The roles of suicide-related rumination and COVID-19 in suicidal ideation and behaviours: Data from a large-scale youth epidemiological sample in Hong Kong

Suicide remains to be one of the leading causes of death amongst young people worldwide. Help-seeking, however, remains disproportionately suboptimal in the youth population. Identifying more effective and less stigmatizing markers of suicidal ideation and behaviours can be important for improving early engagement and intervention work. We therefore examined the prevalence of suicidal ideation, plan, and attempt in a large epidemiological youth sample in Hong Kong (n = 2540) during the period of 2019-2021, as well as the factors associated with each of these outcomes using separate multivariable logistic regression models. In this sample, the 12-month prevalence of suicidal ideation, plan, and attempt was 20.0%, 4.6%, and 1.3%, respectively. In particular, we found 'suicide-related rumination' to be amongst the only factor that was significant for all three outcomes (p < .010). Using a two-stage approach (i.e., selecting only those with suicidal ideation), we found that suicide-related rumination, poorer cognitive ability, and 12-month major depressive episode were specifically associated with 12-month suicide plan, while environmental factors, including COVID-19 stressors, personal life stressors, poorer family relationships, as well as non-suicidal selfharm, were specifically associated with 12-month suicide attempt. A two-stage approach should be considered in future interventions targeting youth suicide. Suicide-related rumination may be an important marker of overall suicidal risk. The role of environmental stressors in addition to intrinsic vulnerability also need to be emphasized to best support young people at risk.

Innovative angles from a youth epidemiological study: Data from the HK-YES in Hong Kong

There are few specific epidemiological studies focusing on youth mental health in a non-western population. In particular, studies which are designed to include a broad range of youth-relevant potential risk and protective factors during the COVID-19 period are scarce. Such data are important for formulating programs to enhance healthy coping, as well as to facilitate the screening of risk factors. We present data from a comprehensive youth epidemiological study in Hong Kong from innovative angles which extend beyond conventional prevalence reporting. For example we investigated the change in major depressive episode states in a cohort with longitudinal data, which provide us with insight into what determines the persistence of depression. We also look into suicidal ideation and the role of rumination in this population. We also report the use of a recently identified marker for brain inhibition/excitation balance (visual stress) as a predictor associated with mental health outcomes. Finally, we studied the role of personality in mediating mental health outcomes.

Rumination about the Russo-Ukrainian War and its related factors among individuals in Poland and Ukraine.

The present study aimed to investigate the factors associated with the level of rumination about the war among people living in Poland and Ukraine. This cross-sectional study recruited internet users from advertisements on social media. Levels of rumination, Depression, Anxiety and Stress Scale (DASS), Impact of Event Scale-Revised (IES-R), time spent on news of the war, and related demographic variables were collected. The reliability and construct validity of rumination were estimated. Potential factors associated with the level of rumination were identified using univariate linear regression analysis, and further entered into a stepwise multivariate linear regression model to identify independent factors. Due to the non-normality of distribution, multivariate linear regression with 5000 bootstrap samples was used to verify the results. A total of 1438 participants were included in the analysis, of whom 1053 lived in Poland and 385 lived in Ukraine. The questionnaires on rumination were verified to have satisfactory reliability and validity. After analysis with stepwise and bootstrap regression, older age, female gender, higher DASS and IES-R scores, and longer time spent on news of the war were significantly associated with higher levels of rumination for both people living in Poland and Ukraine. Lower self-rated health status, history of chronic medical illness and coronavirus disease 2019 infection were also positively associated with rumination for people living in Poland. We identified several factors associated with the level of rumination about the Russo-Ukrainian War. Further investigations are warranted to understand how rumination affects individuals' lives during crises such as war.

Relationship between rumination and post-traumatic growth in mobile cabin hospital nurses: The mediating role of psychological resilience.

