The Association between Ruminative Thoughts and Mindfulness among Patients with Major Depressive Disorder: A Cross-sectional Study
DOI:
https://doi.org/10.60099/jtnmc.v39i03.268804Keywords:
ruminative thoughts, mindfulness, depression, patients with major depressive disorderAbstract
Introduction Addressing depression requires a comprehensive approach. Investigating the relationship between ruminative thought and mindfulness in patients with major depressive disorder is crucial.
Objective This study aimed to investigate the correlation between ruminative thoughts and mindfulness in patients with major depressive disorder in the community.
Design A cross-sectional study
Methodology Participants included 75 patients diagnosed with major depressive disorder in the maintenance phase of antidepressant therapy, purposively selected from a psychiatric hospital and community hospitals in a northeastern province of Thailand. Data were collected using questionnaires consisting of demographic and clinical characteristics, as well as assessments using Beck’s Depression Inventory, Ruminative Response Scale, and Philadelphia Mindfulness Scale. Data were analyzed using descriptive statistics and Pearson’s Product Moment Correlation Coefficient.
Results The majority of participants were female, with an average age of 51.08 years (SD = 15.46). Depressive symptoms over the past two weeks were classified as minimal (33.3%), mild-moderate (25.3%), moderately severe (28.0%), and severe (13.3%). The results indicated a significant positive correlation between depression severity and overall ruminative thought and its dimensions (r = .562, p<.001). Additionally, there were significant positive correlations between depression severity and overall and all dimensions of ruminative thoughts (brooding, reflection, and depression-related items) (r = .441, .483, .592, p<.001, respectively). Furthermore, a significant negative correlation was found between ruminative thoughts and mindfulness (r = -.292, p = .012). However, no correlation was found between depression and mindfulness.
Recommendation Patients with major depressive disorder undergoing antidepressant treatment typically have high ruminative thoughts. The results of this study provide basic information for predictive research that could lead to the development of community-based therapeutic programs for patients with depression, aimed at reducing ruminative thoughts and depression, resulting in preventing recurrent depression.
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GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the global burden of disease study 2017. Lancet (London, England). 2018;392(10159):1789-858. https://doi.org/10.1016/S0140-6736(18)32279-7 PMID: 30496104
Bueno-Notivol J, Gracia-García P, Olaya B, Lasheras I, López-Antón R, Santabárbara J. Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. Int J Clin Health Psychol. 2021;21(1):100196. https://doi.org/10.1016/j.ijchp.2020.07.007 PMID: 32904715
American Psychiatric Association. DSM-5 Overview: The Future Manual. [Last accessed on 2018, Jul 21]. Available from: https://www.psychiatry.org/dsm5
World Health Organization. Depression. [Last accessed on 2020, July 28]. Available from: https://www.who.int/health-topics/depression#tab=tab_1
Singh MK, Gotlib IH. The neuroscience of depression: Implications for assessment and intervention. Behav Res Ther. 2014;62:60-73. https://doi.org/10.1016/j.brat.2017.03.001 PMID: 25239242
LeMoult J, Gotlib IH. Depression: A cognitive perspective. Clin Psychol Rev. 2019;69:51-66. https://doi.org/10.1016/j.cpr.2018.06.008 PMID: 29961601
Hammar Å, Ronold EH, Rekkedal GÅ. Cognitive impairment and neurocognitive profiles in major depression-A clinical perspective. Front Psychiatry. 2022;13: 764374. https://doi.org/10.3389/fpsyt.2022.764374 PMID: 35345877
Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: Findings from the global burden of disease study. J Psychiatr Res. 2020;126:134-40. https://doi.org/10.1016/j.jpsychires.2019.08.002 PMID: 31439359
Odou N, Brinker J. Self-compassion, a better alternative to rumination than distraction as a response to negative mood. J Posit Psychol. 2015;10(5):447-57. https://doi.org/10.1080/17439760.2014.967800
Mahmoud AS, El-said SG, Abd El-Hay NH. Ruminative thinking and mindfulness among patients with depression. International Journal of Psychiatric and Mental Health. 2020;V1(3):1-9
Kim H, Newman MG. Worry and rumination enhance a positive emotional contrast based on the framework of the Contrast Avoidance Model. J Anxiety Disord. 2023;94:102671. https://doi.org/10.1016/j.janxdis.2023.102671 PMID: 36681058
Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3(5):400-24.
Vanderhasselt MA, De Raedt R, Dillon DG, Dutra SJ, Brooks N, Pizzagalli DA. Decreased cognitive control in response to negative information in patients with remitted depression: An event-related potential study. J Psychiatry Neurosci. 2012;37(4):250-8. https://doi.org/10.1503/jpn.110089 PMID: 22433449
Clawson A, Clayson PE, Larson MJ. Cognitive control adjustments and conflict adaptation in major depressive disorder. Psychophysiology. 2013; 50(8):711-21.
Beam E, Appelbaum LG, Jack J, Moody J, Huettel SA. Mapping the semantic structure of cognitive neuroscience. J Cogn Neurosci. 2014;26(9):1949-65. https://doi.org/10.1162/jocn_a_00604 PMID: 24666126.
