Skip to main content
SpringerLink
Log in

The influence of rumination and distraction on depressed and anxious mood: a prospective examination of the response styles theory in children and adolescents

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The present study sought to test predictions of the response styles theory in a sample of children and adolescents. More specifically, a ratio approach to response styles was utilized to examine the effects on residual change scores in depression and anxiety. Participants completed a battery of questionnaires including measures of rumination, distraction, depression, and anxiety at baseline (Time 1) and 8–10 weeks follow-up (Time 2). Results showed that the ratio score of rumination and distraction was significantly associated with depressed and anxious symptoms over time. More specifically, individuals who have a greater tendency to ruminate compared to distracting themselves have increases in depression and anxiety scores over time, whereas those who have a greater tendency to engage in distraction compared to rumination have decreases in depression and anxiety symptoms over time. These findings indicate that a ratio approach can be used to examine the relation between response styles and symptoms of depression and anxiety in non-clinical children and adolescents. Implications of the results may be that engaging in distractive activities should be promoted and that ruminative thinking should be targeted in juvenile depression treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. The association between depression (CDI) and anxiety (STAI-C) was relatively high, possibly threatening the discriminant validity of the scales. To deal with this issue, we conducted an exploratory factor analysis on items of the CDI and the STAI-C in order to obtain relatively pure depression and anxiety factors (see [7]). Items with salient double loadings (i.e., >0.30) were removed. In total, 18 out of 20 STAI-C items and 22 out of 27 CDI items were retained. The correlation coefficient between the reduced scales was 0.65 indicating less overlap. All analyses were conducted for the original scales as well as for the reduced scales. Similar results were found for the original and reduced scales. Therefore, the original scales were used in all analyses in order to be able to compare our findings to previous research.

References

  1. Abela JRZ, Aydin CM, Auerbach RP (2007) Responses to depression in children: reconceptualizing the relation among response styles. J Abnormal Child Psychol 35:913–927

    Article  Google Scholar 

  2. Abela JRZ, Brozina K, de Haigh EP (2002) An examination of the response styles theory of depression in third- and seventh-grade children: a short-term longitudinal study. J Abnormal Child Psychol 30:515–527

    Article  Google Scholar 

  3. Abela JRZ, Hankin BL (2008) Cognitive vulnerability to depression in children and adolescents: a developmental psychopathology perspective. In: Abela JRZ, Hankin BL (eds) Childhood and adolescent depression: causes treatment and prevention. Guilford Press, New York, pp 35–78

    Google Scholar 

  4. Abela JRZ, Vanderbilt E, Rochon A (2004) A test of the integration of the response styles theory and social support theories of depression in third and seventh grade children. J Soc Clin Psychol 5:653–674

    Article  Google Scholar 

  5. Abbott MJ, Rapee RM (2004) Post-event rumination and negative self-appraisal in social phobia and after treatment. J Abnorm Psychol 113:136–144

    Article  PubMed  Google Scholar 

  6. Bagby RM, Rector NA, Bacchiochi JR, McBride C (2004) The stability of the response styles questionnaire rumination scale in a sample of patients with major depression. Cogn Ther Res 28:527–538

    Article  Google Scholar 

  7. Bieling PJ, Antony MM, Swinson RP (1998) The state-trait anxiety inventory, trait version: structure and content re-examined. Behav Res Ther 36:777–788

    Article  PubMed  CAS  Google Scholar 

  8. Blagden JC, Craske MG (1996) Effects of active and passive rumination and distraction: a pilot replication with anxious mood. J Anx Dis 10:243–252

    Article  Google Scholar 

  9. Bögels SM (2006) Task concentration training versus applied relaxation, in combination with cognitive therapy, for social phobia patients with fear of blushing, trembling, and sweating. Behav Res Ther 44:1199–1210

    Article  PubMed  Google Scholar 

  10. Bögels SM, Mansell W (2004) Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention. Clin Psychol Rev 24:827–856

    Article  PubMed  Google Scholar 

  11. Burwell RA, Shirk SR (2007) Subtypes of rumination in adolescence: associations between brooding, reflection, depressive symptoms, and coping. J Clin Child Adolescent Psychol 36:56–65

