Introduction
Study 1: Scale construction and preliminary factor analysis
Method
Participants and procedure
Measures
Demographic and clinical characteristics
The Multidimensional Rumination in Illness Scale (MRIS)
Data analysis
Results
Descriptive statistics
Variable |
n
|
M/% (SD) | Range |
---|---|---|---|
Demographic factors
| |||
Gender (%) | |||
Male | 34 | 18.4 | – |
Female | 151 | 82.8 | – |
Age range, in years (%) | |||
18–20 | 63 | 34.1 | – |
21–30 | 38 | 20.5 | – |
31–40 | 20 | 10.8 | – |
41–50 | 22 | 11.9 | – |
51–60 | 26 | 14.1 | – |
61 and over | 16 | 8.6 | – |
Education (%) | |||
High school | 19 | 10.3 | – |
Technical college | 19 | 10.3 | – |
Undergraduate studies | 95 | 51.4 | – |
Postgraduate studies | 52 | 28.1 | – |
Location (%) | |||
Australia | 102 | 55.1 | – |
Canada | 4 | 2.2 | – |
Finland | 1 | .5 | – |
France | 1 | .5 | – |
Spain | 1 | .5 | – |
United Kingdom | 12 | 6.5 | – |
United States | 64 | 34.6 | – |
Targeted condition (%) | |||
Allergy | 17 | 9.2 | – |
Arthritis | 9 | 4.9 | – |
Autoimmune disease | 16 | 8.6 | – |
Cancer | 9 | 4.9 | – |
Cardiovascular disease | 6 | 3.2 | – |
Chronic pain condition | 4 | 2.2 | – |
Ear disorder | 4 | 2.2 | – |
Endocrine disease | 15 | 8.1 | |
Eye disorder | 3 | 1.6 | – |
Gastrointestinal disease | 15 | 8.1 | – |
Genitourinary disease | 4 | 2.2 | – |
Haematological disorder | 8 | 3.8 | – |
Infectious disease | 3 | 1.6 | – |
Spinal/neck condition | 2 | 1.1 | – |
Musculo-skeletal disorder | 11 | 5.9 | – |
Neurological disorder | 18 | 9.7 | – |
Respiratory disease | 25 | 13.5 | – |
Skin disorder | 17 | 9.2 | – |
Comorbidities | |||
No. of physical conditions | 185 | 2.82 (3.56) | 1–20 |
No. of psychological disorders | 185 | .45 (.77) | 1–3 |
Psychological disorders (%) | |||
None | 128 | 69.2 | – |
Adjustment disorder | 2 | 1.1 | – |
Anxiety | 26 | 14.1 | – |
Depression | 23 | 12.4 | – |
Eating disorder | 1 | .5 | – |
Health anxiety | 3 | 1.6 | – |
Panic disorder | 3 | 1.6 | – |
Phobia | 2 | 1.1 | – |
Post-traumatic stress | 2 | 1.1 | – |
Rumination | |||
Total MRIS score | 185 | 71.58 (39.55) | 0–191 |
Instrumentality | 185 | 11.95 (6.69) | 0–32 |
Intrusion | 185 | 8.82 (8.47) | 0–33 |
Preventability | 185 | 4.41 (3.87) | 0–16 |
Brooding | 185 | 11.98 (7.49) | 0–36 |
Principal axis factor analysis (PFA)
Item | Factor 1 | Factor 2 | Factor 3 | Factor 4 |
---|---|---|---|---|
intrusion | instrumentality | preventability | brooding | |
Once I start thinking about my illness, I find it hard to think of other things | .86 | – | – | – |
It often requires a real effort to stop myself thinking about my illness | .86 | – | – | – |
Once I’m thinking about my illness, I can’t seem to do anything else | .86 | – | – | – |
Sometimes I become lost in thought about my illness | .82 | – | – | – |
Once started, I can spend considerable time thinking about my illness | .75 | – | – | – |
I find myself unexpectedly thinking about my illness | .68 | – | – | – |
I have trouble sleeping because of thinking about my illness | .64 | – | – | – |
I can’t seem to control thinking about my illness | .63 | – | – | – |
I exhaust myself thinking about the reasons for my illness | .60 | – | – | – |
I believe that people would think negatively about me if they realised how much I think about my illness | .49 | – | – | – |
