Introduction
Understanding how various cognitive strategies in response to stress impact affective states among adolescents is important, as it may shape intervention or prevention strategies for adolescents who are experiencing difficulties with managing negative affect related to personal stress (Compas et al.
2001). Various cognitive coping strategies have been described in the literature. The present study focuses on rumination, positive reappraisal, acceptance, and distancing.
Rumination can be defined as repetitively thinking about the causes, implications, and consequences of negative feelings (Nolen-Hoeksema
1987,
1991) and stressful events (Robinson and Alloy
2003). Although people ruminate in an attempt to gain insight in their problems (Nolen-Hoeksema
1991), rumination is likely to have unconstructive consequences because of its abstract-analytical nature, negative content, and its likelihood to occur in negative intrapersonal and situational context (Watkins
2008). Cross-sectional studies have demonstrated that rumination is strongly associated with symptoms of depression and anxiety in adults as well as in adolescents (see reviews Nolen-Hoeksema et al.
2008; Rood et al.
2009; Watkins
2008). Prospective studies have demonstrated that rumination predicts depression in adults (Nolen-Hoeksema et al.
2008; Watkins
2008), and changes in depressive symptoms over time in youth (Rood et al.
2009). Only one study so far has examined the effect of rumination on depressive mood state in an adolescent sample experimentally. Park et al. (
2004) compared the effects of an 8-minute induction of self-focused rumination (i.e., a self-focus on emotions, body state, goals and attributes) to distraction in adolescents aged 12–17. Their findings showed that rumination as compared to distraction worsened depressive mood in clinically depressed adolescents and in community controls.
Positive reappraisal
1 is a meaning-based type of coping that can be defined as reinterpreting events or situations in a positive manner (Folkman and Moskowitz
2000; Helgeson et al.
2006), and includes elements such as attempting to find benefits and personal growth (see conceptualisation of Garnefski et al.
2001). Positive reappraisal of stressful experiences increases awareness of important personal values in life, and encourages to act upon those values (Folkman and Moskowitz
2000), thereby changing the meaning of stressful experiences. As a cognitive coping strategy in response to stressful events, positive reappraisal has been positively related to psychological wellbeing, and to a lesser extent, negatively related to depressive symptoms in adults (see review Helgeson et al.
2006), as well as in adolescents (Garnefski et al.
2001; Garnefski et al.
2002). Tugade and Fredrickson (
2004) have suggested that especially people who have a low resiliency to stress might benefit from a training in the use of positive reappraisal, as it generates positive affect and facilitates adequate emotion regulation. Folkman (
2008) stresses that the experience of positive emotions can play an important adaptive role in coping with stress, for example, by influencing the type of coping strategy that is employed, but also by “charging up the batteries”. An elaborated theory on the role of positive emotions is provided by Fredrickson (
2004), whose broaden-and-build theory posits that positive emotions generate a broader mindset (i.e., momentary thought-action repertoire), which can lead to an increase (build) in physical, social, psychological, and intellectual resources that later help form a buffer against stress. In the current study, the positive reappraisal condition aimed to induce a thinking process focused on benefits and personal growth as a consequence of the stressful event.
Another cognitive coping strategy which could be considered an adaptive alternative to rumination, is mindfulness-based acceptance of thoughts and feelings. Acceptance is one of the core elements of mindfulness (Germer
2005; Williams et al.
2007). The purpose of acceptance in mindfulness practice is not to passively resign to unwanted experiences or emotions, but rather to become aware of thoughts and feelings, observe them as they are, and to accept their presence without judging them as good or bad (Baer
2003; Williams et al.
2007). Mindfulness-based approaches have yielded promising results with regard to the treatment of a wide range of psychological problems in adults, such as dealing with chronic pain, depression, anxiety, and ADHD (Baer
2003). The effects of mindfulness approaches have not yet been extensively studied in youth samples (see Burke
2010); however, intervention studies so far show promising results in adolescents with a range of psychiatric disorders (Biegel et al.
2009; Bögels et al.
2008).
Experimental studies have demonstrated that mindfulness meditation (or mindful acceptance; Singer and Dobson
2007) was significantly more effective in recovering from a sad mood induction than rumination in undergraduate students (Broderick
2005) and in remitted and currently depressed adults (Huffziger and Kuehner
2009; Singer and Dobson
2007). In contrast to these studies, Kuehner et al. (
2009) found that mindfulness meditation did not have a beneficial effect on mood compared to rumination in a sample of undergraduate students. In sum, there is evidence that mindful self-focus or acceptance might be more effective than rumination when processing stressful experiences, though results so far are equivocal. In the present study, the acceptance condition was aimed to induce an attentional, experiential focus on thoughts about the stressful event.
Self-distancing (i.e., looking at self from an observer’s perspective) has a beneficial effect on level of depression (Kross and Ayduk
2009) and may prevent rumination (Kross et al.
2005). An observer’s perspective may reduce emotional arousal when working through negative events, by looking more objectively at the circumstances (Kross et al.
