.

[21]  Kristopher J Preacher,et al.  SPSS and SAS procedures for estimating indirect effects in simple mediation models , 2004, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.

[22]  T. Ellis Cognition and suicide : Theory, research, and therapy , 2006 .

[23]  R. Harrington,et al.  Correlates and Short-Term Course of Self-Poisoning in Adolescents , 1996, British Journal of Psychiatry.

[24]  S. Nolen-Hoeksema Responses to depression and their effects on the duration of depressive episodes. , 1991, Journal of abnormal psychology.

[25]  E. Watkins,et al.  Rumination and social problem-solving in depression. , 2002, Behaviour research and therapy.

[26]  A. Beck Beyond belief A theory of modes, personality, and psychopathology , 1996 .

[27]  Z. Segal,et al.  Cognitive Vulnerability to Depression , 1998, Journal of Cognitive Psychotherapy.

[28]  S. Segerstrom,et al.  A multidimensional structure for repetitive thought: what's on your mind, and how, and how much? , 2003, Journal of personality and social psychology.

[29]  Matthew K Nock,et al.  Examination of affective, cognitive, and behavioral factors and suicide-related outcomes in children and young adolescents. , 2002, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[30]  E. Watkins,et al.  Adaptive and maladaptive ruminative self-focus during emotional processing. , 2004, Behaviour research and therapy.

[31]  L. Abramson,et al.  Suicidality and cognitive vulnerability to depression among college students: a prospective study. , 1998, Journal of adolescence.

[32]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[33]  D. Mackinnon,et al.  Estimating Mediated Effects in Prevention Studies , 1993 .

[34]  R. C. Fraley,et al.  Daily depression and cognitions about stress: evidence for a traitlike depressogenic cognitive style and the prediction of depressive symptoms in a prospective daily diary study. , 2005, Journal of personality and social psychology.

[35]  L. Abramson,et al.  Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression. , 2006, Journal of abnormal psychology.

[36]  Sussie Eshun Role of Gender and Rumination in Suicide Ideation: A Comparison of College Samples From Ghana and the United States , 2000 .

[37]  Paul M. Salkovskis,et al.  Frontiers of Cognitive Therapy , 1997 .

[38]  E. Watkins,et al.  Processing mode influences the relationship between trait rumination and emotional vulnerability. , 2006, Behavior therapy.

[39]  A. Beck,et al.  Problem solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation. , 2005, Journal of abnormal psychology.

[40]  S. Nolen-Hoeksema,et al.  Cognition and depression , 2006 .

[41]  A. Beck,et al.  Screening depressed patients in family practice. A rapid technic. , 1972, Postgraduate medicine.

[42]  C. Zlotnick,et al.  Affect regulation and suicide attempts in adolescent inpatients. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[43]  C. Beevers,et al.  Perfectionism, cognitive bias, and hopelessness as prospective predictors of suicidal ideation. , 2004, Suicide & life-threatening behavior.

[44]  Jutta Joormann,et al.  Adaptive and maladaptive components of rumination? Diagnostic specificity and relation to depressive biases. , 2006, Behavior therapy.