    Article  Google Scholar 

  12. Chang EC (2004) Distinguishing between ruminative and distractive responses in dysphoric college students: does indication of past depression make a difference? Pers Individ Diff 36:845–855

    Article  Google Scholar 

  13. Ciarrochi J, Scott G, Deane F, Heaven P (2003) Relations between social and emotional competence and mental health: a construct validation study. Pers Individ Diff 35:1947–1963

    Article  Google Scholar 

  14. Ciesla JA, Roberts JE (2002) Self-directed thought and response to treatment for depression: a preliminary investigation. J Cogn Psychother 16:435–453

    Google Scholar 

  15. Comer JS, Kendall PC (2004) A symptom-level examination of parent–child agreement in the diagnosis of anxious youths. J Am Acad Child Adolesc Psychiatry 43:878–886

    Article  PubMed  Google Scholar 

  16. Cox BJ, Enns MW, Walker JR, Kjernisted K, Pidlubny SR (2001) Psychological vulnerability in patients with major depression versus panic disorder. Behav Res Ther 39:567–573

    Article  PubMed  CAS  Google Scholar 

  17. Driscoll KA (2004) Children’s response styles and risk for depression and anxiety: developmental and sex differences. Unpublished Dissertation, Florida State University

  18. Finch AJ Jr, Montgomery L, Deardorff P (1974) Reliability of state-trait anxiety with emotionally disturbed children. J Abnorm Child Psychol 2:67–69

    Article  PubMed  Google Scholar 

  19. Flett GL, Madorsky D, Hewitt PL, Heisel MJ (2002) Perfectionism cognitions, rumination, and psychological distress. J Ration Emotive Cogn Behav Ther 20:33–47

    Article  Google Scholar 

  20. Fresco DM, Frankel AN, Mennin DS, Turk CL, Heimberg RG (2002) Distinct and overlapping features of rumination and worry: the relationship of cognitive production to negative affective states. Cogn Ther Res 26:179–188

    Article  Google Scholar 

  21. Harrington JA, Blankenship V (2002) Ruminative thoughts and their relation to depression and anxiety. J Applied Soc Psychol 32:465–485

    Article  Google Scholar 

  22. Harvey A, Watkins E, Mansell W, Shafran R (2004) Cognitive behavioural processes across psychological disorders: a transdiagnostic approach to research and treatment. Oxford University Press, Oxford

    Google Scholar 

  23. Hayes SC, Strosahl KD, Wilson KG (2003) Acceptance and commitment therapy: an experiential approach to behaviour change. Guilford, New York

    Google Scholar 

  24. Hilt LM, Cha CB, Nolen-Hoeksema S (2008) Non-suicidal self-injury in young adolescent girls: moderators of the distress–function relationship. J Consult Clin Psychol 76:63–71

    Article  PubMed  Google Scholar 

  25. Jacobson NS, Dobson KS, Truax PA, Addis ME, Koermer K, Gollan JK, Gortner E, Prince SE (1996) A component analysis of cognitive-behavioral treatment for depression. J Consult Clin Psychol 64:295–304

    Article  PubMed  CAS  Google Scholar 

  26. Jacobson NS, Martell CR, Dimidjian S (2001) Behavioral activation treatment for depression: returning to contextual roots. Clin Psychol Sci Pract 8:255–270

    Article  Google Scholar 

  27. Just N, Alloy LB (1997) The response styles theory of depression: tests and an extension of the theory. J Abnorm Psychol 106:221–229

    Article  PubMed  CAS  Google Scholar 

  28. Kocovski NL, Endler NS, Rector NA, Flett GL (2005) Ruminative coping and post-event processing in social anxiety. Behav Res Ther 43:971–984

    Article  PubMed  Google Scholar 

  29. Kovacs M (1992) Children’s depression inventory, CDI. Manual. Multi-Health Systems Inc., Toronto (Ontario)

    Google Scholar 

  30. Kuehner C, Weber I (1999) Responses to depression in unipolar depressed patients: an investigation of Nolen-Hoeksema’s response styles theory. Psychol Med 29:1323–1333