Psychological resilience helps individuals to actively respond to various emergencies, but its mediating role between the rumination and post-traumatic growth (PTG) of nurses remains unknown. Our study aimed to explore the extent to which psychological resilience mediates the association between rumination and PTG among nurses working in mobile cabin hospitals. This cross-sectional survey was conducted on 449 medical team members working in mobile cabin hospitals to support the prevention and control of coronavirus disease 2019 in Shanghai, China in 2022. Pearson correlation analysis was applied to assess the correlation between rumination, psychological resilience, and PTG. Structural equation models were used to examine the mediating role of psychological resilience between rumination and PTG. Our study results showed that deliberate rumination directly promoted psychological resilience and PTG and had positive effects on PTG through the mediating effect of psychological resilience. Invasive rumination had no direct effect on PTG. However, it had a negative effect on PTG through the mediating effect of psychological resilience. Together the results of this study indicate that the mediating effect of psychological resilience was significant in the association of rumination and PTG among mobile cabin hospital nurses, with a higher individual psychological resilience level helping nurses to achieve PTG. Therefore, targeted interventions should be implemented to improve nurses' psychological resilience and guide their rapid growth.

Relations between anxiety sensitivity's cognitive concerns and anxiety severity: brooding and reflection as serial multiple mediators.

The outbreak of COVID-19 has caused a major impact on productivity and life functioning, and also led to adverse emotional reactions. In the face of this public health event, increased anxiety is one of the most common emotional reactions. Previous studies have shown that anxiety sensitivity, rumination and anxiety are closely related. Various dimensions of anxiety sensitivity have different effects on anxiety. Also, rumination can be divided into brooding and reflection. To explore the relationships among anxiety sensitivity's cognitive concerns, anxiety and different types of rumination, we conducted an online survey during the outbreak of coronavirus (February 17-25, 2020), using the Anxiety Sensitivity Scale-3 (ASI-3), Ruminative Responses Scale (RSS), and Depression Anxiety Stress Scale-21 (DASS-21). The results showed significant positive correlations among anxiety sensitivity's cognitive concerns, anxiety, brooding and reflection. Furthermore, brooding and reflection had a chain mediation effect between cognitive concerns and anxiety, and the mediation effect of reflection was even stronger. Results suggest that anxiety sensitivity's cognitive concerns may not only affect anxiety directly, but also affect anxiety through rumination, especially reflection.

Gender differences and left-behind experiences in the relationship between gaming disorder, rumination and sleep quality among a sample of Chinese university students during the late stage of the COVID-19 pandemic.

Background and aims: Studies have shown that gaming disorder (GD) is associated with rumination and poor sleep quality. However, the reciprocal relationship between GD, rumination and sleep quality is unclear. Moreover, the differences between gender and between left-behind experiences in the aforementioned relationship remain unknown. Therefore, the present study examined gender differences and left-behind experiences in the relationship between GD, rumination, and sleep quality among a sample of Chinese university students during the late stage of COVID-19 pandemic using a network analysis approach. Methods: A cross-sectional online survey of 1,872 Chinese university students was conducted comprising demographic information (age, gender, and left-behind experience), gaming experience, gaming frequency, Gaming Disorder Test (GDT), Short Version of Rumination Response Scale (RRS), and Pittsburgh Sleep Quality Index (PSQI). Results: Among Chinese university students, the prevalence of (i) GD was 3.5% and (ii) sleep disturbance was 14%. GD had positive and weak connection with rumination and sleep quality in the domain-level relational network. The network structures and global strengths both showed no significant differences between gender and between left-behind experiences. The nodes gd3 ("continuation or escalation of gaming") and gd4 ("gaming problems") had the strongest edge in the network. Conclusion: The results suggest reciprocal relationships between GD, rumination, and sleep quality. Gender and left-behind experiences did not influence the reciprocal relationship between GD, rumination, and sleep quality during the late stage of COVID-19 pandemic. Using network analysis, the findings provide novel insights that rumination and sleep quality may have interacted with GD among Chinese students during the late stage of COVID-19 pandemic. Reducing or eliminating negative rumination may decrease GD and improve sleep quality. Moreover, good sleep quality contributes to positive rumination which may decrease the risk of GD among Chinese university students.

