Rumiación cognitiva y afecto negativo como predictores diferenciales de los síntomas psicopatológicos internalizantes / Cognitive rumination and negative affect as differential predictors of internalizing psychopathological symptoms

Resumen Los modelos transdiagnósticos para los problemas de ansiedad, depresión y somatización han tenido evidencia para variables como la rumiación cognitiva y el afecto negativo; sin embargo, las asociaciones diferenciales entre estas dos variables en la explicación psicopatológica requiere aún ser investigada. El objetivo fue analizar la relación entre la rumiación cognitiva según las dimensiones de la rumiación: reproche y reflexión, con el afecto negativo y los síntomas psicopatológicos internalizantes depresivos, ansiosos y psicosomáticos en adultos colombianos. Se llevó a cabo una investigación cuantitativa con un diseño transversal explicativo, en el que se definió una red estructural de relaciones entre constructos mediante un diagrama de senderos y ecuaciones estructurales. Se contó con una muestra final de 640 personas, con una edad media de 31.07 años (DE = 11.27). Los resultados indicaron correlaciones significativas parciales y de orden cero entre las variables transdiagnósticas y las sintomáticas internalizantes, mediante un modelo ajustado que permitió explicar en un 74 % estas problemáticas a partir de la rumiación cognitiva y la función mediadora parcial del afecto negativo. En los síntomas depresivos y ansiosos se obtuvo que están mediados parcialmente por el afecto negativo, mientras que la medida de somatización obtuvo un coeficiente de regresión significativo con el afecto negativo como predictor independiente. Estos resultados aportan a la comprensión de la interacción de la rumiación y el afecto en la aparición de los síntomas internalizantes de manera diferencial. Se recomendó contar con una muestra clínica que ayudaría a identificar con mayor precisión la varianza explicada del modelo obtenido, lo que favorecerá los actuales tratamientos transdiagnósticos disponibles.

Abstract The transdiagnostic models of anxiety, depression and somatization problems have had evidence for variables such as cognitive rumination and negative affect, however, the differential associations between these two variables in the psychopathological explanation, still need to be investigated. The aim was to analyze the relationship between cognitive rumination according to the two dimensions: brooding and reflection, with negative affect and depressive, anxious, and psychosomatic internalizing psychopathological symptoms. A quantitative research was carried out with an explanatory cross-sectional design in which a structural network of relationships between constructs was defined by a path diagram and structural equations. There was a final sample of 640 people with a mean age of 31.07 years (SD = 11.27). The results indicated significant partial and zero-order correlations between transdiagnostic and internalizing symptomatic variables, using an adjusted model that allowed explaining these problems in 74% from cognitive rumination, and the partial mediating function of negative affect. In depressive and anxious symptoms, they were partially mediated by the negative affect, while the somatization measure obtained a significant regression coefficient with the negative affect as an independent predictor. These results contribute to the understanding of the interaction of rumination and affect in the appearance of differential internalizing symptoms. It was recommended to have a clinical sample that would help to more accurately identify the explained variance of the obtained model, as well as favor the current and available transdiagnostic treatments.

The effectiveness of mindfulness-based cognitive therapy for reducing rumination and improving mindfulness and self-compassion in patients with treatment-resistant depression

Abstract Introduction Depression is one of the most important psychiatric disorders, and the rate of recurrence is high. The heavy cost burden of depression is probably due to treatment-resistant depression. The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) in patients with treatment-resistant depression (TRD). Method The present study was a quasi-experimental study conducted with twenty-four patients with treatment-resistant depression. Participants were selected by purposive sampling and randomly assigned to two groups, an experimental group and a control group. The experimental group received MBCT and antidepressants, while the control group received antidepressants only. The Hamilton and Beck Depression Inventory, Self-Compassion Scale, Thought Rumination Scale, and Mindfulness Scale were administered. The treatment program was conducted in eight sessions; with a follow-up period of one month subsequent to treatment termination. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance for repeated measures and Bonferroni's post-hoc test). Results The results showed that MBCT significantly reduced depression and ruminative thinking in the experimental group and also improved mediators such as mindfulness and self-compassion. Patients maintained gains over the one month follow-up period (p < 0.01). Conclusion The present study provides additional evidence for the effectiveness of MBCT for TRD.

Rumiación cognitiva y psicopatologías externalizantes: una revisión sistemática / Cognitive rumination and externalizing psychopathologies: a systematic review

Las psicopatologías internalizantes y externalizantes se asocian con la rumiación cognitiva según el modelo transdiagnóstico. Sin embargo, en las externalizantes esta asociación requiere mayores avances investigativos en el campo. El objetivo del estudio fue evidenciar de manera sistemática y estructurada, la investigación reciente sobre la relación entre la psicopatología externalizante y la rumiación cognitiva. Se realizó una revisión sistemática a partir de las pautas del Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). En las bases de datos científicas y metabuscadores se seleccionaron los estudios publicados que cumplían con los criterios de elegibilidad propuestos para el estudio. Se empleó un sistema de calificación por jueces para el control de sesgo. En la selección final, se obtuvieron 17 artículos de investigación depurados de los 7636 seleccionados inicialmente. Los resultados evidenciaron que las conductas desadaptadas, agresivas, el tono de voz elevado, la ingesta desproporcionada de alcohol, la agitación psicomotora y la desobediencia, están asociados a la rumiación cognitiva. Esto se evidenció en correlaciones estadísticamente significativas con la ira, como un factor antecesor de la conducta externalizante. Por otra parte, se encontró que los factores como la angustia, el estrés, la irritabilidad, el miedo y las experiencias laborales negativas, desencadenan un incremento en la rumiación cognitiva. Esto conlleva a desajustes comportamentales, asociados a escasos de recursos de afrontamiento y autocontrol, en particular ante la provocación y la respuesta emocional de ira.