2005; Nigro and Neisser
1983). However, the observer’s perspective also plays a role in the maintenance of certain psychological disorders: as a maladaptive attentional process in social anxiety (see Bögels and Mansell
2004) and as a cognitive avoidance strategy in PTSD (Kenny and Bryant
2007). A distancing induction was included with the intention to make participants think about all negative aspects of the stressful event from an observer’s perspective, thus in a non-ruminative (and non-verbal) manner. A neutral control condition was not included in our study, as a “think about anything” manipulation without instructions would allow participants to employ various types of coping strategies including the ones we wanted to manipulate in the other conditions (such as rumination), and would therefore not adequately serve as a control condition.
Whereas cross-sectional and longitudinal studies provide information on the strengths of relationships between variables, experimental studies enable a more direct examination of causal relationships. The purpose of this study was to compare the effects of various cognitive coping strategies i.e., rumination, positive reappraisal, acceptance, and distancing, on positive and negative affect states related to personal stress in a sample of non-clinical adolescents. We expected that (1) participants would show a greater increase in negative affect after the rumination induction compared to the acceptance, positive reappraisal, and distancing inductions; and (2) participants would show a stronger increase in positive affect, and a stronger decrease in negative affect, after the positive reappraisal induction compared to the other inductions. As the consequences of rumination have been found to be more unconstructive in the presence of other vulnerability factors such as low self-esteem and negative beliefs (see Watkins
2008), we examined whether the effect of condition on affect states would be moderated by the level of trait-rumination (SRRS-C; see
Measures). High trait-ruminators were expected to report a greater increase in negative affect after the rumination induction compared to low trait-ruminators. More speculatively, high trait-ruminators were expected to respond less favourably to the expected relatively beneficial effects of the acceptance and positive reappraisal manipulations, compared to the low trait-ruminators.
Additional hypotheses were formulated on differences between conditions regarding certain characteristics that may co-determine the outcome of cognitive strategies. Intrinsic to meaning-based coping, rumination and positive reappraisal are both abstract styles of thinking (Folkman
2008; Watkins
2008). There is some evidence that the beneficial effects of mindfulness are due to the reduction of abstract-evaluative thinking (Heeren and Philippot
2009). Therefore, the level of abstractness of thoughts was expected to be higher in the rumination and positive reappraisal conditions than in the acceptance and distancing conditions. As abstractness of thought may be related to a predominance of words over images in thought (see Stöber and Borkovec
2002), the ratio of words by images was expected to be higher in the rumination and positive reappraisal conditions than in the acceptance and distancing conditions. The level of concreteness of thoughts was expected to be highest in the distancing condition, which is likely to evoke imagery because of its visual focus. Furthermore, although a component of rumination, self-focused attention is not necessarily maladaptive. Self-focus in a positive intrapersonal and environmental context has been found to reduce negative affect (see Mor and Winquist
2002). There is some evidence that mindful self-focus improves sad mood (Huffziger and Kuehner
2009). The degree of self-focus was expected to be similar across conditions.
To the authors’ best knowledge, the present study is the first study to compare the short-term effects of rumination, positive reappraisal, acceptance, and distancing on negative and positive affect states in adolescents in an experimentally controlled design. The examination of how different strategies to cope with stressful experiences influence negative and positive affect states in non-clinical adolescents may generate hypotheses regarding maintaining or exacerbating variables in depression, which is characterized by the combination of high negative affect and low positive affect (Watson et al.
1988).
Discussion
The aim of the present study was to compare the effects of experimentally induced rumination, acceptance, distancing, and positive reappraisal on negative and positive affect states in a sample of adolescents. In sum, results showed that a brief manipulation of positive reappraisal in response to thinking about a recent stressful experience significantly increased positive affect, and decreased negative affect, compared to rumination, acceptance, and distancing. This means that after thinking about a personal stressor, adolescents’ positive affect improved most, and negative affect decreased most, when they thought about what they learned from a stressful experience, and how it made them stronger. These findings are in line with earlier studies demonstrating a positive relationship between positive reappraisal and well-being (see Helgeson et al.
2006), and point to a beneficial role for positive reappraisal in influencing both positive and negative affect.
An interesting finding is that positive reappraisal seemed to be characterized by more verbal activity than imagery compared to the other conditions. The positive words/images ratio may be indicative of an abstract level of construal, which is intrinsic to meaning-based coping (Folkman
2008), and which has been shown to be constructive in the context of positive mood with respect to motivation and goal setting (Labroo and Patrick
2009; Vasquez and Buehler
2007). As rumination may be a predominantly verbal and abstract activity (McLaughlin et al.
2007; Stöber and Borkovec
2002), positive reappraisal might be an attractive alternative coping strategy for predominantly “verbal” thinkers. However, the long-term effect of positive reappraisal on mood should be examined in order to check whether positive reappraisal is not some form of cognitive avoidance (see Borkovec et al.
1998).
Unexpectedly, the short-term effect of acceptance of thoughts and feelings was not beneficial over the effect of rumination or distancing. This is inconsistent with Broderick (
2005) and Singer and Dobson (
2007); however, it is consistent with Kuehner et al. (
2009), who found that the effect of mindful self-focus on mood did not differ from rumination in a non-clinical sample. There are three potential explanations for this null-finding. First, acceptance may be more effective in reducing negative mood states in (formerly) depressed individuals (Kuehner et al.
