Thought Suppression, Depressive Rumination and Depression: A Mediation Analysis
Szasz, Paul Lucian, Journal of Evidence-Based Psychotherapies
The present study is an investigation of the relationship between depressive rumination and thought suppression in predicting clinical depression. While there is significant amount of data supporting their role in depression, no attempts have been made so far to study the relationship between these two types of mental control strategies and emotion regulation in clinical depression. Depressed patients completed a battery of questionnaires including measures of thought suppression, depressive rumination, and depressive symptoms. Results show that both thought suppression and depressive rumination are related to depression, and that the impact of thought suppression on depression is completely mediated by depressive rumination (as an ironic effect of thought suppression). The roles of thought suppression and depressive rumination in depression, potential mechanisms and implications are discussed.
Keywords: depressive rumination, thought suppression, depression
Depressed people often put much more effort that their non-depressed counterparts in trying to cognitively regulate their emotions in order to achieve a positive desired mental state. However, they often fail, and engage in counterproductive mental control strategies such as depressive rumination (Nolen-Hoeksema, 1991, 1998, 2000) and chronic thought suppression (Wenzlaff & Bates, 1998; Wegner & Zanakos, 1994). According to Response Style Theory (Nolen-Hoeksema, 1991), rumination is a process whereby one turns one's attention to the causes and consequences of depressive symptoms. In their studies Nolen-Hoeksema and her colleagues revealed that rumination in the context of depressed moods prolongs and exacerbates depressive symptoms (Marrow & Nolen-Hoeksema, 1990). Longitudinal studies of naturally occurring depressed moods also show that people who respond to these moods with rumination manifest longer periods of depressed mood (Nolen-Hoeksema & Morow, 1991; Nolen-Hoeksema, Morrow, & Frederickson, 1993).
A longitudinal community-based study of over 1,100 adults showed that those who exhibited clinical depression and a ruminative thinking style at the initial assessment had relatively more severe and longer lasting depressive symptoms after the first year, were lees likely to show remission of their depression, and more likely to have symptoms of anxiety (Lyubomirsky & Tkach, 2003; Nolen-Hoeksema, 2000; Nolen-Hoeksema et al., 1999) In laboratory studies it has been found that among dysphoric individuals, a ruminative task leads to persistence of depressive mood, whereas a distracting task leads to decreases in such mood (Lyubomirsky & Nolen-Hoeksema, 1993, 1995; Nolen- Hoeksema & Morrow, 1993). Recent studies have extended these findings to clinical depression (Just & Alloy, 1997; Nolen-Hoeksema, 2000; Raes et al., 2006). Rumination also predicts elevated levels of depressive symptoms (Just & Alloy, 1997) and episodes of major depression (Kuehner & Weber, 1999). Kuehner & Weber (1999) showed that among unipolar depressed inpatients, those who had a ruminative style had higher levels of depression and were more inclined to still show signs of a major depressive episode at four months after discharge. It has also been found for the interaction between rumination and negative cognition, that the tendency to ruminate in response to stressful life events was more strongly predictive of future episodes of major and hopeless depression among individuals who reported high levels of negative thought content than among individuals who reported low levels (Robinson & Alloy, 2003). Compared to depressed people induced to distract, or nondepressed people who either ruminate or distract, depressed people when induced to ruminate generate more negative memories from the past (Lyubomirsky, Caldwell, & Nolen-Hoeksema, 1998), are more negative in their evaluations of current situations (Lyubomirsky & Nolen-Hoeksema, 1995), and are more pessimistic in their expectations for the future (Lyubomirsky & Nolen-Hoeksema, 1995). …