Skip to main content
Top
Gepubliceerd in: Cognitive Therapy and Research 5/2016

03-05-2016 | Original Article

Stress-Related Symptoms and Suicidal Ideation: The Roles of Rumination and Depressive Symptoms Vary by Gender

Auteurs: Lillian Polanco-Roman, Judelysse Gomez, Regina Miranda, Elizabeth Jeglic

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 5/2016

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

There is a growing body of literature suggesting that reactions to stressful life events, such as intrusive thoughts, physiological hyperarousal, and cognitive/behavioral avoidance (i.e., stress-related symptoms) may increase risk for thinking about and attempting suicide. Cognitive vulnerability models have identified rumination (i.e., perseverating on a negative mood) as a maladaptive response that may increase risk for suicidal behavior, as it has also been linked to depression. The present study examined the direct and indirect effects of stress-related symptoms on suicidal ideation through rumination and depressive symptoms. Participants were 1375 young adults, primarily non-White (78 %) females (72 %), recruited from a public university in the Northeastern U.S., who completed measures of stress-related symptoms (as a response to a stressful event), rumination, depressive symptoms, and suicidal ideation. The relation between stress-related symptoms and suicidal ideation was accounted for by the brooding subtype of rumination and depressive symptoms among females. Depressive symptoms, but not rumination, better accounted for suicidal ideation among males. These findings suggest that the role of brooding and depressive symptoms in the relationship between stress-related symptoms and suicidal ideation may vary by gender.
Voetnoten
1
To rule out moderation (vs. mediation), a linear regression analysis was conducted to examine brooding as a potential moderator of the relation between stress-related symptoms and suicidal ideation, adjusting for age and gender. There was a significant main effect of stress-related symptoms (b = 0.005, 95 % CI 0.002–0.007, p < .001), and a significant main effect of brooding (b = 0.04, 95 % CI 0.03–0.05, p < .001) on suicidal ideation. However, the interaction between stress-related symptoms and brooding was not significant (b = 0.0001, 95 % CI −0.0003 to 0.0006, p = .46).
 
2
A linear regression analysis was conducted to examine reflection rumination as a potential moderator of the relation between stress-related symptoms and suicidal ideation, adjusting for age and gender. There was a significant main effect of stress-related symptoms (b = 0.007, 95 % CI 0.005–0.009, p < .001), and a significant main effect of reflection (b = 0.02, 95 % CI 0.01–0.03, p < .001). However, the interaction effect between stress-related symptoms and reflection was not significant (b = 0.0002, 95 % CI −0.0003–0.001, p = .48).
 
