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The interpersonal context of rumination: An investigation of interpersonal antecedents
and consequences of the ruminative response style
Submitted by Katherine A. Pearson to the University of Exeter as a thesis for the
degree of Doctor of Philosophy in Psychology, April 2010
This thesis is available for Library use on the understanding that it is copyright
material and that no quotation from the thesis may be published without proper
acknowledgement.
I certify that all material in this thesis which is not my own work has been identified
and that no material has previously been submitted and approved for the award of
adegree by this or any other University. ....................................................(signature)
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Acknowledgments
I am especially grateful to my supervisors, Professor Ed Watkins and Dr Eugene
Mullan, for their ongoing support and guidance throughout the thesis. Thanks also to
the following people, who in so many ways have helped to make the thesis possible,
and to whom I am greatly indebted: Dr Nick Moberly, Professor Willem Kuyken,
Sian Newman, Tamsin Armstrong, Ben Ashton, Rebecca Read, Dr Céline Baeyens,
Dr Lynn Watson, and my family, especially my partner Graeme. In particular, I would
like to thank all of the participants who so kindly committed their time and energy to
help with the research, and the North Devon AccePT team.
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Abstract
The thesis aim was to increase understanding of interpersonal antecedents and
consequences of rumination, defined as ‘repetitive and passive thinking about one’s
symptoms of depression and the possible causes and consequences of those
symptoms’ (Nolen-Hoeksema, 2004, p.107). As a proof-of-principle study,
rumination predicted diminished relationship satisfaction, three months later, in a
sample of remitted depressed adults (N = 57). In the next study, rumination was
associated with a maladaptive submissive interpersonal style and rejection sensitivity,
controlling for depressive symptoms, other interpersonal styles and gender, in a
different sample (N = 103 currently depressed, previously depressed and never
depressed adults). Subsequent chapters incorporated a second assessment point of
data from this same sample. Longitudinal analyses were undertaken to investigate; a)
do rumination and depressogenic interpersonal factors predict future depression?; b)
does rumination prospectively predict increased rejection sensitivity and submissive
interpersonal behaviours, and, vice-versa, do these interpersonal factors predict
increased rumination?; c) does rumination prospectively predict poor social
adjustment and interpersonal stress? Consistent with previous findings, Time 1
rumination predicted increased depression six months later. Unexpectedly, the effect
of rumination on future depression was mediated by its relationship with the
submissive interpersonal style. Partially consistent with the stated predictions, Time 1
rejection sensitivity (but not the submissive interpersonal style) prospectively
predicted increased rumination, but rumination did not predict rejection sensitivity or
the submissive interpersonal style. As predicted, rumination prospectively predicted
increased chronic interpersonal stress and poor social adjustment (but not acute
interpersonal stress). In a final study, rumination was manipulated via an applied
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intervention (concreteness training, CT), within the context of a randomized
controlled trial (N = 79 clinically depressed adults). Analyses compared the change in
social adjustment and submissive interpersonal behaviour reported in the CT
condition compared to a treatment as usual (TAU) condition. There was a
significantly greater reduction in rumination in the CT compared to TAU condition, p
< .05. Moreover, the reduction in submissive interpersonal behaviours was
significantly greater in the CT compared to TAU condition, p < .05. The change in
social adjustment was not greater in the CT compared to TAU condition. Thus, a
psychological intervention which reduces rumination decreased maladaptive
submissive interpersonal behaviour. The implications of the findings are discussed in
relation to theory of rumination and interpersonal theories of depression.
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List of contents
Notes on thesis structure .............................................. Error! Bookmark not defined.
CHAPTER 1: Introduction .......................................... Error! Bookmark not defined.
Thesis outline and objectives ................................... Error! Bookmark not defined.
CHAPTER 2: Literature review................................... Error! Bookmark not defined.
2.1 Depression symptomatology and prevalence..... Error! Bookmark not defined.
2.2 Depressive rumination: A key cognitive mechanism in depression ...........Error!
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2.2.1 Aetiology of rumination .................................. Error! Bookmark not defined.
2.2.2 Response styles theory (RST) ......................... Error! Bookmark not defined.
2.2.3 Control theory and reduced concreteness hypothesis .... Error! Bookmark not
defined.
2.2.4 Clinical treatment of rumination in depression .............. Error! Bookmark not
defined.
2.2.5 Interim summary: Rumination ........................ Error! Bookmark not defined.
2.3 The interpersonal context of depression ............ Error! Bookmark not defined.
2.3.1 Depression and impaired social adjustment .... Error! Bookmark not defined.
2.3.2 Interpersonal factors confer vulnerability to depression Error! Bookmark not
defined.
2.3.3 Stress generation in depression ....................... Error! Bookmark not defined.
2.3.4 Clinical treatment of interpersonal problems in depression Error! Bookmark
not defined.