Cognitive, Motor, & Negative Valence Systems in Neurologic Pasc: A Preliminary Study

Background: Nervous system post-acute sequelae of COVID-19 (NS-PASC) include cognitive and mental health symptoms. To further define these, we applied a Research Domain Criteria (RDoC) approach to examine motor, positive valence (PV) and negative valence (NV) systems, and social processing data in The COVID Mind Study of NS-PASC. Method(s): NS-PASC participants (>3 months after COVID-19) referred from a NeuroCOVID Clinic and non-COVID controls from New Haven, CT and Baltimore, MD completed an RDoC test battery for cognition (language, declarative and working memory, cognitive control, perception), motor, PV, NV, and social processes. To date, 3T MRI with diffusion tensor imaging was performed in 11 NS-PASC to assess white matter integrity (global white matter fractional anisotropy [FA]) as a contributor to alterations identified on the RDoC tests. Analysis of Covariance examined group differences after adjusting for sex, race, ethnicity, age, and years of education. Result(s): 25 NS-PASC participants (age 43.4+/-11.3 yrs, 76% female, 402 days after COVID-19 symptom onset) and 29 controls (age 46.2.6+/-13.1 yrs, 66% female) completed the battery. Controls were more racially diverse and less educated than NS-PASC (43% vs. 12% Black, p=0.005;14.5 vs. 16.1 yrs of education, p< 0.05). Means and statistics for RDoC between NS-PASC and controls are shown in Table. NS-PASC performed worse in language, verbal working and declarative memory, and perception and reported greater cognitive control difficulties (e.g., behavioral inhibition, set shifting) without issues on performance-based metrics (Stroop, Trail Making Test-Part B), and had slower motor function. NS-PASC reported more NV issues including greater symptoms of depression, rumination in response to depressive mood, apathy, childhood trauma, anxiety, and perceived stress. There were no differences in PV and social processing. In a subset of NS-PASC participants who underwent MRI, there was a dynamic range of FA values with a mean of 0.509 (IQR 0.481 - 0.536). Conclusion(s): Our findings extend previous PASC studies characterizing cognitive and mental health alterations, indicating that additional RDoC assessments warrant focus, including alterations in motor and the negative valence system. In future analyses, we will examine white matter integrity as a pathophysiologic contributor to these RDoC systems.

Mental health outcomes in patients discharged after COVID-19 hospitalization: the case report of a male nurse in the context of occupational surveillance program of health care workers

This case study draws attention on mental health sequelae that emerged in the context of the COVID-19 outbreak after recovery from hospitalization, even in subjects without personal psychiatric history. The case involves a 65-year-old male shift nurse who took SARS-COV-2 infection through a co-worker and that had been hospitalized for interstitial pneumonia from April 6 to April 17. After recovery, he developed psychiatric symptoms overlapping between different dimensions of psychiatric disorders and started to be followed by the Occupational Health Department of a Major University Hospital in central Italy. He reported a score of 28 at the Peritraumatic Distress Inventory and of 39 at the Self-Rating Anxiety State. He was treated with a combination therapy of SSRI and NaSSA antidepressants with clinical remission. In this case study, authors discuss the possible overlapping role of post-traumatic stress and anxiety symptoms in patients discharged after COVID-19 hospitalization that may deserve appropriate classification, treatment and follow up with the future goal to refine clinical management of post and long COVID syndromes of subjects who present low abnormalities in other specialty investigations.Copyright © 2022 EDIZIONI MINERVA MEDICA.

Youth pre-pandemic executive function relates to year one COVID-19 difficulties.