    Article  PubMed  CAS  Google Scholar 

  31. Lam D, Smith S, Checkley S, Rijsdijk F, Sham P (2003) Effect of neuroticism, response style and information processing on depression severity in a clinically depressed sample. Psychol Med 33:469–479

    Article  PubMed  CAS  Google Scholar 

  32. Lara ME, Klein DN, Kasch KL (2000) Psychosocial predictors of the short-term course and outcome of major depression: a longitudinal study of a nonclinical sample with recent-onset episodes. J Abnorm Psychol 109:644–650

    Article  PubMed  CAS  Google Scholar 

  33. Lewinsohn PM, Antonuccio DO, Breckenridge JS, Teri L (1984) The coping with depression course. Eugene, OR, Castalia

    Google Scholar 

  34. Lyubomirsky S, Nolen-Hoeksema S (1993) Self-perpetuating properties of dysphoric rumination. J Pers Soc Psychol 65:339–349

    Article  PubMed  CAS  Google Scholar 

  35. Lyubomirsky S, Tucker KL, Caldwell ND, Berg K (1999) Why ruminators are poor problem solvers: clues from the phenomenology of dysphoric rumination. J Pers Soc Psychol 77:1041–1060

    Article  PubMed  CAS  Google Scholar 

  36. Miranda R, Nolen-Hoeksema S (2007) Brooding and reflection: rumination predicts suicidality at one-year follow up in a community sample. Behav Res Ther 45:3088–3095

    Article  PubMed  Google Scholar 

  37. Morrow J, Nolen-Hoeksema S (1990) Effects of responses to depression on the remediation of depressive affect. J Pers Soc Psychol 58:519–527

    Article  PubMed  CAS  Google Scholar 

  38. Muris P, Roelofs J, Meesters C, Boomsma P (2004) Rumination and worry in nonclinical adolescents. Cogn Ther Res 28:539–554

    Article  Google Scholar 

  39. Muris P, Roelofs J, Rassin E, Franken I, Mayer B (2005) Mediating effects of rumination and worry on the links between neuroticism, anxiety, and depression. Pers Individ Diff 39:1105–1111

    Article  Google Scholar 

  40. Muris P, Fokke M, Kwik D (2009) The ruminative response style in adolescents: an examination of its specific link to symptoms of depression. Cogn Ther Res 33:21–32

    Article  Google Scholar 

  41. Nolen-Hoeksema S (1987) Sex differences in unipolar depression: evidence and theory. Psychol Bull 101:259–282

    Article  PubMed  CAS  Google Scholar 

  42. Nolen-Hoeksema S (1991) Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol 100:569–582

    Article  PubMed  CAS  Google Scholar 

  43. Nolen-Hoeksema S (1998) Ruminative coping with depression. In: Heckhausen J, Dweck CS (eds) Motivation and self-regulation across the life span. Cambridge University Press, New York, pp 237–256

    Google Scholar 

  44. Nolen-Hoeksema S (2000) The role of rumination in depressive disorder and mixed anxiety/depressive symptoms. J Abnorm Psychol 109:504–511

    Article  PubMed  CAS  Google Scholar 

  45. Nolen-Hoeksema S, Girgus JS (1994) The emergence of gender differences in depression during adolescence. Psychol Bull 115:424–443

    Article  PubMed  CAS  Google Scholar 

  46. Nolen-Hoeksema S, Harrell ZA (2002) Rumination, depression, and alcohol use: tests of gender differences. J Cogn Psychother 16:391–403

    Google Scholar 

  47. Nolen-Hoeksema S, Morrow J (1991) A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta earthquake. J Pers Soc Psychol 61:115–121

    Article  PubMed  CAS  Google Scholar 

  48. Nolen-Hoeksema S, Morrow J (1993) Effects of rumination and distraction on naturally occurring depressed mood. Cogn Emot 7:561–570

