The author reviews research showing that repetitive thought (RT) can have constructive or unconstructive consequences. The main unconstructive consequences of RT are (a) depression, (b) anxiety, and (c) difficulties in physical health. The main constructive consequences of RT are (a) recovery from upsetting and traumatic events, (b) adaptive preparation and anticipatory planning, (c) recovery from depression, and (d) uptake of health-promoting behaviors. Several potential principles accounting for these distinct consequences of RT are identified within this review: (a) the valence of thought content, (b) the intrapersonal and situational context in which RT occurs, and (c) the level of construal (abstract vs. concrete processing) adopted during RT. Of the existing models of RT, it is proposed that an elaborated version of the control theory account provides the best theoretical framework to account for its distinct

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Constructive and Unconstructive Repetitive Thought.

Depression ranks as the primary emotional problem for which help is sought Depressed people often have severe, complex problems, and rumination is a common feature Depressed people often believe that their ruminations give them insight into their problems, but clinicians often view depressive rumination as pathological because it is difficult to disrupt and interferes with the ability to concentrate on other things Abundant evidence indicates that depressive rumination involves the analysis of episode-related problems Because analysis is time consuming and requires sustained processing, disruption would interfere with problem-solving The analytical rumination (AR) hypothesis proposes that depression is an adaptation that evolved as a response to complex problems and whose function is to minimize disruption of rumination and sustain analysis of complex problems It accomplishes this by giving episode-related problems priority access to limited processing resources, by reducing the desire to engage in distracting activities (anhedonia), and by producing psychomotor changes that reduce exposure to distracting stimuli Because processing resources are limited, the inability to concentrate on other things is a tradeoff that must be made to sustain analysis of the triggering problem The AR hypothesis is supported by evidence from many levels, including genes, neurotransmitters and their receptors, neurophysiology, neuroanatomy, neuroenergetics, pharmacology, cognition and behavior, and the efficacy of treatments In addition, we address and provide explanations for puzzling findings in the cognitive and behavioral genetics literatures on depression In the process, we challenge the belief that serotonin transmission is low in depression Finally, we discuss implications of the hypothesis for understanding and treating depression

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The bright side of being blue: depression as an adaptation for analyzing complex problems.

Sleep duration is an important concept in epidemiological studies. It characterizes a night's sleep or a person's sleep pattern, and is associated with numerous health outcomes. In most large studies, sleep duration is assessed with questionnaires or sleep diaries. As an alternative, actigraphy may be used, as it objectively measures sleep parameters and is feasible in large studies. However, actigraphy and sleep diaries may not measure exactly the same phenomenon. Our study aims to determine disagreement between actigraphic and diary estimates of sleep duration, and to investigate possible determinants of this disagreement. This investigation was embedded in the population-based Rotterdam Study. The study population consisted of 969 community-dwelling participants aged 57-97 years. Participants wore an actigraph and kept a sleep diary for, on average, six consecutive nights. Both measures were used to determine total sleep time (TST). In 34% of the participants, the estimated TST in the sleep diaries deviated more than 1 h from actigraphically measured TST. The level of disagreement between diary and actigraphic measures decreased with subjective and actigraphic measures of sleep quality, and increased with male gender, poor cognitive function and functional disability. Actigraphically measured poor sleep was often accompanied by longer subjective estimates of TST, whereas subjectively poor sleepers tended to report shorter TST in their diaries than was measured with actigraphy. We recommend, whenever possible, to use multiple measures of sleep duration, to perform analyses with both, and to examine the consistency of the results over assessment methods. © 2008 European Sleep Research Society.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2869.2008.00638.x

Disagreement between subjective and actigraphic measures of sleep duration in a population-based study of elderly persons

A total of 100 experimental, cross-sectional and longitudinal studies on the association between rumination and negative affects are reviewed. Experimental and cross-sectional studies support a positive association between rumination and sadness-depression whereas longitudinal studies show more diverse results. Longitudinal studies sampling clinical populations and with treatment during the follow-up display more null results. Concerning the relation between rumination and other negative affects there is strongest evidence for a positive association between rumination and anxiety, but more studies are necessary to illuminate the relation between rumination and other negative affects. The functionality of rumination is discussed along with possible explanations for the associations between rumination and different negative affects. The need for further differentiation of rumination is highlighted in order to distinguish the concept from other types of repetitive, negative thoughts.

The association between rumination and negative affect: A review

The present investigation employed a meta-analysis of 179 correlational studies and 37 clinical group comparison studies to examine the association between rumination and symptoms of anxiety and depression. Meta-analytic correlations revealed moderate associations between rumination and symptoms of anxiety and depression that were strongest for brooding and emotion-driven rumination. Symptoms of anxiety and depression also had significant independent effects on overall rumination and emotion-driven rumination. However, worry partially accounted for the associations of both depression and anxiety with rumination. Those with mood and anxiety disorders also reported more rumination than controls, an effect that was amplified by increased comorbidity. Those with mood disorders reported significantly more rumination than those with anxiety disorders. The implications of these findings for a transdiagnostic view of rumination are discussed.