Whitmer AJ, Gotlib IH. An attentional scope model of rumination. Psychol Bull. 2013;139(5):1036-61. https://doi.org/10.1037/a0030923 PMID: 23244316
Wagner G, Sinsel E, Sobanski T, Köhler S, Marinou V, Mentzel HJ, et al. Cortical inefficiency in patients with unipolar depression: An event-related fmri study with the stroop task. Biol Psychiatry. 2006;59(10): 958-65. https://doi.org/10.1016/j.biopsych.2005.10.025 PMID: 16458263
Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clin. Psychol.: Sci. Pract. 2003;10(2):144-56.
Lopez GC. Do mindfulness, rumination or social problem-solving factors predict distress? United States: Rowan University; 2015.
Foroughi A, Sadeghi K, Parvizifard A, Parsa Moghadam A, Davarinejad O, Farnia V, et al. The effectiveness of mindfulness-based cognitive therapy for reducing rumination and improving mindfulness and selfcompassion in patients with treatment-resistant depression. Trends Psychiatry Psychother. 2020;42: 138-46. https://doi.org/10.1590/2237-6089-2019-0016 PMID: 32696895
Williams JM, Crane C, Barnhofer T, Brennan K, Duggan DS, Fennell MJ, et al. Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: A randomized dismantling trial. J Consult Clin Psychol. 2014;82(2):275-86. https://doi.org/10.1037/a0035036 PMID: 24294837
Royuela-Colomer E, Calvete E. Mindfulness facets and depression in adolescents: Rumination as a mediator. Mindfulness. 2016;7(5):1092-102.
Kearns NP, Shawyer F, Brooker JE, Graham AL, Enticott JC, Martin PR, et al. Does rumination mediate the relationship between mindfulness and depressive relapse? Psychol Psychother. 2016;89(1):33-49. https://doi.org/10.1111/papt.12064 PMID: 26 119013
Raes F, Williams JMG. The relationship between mindfulness and uncontrollability of ruminative thinking. Mindfulness. 2010;1(4):199-203.
Gopalkrishnan N. Cultural diversity and mental health: Considerations for policy and practice. Front Public Health. 2018;6:179. https://doi.org/10.3389/fpubh.2018.00179 PMID: 29971226
Heissel A, Pietrek A, Kangas M, Van der Kaap-Deeder J, Rapp MA. The mediating role of rumination in the relation between basic psychological need frustration and depressive symptoms. J Clin Med. 2023;12(2): 395. https://doi.org/10.3390/jcm12020395 PMID: 36675329
Segal ZV, Williams JMG, Teasdale JD. Mindfulness- Based Cognitive Therapy for Depression (2nd ed.). The Guilford Press; 2013.
Thompson, R., & Green, D. (2019). Ensuring Robust Study Results through Adequate Sample Sizes. Research Methods Quarterly. 2019;58(1), 98-107.
Beck AT, Steer RA, Carbin MG. Psychometric properties of the beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review. 1988; 8(1):77-100.
Sriyong M. Beck depression inventory ia, bdi-ia. Bangkok: Ramkhamhaeng University; 1979.
Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 loma prieta earthquake. J Pers Soc Psychol. 1991;61(1):115-21.
Thanoi W, Panitrat R, Phancharoenworakul K, Thompson EA, Nityasuddhi D. The adolescent ruminative response scale (Thai version): Psychometric properties. J Nurs Sci. 2001;29(3):19-38.
Cardaciotto L, Herbert JD, Forman EM, Moitra E, Farrow V. The assessment of present-moment awareness and acceptance: The philadelphia mindfulness scale. Assessment. 2008;15(2):204-23.
Silpakit C, Wisajun P, Silpakit O. The validity of philadelphia mindfulness scale Thai version. J Ment Health Thai. 2001;19(3):140-7.
Brosschot JF, Gerin W, Thayer JF. The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. J Psychosom Res. 2006;60(2):113-24. https://doi.org/10.1016/j.jpsychores.2005.06.074 PMID: 16439263
Watkins ER. Constructive and unconstructive repetitive thought. Psychol Bull. 2008;134(2): 163-206. https://doi.org/10.1037/0033-2909.134.2.163 PMID: 18298268
Goldney R. Depressive rumination: Nature, theory and treatment. Aust. N. Z. J. Psychiatry. 2004;38(8):655-6.
Rungreangkulkij S, Thongyot S, Kotnara I, Wannatong K. Efficacy of Buddhist counseling on decrease depressive symptoms of patients with depressive disorder. J Psychiatr Assoc Thailand. 2014;59(4): 381-93.
Gherardi-Donato EdS, Moraes VSd, Esper LH, Zanetti ACG, Fernandes MNdF. Mindfulness measurement instruments: A systematic review. Int J Psychiatr Res. 2020;3(4):1-12.
Watkins ER, Roberts H. Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination. Behav Res Ther. 2020;127:103573. https://doi.org/10.1016/j.brat.2020.103573 PMID: 32087393.
C-Maharsujchakuen J, Uthis P. The effect of mindful self-compassion training program on depression in persons with depressive disorder. RTN Med J. 2019;46(1):98-114.
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