Introduction: The first year of the COVID-19 pandemic presented a series of stressors that could relate to psychological difficulties in children and adolescents. Executive functioning (EF) supports goal achievement and is associated with life success, and better outcomes following early life adversity. EF is also strongly related to processing speed, another predictor of life outcomes. Methods: This longitudinal study examined 149 youths' pre-pandemic EF and processing speed abilities as predictors of self-reported emotional, cognitive, and social experiences during the first year of the COVID-19 pandemic. EF and processing speed were measured with a total of 11 behavioral tasks. The COVID-era data was collected during two timepoints, during early (May-July 2020) and mid- (January-March of 2021) pandemic. Results: Better pre-pandemic EF skills and processing speed abilities predicted more mid-COVID-19 pandemic emotional and cognitive difficulties. On the other hand, better switching (a subcomponent of EF) and processing speed abilities predicted more mid-pandemic social interactions. EF and processing speed abilities did not relate to the well-being reports from the initial months of the pandemic. Our EF - but not processing speed - results were largely maintained when controlling for pre-pandemic mental health burden, socioeconomic status (SES), and gender. Discussion: Better cognitive abilities may have contributed to worse mid-pandemic functioning by supporting the meta-cognition needed for attending to the chaotic and ever-changing pandemic news and advice, leading to higher stress-induced worry and rumination. Our study highlights a potential downside of higher EF - often largely viewed as a protective factor - in youth.

Reducing Test Anxiety During the COVID-19 Pandemic: A Comparison of the Effectiveness of Cognitive Behavioral Therapy and Acceptance and Commitment Therapy.

Educational assessments can affect students' mental health, particularly during a pandemic. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are widely efficacious for reducing test anxiety, as well as general anxiety and rumination. However, the effectiveness of these two therapies for students during COVID-19 is unclear. We measured the effectiveness of ACT and CBT for managing test anxiety, general anxiety, and rumination during COVID-19 for 77 students taking Türkiye's national university entrance exam, assigned to either the ACT or CBT psychoeducation programs. Both programs reduced test anxiety, general anxiety, and rumination, and showed similar levels of effectiveness. This suggests that ACT and CBT are both important for improving students' mental health during COVID-19 and either may be beneficial.

Feasibility and effect of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking for Colombian young women

Online psychological interventions (OPI) are evidence-based programs that provide mental health treatment over the internet. Meta-analytic data suggests that OPI's effectively treat emotional symptomatology. RNT-focused ACT consider psychological inflexibility and RNT as trans-diagnostic process that significantly predict emotional symptomatology. The present study analyzed the effect of a self-help OPI which contents have previously shown content validity, user feasibility and effectivity. This is an open trial design with repeated measures of emotional symptomatology and behavioral change processes. Bayesian analysis of variance for repeated measures was conducted with JASP for each variable, Bayes Factors (BF10) determined how much the evidence favored OPI effect. Effect sizes, reliable and significant change and moderation analyses were also conducted. 18 cisgender women around 30 years old mostly heterosexual, single and unemployed finished the OPI. There is decisive evidence for OPI effect on emotional symptomatology and behavioral change processes (experiential avoidance, cognitive fusion and RNT). There is also anecdotal evidence for the moderating role of the number of hierarchical RNT triggers ( private events), their type and intimate partner relationship distress as well as anecdotal evidence against the moderating role of being a psychologist. Results need to be considered in the context of the study limitations and future research should explore the program's feasibility and effect in other populations and cultures. However, the program is feasible and efficacious for the treatment of emotional symptomatology at least for young cisgender women in Colombia.

Daily Self-Leadership and Playful Work Design: Proactive Approaches of Work in Times of Crisis

This study investigates how employees may use proactive work strategies to satisfy their basic psychological needs during the coronavirus disease 2019 (COVID-19) pandemic. We use self-determination theory to hypothesize that daily self-leadership (e.g., goal setting, constructive cognition) and playful work design (PWD;redesigning work to be more fun/challenging) satisfy basic psychological needs and facilitate job performance. We also predict that the use of these proactive strategies is particularly important when individuals ruminate a lot about the COVID-19 crisis. Daily diary data collected among a heterogeneous group of employees largely confirm these theoretical predictions. For organizational practitioners, this study thus suggests that it is important to encourage employees to be proactive. Although this may be challenging during crises, leaders could provide autonomy and feedback to foster self-leadership and PWD. In addition, organizations may offer training interventions so that employees learn to apply these proactive work strategies. AD -, Rotterdam, the Netherlands;, Johannesburg, South Africa ;, Rotterdam, the Netherlands ;, Rotterdam, the Netherlands;, Johannesburg, South Africa

