عوامل مرتبط با روانی- اجتماعی نشخوار فکری افسرده

The study examined the relationship between brooding, the maladaptive sub-component of depressive rumination, an important cognitive mechanism implicated in the aetiology of depression, and a range of depressogenic psychosocial factors, including insecure attachment styles and maladaptive interpersonal behaviours. It was hypothesised that brooding (but not the more adaptive reflection component) is associated with an attachment pattern characterised by fear of rejection, and an interpersonal style characterised by submissiveness. Currently depressed (n = 29), previously depressed (n = 42) and never-depressed (n = 32) adults completed self-report measures assessing depressive symptoms, rumination (brooding and reflection), attachment orientation and maladaptive interpersonal behaviours. The study hypotheses were partially supported: After controlling for gender and depressive symptoms, brooding was significantly associated with one indicator of underlying rejection concerns (rejection sensitivity, p = .05), but was not associated with another indicator of underlying rejection concerns (anxious attachment style) or with avoidant attachment style. After controlling for depressive symptoms, brooding was uniquely associated with the submissive interpersonal style (p < .01). Brooding was not correlated with needy or cold interpersonal styles after controlling for depressive symptoms.

Rumination, defined as repetitive focus on depressive symptoms and their causes and meanings (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008), has been implicated in the onset and maintenance of depression, in both experimental and prospective longitudinal studies (for reviews see Nolen-Hoeksema et al., 2008 and Watkins, 2008). Treynor, Gonzalez, and Nolen-Hoeksema (2003) distinguished between maladaptive brooding, defined as “a passive comparison of one’s current situation with some unachieved standard” (p. 256), which prospectively predicted increase in depressive symptoms, and a more adaptive reflection factor, defined as actively attempting to gain insight into problems, which did not. Previous empirical studies indicate that brooding encapsulates the most harmful aspects of rumination (Burwell and Shirk, 2007 and Treynor et al., 2003). Thus, brooding but not reflection has been found to prospectively predict depression in community adults (Treynor et al., 2003), adolescents (Burwell & Shirk, 2007) and students (Olson & Kwon, 2008). Similarly, there is a body of theory and supporting empirical evidence which indicates that interpersonal factors can confer vulnerability to depression. Indeed, Joiner, Coyne, and Blalock (1999, p. 7) argued that ‘the strongest implication of the interpersonal approach is that depression not only has interpersonal features and consequences but also is fundamentally interpersonal in nature’. Interpersonal factors implicated in the aetiology of depression include insecure attachment orientations characterised by fear of rejection (anxious attachment style; Carnelley, Pietromonaco, & Jaffe, 1994, rejection sensitivity; Ayduk, Downey, & Kim, 2001) and specific maladaptive interpersonal behaviours, such as submissive behaviours (Allan and Gilbert, 1997, Cheung et al., 2004 and Irons and Gilbert, 2005), lack of assertiveness (Ball et al., 1994, Hirschfeld et al., 1983, Segal, 2005 and Youngren and Lewinsohn, 1980), and excessive reassurance-seeking (Joiner and Metalsky, 2001 and Joiner and Schmidt, 1998). Given that rumination, insecure attachment styles, and maladaptive interpersonal behaviours are all implicated in the aetiology of depression, it is unsurprising that these processes are associated. In a sample of individuals with major depression, Lam, Schuck, Smith, Farmer, and Checkley (2003) found that rumination was significantly positively correlated with a spectrum of interpersonal difficulties related to control, assertiveness, submission, intimacy, and impaired social functioning. In another correlational study, rumination was associated with reduced relationship satisfaction in a sample of remitted depressed individuals (Kuehner & Buerger, 2005). These findings are consistent with the hypothesis that rumination is a “cognitive motor” contributing to the development of maladaptive interpersonal processes, such as excessive reassurance-seeking, passivity and poor social problem solving (Joiner, 2000, p. 211). However, a number of important questions remain unresolved about the relationship between interpersonal functioning and rumination in depression. First, is the relationship simply a result of their shared association with depressive symptoms? Second, is rumination generally associated with all forms of poor interpersonal functioning, or with specific interpersonal styles? Third, what is the causal direction between rumination and poor interpersonal functioning? This cross-sectional study attempts to answer the first two questions. Given an increasing interest in rumination and interpersonal functioning, it is clearly important to determine whether any association between rumination and interpersonal functioning is dependent upon shared variance with depression. Without this clarification, a literature could emerge which is built on unreliable foundations. A closer examination of the rumination literature suggests the hypothesis that depressive rumination is associated with a specific subset of interpersonal difficulties and that this association is not solely due to shared associations with depression. First, Nolen-Hoeksema