2.3.5 Interim summary: Interpersonal context of depression . Error! Bookmark not
defined.
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2.4 Rumination, interpersonal style and poor social adjustment .. Error! Bookmark
not defined.
2.4.1 Adverse interpersonal consequences of rumination ...... Error! Bookmark not
defined.
2.4.2 Interpersonal vulnerability to rumination ....... Error! Bookmark not defined.
2.4.3 Rumination and interpersonal functioning: Evidence of an association ..Error!
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2.4.4 Summary: Interpersonal context of rumination ............. Error! Bookmark not
defined.
2.5 Hypothesised thesis model ................................. Error! Bookmark not defined.
2.6 Thesis hypotheses .............................................. Error! Bookmark not defined.
2.7 Secondary thesis hypotheses .............................. Error! Bookmark not defined.
CHAPTER 3: Interpersonal consequences of rumination: A preliminary test .....Error!
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3.1 Preface................................................................ Error! Bookmark not defined.
3.2 Abstract .............................................................. Error! Bookmark not defined.
3.3 Introduction ........................................................ Error! Bookmark not defined.
3.4 Data Analysis ..................................................... Error! Bookmark not defined.
3.5 Results ................................................................ Error! Bookmark not defined.
3.6 Discussion .......................................................... Error! Bookmark not defined.
CHAPTER 4: Psychosocial correlates of depressive rumination ..... Error! Bookmark
not defined.
4.1 Preface................................................................ Error! Bookmark not defined.
4.2 Abstract .............................................................. Error! Bookmark not defined.
4.3 Introduction ........................................................ Error! Bookmark not defined.
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4.4 Method ............................................................... Error! Bookmark not defined.
4.5 Results ................................................................ Error! Bookmark not defined.
4.6. Discussion ......................................................... Error! Bookmark not defined.
4.7 Appendix A: A priori power analysis ................ Error! Bookmark not defined.
4.8 Appendix B: Post hoc power analyses ............... Error! Bookmark not defined.
4.9 Appendix C: Correlation between self and partner report of maladaptive
interpersonal behaviour ............................................ Error! Bookmark not defined.
4.10 Appendix D: Replication of analyses controlling for diagnostic status ...Error!
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4.11 Appendix E: Replication of analyses with a different sample ..................Error!
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CHAPTER 5: Submissive interpersonal style and rumination predict future depression
...................................................................................... Error! Bookmark not defined.
5.1 Preface................................................................ Error! Bookmark not defined.
5.2 Abstract .............................................................. Error! Bookmark not defined.
5.3 Introduction ........................................................ Error! Bookmark not defined.
5.4 Method ............................................................... Error! Bookmark not defined.
5.5 Procedure ........................................................... Error! Bookmark not defined.
5.6 Results ................................................................ Error! Bookmark not defined.
5.7 Discussion .......................................................... Error! Bookmark not defined.
5.8 Appendix A: Time 2 BDI transformation .......... Error! Bookmark not defined.
5.9 Appendix B: Comparison of study completers and non-completers ..........Error!
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5.10 Appendix C: Rumination and submissive interpersonal style predict diagnostic
status ........................................................................ Error! Bookmark not defined.
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CHAPTER 6: The prospective relationship between rumination, rejection sensitivity
and submissive interpersonal style............................... Error! Bookmark not defined.
6.1 Preface................................................................ Error! Bookmark not defined.
6.2 Abstract .............................................................. Error! Bookmark not defined.
6.3 Introduction ........................................................ Error! Bookmark not defined.
6.4 Method ............................................................... Error! Bookmark not defined.
6.5 Procedure ........................................................... Error! Bookmark not defined.
6.6 Results ................................................................ Error! Bookmark not defined.
6.7 Discussion .......................................................... Error! Bookmark not defined.
6.8 Appendix: Rejection sensitivity predicts submissive interpersonal style ...Error!
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CHAPTER 7: Adverse interpersonal consequences of rumination: chronic stress and
poor social adjustment ................................................. Error! Bookmark not defined.
7.1 Preface................................................................ Error! Bookmark not defined.
7.2 Abstract .............................................................. Error! Bookmark not defined.
7.3 Introduction ........................................................ Error! Bookmark not defined.
7.4 Method ............................................................... Error! Bookmark not defined.
7.5 Results ................................................................ Error! Bookmark not defined.
7.6 Discussion .......................................................... Error! Bookmark not defined.
7.7 Appendix A: Square root transformation of the event stress variables ......Error!
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7.8 Appendix B: Bi-directional relationship between brooding and poor social
adjustment ................................................................ Error! Bookmark not defined.
