The cognitive vulnerability to depressive rumination in people diagnosed with major depressive disorder.
Doctoral thesis, UCL (University College London).
Chan, CSJ. 2011 DClinPsy Thesis.pdf
Available under License : See the attached licence file.
This research project focuses on the cognitive process of rumination and its association to depression. Part one of the project is a literature review, which aimed to provide a comprehensive summary of the current state of research on the relations between rumination and the major cognitive processes in people with depression. A systematic search identified 25 studies in the existing literature which fulfilled the basic requirements of studying rumination and at least one other cognitive process with valid measure(s) or experimental manipulations in people with a diagnosis of major depressive disorder. These studies covered 8 domains of cognitive deficits and biases related to rumination. They included overgeneralised memory, memory biases, thinking biases, attentional biases, inhibitory deficits, impairments in general resource allocation, maladaptive thought control strategies, and problem-solving deficits. The review investigated the conclusions made by these studies in terms of their suggestions on the interrelations between depressive symptoms, rumination, the cognitive process in question. Particular attention was paid to each study's conceptualisation of rumination, and whether it addressed subcomponents of rumination which underlie its negative effects. Part two consisted of the empirical paper. The empirical study focussed on the ability of one particular hypothesis - the mood-as-input model -to explain the mechanisms underlying the perseverative thinking style which characterised depressive rumination. Using a rumination interview paradigm, it compared participants with major depressive disorder (MDD) with healthy controls for the extent of their perseverative thinking during the rumination task. The performance of each participant in both the depressed and control group was also measured and contrasted across two experimental conditions. In each these conditions, participants were asked to adopt either an 'as-much-as-can' or a 'feel-like-continuing' stop-rule as guidelines for decision making on how and when to terminate the task. Results indicated that the interaction of depressive symptoms and 'stop-rule' significantly influenced perseveration in all participants. Participants' changes of mood during the rumination task, as well as their spontaneous selection of stop-rule in their daily life were also explored. Finally, the critical appraisal in part three offered a reflection on the my motivations for undertaking this research and some reasons for the important decisions made in the process. It also provided further discussions on the designs and methodologies of the experimental study, and the research and clinical implications of its findings.
|Title:||The cognitive vulnerability to depressive rumination in people diagnosed with major depressive disorder|
|Open access status:||An open access version is available from UCL Discovery|
|Additional information:||Thesis in two volumes: volume 2 is restricted|
|Keywords:||rumination, mood-as-input, metacognitive, depression, stop-rule|
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