Construal level, rumination and psychological distress in palliative care

Abstract

Background Patients with a life-limiting illness, such as cancer, and their carers experience elevated psychological distress. However, the psychological mechanisms underpinning psychological distress in palliative care have been little studied. Recent theories predict that individuals who experience increased uncertainty in the contexdt of ongoing difficulties, such as palliative-care patients and their carers, will (a) think more abstractly; (b) ruminate more; and (c) be more distressed.

Methods Patients (n=36, 90% with cancer), their carers (n=29), and age-matched controls (n = 30) completed standardized questionnaires to assess anxiety, depression, and rumination, and open-ended interviews to identify their concerns and idiosyncratic levels of rumination. Concerns were analyzed linguistically for level of abstraction.

Results As predicted, (i) palliative patients and carers reported significantly more uncertainty, rumination, and abstract thinking than controls; (ii) uncertainty, abstractedness, and rumination were associated with psychological distress.

Conclusions Abstraction and rumination are psychological mechanisms potentially involved in increased psychological distress in palliative care.

Galfin, J. M., & Watkins, E. R. (2011). Construal level, rumination and psychological distress in palliative care. [Electronic version]. Psycho-Oncology.

Rumination, adolescents and depression

Kuyken, W., Watkins, E., Holden,E., & Cook, W. (2006). Rumination in adolescents at risk for depression. Journal of Affective Disorders, 96, 39-47.

Abstract

Background: Identifying high-risk adolescents and understanding first onset of depression in adolescence are important steps in reducing depression morbidity. There is compelling evidence that the personality dimension neuroticism is a risk factor for depression, but the vulnerability mechanism is not yet understood. This study examined the association between a hypothesized psychological vulnerability factor (rumination) and depression in adolescents.
Methods: A behavioural high-risk design differentiated a sample of 326 adolescents (aged 14–18) as either at normal or high risk for depression (operationalized as scores on a measure of neuroticism).
Results: Adolescents at risk for depression reported more rumination than adolescents not at risk. We hypothesized that the well established relationship between neuroticism and depression would be mediated by rumination in cross-sectional analyses, and our findings suggest that rumination partially mediated this relationship.
Conclusions: The findings tentatively suggest that neuroticism acts as a risk factor for adolescent onset depression through increased tendency towards brooding rumination (i.e. moody self-evaluative dwelling) in response to depressed mood. Prospective and experimental research examining this mechanism is required.