2009). Second, since groups did not differ on the manipulation checks for acceptance, our acceptance manipulation may have failed. Either the instructions were not effective, or adolescents have not yet developed the cognitive capacity or maturity to follow the acceptance instructions. Third, beneficial effects on mood are more likely to be expected after weeks of mindfulness training in which acceptance is practiced intensively (see Kabat-Zinn
2003; Segal et al.
2002), or perhaps after a longer manipulation; acceptance implicates exposure to all (also negative) aspects of the event, which could explain why the short-term effect of acceptance was not beneficial over rumination.
Remarkable is the unexpected decrease in negative affect in the rumination condition. This finding is not in line with Park et al. (
2004), who found that rumination increased depressed mood in non-clinical adolescents. First, it needs to be remarked that there seems to be a ceiling effect for negative affect after the stress-induction, as participants generally reported maximum levels of negative affect at T2, which makes it impossible to have higher rates of negative affect at T3 (post-manipulation). Second, it is possible that paradoxically the effect of naturally occurring rumination was attenuated, because the cards offer a certain degree of structure which would not be present in natural ruminative thinking, or that our instructions elicited also more constructive forms of rumination (see Treynor et al.
2003); however, our manipulation checks showed that participants did not gain more insight after rumination compared to the other conditions. Another explanation could be that rumination in response to stress is not per se maladaptive in non-dysphoric subjects as has been found in adult samples (Nolen-Hoeksema et al.
2008). According to Watkins (
2008), level of abstract processing and negative thought content determine whether the outcome of rumination is unconstructive and could lead to worsening of negative mood. It should be noted that the rumination condition was not characterized by reduced concreteness/increased abstractness of thoughts compared to the other conditions, moreover, the rated levels of abstractness were generally low (perhaps due to the level of cognitive development), which might explain why rumination did not maintain, but slightly improved negative affect. Distancing maintained negative affect state, which is consistent with findings regarding the role of imagery in evoking emotions (see Holmes and Mathews
2010), and with the finding that taking an observer’s perspective without engaging in reflection leads to negative affect (Kross et al.
2005).
The effect of condition was not dependent of a general tendency to ruminate. The current finding may implicate that non-clinical adolescents with a relatively stronger tendency to ruminate benefit from applying positive reappraisal when thinking about stressful events as much as other adolescents. However, considering the fact that the mean scores on the SRRS-C in this sample ranged between average (i.e., “sometimes”) and below average, and that the standard deviations were relatively low, an alternative explanation for this null-finding may be that there was insufficient variability in trait-rumination scores to be able to compare high and low trait-ruminators. Thus, current questions should be examined in more clinically proximal ways.
As for clinical implications, Garnefski et al. (
2002) showed that adults use significantly more positive reappraisal to cope with stressful events compared to adolescents, suggesting that positive reappraisal is a coping strategy that one learns to employ later in life. However, the current study demonstrates that adolescents have the capacity to apply this coping strategy, and that it works for them. Adolescents might benefit from being made aware of this strategy earlier in life by psycho-education; furthermore, positive reappraisal could be applied in intervention and prevention strategies for youth experiencing difficulties with affective functioning.
This study contributes to existing literature on the role of various cognitive coping strategies in the regulation of affect in youth by its experimentally controlled design. As yet, only Park et al. (
2004) have examined the effect of rumination on the maintenance of depressed mood in youth experimentally. A strength of the present study is that a self-rated as well as an observer-rated manipulation check showed that our inductions of positive reappraisal, rumination, and distancing (but not acceptance) succeeded. Another strength is that participants were to select a personally relevant topic to cope with. Furthermore, the sample is relatively large and representative of Dutch youth in terms of educational level and SES.
Some limitations need to be addressed as well. First, the manipulations were short and there was no follow-up measurement. Second, we did not choose for a think-aloud procedure during the cognitive coping manipulation, because we did not want to disturb the thinking process, but checked the effect of the manipulations through a writing assignment afterwards. As a result, the written texts might not represent all thoughts during the experiment. Moreover, we might not have captured the process of thinking, which may be equally important as the content of thoughts. Finally, although checks showed that participants did not guess the full purpose of the study, there is still a possibility that demand effects influenced the results, as we did not check whether they expected our instructions to be helpful.
Future experimental research should examine the long-term effects of rumination, positive reappraisal, acceptance, and distancing on the regulation of affect states in adolescents including psycho-physiological measures. It would be interesting to compare the effects of a short training in these cognitive coping strategies on the regulation of positive and negative affect states in response to stress. Furthermore, the effects of coping strategies on third variables, such as problem-solving ability, overgeneral memory, or attentional biases, need examination. Testing the current hypotheses in high risk and clinically depressed youth samples is warranted in order to further shape models of the pathogenesis of depression, as well as intervention and prevention programs. To conclude, when thinking about stressful events, positive reappraisal significantly enhances positive affect and decreases negative affect in the short-term, compared to rumination, acceptance, and distancing.