Intolerance of Uncertainty and Mental Wellbeing: Serial Mediation by Rumination and Fear of COVID-19

The novel coronavirus-2019 (COVID-19) pandemic has become globally widespread with millions of confirmed cases and many countries implementing various levels of quarantine. Therefore, it is important to investigate the psychological consequences of this process, given the unique situation that has been experienced globally. Therefore, the present study examined whether intolerance of uncertainty was related to mental wellbeing and whether this relationship was mediated by rumination and fear of COVID-19. The sample comprised 1772 Turkish individuals (aged between 18 and 73 years) from 79 of 81 cities in Turkey, who completed measures of mental wellbeing, intolerance of uncertainty, rumination, and fear of COVID-19. Results of serial mediation analyses showed that intolerance of uncertainty had a significant direct effect on mental wellbeing. Rumination and fear of COVID-19, in combination, serially mediated the association between intolerance of uncertainty and mental wellbeing. The findings are discussed within the framework of the psychological consequences of the COVID-19 pandemic and related literature.

Simultaneous Individual Complicated Grief Treatment With a Couple

Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.Copyright © The Author(s) 2022.

A case of catatonia in the aftermath of the COVID-19 pandemic: Does autism spectrum matter?

Background: There is growing concern about the psychopathological consequences of the COVID-19 pandemic. The prolonged stress due to the spreading fear of the contagion and to the enforced containment measures are deemed to trigger recurrences of preexisting mental disorders as well as the onset of new ones. From such perspective, clinical cases may be of primary ground to identify individual features and pandemic-related factors predisposing to the development of serious psychiatric symptoms. Case presentation: Mr. R. is a 64-year-old, married, unemployed man, whose premorbid personality was characterized by relevant autistic traits. The patient developed catatonia in the context of the COVID-19 pandemic. We aimed at discussing the role of both preexisting and precipitating factors. Conclusions: Autism spectrum could represent a predisposing factor for severe psychopathological outcome and catatonia. Furthermore, the present clinical case highlights the role of COVID-19 pandemic in influencing physical and mental health. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Intrapersonal and interpersonal processes associated with co-reflection and co-brooding

