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Open Access 01-08-2008 | Original Article

The Role of Rumination and Reduced Concreteness in the Maintenance of Posttraumatic Stress Disorder and Depression Following Trauma

Authors: Thomas Ehring, Silke Frank, Anke Ehlers

Published in: Cognitive Therapy and Research | Issue 4/2008

Abstract

Rumination has been linked to posttraumatic stress disorder (PTSD) and depression following trauma. A cross-sectional (N = 101) and a prospective longitudinal study (N = 147) of road traffic accident survivors assessed rumination, PTSD and depression with self-report measures and structured interviews. We tested the hypotheses that (1) rumination predicts the maintenance of PTSD and depression and (2) reduced concreteness of ruminative thinking may be a maintaining factor. Rumination significantly predicted PTSD and depression at 6 months over and above what could be predicted from initial symptom levels. In contrast to the second hypothesis, reduced concreteness in an iterative rumination task was not significantly correlated with self-reported rumination frequency, and did not consistently correlate with symptom severity measures. However, multiple regression analyses showed that the combination of reduced concreteness and self-reported frequency of rumination predicted subsequent PTSD better than rumination frequency alone. The results support the view that rumination is an important maintaining factor of trauma-related emotional disorders.

Rumination as defined by Ehlers and Clark (2000) includes thoughts about the past as well as the future. It could therefore be argued that these are two different forms of perseverative thinking, namely ‘worry’ (i.e., recurrent anxious thoughts about the future; see Borkovec, 1994) in addition to ‘rumination’ (i.e., recurrent negative thoughts about the past and the present; see Papageorgiou & Wells, 2004). However, for reasons of simplicity and in line with Ehlers and Clark, only the term ‘rumination’ will be used in this paper to describe perseverative thinking about the trauma and its consequences, including thoughts about the past or present as well as anxious thoughts about the future.

For nine participants, only data from one of the interview parts was available and therefore the available score was used in the analyses. Excluding these participants from the analyses did not change the results.

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Title: The Role of Rumination and Reduced Concreteness in the Maintenance of Posttraumatic Stress Disorder and Depression Following Trauma
Authors: Thomas Ehring
Silke Frank
Anke Ehlers
Publication date: 01-08-2008
Publisher: Springer US
Published in: Cognitive Therapy and Research / Issue 4/2008
Print ISSN: 0147-5916
Electronic ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-006-9089-7

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The Role of Rumination and Reduced Concreteness in the Maintenance of Posttraumatic Stress Disorder and Depression Following Trauma

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