7.9 Appendix C: Chronic stress predicts ruminationError! Bookmark not defined.
7.10 Appendix D: Maladaptive interpersonal styles predict interpersonal stress
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.................................................................................. Error! Bookmark not defined.
CHAPTER 8: Concreteness training reduces rumination and submissive interpersonal
behaviour in a depressed sample.................................. Error! Bookmark not defined.
8.1 Preface................................................................ Error! Bookmark not defined.
8.2 Abstract .............................................................. Error! Bookmark not defined.
8.3 Introduction ........................................................ Error! Bookmark not defined.
8.4 Method ............................................................... Error! Bookmark not defined.
8.5 Results ................................................................ Error! Bookmark not defined.
8.6 Discussion .......................................................... Error! Bookmark not defined.
CHAPTER 9: General Discussion ............................... Error! Bookmark not defined.
9.1 Summary of the thesis findings.......................... Error! Bookmark not defined.
9.2 Discussion of the thesis findings........................ Error! Bookmark not defined.
9.2.1 Implications of study findings for Response Styles Theory (RST) .........Error!
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9.2.2 Implications for theories predicting that rumination generates adverse
interpersonal consequences (Joiner, 2000; Lyubomirsky & Tkach, 2004; Tse &
Bond, 2004).............................................................. Error! Bookmark not defined.
9.2.3 Implications for stress generation model ........ Error! Bookmark not defined.
9.2.4 Implications for Coyne’s interactional model. Error! Bookmark not defined.
9.2.5 Rumination and its subcomponents ................ Error! Bookmark not defined.
9.2.6 Gender effects ................................................. Error! Bookmark not defined.
9.3 Methodological implications ............................. Error! Bookmark not defined.
9.4 Strengths and limitations of the thesis research . Error! Bookmark not defined.
9.5 Future research directions .................................. Error! Bookmark not defined.
9.6 Implications for clinical intervention in depression.......... Error! Bookmark not
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defined.
9.7 Final Summary ................................................... Error! Bookmark not defined.
References .................................................................... Error! Bookmark not defined.
Appendix 1: Thesis declaration ................................... Error! Bookmark not defined.
Appendix 2: Thesis measures ...................................... Error! Bookmark not defined.
Appendix 3: Ethics documentation .............................. Error! Bookmark not defined.
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List of Tables
Table i .......................................................................... Error! Bookmark not defined.
Publication status of papers presented in the thesis .... Error! Bookmark not defined.
Table 3.1 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses: (a) Cross-sectional: Time 2 Brooding
and Time 2 Depressive Symptoms Explain Variance in Time 2 Relationship
Satisfaction, (b) Prospective: Time 1 Relationship Satisfaction and Brooding Predict
Time 2 Relationship Satisfaction (Three Months Later). ............ Error! Bookmark not
defined.
Table 4.1 ...................................................................... Error! Bookmark not defined.
Demographic Information and Mean (Standard Deviation) Scores by Group for Key
Measures ...................................................................... Error! Bookmark not defined.
Table 4.2 ...................................................................... Error! Bookmark not defined.
Inter-correlations between Depression, Rumination and Interpersonal Variables
...................................................................................... Error! Bookmark not defined.
Table 4.3 ...................................................................... Error! Bookmark not defined.
Obliquely Rotated (Direct Oblimin) Factor Loadings and Communalities for the 3
Factor Solution ............................................................ Error! Bookmark not defined.
Table 4.4 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses (final step) With Brooding as the
Criterion Variable........................................................ Error! Bookmark not defined.
Table 4.5 ...................................................................... Error! Bookmark not defined.
Inter-correlations between Self and Partner Ratings of Maladaptive Interpersonal
Behaviours ................................................................... Error! Bookmark not defined.
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Table 4.6 ...................................................................... Error! Bookmark not defined.
Summary of Supplementary Hierarchical Regression Analyses (final step) With
Brooding as the Criterion Variable, Controlling for Diagnostic Status ..............Error!
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Table 4.7 ...................................................................... Error! Bookmark not defined.
Replication of cross-sectional analyses with Sample 3 data (N = 79 clinically
depressed adults) ......................................................... Error! Bookmark not defined.
Table 5.1 ...................................................................... Error! Bookmark not defined.
Inter-correlations between Depression, Brooding, Reflection and Interpersonal
Variables ...................................................................... Error! Bookmark not defined.
Table 5.2 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analysis testing whether Brooding and
Reflection at Time 1 Predict Time 2 Depression ......... Error! Bookmark not defined.
Table 5.3 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses testing whether Depressogenic
Interpersonal Variables at Time 1 Predict Time 2 Depression .. Error! Bookmark not
defined.
Table 5.4 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses testing whether Brooding and the
Submissive Interpersonal Style Predict Time 2 Depression ....... Error! Bookmark not
defined.