Literatuur
go back to reference Abramson, L. Y., Alloy, L. B., Hogan, M. E., Whitehouse, W. G., Cornette, M., Akhavan, S., & Chiara, A. (1998). Suicidality and cognitive vulnerability to depression among college students: A prospective study. Journal of Adolescence, 21, 473–487.CrossRefPubMed Abramson, L. Y., Alloy, L. B., Hogan, M. E., Whitehouse, W. G., Cornette, M., Akhavan, S., & Chiara, A. (1998). Suicidality and cognitive vulnerability to depression among college students: A prospective study. Journal of Adolescence, 21, 473–487.CrossRefPubMed
go back to reference Abramson, L. Y., Alloy, L. B., Hogan, M. E., Whitehouse, W. G., Donovan, P., Rose, D. T., et al. (1999). Cognitive vulnerability to depression: Theory and evidence. Journal of Cognitive Psychotherapy, 13, 5–20. Abramson, L. Y., Alloy, L. B., Hogan, M. E., Whitehouse, W. G., Donovan, P., Rose, D. T., et al. (1999). Cognitive vulnerability to depression: Theory and evidence. Journal of Cognitive Psychotherapy, 13, 5–20.
go back to reference American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (DSM-IV-TR). American Psychiatric Pub. American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (DSM-IV-TR). American Psychiatric Pub.
go back to reference Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: The Psychological Corporation. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: The Psychological Corporation.
go back to reference Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S. M., & Olfson, M. (2008). Mental health of college students and their non-college-attending peers: Results from the national epidemiologic study on alcohol and related Conditions. Archives of General Psychiatry, 65, 1429–1437.CrossRefPubMedPubMedCentral Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S. M., & Olfson, M. (2008). Mental health of college students and their non-college-attending peers: Results from the national epidemiologic study on alcohol and related Conditions. Archives of General Psychiatry, 65, 1429–1437.CrossRefPubMedPubMedCentral
go back to reference Brosschot, J. F., Gerin, W., & Thayer, J. F. (2006). The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60, 113–124.CrossRefPubMed Brosschot, J. F., Gerin, W., & Thayer, J. F. (2006). The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60, 113–124.CrossRefPubMed
go back to reference Burke, T. A., Connolly, S. L., Hamilton, J. L., Stange, J. P., Abramson, L. Y., & Alloy, L. B. (2015). Cognitive risk and protective factors for suicidal ideation: A two-year longitudinal study in adolescence. Journal of Abnormal Child Psychology. doi:10.1007/s10802-015-0104-x. Burke, T. A., Connolly, S. L., Hamilton, J. L., Stange, J. P., Abramson, L. Y., & Alloy, L. B. (2015). Cognitive risk and protective factors for suicidal ideation: A two-year longitudinal study in adolescence. Journal of Abnormal Child Psychology. doi:10.​1007/​s10802-015-0104-x.
go back to reference Chan, S., Miranda, R., & Surrence, K. (2009). Subtypes of rumination in the relationship between negative life events and suicidal ideation. Archives of Suicide Research, 13, 123–135.CrossRefPubMed Chan, S., Miranda, R., & Surrence, K. (2009). Subtypes of rumination in the relationship between negative life events and suicidal ideation. Archives of Suicide Research, 13, 123–135.CrossRefPubMed
go back to reference Conner, K. R., Meldrum, S., Wieczorek, W. F., Duberstein, P. R., & Welte, J. W. (2004). The association of irritability and impulsivity with suicidal ideation among 15- to 20-year-old males. Suicide and Life-Threatening Behavior, 34, 363–373.CrossRefPubMed Conner, K. R., Meldrum, S., Wieczorek, W. F., Duberstein, P. R., & Welte, J. W. (2004). The association of irritability and impulsivity with suicidal ideation among 15- to 20-year-old males. Suicide and Life-Threatening Behavior, 34, 363–373.CrossRefPubMed