I often feel the need to be by myself to think about my illness | .45 | – | – | – |
Thinking helps me understand my illness | – | .79 | – | – |
Thinking about my illness helps me work out what I need to do to manage it | – | .73 | – | – |
Thinking about my illness helps me focus on what is important to me | – | .71 | – | – |
Thinking about my illness is helpful in terms of protecting my health | – | .70 | – | – |
Thinking about my illness helps me work out how to cope | – | .66 | – | – |
Thinking about my illness helps me focus on what is still good in my life | – | .64 | – | – |
Thinking about my illness helps me understand its cause | – | .59 | – | – |
Thinking helps me work out what I need to do to regain a sense of ‘normality’ | – | .57 | – | – |
I think about whether I could have avoided my illness if I’d taken better care of myself | – | – | .87 | – |
I think about whether I might have done anything to cause my illness | – | – | .85 | – |
I think about where things went wrong | – | – | .67 | – |
I repeatedly go over possible causes for my illness | – | – | .59 | – |
I think about the impact the illness will have on my life | – | – | – | .71 |
I think about the things I can no longer do | – | – | – | .70 |
I think about what life would have been like if I had not become ill | – | – | – | .70 |
I think about the things my illness might stop me doing | – | – | – | .69 |
I think about the seriousness of my illness | – | – | – | .63 |
I think about the goals I had that I may no longer be able to reach | – | – | .62 | |
I think about how little I can do to improve my situation | – | – | – | .59 |
I think that no matter what I do now, my life will never get better | – | – | – | .56 |
I think that trying new things may be pointless | – | – | – | .48 |
Intrusion | Instrumentality | Preventability | Brooding | |
---|---|---|---|---|
Intrusion | 1.00 | – | – | – |
Instrumentality | .21 | 1.00 | – | – |
Searching for meaning | .42 | .17 | 1.00 | – |
Brooding | .60 | .25 | .30 | 1.00 |
Study 2: Confirmatory factor analysis and validation testing
Method
Participants and procedure
Measures
Demographic and clinical characteristics
Multidimensional Rumination in Illness Scale (MRIS)
Ruminative Responses Subscale of the Response Styles Questionnaire (RRRSQ)
Intrusion Subscale of the Revised Impact of Events Scale (IES-R-I)
Depression, Anxiety and Stress Scale (DASS)
Positive Beliefs about Rumination Scale (PBRS)
Negative Beliefs about Rumination Scale (NBRS)
Big Five Inventory-Neuroticism Scale (BFI-N)
Negative Affect SubScale (Positive and Negative Affect Scale) (PANAS-N; Watson et al., 1988)
Penn State Worry Questionnaire (PSWQ; Meyer et al., 1990)
Data analysis
Results
Descriptive statistics
Variable | n | M/% (SD) | Range |
---|---|---|---|
Demographic factors
| |||
Gender (%) | |||
Male | 25 | 15.3 | – |
Female | 138 | 84.7 | – |
Age (years) | 163 | 37.02 (15.81) | 18–75 |
Education, level completed (%) | |||
High School | 44 | 27.0 | – |
Technical College | 15 | 9.2 | – |
Undergraduate studies | 47 | 28.8 | – |
Postgraduate studies | 57 | 35.0 | – |
Location (%) | |||
Australia | 94 | 57.7 | – |
Austria | 1 | .6 | – |
Belgium | 1 | .6 | – |
Canada | 2 | 1.2 | – |
Finland | 8 | 4.9 | – |
Italy | 1 | .6 | – |
Norway | 1 | .6 | – |
