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Ruminatif Düşünme ve Depresif Belirtiler Arasındaki İlişkide Cinsiyetin Etkisi

Year 2023, Volume: 15 Issue: Supplement 1, 313 - 320, 29.12.2023

Yasemin Hosgören Alıcı Jamal Hasanlı

https://doi.org/10.18863/pgy.1322319

Abstract

Ruminasyon, kişinin kendi duygu ve düşünceleriyle pasif ve tekrarlayıcı bir şekilde ilgilenmesi anlamına gelir. Ruminasyonun iki türü vardır; derin düşünme(refleksiyon) ve kara kara düşünme (brooding). Ruminasyon, başta depresyon olmak üzere birçok ruhsal bozukluk için uygun bir zemin hazırladığı düşünülmektedir. Kadınlarda depresif belirtilerin görülme sıklığının erkeklere göre daha yüksek olduğu bildirilmiştir. Kadınlarda ruminasyonun da daha yüksek olması nedeniyle depresyon sıklığının ve şiddetinin ruminasyon nedeniyle artıyor olabileceği iddia edilmiştir. Literatürdeki çalışmalar genellikle tek bir ruminasyon türü olan kara kara düşünme üzerinden ilerlemiştir. Refleksiyon, problem çözme ile ilişkili görüldüğünden sıklıkla olumlu bir basetme yöntemi gibi ele alınsa da depresyonla ilişkisine dair çalışmalar birbirleri ile çelişen sonuçlar vermiştir. Biz çalışmamızda refleksiyon ve kara kara düşünmeyi ayrı ayrı ele alarak cinsiyetin depresif semptomlar üzerindeki etkisini incelemeyi amaçladık. Çalışmaya iki yüz yirmi yedi üniversite öğrencisi çalışmaya davet edildi, 196 kişi çalışmaya katılmayı kabul etti. Çalışmayı kabul eden katılımcılara sosyodemografik form, ruminatif tepkiler ölçeği ve hasta sağlık anketi (HSA-9) uygulanmıştır. Elde edilen verilere korelasyon analizi ve doğrusal regresyon uygulanmıştır. Kara kara düşünme ve refleksiyon puanları HSA-9 puanı ile pozitif korelasyon göstermiştir. Kadınların kara kara düşünme ve refleksion puanları erkeklere göre anlamlı derecede daha yüksektir. Kadınlar HSA-9'da erkeklerden daha yüksek puan olsa da iki grup arasında istatistiksel olarak anlamlı fark yoktur. Doğrusal regresyon analizlerinde, brooding ve refleksiyon puanları HSA-9 puanlarını pozitif yönde anlamlı şekilde yordamıştır. Kadınlar daha yüksek depresif semptomlara sahiptir ve daha ruminatif olarak kabul edilir, ancak sadece ruminatif düşünce (hem kara kara düşünme hem de refleksiyon) depresif semptomları öngörebilmektedir. Depresif bozukluk tedavisinde hem kara kara düşünme hem de işlevsiz olabilecek refleksiyonu hedefleyen müdahaleler göz önünde bulundurulmalıdır.