go back to reference Dumais, A., Lesage, A. D., Alda, M., Rouleau, G., Dumont, M., Chawky, N., et al. (2005). Risk factors for suicide completion in major depression: A case-control study of impulsive and aggressive behaviors in men. American Journal of Psychiatry, 162, 2116–2124.CrossRefPubMed Dumais, A., Lesage, A. D., Alda, M., Rouleau, G., Dumont, M., Chawky, N., et al. (2005). Risk factors for suicide completion in major depression: A case-control study of impulsive and aggressive behaviors in men. American Journal of Psychiatry, 162, 2116–2124.CrossRefPubMed
go back to reference Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.CrossRefPubMed Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.CrossRefPubMed
go back to reference Elwood, L. S., Hahn, K. S., Olatunji, B. O., & Williams, N. L. (2009). Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clinical Psychology Review, 29, 87–100.CrossRefPubMed Elwood, L. S., Hahn, K. S., Olatunji, B. O., & Williams, N. L. (2009). Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clinical Psychology Review, 29, 87–100.CrossRefPubMed
go back to reference Gold, D. B., & Wegner, D. M. (1995). Origins of ruminative thought: Trauma, incompleteness, nondisclosure, and suppression. Journal of Applied Social Psychology, 25, 1245–1261.CrossRef Gold, D. B., & Wegner, D. M. (1995). Origins of ruminative thought: Trauma, incompleteness, nondisclosure, and suppression. Journal of Applied Social Psychology, 25, 1245–1261.CrossRef
go back to reference Grover, K. E., Green, K. L., Pettit, J. W., Monteith, L. L., Garza, M. J., & Venta, A. (2009). Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence. Journal of Clinical Psychology, 65(12), 1281–1290.CrossRefPubMed Grover, K. E., Green, K. L., Pettit, J. W., Monteith, L. L., Garza, M. J., & Venta, A. (2009). Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence. Journal of Clinical Psychology, 65(12), 1281–1290.CrossRefPubMed
go back to reference Hayes, A. F. (2013). An introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York, NY: Guilford Press. Hayes, A. F. (2013). An introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York, NY: Guilford Press.
go back to reference Jaccard, J. (2001). Interaction effects in logistic regression. Thousand Oaks, CA: Sage.CrossRef Jaccard, J. (2001). Interaction effects in logistic regression. Thousand Oaks, CA: Sage.CrossRef
go back to reference Kessler, R. C., Berglund, P., Borges, G., Nock, M., & Wang, P. S. (2005). Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. Journal of the American Medical Association, 293, 2487–2495.CrossRefPubMed Kessler, R. C., Berglund, P., Borges, G., Nock, M., & Wang, P. S. (2005). Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. Journal of the American Medical Association, 293, 2487–2495.CrossRefPubMed
go back to reference King, R. A., Schwab-Stone, M., Flisher, A. J., Greenwald, S., Kramer, R. A., Goodman, S. H., et al. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 837–846.CrossRefPubMed King, R. A., Schwab-Stone, M., Flisher, A. J., Greenwald, S., Kramer, R. A., Goodman, S. H., et al. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 837–846.CrossRefPubMed
go back to reference Kraemer, H. C., Stice, E., Kazdin, A., Offord, D., & Kupfer, D. (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry, 158, 163–171.CrossRef Kraemer, H. C., Stice, E., Kazdin, A., Offord, D., & Kupfer, D. (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry, 158, 163–171.CrossRef
go back to reference Linehan, M. M., & Nielsen, S. L. (1981). Assessment of suicide ideation and parasuicide: Hopelessness and social desirability. Journal of Consulting and Clinical Psychology, 49, 773.CrossRefPubMed Linehan, M. M., & Nielsen, S. L. (1981). Assessment of suicide ideation and parasuicide: Hopelessness and social desirability. Journal of Consulting and Clinical Psychology, 49, 773.CrossRefPubMed
go back to reference Marshall, R. D., Olfson, M., Hellman, F., Blanco, C., Guardino, M., & Struening, E. L. (2001). Comorbidity, impairment, and suicidality in subthreshold PTSD. American Journal of Psychiatry, 158, 1467–1473.CrossRefPubMed Marshall, R. D., Olfson, M., Hellman, F., Blanco, C., Guardino, M., & Struening, E. L. (2001). Comorbidity, impairment, and suicidality in subthreshold PTSD. American Journal of Psychiatry, 158, 1467–1473.CrossRefPubMed