Depression is one of the most pervasive and debilitating psychiatric disorders, and it is thus imperative that research identifies factors that characterize depression vulnerability. Although subsyndromal depressive symptoms (i.e., dysphoria) are a depression risk factor, the way that an individual responds to negative emotions may also mitigate or prolong that emotional state, thereby modulating depression vulnerability. Much research on depression has examined how thinking about a negative event in the form of reflective rumination (problem-solving) and brooding rumination (focusing on negative events and their consequences) differentially predicts both depressive symptoms and maladaptive avoidance behaviors. Comparatively less research has examined the use of co-rumination, wherein dyads collaboratively co-reflect and co-brood. Notably, existing research does indicate that co-reflection and co-brooding subtypes are differentially associated with depressive symptoms, yet more research is needed to examine the robustness of this relationship. Additionally, less is known about intrapersonal and interpersonal processes that modulate the use of co-brooding and co-reflection, or the mechanisms through which these co-rumination subtypes modulate depression risk, especially during an ongoing negative event, such as Covid-19. The current study examined (a) the relationship between depression risk, co-rumination subtypes, and avoidance behaviors, (b) intrapersonal (e.g., personality) factors' association with co-rumination subtypes, (c) the association between co-ruminating partners' use of acceptance statements (positive regard and attentiveness) and challenge statements (goal motivation) on the use of co-rumination subtypes and avoidance behaviors, and (d) the relationship between co-rumination subtypes, negative events surrounding an ongoing stressor (Covid-19), and depression risk. Participants were undergraduate students from the University of Kansas' introductory psychology course who reported their interpersonal and intrapersonal rumination, affect, negative experience with Covid-19, avoidance behaviors, emotion reactivity and tolerance, neuroticism, and the frequency with which their close friend provides acceptance and challenge statements during problem-focused talk. Hierarchical multiple regression and moderation analyses indicated that neither co-rumination subtypes were associated with current depressive symptoms, and co-brooding was not associated with avoidance behaviors. Moreover, avoidance behaviors and intrapersonal rumination were not shown to moderate the relationship between co-brooding and current depressive symptoms. Regarding intrapersonal factors, emotion reactivity and emotion tolerance, but not neuroticism, were associated with use of co-rumination subtypes. Regarding acceptance and challenge statements, both were differentially associated with avoidance behaviors, and at higher levels, they interacted to predict decreased behavioral nonsocial avoidance. Finally, co-rumination subtypes did not moderate the relationship between negative events related to Covid-19 and current depressive symptoms. Results indicated that co-rumination subtypes may not always have an adaptive or maladaptive association with depressive symptoms;however, results indicated intrapersonal factors that can be used to identify individuals who might be more likely to use co-rumination subtypes. Additionally, although the current study did not find evidence to support the relationship between co-rumination and avoidance behaviors, it does appear that messages exchanged within a dyad can modulate the use of avoidance behaviors, which has implications for interpersonal treatment approaches targeting avoidance behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Depressive and anxious symptomatology in a Lebanese sample during the COVID-19 outbreak

This study explores the correlates of depressive and anxious symptomatology in a Lebanese sample during the COVID-19 outbreak. A convenience sample of 191 respondents participated in a cross-sectional survey and completed measures of fear of COVID-19, rumination about COVID-19, job insecurity, political trust, depression, and generalized anxiety. Results indicated that political trust was associated with greater wellbeing (manifested as decreased job insecurity, fear of COVID-19, depression, and anxiety). Respondents who reported no compliance with self-isolation measures reported less rumination about COVID-19 and less fear of COVID-19 than those who did. Multiple regression analyses showed that fear of, and rumination about, COVID-19 predicted depressive and anxious symptomatology while political trust was protective against depressive symptomatology only. This study provides a novel perspective on mental health in Lebanon, by focusing on its social and psychological predictors during the COVID-19 pandemic. Due to political and economic instability in Lebanon, the COVID-19 crisis may have deleterious effects on mental health in the Lebanese population. Internet-based cognitive behavioral therapy is an evidence-based and cost-effective approach to enhancing mental health during the pandemic and may be beneficial in the Lebanese context.Copyright © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Mental Health Risks after Repeated Exposure to Multiple Stressful Events during Ongoing Social Unrest and Pandemic in Hong Kong: The Role of Rumination: Risques pour la santé mentale après une exposition répétée à de multiples événements stressants d'agitation sociale durable et de pandémie à Hong Kong: le rôle de la rumination.