and Jackson (2001) argued that individuals who are preoccupied with maintaining close relationships are likely to engage in rumination as a form of hyper-vigilance to emotional states in self and others. Moreover, Saffrey and Ehrenberg (2007) hypothesised that rumination maintains awareness of vulnerability to abandonment, and that individuals who are sensitive to rejection are likely to ruminate in response to interpersonal loss, and to demonstrate a “difficulty overcoming depression and despair, resulting in preoccupation with the lost relationship” (p. 253). Thus, it is theoretically plausible both that rejection sensitivity might fuel rumination, and that rumination might activate underlying rejection concerns. Second, because rumination is a passive response mode implicated in both increased negative thinking and impaired interpersonal problem solving (Lyubomirsky and Nolen-Hoeksema, 1995 and Lyubomirsky et al., 1999), and reduced motivation and initiative (Lyubomirsky & Nolen-Hoeksema, 1993), it is feasible that rumination is associated with a submissive interpersonal style. Thus, relevant theories suggest that there may be a bidirectional, relationship between rumination and an attachment orientation characterised by rejection concerns and interpersonal style characterised by passivity/submissiveness. Consistent with this hypothesis, there is a broad pattern of evidence suggesting that rumination is associated with an attachment orientation characterised by fear of rejection and submissive, overly-accommodating, non-assertive and self-sacrificing behaviours, First, rumination mediated the effect of attachment anxiety on how individuals responded to a relationship break-up, with rumination associated with increased adjustment difficulties in anxiously attached individuals (Saffrey & Ehrenberg, 2007). Second, rumination was positively correlated with ‘unmitigated communion’, defined as “focus on others to the exclusion of self” (Helgeson, 1994, p. 416), which reflects an undue sense of responsibility for maintaining the emotional tone of relationships (Nolen-Hoeksema & Jackson, 2001), Third, rumination was positively correlated with sociotropy, a measure assessing “motivation toward social-relatedness success”, in a student sample (Gorski & Young, 2002, p. 465). Thus, there is some evidence consistent with the hypothesis that rumination is associated with an attachment orientation characterised by rejection sensitivity, and a submissive interpersonal style. However, there are a number of limitations to the existing data. First, some of the studies which have investigated psychosocial correlates of rumination did not control for level of depression (e.g., Gorski & Young, 2002) and a number utilized only non-clinical student samples (e.g., Gorski and Young, 2002 and Saffrey and Ehrenberg, 2007) or only clinical samples (e.g., Lam et al., 2003). Second, the majority of studies only assessed one or two interpersonal constructs rather than incorporating a range of measures that provide comprehensive coverage across the spectrum of interpersonal styles and behaviours. The inclusion of a range of interpersonal measures is necessary to determine whether rumination is associated with insecure attachment patterns generally or specifically the anxious attachment style, and to assess whether rumination is associated specifically with the submissive interpersonal styles, or whether rumination is also correlated with other maladaptive interpersonal styles, or whether the association with rumination is specific to one interpersonal style, which accounts for the variance of the other styles with rumination. Third, few studies have assessed patterns of interpersonal behaviour. This is an important omission because we would expect rumination and maladaptive interpersonal behaviours to be influenced by underlying relationship concerns. For example, anxiety about rejection would be expected to trigger rumination and submissive and placating behaviours to prevent abandonment (Zuroff & Fitzpatrick, 1995). Fourth, whilst the findings are broadly consistent with rumination being associated with excessive relatedness concerns, there are some mixed findings: Spasojević and Alloy (2001) found a relationship between rumination and the self-critical style, whilst Gorski and Young (2002) found a relationship between rumination and autonomy, conceptually similar constructs assessing investment in independence and achievement-related goals. The current study tested the hypotheses that: (a) rumination is associated with an attachment orientation characterised by fear of rejection; (b) rumination is associated with an interpersonal style characterised by submissive interpersonal behaviours. Importantly, we predicted that the relationship between rumination and these depressogenic interpersonal variables is not simply the consequence of a shared association with level of depression. Moreover, we predicted that the hypothesised relationships between rumination and these depressogenic interpersonal variables would be specifically attributable to the maladaptive brooding component, and that the predicted pattern of results would not be replicated with the reflection sub-scale. To test this hypothesis, the current study extended previous research by including a comprehensive range of interpersonal measures, by statistically controlling for depressive symptoms, by differentiating between brooding and reflection, and by selecting a mixed sample of currently depressed, formerly depressed, and never-depressed participants.