go back to reference Mazza, J. J. (2000). The relationship between posttraumatic stress symptomatology and suicidal behavior in school-based adolescents. Suicide and Life-Threatening Behavior, 30, 91–103.PubMed Mazza, J. J. (2000). The relationship between posttraumatic stress symptomatology and suicidal behavior in school-based adolescents. Suicide and Life-Threatening Behavior, 30, 91–103.PubMed
go back to reference Miranda, R., & Nolen-Hoeksema, S. (2007). Brooding and reflection: Rumination predicts suicidal ideation at 1-year follow-up in a community sample. Behaviour Research and Therapy, 45, 3088–3095.CrossRefPubMedPubMedCentral Miranda, R., & Nolen-Hoeksema, S. (2007). Brooding and reflection: Rumination predicts suicidal ideation at 1-year follow-up in a community sample. Behaviour Research and Therapy, 45, 3088–3095.CrossRefPubMedPubMedCentral
go back to reference Morrison, R., & O’Connor, R. C. (2008). A systematic review of the relationship between rumination and suicidality. Suicide and Life-Threatening Behavior, 38, 523–538.CrossRefPubMed Morrison, R., & O’Connor, R. C. (2008). A systematic review of the relationship between rumination and suicidality. Suicide and Life-Threatening Behavior, 38, 523–538.CrossRefPubMed
go back to reference Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic Reviews, 30, 133–154.CrossRefPubMedPubMedCentral Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic Reviews, 30, 133–154.CrossRefPubMedPubMedCentral
go back to reference Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061.CrossRefPubMed Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061.CrossRefPubMed
go back to reference Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400–424.CrossRefPubMed Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400–424.CrossRefPubMed
go back to reference Oquendo, M. A., Sullivan, G. M., Sudol, K., Baca-Garcia, E., Stanley, B. H., Sublette, M. E., & Mann, J. J. (2014). Toward a biosignature for suicide. American Journal of Psychiatry, 171, 1259–1277.CrossRefPubMedPubMedCentral Oquendo, M. A., Sullivan, G. M., Sudol, K., Baca-Garcia, E., Stanley, B. H., Sublette, M. E., & Mann, J. J. (2014). Toward a biosignature for suicide. American Journal of Psychiatry, 171, 1259–1277.CrossRefPubMedPubMedCentral
go back to reference Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and nonclinical samples. Assessment, 8, 443–454.CrossRefPubMed Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The Suicidal Behaviors Questionnaire-Revised (SBQ-R): Validation with clinical and nonclinical samples. Assessment, 8, 443–454.CrossRefPubMed
go back to reference Pettit, J. W., & Joiner, T. J. (2006). Cognitive vulnerability to suicide. In L. B. Alloy, J. H. Riskind, L. B. Alloy, & J. H. Riskind (Eds.), Cognitive vulnerability to emotional disorders (pp. 125–154). Mahwah, NJ: Lawrence Erlbaum Associates Publishers. Pettit, J. W., & Joiner, T. J. (2006). Cognitive vulnerability to suicide. In L. B. Alloy, J. H. Riskind, L. B. Alloy, & J. H. Riskind (Eds.), Cognitive vulnerability to emotional disorders (pp. 125–154). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
go back to reference Polanco-Roman, L., Jurska, J., Quiñones, V., & Miranda, R. (2015). Brooding, reflection, and distraction: Relation to non-suicidal self-injury versus suicide attempts. Archives of Suicide Research, 19, 350–365.CrossRefPubMed Polanco-Roman, L., Jurska, J., Quiñones, V., & Miranda, R. (2015). Brooding, reflection, and distraction: Relation to non-suicidal self-injury versus suicide attempts. Archives of Suicide Research, 19, 350–365.CrossRefPubMed
go back to reference Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavioral Research Methods, 40, 879–891.CrossRef Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavioral Research Methods, 40, 879–891.CrossRef