Keywords

depresyon ruminasyon cinsiyet kara kara düşünme derin düşünme

Supporting Institution

yok

Project Number

KA22/473

Thanks

yok

References

  • Avenevoli S, Swendsen J, He JP, Burstein M, Merikangas KR (2015) Major depression in the national comorbidity survey–adolescent supplement:Prevalence, correlates, and treatment. J Am Acad Child Adolesc Psychiatry, 54:37-44.
  • Banich MT (2009) Executive function:The search for an integrated account. Curr Dir Psychol Sci, 18:89-94.
  • Boggiano AK, Barrett M (1991) Gender differences in depression in college students. Sex Roles, 25:595-605
  • Boughton S, Street H (2007) Integrated review of the social and psychological gender differences in depression. Aust Psychol, 42:187-197.
  • Broderick PC (1998) Early adolescent gender differences in the use of ruminative and distracting coping strategies. J Early Adolesc, 18:173-191.
  • Burwell RA, Shirk SR (2007) Subtypes of rumination in adolescence:Associations between brooding, reflection, depressive symptoms, and coping. J Clin Child Adolesc Psychol, 36:56-65.
  • Cano-López JB, García-Sancho E, Fernández-Castilla B, Salguero JM (2022) Empirical evidence of the metacognitive model of rumination and depression in clinical and nonclinical samples: A systematic review and meta-analysis. Cognit Ther Res, 46:367-392.
  • Cohen N, Daches S, Mor N, Henik A (2014) Inhibition of negative content—A shared process in rumination and reappraisal. Front Psychol, 5:622.
  • Cox S, Funasaki K, Smith L., Mezulis AH (2012) A prospective study of brooding and reflection as moderators of the relationship between stress and depressive symptoms in adolescence. Cognit Ther Res, 36:290-299.
  • De Lissnyder E, Koster EH, Derakshan N, De Raedt R (2010) The association between depressive symptoms and executive control impairments in response to emotional and non-emotional information. Cogn Emot, 24:264-280.
  • De Raedt R, Koster EH (2010) Understanding vulnerability for depression from a cognitive neuroscience perspective: A reappraisal of attentional factors and a new conceptual framework. Cogn Affect Behav Neurosci, 10:50-70.
  • Erdur-Baker Ö, Bugay A (2010) The short version of ruminative response scale: reliability, validity and its relation to psychological symptoms. Procedia Soc Behav Sci, 5:2178-2181.
  • Hankin BL, Abramson LY (2001) Development of gender differences in depression: An elaborated cognitive vulnerability–transactional stress theory. Psychol Bull, 127:773-796.
  • Hankin BL, Young JF, Abela JR, Smolen A, Jenness JL, Gulley LD et al. (2015) Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress. J Abnorm Psychol, 124:803-816.
  • Hyde JS, Mezulis AH, Abramson LY (2008) The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev, 115:291-313.
  • Johnson DP, Whisman MA (2013) Gender differences in rumination: A meta-analysis. Pers Individ Dif, 55:367-374.
  • Joormann J, Dkane M, Gotlib IH (2006) Adaptive and maladaptive components of rumination? Diagnostic specificity and relation to depressive biases. Behav Ther, 37:269-280.
  • Jose PE, Brown I (2008) When does the gender difference in rumination begin? Gender and age differences in the use of rumination by adolescents. J Youth Adolesc, 37:180-192.
  • Kessler RC (2006) The epidemiology of depression among women. In Women and Depression: A Handbook for the Social, Behavior, and Biomedical Sciences (EDs CL Keyes, SH Goodman):22–40. New York, Cambridge University Press.
  • Kornstein SG (2001) The evaluation and management of depression in women across the life span. J Clin Psychiatry, 62(Suppl 24):11-17.
  • Kornstein SG, Schatzberg AF, Thase ME, Yonkers KA, McCullough JP, Keitner GI et al. (2000) Gender differences in chronic major and double depression. J Affect Disord., 60: 1-11.
  • Koster EH, De Lissnyder E, Derakshan N, De Raedt R. (2011) Understanding depressive rumination from a cognitive science perspective: The impaired disengagement hypothesis. Clin Psychol Rev, 31:138-145.
  • Kross E, Ayduk O, Mischel W (2005) When asking “why” does not hurt distinguishing rumination from reflective processing of negative emotions. Psychol Sci, 16:709-715.
  • Krueger RF, Eaton NR (2015) Transdiagnostic factors of mental disorders. World Psychiatry, 14:27-29.
  • Kuehner C (2017) Why is depression more common among women than among men?. Lancet Psychiatry, 4:146-158.
  • Kuehner C, Weber I (1999) Responses to depression in unipolar depressed patients: An investigation of Nolen-Hoeksema's response styles theory. Psychol Med, 29:1323-1333.
  • Marroquín BM, Fontes M, Scilletta A, Miranda R (2010) Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms. Cogn Emot, 24:1446-1455.
  • Morrow J, Nolen-Hoeksema S (1990) Effects of responses to depression on the remediation of depressive affect. J Pers Soc Psychol, 58:519-527.
  • Nolen-Hoeksema S (1991) Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol, 100:569-582.
  • Nolen-Hoeksema S (2001) Gender differences in depression. Curr Dir Psychol Sci, 10:173-176.
  • Nolen-Hoeksema S, Hilt LM(2009) Gender differences in depression. In Handbook of Depression(Eds IH Gottlieb, C Hammen):386–404: New York, Guilford Press.
  • Nolen-Hoeksema S, Larson J, Grayson C (1999) Explaining the gender difference in depressive symptoms. J Pers Soc Psychol, 77:1061-1072.
  • Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci, 3:400-424.
  • Nolen-Hoeksema S(2000) The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnorm Psychol, 109:504-511.
  • Oldehinkel AJ, Bouma EM (2011) Sensitivity to the depressogenic effect of stress and HPA-axis reactivity in adolescence: a review of gender differences. Neurosci Biobehav Rev, 35:1757-1770.
  • Papageorgiou C, Wells A (2009) A prospective test of the clinical metacognitive model of rumination and depression. Int J Cogn Ther, 2:123-131.
  • Piccinelli M, Wilkinson G (2000) Gender differences in depression: Critical review. Br J Psychiatry, 177:486-492.
  • Roelofs J, Huibers M, Peeters F, Arntz A, van Os J (2008) Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals. Behav Res Ther, 46:1283-1289.
  • Rood L, Roelofs J, Bögels SM, Nolen-Hoeksema S, Schouten E (2009) The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review. Clin Psychol Rev, 29:607-616.
  • Rude SS, Little Maestas K, Neff K (2007) Paying attention to distress: What's wrong with rumination? Cogn Emot, 21:843-864.
  • Sarı YE, Kökoglu B, Balcıoğlu H, Bilge U, Çolak E, Unluoglu İ (2016) Turkish reliability of the patient health questionnaire-9. Biomedical Research-India, Special Issue:S460-S462.
  • Sharpley CF, Palanisamy SK, Glyde NS, Dillingham PW, Agnew LL (2014) An update on the interaction between the serotonin transporter promoter variant (5-HTTLPR), stress and depression, plus an exploration of non-confirming findings. Behav Brain Res, 273:89-105.
  • Soo H, Sherman K A (2015) Rumination, psychological distress and post‐traumatic growth in women diagnosed with breast cancer. Psychooncology, 24:70-79.
  • Spitzer RL, Kroenke K, Williams JB, Patient Health Questionnaire Primary Care Study Group (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282:1737-1744.
  • Tamres LK, Janicki D, Helgeson, VS (2002) Sex differences in coping behavior: A meta-analytic review and an examination of relative coping. Pers Soc Psychol Rev, 6:2-30.
  • Treynor W, Gonzalez R, Nolen-Hoeksema S (2003) Rumination reconsidered: A psychometric analysis. Cognit Ther Res, 27:247-259.
  • Wang WT, Tu PC, Liu TJ, Yeh DC, Hsu WY (2013) Mental adjustment at different phases in breast cancer trajectory: Re‐examination of factor structure of the Mini‐MAC and its correlation with distress. Psychooncology, 22:768-774.
  • Watkins ED (2004) Adaptive and maladaptive ruminative self-focus during emotional processing. Behav Res Ther, 42:1037-1052.
  • Watkins ER (2008) Constructive and unconstructive repetitive thought. Psychol Bull, 134:163-206.
  • Whisman MA, du Pont A, Butterworth P (2020) Longitudinal associations between rumination and depressive symptoms in a probability sample of adults. J Affect Disord, 260:680-686.
  • Whitmer AJ, Banich MT (2007) Inhibition versus switching deficits in different forms of rumination. Psychol Sci, 18:546-553.