    Article  Google Scholar 

  49. Nolen-Hoeksema S, Stice E, Wade E, Bohon C (2007) Reciprocal relations between rumination and bulimic, substance abuse and depressive symptoms in female adolescents. J Abnorm Psychol 116:198–207

    Article  PubMed  Google Scholar 

  50. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci 3:400–424

    Article  Google Scholar 

  51. Papageorgiou C, Wells A (2004) Depressive rumination: nature, theory and treatment. Wiley, Chichester

    Google Scholar 

  52. Robinson LA, Alloy LB (2003) Negative cognitive styles and stress-reactive rumination interact to predict depression: a prospective study. Cogn Ther Res 27:275–292

    Article  Google Scholar 

  53. Schwartz JAJ, Koenig LJ (1996) Response styles and negative affect among adolescents. Cogn Ther Res 20:13–36

    Article  Google Scholar 

  54. Segal ZV, Williams JMG, Teasdale JD (2002) Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. Guilford, New York

    Google Scholar 

  55. Segerstrom SC, Tsao JCI, Alden LE, Craske MG (2000) Worry and rumination: repetitive thought as a concomitant and predictor of negative mood. Cogn Ther Res 24:671–688

    Article  Google Scholar 

  56. Smith JM, Alloy LB, Abramson LY (2006) Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: Multiple pathways to self-injurious thinking. Suicide Life Threat Behav 36:443–454

    Article  PubMed  Google Scholar 

  57. Spasojevic J, Alloy LB (2001) Rumination as a common mechanism relating depressive risk factors to depression. Emotion 1:25–37

    Article  PubMed  CAS  Google Scholar 

  58. Spielberger CD (1973) Manual for the state-trait anxiety inventory for children. Consulting Psychologists Press, Palo Alto

    Google Scholar 

  59. Vaus D (2001) Research designs in social research. Sage Publications Ltd, London

    Google Scholar 

  60. Vickers KS, Vogeltanz-Holm ND (2003) The effects of rumination and distraction tasks on psychophysiological responses and mood in dysphoric and nondysphoric individuals. Cogn Ther Res 27:331–348

    Article  Google Scholar 

  61. Ward A, Lyubomirsky S, Sousa L, Nolen-Hoeksema S (2003) Can’t quite commit: rumination and uncertainty. Pers Soc Psychol Bull 29:96–107

    Article  PubMed  Google Scholar 

  62. Watkins E (2004) Appraisals and strategies associated with rumination and worry. Pers Individ Diff 37:679–694

    Article  Google Scholar 

  63. Wood JV, Saltzberg JA, Neale JM, Stone AA, Rachmiel TB (1990) Self-focused attention, coping responses, and distressed mood in everyday life. J Pers Soc Psychol 58:1027–1036

    Article  PubMed  CAS  Google Scholar 

  64. Ziegert DI, Kistner JA (2002) Response styles theory: downward extension to children. J Clin Child Adolescent Psychol 31:325–334

    Google Scholar 

Download references

Acknowledgments

The contribution of Jeffrey Roelofs was supported by the NWO Social Sciences Research Council of The Netherlands, Grant No. 451-05-019.

Author information

Authors and Affiliations

  1. Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands

    Jeffrey Roelofs, Lea Rood, Cor Meesters & Valérie te Dorsthorst

  2. University of Amsterdam, Amsterdam, The Netherlands

    Susan Bögels

  3. Temple University, Philadelphia, USA

    Lauren B. Alloy

  4. Yale University, New Haven, USA

    Susan Nolen-Hoeksema

Authors
  1. Jeffrey Roelofs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lea Rood
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cor Meesters
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Valérie te Dorsthorst
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susan Bögels
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lauren B. Alloy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Susan Nolen-Hoeksema
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey Roelofs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roelofs, J., Rood, L., Meesters, C. et al. The influence of rumination and distraction on depressed and anxious mood: a prospective examination of the response styles theory in children and adolescents. Eur Child Adolesc Psychiatry 18, 635–642 (2009). https://doi.org/10.1007/s00787-009-0026-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-009-0026-7

Keywords

Search

Navigation