Specificity of Rumination in Anxiety and Depression: A Multimodal Meta‐Analysis

The literature investigating the relationship between objective and subjective sleep in depressed patients is limited and the results are inconsistent. Furthermore, many factors that influence the aforementioned relationship have not been investigated. The present study was carried out to clarify the characteristics of self-estimation of sleep in depressed patients. Sleep was estimated concurrently using a sleep log and polysomnography for 5 consecutive days to investigate the relationship between subjective sleep estimation and objective sleep estimation in 23 patients with major depression (Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, revised; DSM-III-R). Factors related to a discrepancy between both types of estimation were identified. The subjective total sleep time showed a significant, but moderate, positive correlation (correlation coefficient: 0.63) with the objective total sleep time. The degree of discrepancy was significantly correlated with various objective sleep variables and severity of depression. In the underestimation group in which the subjective total sleep time was shorter than the objective total sleep time, the objective total sleep time and slow-wave sleep time were shorter, age was greater and the extroversion score (Maudsley Personality Inventory) was lower than in the overestimation group in which the subjective total sleep time was longer than the objective total sleep time. The data suggest that subjective sleep estimation in depressed patients is influenced by their objective sleep, severity of depression, age and personality.

Discrepancy between subjective and objective sleep in patients with depression.

The aim of this study was to investigate methods for predicting the efficacy of electroconvulsive therapy (ECT) in patients with major depressive disorder. Subjects comprised 24 inpatients with major depressive disorder diagnosed according to DSM-IV criteria who were resistant to antidepressant therapy or who, due to adverse reactions, could not undergo pharmacotherapy at adequate doses for sufficient durations. ECT was generally performed 12 times using a sinusoidal-wave device. Efficacy of ECT was evaluated using the 17-item Hamilton Rating Scale for Depression (HRSD). Multiple regression analysis was performed, using the final rate of improvement with ECT as the dependent variable, and improvement rate at completion of three ECT sessions and adequacy of pharmacotherapy before ECT as independent variables. Significant positive correlations were seen between final improvement rate with ECT and improvement rate at completion of three ECT sessions (partial correlation coefficient, 0.50, P<0.02), and significant negative correlations were seen between final improvement rate and adequacy of pharmacotherapy before ECT (partial correlation coefficient, -0.51, P<0.02). No significant differences were identified between responders and non-responders with respect to age, sex, duration of index episode, number of previous depressive episodes, whether depression was melancholia-type, whether depression was accompanied by psychotic features, total HRSD score immediately before ECT, and HRSD retardation or agitation scores. These results suggest that history of pharmacotherapy prior to ECT and improvement rate at completion of three ECT sessions may offer predictors for the final rate of improvement with ECT.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1440-1819.2005.01412.x

Predicting efficacy of electroconvulsive therapy in major depressive disorder.

Cholecystokinin tetrapeptide-induced calcium mobilization in T cells of patients with panic disorder, major depression, or schizophrenia

The relationship of coping behavior to outcome in depressed patients was examined. Subjects (n=105) with major depressive disorder (n=85), depressive disorder not otherwise specified (n=7) or major depressive disorder with axis I comorbidity (n=13) were followed for 6 months. Their coping behavior (i.e. rumination, active distraction, cognitive distraction and dangerous activities) was defined using the Comprehensive Assessment List for Affective Disorders. Based on their Hamilton Rating Scale for Depression (HRSD) scores at 6 months, the patients were categorized as having had a good or a poor outcome. Severity of depression and coping behavior were similar among the three diagnostic groups. At baseline assessment, coping behavior was not correlated with either HRSD score or age. However, males were significantly more likely to be engaged in dangerous activity as a coping behavior than females. Patients with a good outcome at 6 months were significantly more likely to use rumination as a coping behavior while patients with a poor outcome were significantly more likely to use dangerous activity. Multiple regression analysis confirmed this finding, indicating that rumination and dangerous activity were significant predictors of outcome at 6 months. Rumination might be associated with good outcomes in depressed patients while dangerous activity might be associated with poor outcomes.

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Coping behavior in depressed patients: a longitudinal study

1. The effect of chronic administration of an tidepre ssant s and electroconvu1sive shock (ESC) on the hypothermic response (HTR) induced by 8-hydroxy-2-(di-n-propyramino)te tralin (8-OH-DPAT) as an index of the function of 5-HT 1A receptors was investigated in the rat. 2. 8-OH-DPAT dose-dependently decreased the rectal temperature. 3. Pretreatment with parachlorophenylalanine increased HTR. 4. Chronic administration of the an tidepressants, trazodone, imipramine, amitriptyline, and fluoxetine had no effect on HTR, whereas administration of clorgyline attenuated HTR significantly. 5. Repeated ECS had no effect on HTR. 6. These results suggest that the action site of 8-OH-DPAT is postsynaptic 5-HT 1A receptors and that the chronic administration of some an tidepressants and ECS has no direct action on these receptors. 7. Therefore, the an tidepressant effects of these drugs are not produced by direct action on postsynaptic 5-HT 1A receptors.

The effect of chronic administration of antidepressants and electroconvulsive shock on the 5-HT1A receptor mediated hypothermic response induced by 8-OH-DPAT in the rat.

Kumiko Yamada

Papers

Discrepancy between subjective and objective sleep in patients with depression.

Predicting efficacy of electroconvulsive therapy in major depressive disorder.

Cholecystokinin tetrapeptide-induced calcium mobilization in T cells of patients with panic disorder, major depression, or schizophrenia

Coping behavior in depressed patients: a longitudinal study

The effect of chronic administration of antidepressants and electroconvulsive shock on the 5-HT1A receptor mediated hypothermic response induced by 8-OH-DPAT in the rat.