Effect of Gender on the Relationship Between Ruminative Thinking and Depressive Symptoms

Year 2023, Volume: 15 Issue: Supplement 1, 313 - 320, 29.12.2023

Yasemin Hosgören Alıcı Jamal Hasanlı

https://doi.org/10.18863/pgy.1322319

Abstract

Rumination means dealing with one's own feelings and thoughts passively and repetitively. There are two types of rumination: reflection, and brooding. Rumination prepares a suitable ground for many mental disorders, especially depression. The incidence of depressive symptoms in women was reported to be higher than in men. It has been claimed that the frequency and severity of depression may be increasing due to rumination since rumination is also higher in women. Studies in the literature have often progressed on a single type of rumination, brooding. Reflection is often considered a positive coping style and protective because it is related to problem solving, but inconsistent results have been obtained in studies on the effect on depression. In our study, we aimed to examine the effect of gender on depression by considering reflection and brooding separately instead of evaluating rumination only through brooding. Two hundred and twenty-seven university students were invited to the study, and 196 of them agreed to participate in the study. A sociodemographic form, ruminative responses scale, and patient health questionnaire (PHQ-9) were applied to the participants who accepted the study. Correlation analyses and linear regression were applied to the obtained data. Brooding and reflection scores were positively correlated with the PHQ-9 scores. Women got higher scores in brooding and reflection scales than men. Women got higher scores in PHQ-9 than men but it is not significant statistically. In linear regression analyses, brooding and reflection scores positively significantly predicted PHQ-9 scores. Women have higher depressive symptoms and are considered more ruminative, but only ruminative thinking (both brooding and reflection) can predict depressive symptoms. Interventions targeting both brooding and maladaptive reflection are recommended to treat major depression.