Internalizing and externalizing psychopathologies are associated with cognitive rumination according to the transdiagnostic model. However, in externalizing, this association requires further research in the field. The aim of the study, was to provide systematic and structured evidence of recent research, about the relationship between externalizing psychopathology and cognitive rumination. A systematic review was performed based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Published studies that met the proposed eligibility criteria for the study were selected from the scientific and database metasearch engines. Interjudges agreement system was used to control bias. In the final selection, 17 refined research articles were obtained from the 7636 initially selected. The results showed that maladaptive, aggressive behaviors, high tone of voice, disproportionate alcohol intake, psychomotor agitation, and oppositional behavior, are associated with cognitive rumination. It was evidenced in statistically significant correlations with anger, as a predisposing factor for externalizing behavior. Moreover, it was found that factors such as anxiety, stress, irritability, fear, and negative work experiences, trigger an increase in cognitive rumination. This leads to behavioral maladjustments, associated with scarce coping and self-control resources, particularly in the face of provocation and the emotional response of anger

Brazilian Portuguese version of the Anger Rumination Scale (ARS-Brazil) / Versão em português brasileiro da Escala de Ruminação de Raiva (ARS-Brasil)

Abstract Objective To describe the cross-cultural adaptation of the Anger Rumination Scale (ARS) for use in Brazil. Methods The cross-cultural adaptation followed a four-step process, based on specialized literature: 1) investigation of conceptual and item equivalence; 2) translation and back-translation; 3) pretest; and 4) investigation of operational equivalence. Results A final Brazilian version of the instrument (ARS-Brazil) was defined and is presented. Pretest results revealed that the instrument was generally well understood by adults as well as indicated a few modifications that were included in the final version presented here. Conclusion The Brazilian Portuguese version of the ARS seems to be very similar to the original ARS in terms of conceptual and item equivalence, semantics, and operational equivalence, suggesting that future cross-cultural studies may benefit from this early version. As a result, a new instrument is now available for the assessment of rumination symptoms of anger and irritability for adults in community, clinical, and research settings.

Resumo Objetivo Descrever a adaptação transcultural da Escala de Ruminação de Raiva (Anger Rumination Scale, ARS) para uso no Brasil. Método A adaptação transcultural seguiu um processo de quatro etapas baseado em literatura especializada: 1) investigação da equivalência conceitual e dos itens; 2) tradução e retrotradução; 3) pré-teste; e 4) investigação da equivalência operacional. Resultados Uma versão final brasileira do instrumento, denominada ARS-Brasil, foi obtida e é apresentada. Os resultados do pré-teste demonstraram que a escala foi predominantemente bem entendida entre adultos, e indicaram algumas modificações que foram incluídas na versão final. Conclusão A versão da ARS adaptada para o português brasileiro mostra-se muito similar à versão original da ARS no que diz respeito à equivalência conceitual e dos itens, semântica e equivalência operacional, sugerindo que futuros estudos transculturais poderiam se beneficiar desta primeira versão. Como resultado, um novo instrumento está agora disponível para a avaliação de sintomas de ruminação da raiva e da irritabilidade para adultos, em contextos comunitário, clínico e de pesquisa.

Cognitive processes of cancer patients: a major threat to patients' quality of life

Objective: To explore the effects of intrusive and deliberate rumination on the quality of life of cancer patients

Study Design: Descriptive cross-sectional design

Place and Duration of Study: PIMS and NORI Hospital between July to September 2016

Methodology: A sample of 100 cancer patients participated in the study. The patients fulfilling the inclusion criteria were given a written consent form. Event related Rumination Inventory and WHO Quality of Life-Bref scale was used for data collection

Results: There were 57 male and 43 female patients within the age range of 18 to 66 years [mean = 36.62 +/- 13.77 years]. A significant negative correlation was found between intrusive rumination and all domains of quality of life as physical [r = -0.28, p<0.01], psychological [r = -0.19, p<0.01], social [r = -0.20, p<0.01], environmental [r = -0.17, p<0.05], and global [r = -0.26, p<0.01] functioning. Furthermore, results on regression analysis showed the significant prediction of the intrusive rumination on all domains of quality of life. The effect of deliberate rumination was found to be non-significant

Conclusion: Intrusive rumination significantly negatively predicted all domains of quality of life, whereas, quality of life of cancer patients was not significantly predicated by deliberate rumination

Are happier people less vulnerable to rumination, anxiety, and post-traumatic stress? Evidence from a large scale disaster

Abstract The present longitudinal study tested hypotheses about the relationship of subjective well-being and neuroticism with rumination, anxiety, and post-traumatic stress in university students after a large scale disaster. Measures of subjective well-being and personality were obtained two months before the 2013 Santa Maria’s fire. Measures of rumination, PTSD and anxiety were collected five months after the disaster with the same students. The results provide evidence that life satisfaction correlated negatively with rumination, anxiety, and post-traumatic stress. Positive affect presented similar but slightly smaller negative correlations with these variables, while negative affect presented higher correlations with rumination, anxiety, and post-traumatic stress. These findings provide evidence that subjective well-being components may constitute important predictors of psychopathological symptomatology after a disaster and may be helpful to plan clinical interventions. (AU)