go back to reference Selaman, Z. M., Chartrand, H. K., Bolton, J. M., & Sareen, J. (2014). Which symptoms of post-traumatic stress disorder are associated with suicide attempts? Journal of Anxiety Disorders, 28, 246–251.CrossRefPubMed Selaman, Z. M., Chartrand, H. K., Bolton, J. M., & Sareen, J. (2014). Which symptoms of post-traumatic stress disorder are associated with suicide attempts? Journal of Anxiety Disorders, 28, 246–251.CrossRefPubMed
go back to reference Smith, J. M., Alloy, L. B., & Abramson, L. Y. (2006). Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: Multiple pathways to self-injurious thinking. Suicide and Life-threatening Behavior, 36, 443–454.CrossRefPubMed Smith, J. M., Alloy, L. B., & Abramson, L. Y. (2006). Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: Multiple pathways to self-injurious thinking. Suicide and Life-threatening Behavior, 36, 443–454.CrossRefPubMed
go back to reference Surrence, K., Miranda, R., Marroquin, B. M., & Chan, S. (2009). Brooding and reflective rumination among suicide attempters: Cognitive vulnerability to suicidal ideation. Behaviour Research and Therapy, 47, 803–808.CrossRefPubMed Surrence, K., Miranda, R., Marroquin, B. M., & Chan, S. (2009). Brooding and reflective rumination among suicide attempters: Cognitive vulnerability to suicidal ideation. Behaviour Research and Therapy, 47, 803–808.CrossRefPubMed
go back to reference Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247–259.CrossRef Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247–259.CrossRef
go back to reference Wang, Y., Sareen, J., Afifi, T. O., Bolton, S. L., Johnson, E. A., & Bolton, J. M. (2012). Recent stressful life events and suicide attempt. Psychiatric Annals, 42(3), 101–108. Wang, Y., Sareen, J., Afifi, T. O., Bolton, S. L., Johnson, E. A., & Bolton, J. M. (2012). Recent stressful life events and suicide attempt. Psychiatric Annals, 42(3), 101–108.
go back to reference Weiss, D. S. (2007). The impact of event scale: Revised. In J. P. Wilson, & C. S. Tang (Eds.), Cross-cultural assessment of psychological trauma and PTSD (pp. 219–238). New York, NY, US: Springer Science + Business Media. Weiss, D. S. (2007). The impact of event scale: Revised. In J. P. Wilson, & C. S. Tang (Eds.), Cross-cultural assessment of psychological trauma and PTSD (pp. 219–238). New York, NY, US: Springer Science + Business Media.
go back to reference Wenzel, A., & Beck, A. T. (2008). A cognitive model of suicidal behavior: Theory and treatment. Applied and Preventive Psychology, 12, 189–201.CrossRef Wenzel, A., & Beck, A. T. (2008). A cognitive model of suicidal behavior: Theory and treatment. Applied and Preventive Psychology, 12, 189–201.CrossRef
go back to reference Wu, K., Zhang, Y., Liu, Z., Zhou, P., & Wei, C. (2015). Coexistence and different determinants of posttraumatic stress disorder and posttraumatic growth among Chinese survivors after earthquake: Role of resilience and rumination. Frontiers in Psychology, 6(1043), 1–9. Wu, K., Zhang, Y., Liu, Z., Zhou, P., & Wei, C. (2015). Coexistence and different determinants of posttraumatic stress disorder and posttraumatic growth among Chinese survivors after earthquake: Role of resilience and rumination. Frontiers in Psychology, 6(1043), 1–9.
go back to reference Zetsche, U., Ehring, T., & Ehlers, A. (2009). The effects of rumination on mood and intrusive memories after exposure to traumatic material: An experimental study. Journal of Behavior Therapy and Experimental Psychiatry, 40, 499–514.CrossRefPubMedPubMedCentral Zetsche, U., Ehring, T., & Ehlers, A. (2009). The effects of rumination on mood and intrusive memories after exposure to traumatic material: An experimental study. Journal of Behavior Therapy and Experimental Psychiatry, 40, 499–514.CrossRefPubMedPubMedCentral
Metagegevens
Titel
Stress-Related Symptoms and Suicidal Ideation: The Roles of Rumination and Depressive Symptoms Vary by Gender
Auteurs
Lillian Polanco-Roman
Judelysse Gomez
Regina Miranda
Elizabeth Jeglic
Publicatiedatum
03-05-2016
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 5/2016
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-016-9782-0

Andere artikelen Uitgave 5/2016

Cognitive Therapy and Research 5/2016 Naar de uitgave