Keywords

depression rumination gender brooding reflection

Project Number

KA22/473

References

  • Avenevoli S, Swendsen J, He JP, Burstein M, Merikangas KR (2015) Major depression in the national comorbidity survey–adolescent supplement:Prevalence, correlates, and treatment. J Am Acad Child Adolesc Psychiatry, 54:37-44.
  • Banich MT (2009) Executive function:The search for an integrated account. Curr Dir Psychol Sci, 18:89-94.
  • Boggiano AK, Barrett M (1991) Gender differences in depression in college students. Sex Roles, 25:595-605
  • Boughton S, Street H (2007) Integrated review of the social and psychological gender differences in depression. Aust Psychol, 42:187-197.
  • Broderick PC (1998) Early adolescent gender differences in the use of ruminative and distracting coping strategies. J Early Adolesc, 18:173-191.
  • Burwell RA, Shirk SR (2007) Subtypes of rumination in adolescence:Associations between brooding, reflection, depressive symptoms, and coping. J Clin Child Adolesc Psychol, 36:56-65.
  • Cano-López JB, García-Sancho E, Fernández-Castilla B, Salguero JM (2022) Empirical evidence of the metacognitive model of rumination and depression in clinical and nonclinical samples: A systematic review and meta-analysis. Cognit Ther Res, 46:367-392.
  • Cohen N, Daches S, Mor N, Henik A (2014) Inhibition of negative content—A shared process in rumination and reappraisal. Front Psychol, 5:622.
  • Cox S, Funasaki K, Smith L., Mezulis AH (2012) A prospective study of brooding and reflection as moderators of the relationship between stress and depressive symptoms in adolescence. Cognit Ther Res, 36:290-299.
  • De Lissnyder E, Koster EH, Derakshan N, De Raedt R (2010) The association between depressive symptoms and executive control impairments in response to emotional and non-emotional information. Cogn Emot, 24:264-280.
  • De Raedt R, Koster EH (2010) Understanding vulnerability for depression from a cognitive neuroscience perspective: A reappraisal of attentional factors and a new conceptual framework. Cogn Affect Behav Neurosci, 10:50-70.
  • Erdur-Baker Ö, Bugay A (2010) The short version of ruminative response scale: reliability, validity and its relation to psychological symptoms. Procedia Soc Behav Sci, 5:2178-2181.
  • Hankin BL, Abramson LY (2001) Development of gender differences in depression: An elaborated cognitive vulnerability–transactional stress theory. Psychol Bull, 127:773-796.
  • Hankin BL, Young JF, Abela JR, Smolen A, Jenness JL, Gulley LD et al. (2015) Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress. J Abnorm Psychol, 124:803-816.
  • Hyde JS, Mezulis AH, Abramson LY (2008) The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychol Rev, 115:291-313.
  • Johnson DP, Whisman MA (2013) Gender differences in rumination: A meta-analysis. Pers Individ Dif, 55:367-374.
  • Joormann J, Dkane M, Gotlib IH (2006) Adaptive and maladaptive components of rumination? Diagnostic specificity and relation to depressive biases. Behav Ther, 37:269-280.
  • Jose PE, Brown I (2008) When does the gender difference in rumination begin? Gender and age differences in the use of rumination by adolescents. J Youth Adolesc, 37:180-192.
  • Kessler RC (2006) The epidemiology of depression among women. In Women and Depression: A Handbook for the Social, Behavior, and Biomedical Sciences (EDs CL Keyes, SH Goodman):22–40. New York, Cambridge University Press.
  • Kornstein SG (2001) The evaluation and management of depression in women across the life span. J Clin Psychiatry, 62(Suppl 24):11-17.
  • Kornstein SG, Schatzberg AF, Thase ME, Yonkers KA, McCullough JP, Keitner GI et al. (2000) Gender differences in chronic major and double depression. J Affect Disord., 60: 1-11.
  • Koster EH, De Lissnyder E, Derakshan N, De Raedt R. (2011) Understanding depressive rumination from a cognitive science perspective: The impaired disengagement hypothesis. Clin Psychol Rev, 31:138-145.
  • Kross E, Ayduk O, Mischel W (2005) When asking “why” does not hurt distinguishing rumination from reflective processing of negative emotions. Psychol Sci, 16:709-715.
  • Krueger RF, Eaton NR (2015) Transdiagnostic factors of mental disorders. World Psychiatry, 14:27-29.
  • Kuehner C (2017) Why is depression more common among women than among men?. Lancet Psychiatry, 4:146-158.
  • Kuehner C, Weber I (1999) Responses to depression in unipolar depressed patients: An investigation of Nolen-Hoeksema's response styles theory. Psychol Med, 29:1323-1333.