OBJECTIVES: The co-occurrence of different classes of population-level stressors, such as social unrest and public health crises, is common in contemporary societies. Yet, few studies explored their combined mental health impact. The aim of this study was to examine the impact of repeated exposure to social unrest-related traumatic events (TEs), coronavirus disease 2019 (COVID-19) pandemic-related events (PEs), and stressful life events (SLEs) on post-traumatic stress disorder (PTSD) and depressive symptoms, and the potential mediating role of event-based rumination (rumination of TEs-related anger, injustice, guilt, and insecurity) between TEs and PTSD symptoms. METHODS: Community members in Hong Kong who had utilized a screening tool for PTSD and depressive symptoms were invited to complete a survey on exposure to stressful events and event-based rumination. RESULTS: A total of 10,110 individuals completed the survey. Hierarchical regression analysis showed that rumination, TEs, and SLEs were among the significant predictors for PTSD symptoms (all P < 0.001), accounting for 32% of the variance. For depression, rumination, SLEs, and PEs were among the significant predictors (all P < 0.001), explaining 24.9% of the variance. Two-way analysis of variance of different recent and prior TEs showed significant dose-effect relationships. The effect of recent TEs on PTSD symptoms was potentiated by prior TEs (P = 0.005). COVID-19 PEs and prior TEs additively contributed to PTSD symptoms, with no significant interaction (P = 0.94). Meanwhile, recent TEs were also potentiated by SLEs (P = 0.002). The effects of TEs on PTSD symptoms were mediated by rumination (ß = 0.38, standard error = 0.01, 95% confidence interval: 0.36 to 0.41), with 40.4% of the total effect explained. All 4 rumination subtypes were significant mediators. CONCLUSIONS: Prior and ongoing TEs, PEs, and SLEs cumulatively exacerbated PTSD and depressive symptoms. The role of event-based rumination and their interventions should be prioritized for future research.

Role of rumination and hope on negative life events and suicidal ideation under the background of normalization of pandemic prevention and control: A moderated mediation model.

Introduction: The study aimed to investigate the impact and mechanism of negative life events on college students' suicidal ideation during the COVID-19 pandemic and the buffering effect of hope under the background of normalization of pandemic. Methods: A total of 5211 participants took part in this study. Self-reported negative life events, rumination, hope and suicide ideation were measured using a range of questions and scales. Our research demonstrated that the incidence of suicidal ideation among college freshmen in the past week was higher during the COVID-19 pandemic than that before the pandemic. In this study, conditional process model 15 was used to verify the hypothetical model of rumination as a potential mediator and hope as a moderator. Results: The hypothesized moderated mediation model was verified significant (ß = -0.047, 95% CI = [-0.061, -0.035]), and hope was found to moderate the direct effect of negative life events on suicidal ideation (ß = -0.039, t = -2.937, 95% CI = [-0.065, -0.013]) as well as the indirect effect of through the mediator rumination (ß = -0.134, t = -10.850, 95% CI = [-0.158, -0.110]). Discussion: We found that rumination partially mediated the effect of negative life events on suicidal ideation, and hope buffered the direct and indirect effect of negative life events on suicidal ideation. The implications of the findings for clinical interventions are discussed, including the importance of hope arousal as a protective factor and rumination as a cognitive mechanism for emotion regulation under the background of normalization of pandemic.

The influence of deliberate rumination on the post-traumatic growth of college students during the COVID-19 pandemic and the moderating role of self-efficacy.

Objective: To understand the relationship between deliberate rumination and post-traumatic growth and the mechanisms affecting this relationship, we constructed an adjustment model to test the impact of deliberate rumination on the post-traumatic growth of college students and the moderating role of self-efficacy during the 2019 COVID-19 pandemic. Study design and setting: A total of 881 college students from a university of science and technology in Guangdong Province, China, completed a questionnaire that measured deliberate rumination, post-traumatic growth, and self-efficacy. SPSS (version 26) and the PROCESS plug-in (version 4.0) were used for correlation and moderation analyses. Results: The correlation analysis showed that deliberate rumination was positively correlated with post-traumatic growth (r = 0.353, P < 0.01) and self-efficacy (r = 0.261, P < 0.01). Self-efficacy was also positively correlated with post-traumatic growth (r = 0.466, P < 0.01). In addition, we found that self-efficacy had a regulatory effect on the relationship between deliberate rumination and post-traumatic growth (R 2 = 0.287, P < 0.001) and that this effect was significant. Conclusion: The results show that deliberate rumination can be a positive predictor of post-traumatic growth and can play a certain role in fostering such growth. In addition, self-efficacy is a moderator that plays a buffer role between deliberate rumination and post-traumatic growth. These results contribute to a more comprehensive understanding of the mechanisms that affect post-traumatic growth.