Bidirectional Association Between Rumination, Depressive Symptoms

woman hand on her head ruminating
Researchers cite the scar hypothesis that depression causes changes in thinking that lead to rumination, but they suggest that there is reciprocity between rumination as a cause for depression.

While rumination may be a risk factor for increased depressive symptoms, it may also be a result of depressive symptoms, according to results published in the Journal of Affective Disorders.

The study included a probability sample of Australian adults (n=5891). Participants completed self-report measures of rumination, neuroticism, and depressive symptoms at baseline. At 4 years of follow-up, they self-reported measures of rumination and depressive symptoms. The researchers used linear regression analyses to assess the bidirectional longitudinal associations between rumination and depressive symptoms.

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The researchers used a 10-item version of the original Ruminative Responses Scale to assess rumination, the Brief Patient Health Questionnaires to assess depression, and the neuroticism scale from the short form of the Eysenck Personality Questionnaire Revised to assess neuroticism.

The results indicated that rumination predicted residual change in depressive symptoms. However, the researchers also found that depressive symptoms predicted residual change in rumination, which suggests that rumination and depressive symptoms act on each other in a bidirectional, recursive way.

After performing analyses that included covariates of age, gender, and neuroticism, the results indicated that the bidirectional, longitudinal associations between rumination and depressive symptoms could not be explained by shared associations with these covariables. The researchers did not find that gender significantly modified the associations between rumination and depressive symptoms.

The study included several limitations. The researchers noted that for a study to better test the potential causal association between rumination and depressive symptoms, it should include within-person analyses, repeated assessments, shorter time intervals, and assessment of brooding rumination.

“Taken together, results support the need for continued research on the role of rumination in the onset, maintenance, severity, and remission of depression,” the researchers wrote.


Whisman MA, du Pont A, Butterworth P. Longitudinal associations between rumination and depressive symptoms in a probability sample of adults. J Affect Disord. 2020;260:680-686.