  • Marroquín BM, Fontes M, Scilletta A, Miranda R (2010) Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms. Cogn Emot, 24:1446-1455.
  • Morrow J, Nolen-Hoeksema S (1990) Effects of responses to depression on the remediation of depressive affect. J Pers Soc Psychol, 58:519-527.
  • Nolen-Hoeksema S (1991) Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol, 100:569-582.
  • Nolen-Hoeksema S (2001) Gender differences in depression. Curr Dir Psychol Sci, 10:173-176.
  • Nolen-Hoeksema S, Hilt LM(2009) Gender differences in depression. In Handbook of Depression(Eds IH Gottlieb, C Hammen):386–404: New York, Guilford Press.
  • Nolen-Hoeksema S, Larson J, Grayson C (1999) Explaining the gender difference in depressive symptoms. J Pers Soc Psychol, 77:1061-1072.
  • Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci, 3:400-424.
  • Nolen-Hoeksema S(2000) The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnorm Psychol, 109:504-511.
  • Oldehinkel AJ, Bouma EM (2011) Sensitivity to the depressogenic effect of stress and HPA-axis reactivity in adolescence: a review of gender differences. Neurosci Biobehav Rev, 35:1757-1770.
  • Papageorgiou C, Wells A (2009) A prospective test of the clinical metacognitive model of rumination and depression. Int J Cogn Ther, 2:123-131.
  • Piccinelli M, Wilkinson G (2000) Gender differences in depression: Critical review. Br J Psychiatry, 177:486-492.
  • Roelofs J, Huibers M, Peeters F, Arntz A, van Os J (2008) Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals. Behav Res Ther, 46:1283-1289.
  • Rood L, Roelofs J, Bögels SM, Nolen-Hoeksema S, Schouten E (2009) The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review. Clin Psychol Rev, 29:607-616.
  • Rude SS, Little Maestas K, Neff K (2007) Paying attention to distress: What's wrong with rumination? Cogn Emot, 21:843-864.
  • Sarı YE, Kökoglu B, Balcıoğlu H, Bilge U, Çolak E, Unluoglu İ (2016) Turkish reliability of the patient health questionnaire-9. Biomedical Research-India, Special Issue:S460-S462.
  • Sharpley CF, Palanisamy SK, Glyde NS, Dillingham PW, Agnew LL (2014) An update on the interaction between the serotonin transporter promoter variant (5-HTTLPR), stress and depression, plus an exploration of non-confirming findings. Behav Brain Res, 273:89-105.
  • Soo H, Sherman K A (2015) Rumination, psychological distress and post‐traumatic growth in women diagnosed with breast cancer. Psychooncology, 24:70-79.
  • Spitzer RL, Kroenke K, Williams JB, Patient Health Questionnaire Primary Care Study Group (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282:1737-1744.
  • Tamres LK, Janicki D, Helgeson, VS (2002) Sex differences in coping behavior: A meta-analytic review and an examination of relative coping. Pers Soc Psychol Rev, 6:2-30.
  • Treynor W, Gonzalez R, Nolen-Hoeksema S (2003) Rumination reconsidered: A psychometric analysis. Cognit Ther Res, 27:247-259.
  • Wang WT, Tu PC, Liu TJ, Yeh DC, Hsu WY (2013) Mental adjustment at different phases in breast cancer trajectory: Re‐examination of factor structure of the Mini‐MAC and its correlation with distress. Psychooncology, 22:768-774.
  • Watkins ED (2004) Adaptive and maladaptive ruminative self-focus during emotional processing. Behav Res Ther, 42:1037-1052.
  • Watkins ER (2008) Constructive and unconstructive repetitive thought. Psychol Bull, 134:163-206.
  • Whisman MA, du Pont A, Butterworth P (2020) Longitudinal associations between rumination and depressive symptoms in a probability sample of adults. J Affect Disord, 260:680-686.
  • Whitmer AJ, Banich MT (2007) Inhibition versus switching deficits in different forms of rumination. Psychol Sci, 18:546-553.
There are 51 citations in total.

Details

Primary Language English
Subjects Psychiatry, Clinical Psychology
Journal Section Research
Authors

Yasemin Hosgören Alıcı 0000-0003-3384-8131

Jamal Hasanlı 0000-0003-1364-625X

Project Number KA22/473
Early Pub Date October 17, 2023
Publication Date December 29, 2023
Acceptance Date September 17, 2023
Published in Issue Year 2023 Volume: 15 Issue: Supplement 1

Cite

AMA Hosgören Alıcı Y, Hasanlı J. Effect of Gender on the Relationship Between Ruminative Thinking and Depressive Symptoms. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2023;15(Supplement 1):313-320. doi:10.18863/pgy.1322319

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