Singapore | 1 | .6 | – |
United Kingdom | 13 | 8.0 | – |
United States | 41 | 25.2 | – |
Physical health targeted condition (%) | |||
Allergy | 12 | 7.4 | – |
Arthritis | 15 | 9.2 | – |
Autoimmune disorder | 11 | 6.7 | – |
Cancer | 31 | 19.0 | – |
Cardiovascular disorder | 4 | 2.5 | – |
Endocrine disorder | 10 | 6.1 | – |
Eye disorder | 4 | 2.5 | – |
Gastrointestinal disorder | 10 | 6.0 | – |
Haematological disorder | 8 | 4.9 | – |
Infectious disorder | 6 | 3.7 | – |
Musculo-skeletal disorder | 28 | 17.2 | – |
Neurological disorder | 9 | 5.5 | – |
Respiratory disorder | 6 | 3.7 | – |
Skin disorder | 3 | 1.8 | – |
Other | 6 | 3.7 | – |
Psychological disorders (%) | |||
None reported | 108 | 66.3 | – |
Adjustment disorder | 1 | .6 | – |
Anxiety disorder | 13 | 8.0 | – |
Bipolar disorder | 3 | 1.8 | – |
Depression | 23 | 14.1 | – |
Eating disorder | 5 | 3.1 | – |
Health anxiety | 1 | .6 | – |
Obsessive–compulsive | 4 | 2.5 | – |
Panic disorder | 3 | 1.8 | – |
Phobia disorder | 3 | 1.8 | – |
Post-traumatic stress | 6 | 3.7 | – |
Social phobia | 2 | 1.2 | – |
Substance disorder | 1 | .6 | – |
Comorbidities | |||
No. of physical conditions | 141 | 3.12 (3.21) | 1–15 |
No. of psychological disorders | 48 | 1.88 (1.73) | 1–7 |
Measures
| |||
MRIS score | 163 | 52.75 (27.62) | 3–129 |
RRRSQ score | 157 | 20.16 (12.47) | 0–57 |
IES-R-I score | 155 | 7.52 (5.84) | 0–28 |
PBRS score | 152 | 16.42 (6.65) | 9–36 |
NBRS score | 154 | 16.90 (6.26) | 11–41 |
PSWQ score | 153 | 48.42 (15.58) | 17–77 |
PANAS-NA score | 153 | 16.18 (7.49) | 10–43 |
BIG5 N score | 154 | 23.03 (6.61) | 8–38 |
Gender, number of physical illnesses and comorbid psychological conditions
Confirmatory factor analysis
Intrusion | Instrumentality | Brooding | |
---|---|---|---|
Intrusion | 1.00 | – | – |
Instrumentality | .42 | 1.00 | – |
Brooding | .78 | .37 | 1.00 |
Reliability testing
Validation testing
Scale/dimension | Mean (SD) |
n
|
R
| |
---|---|---|---|---|
RRRSQ | 20.16 (12.47) | MRIS | 157 | .61** |
Intrusion | 157 | .63** | ||
Brooding | 157 | .60** | ||
Instrumentality | 157 | .13 | ||
IES-R-I | 7.52 (5.84) | MRIS | 155 | .56** |
Intrusion | 155 | .55** | ||
Brooding | 155 | .56** | ||
Instrumentality | 155 | .16* | ||
PBRS | 16.42 (6.65) | MRIS | 152 | .56** |
Intrusion | 152 | .56** | ||
Brooding | 152 | .49** | ||
Instrumentality | 152 | .26** | ||
NBRS | 16.90 (6.26) | MRIS | 154 | .37** |
Intrusion | 154 | .41** | ||
Brooding | 154 | .37 | ||
Instrumentality | 154 | −.04 | ||
DASS-D | 8.30 (8.70) | MRIS | 159 | .48** |
Intrusion | 159 | .46** | ||
Brooding | 159 | .54** | ||
Instrumentality | 159 | .02 | ||
DASS-A | 6.34 (6.63) | MRIS | 160 | .52** |
Intrusion | 160 | .56** | ||
Brooding | 160 | .44** | ||
Instrumentality | 160 | .17** | ||
DASS-S | 12.56 (9.08) | MRIS | 161 | .50** |
Intrusion | 161 | .54** | ||
Brooding | 161 | .46** | ||
Instrumentality | 161 | .09 | ||
BIG-5-N | 23.03 (6.61) | MRIS | 154 | .36** |
Intrusion | 154 | .34** | ||
Brooding | 154 | .41** | ||
Instrumentality | 154 | .02 | ||
PANAS-N | 16.18 (7.49) | MRIS | 153 | .42 |
Intrusion | 153 | .43 | ||
Brooding | 153 | .38 | ||
Instrumentality | 153 | .11 | ||
PSWQ | 48.42 (15.58) | MRIS | 153 | .36** |
Intrusion | 153 | .32 | ||
Brooding | 153 | .42 | ||
Instrumentality | 153 | .01 |