Understanding and treating depressive rumination

Zygouris, Nikolaos (2012). Understanding and treating depressive rumination. University of Birmingham. Clin.Psy.D.

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Abstract

Introduction
Depressive rumination is a type of repetitive thought with deleterious effect on mental health. Depressive rumination is associated with deficits in the control of working memory and has been shown to be a robust predictor of onset and severity of a depressive episode. Consequently, a number of therapeutic approaches for depression endeavour to remediate depressive rumination either directly or by proxy in an effort to alleviate depressed mood and to prevent relapse. Maintenance of depressed mood has been argued to be the result of a deficit in the ability to regulate depressiogenic cognitive structures. This review investigates which of these structures are targeted by current psychotherapeutic interventions.

Method
A computerised search using key words was conducted on a number of academic databases to identify peer-reviewed articles documenting the efficacy of treatments of depressive rumination. Additional references were obtained through the references section of relevant articles and chapters. The resulting articles were arranged thematically under their respective intervention within two broad groups: interventions aimed at restructuring cognitive content and behavioural interventions.

Results
Results identified evidence for both cognitive interventions, such as cognitive therapy, metacognitive therapy and mindfulness therapy, and for behavioural interventions, such as distraction, aversion behavioural activation and graded exposure.

Discussion
Current therapeutic treatments of depressive rumination appear to privilege interventions targeting the reappraisal of cognitive content and the disruption of activation of mood congruent cognitions, whilst omitting to directly remediate the structural deficit in cognitive inhibition of depressiogenic thoughts. Treatments such as cognitive remediation therapy can target such structural cognitive deficits. The article proposes that future research needs to investigate the effectiveness of such interventions for the treatment of depressive rumination and depression.

Type of Work:

Thesis (Doctorates > Clin.Psy.D.)

Award Type:

Doctorates > Clin.Psy.D.

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