Table 5.5 ...................................................................... Error! Bookmark not defined.
Study Completers Versus Non-Completers Comparison ............ Error! Bookmark not
defined.
Table 5.6 ...................................................................... Error! Bookmark not defined.
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Summary of Logistic Regression Analysis testing whether Interpersonal Factors and
Brooding at Time 1 Predict Time 2 Diagnostic Status Error! Bookmark not defined.
Table 6.1 ...................................................................... Error! Bookmark not defined.
Intercorrelations between Brooding, Reflection, Depressive Symptoms and
Interpersonal Variables ............................................... Error! Bookmark not defined.
Table 6.2 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analysis testing whether Time 1 Submissive
Interpersonal Style and Time 1 Rejection Sensitivity predict Time 2 Brooding ...Error!
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Table 6.3 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analysis testing whether Time 1 Rumination
Predicts Time 2 Submissive Interpersonal Style .......... Error! Bookmark not defined.
Table 6.4 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analysis testing whether Time 1 Rumination
Predicts Time 2 Rejection Sensitivity ........................... Error! Bookmark not defined.
Table 7.1 ...................................................................... Error! Bookmark not defined.
Intercorrelations Between Dependent Interpersonal Event Stress, Chronic
Interpersonal Stress and Independent Event Stress, Rumination and Key Interpersonal
Variables ...................................................................... Error! Bookmark not defined.
Table 7.2 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses (final step) Predicting Dependent
Interpersonal Event Stress ........................................... Error! Bookmark not defined.
Table 7.3 ...................................................................... Error! Bookmark not defined.
Anxious Attachment Style Mediates the Effect of Excessive Reassurance Seeking on
Dependent Interpersonal Event Stress ......................... Error! Bookmark not defined.
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Table 7.4 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses (final step) Predicting Chronic
Interpersonal Stress ..................................................... Error! Bookmark not defined.
Table 7.5 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses (final step) Predicting Poor Social
Adjustment.................................................................... Error! Bookmark not defined.
Table 7.6 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses (final step) Predicting Brooding
...................................................................................... Error! Bookmark not defined.
Table 7.7 ...................................................................... Error! Bookmark not defined.
Summary of Hierarchical Regression Analyses (final step) Maladaptive Interpersonal
Styles Predicting Dependent Interpersonal Event Stress............ Error! Bookmark not
defined.
Table 8.1 ...................................................................... Error! Bookmark not defined.
Demographic Characteristics of the Sample at Baseline Assessment by Condition
...................................................................................... Error! Bookmark not defined.
Table 8.2 ...................................................................... Error! Bookmark not defined.
Mean Pre and Post Intervention Scores for Key Study Variables by Condition (CT, RT
and TAU)...................................................................... Error! Bookmark not defined.
List of Figures
Figure 2.1:.................................................................... Error! Bookmark not defined.
Hypothesised Thesis Model ......................................... Error! Bookmark not defined.
Figure 3.1:.................................................................... Error! Bookmark not defined.
Hypothesised Thesis Model: Study 1, Hypothesis 2 ... Error! Bookmark not defined.
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Figure 4.1:.................................................................... Error! Bookmark not defined.
A Priori Power Analysis .............................................. Error! Bookmark not defined.
Figure 4.2..................................................................... Error! Bookmark not defined.
Post-hoc Power Analysis: Attachment Style Explains Variance in Brooding ......Error!
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Figure 4.3..................................................................... Error! Bookmark not defined.
Post-hoc Power Analysis: Interpersonal Style Explains Variance in Brooding ...Error!
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Figure 5.1..................................................................... Error! Bookmark not defined.
Hypothesised Thesis Model: Study 3, Hypothesis 5 ... Error! Bookmark not defined.
Figure 5.2..................................................................... Error! Bookmark not defined.
Distribution of the Time 2 BDI Variable Before and After (Log) Transformation
...................................................................................... Error! Bookmark not defined.
Figure 6.1..................................................................... Error! Bookmark not defined.
Hypothesised Thesis Model: Study 4, Hypothesis 3 ... Error! Bookmark not defined.
Figure 7.1..................................................................... Error! Bookmark not defined.
Hypothesised Thesis Model: Study 5, Hypothesis 2 ... Error! Bookmark not defined.
Figure 7.2..................................................................... Error! Bookmark not defined.
Distribution of the Interpersonal Dependent Event Variable Before and After Square
Root Transformation .................................................... Error! Bookmark not defined.
Figure 7.3..................................................................... Error! Bookmark not defined.
Distribution of the Interpersonal Independent Event Variable Before and After Square
Root Transformation .................................................... Error! Bookmark not defined.
Figure 9.1..................................................................... Error! Bookmark not defined.
Final Thesis Model ...................................................... Error! Bookmark not defined.
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