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Frontiers in Psychology 2022Head and neck cancer (HNC) diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth (PTG), which has been linked...
INTRODUCTION
Head and neck cancer (HNC) diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth (PTG), which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors' experiences of rumination.
METHODS
Twenty HNC survivors between 9 months and 5 years post-diagnosis were recruited (11 male, 9 female, age range 46-83). They had a range of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.
RESULTS
Four themes with linked subthemes on the content and process of rumination were identified. Theme 1 was . Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was . This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was . This theme encompassed retrospective thinking (e.g., on treatment decisions made) and comparisons between the participant now versus the early days after diagnosis. Theme 4 was . This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears (e.g., concerns about their future) or returned to negative experiences (e.g., distressing exchanges with healthcare professionals or what they perceived as poor care).
CONCLUSION
This study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination (commonly focused on ongoing fears or inability to resolve difficult experiences) helps to identify those who may benefit from more directed psychological support.
PubMed: 36389537
DOI: 10.3389/fpsyg.2022.995187 -
Gastroenterology Mar 2022Rumination syndrome is a Disorder of Gut-Brain Interaction (DGBI) of unknown etiology. We aimed to assess its global prevalence and potential associations with other...
BACKGROUND & AIMS
Rumination syndrome is a Disorder of Gut-Brain Interaction (DGBI) of unknown etiology. We aimed to assess its global prevalence and potential associations with other medical conditions.
METHODS
Data were collected via the Internet in 26 countries. Subjects were evenly distributed by country, sex, and age groups and were invited for a "health survey" using the Rome IV diagnostic questionnaire and a supplementary questionnaire addressing factors potentially associated with DGBI.
RESULTS
In all, 54,127 subjects completed the survey (51% male; mean age, 44.3 years). The overall prevalence of rumination syndrome was 3.1% (95% confidence interval [CI], 3.0-3.3%). It was highest in Brazil (5.5% CI, 4.5-6.5) and lowest in Singapore (1.7% CI, 1.1-2.2). The mean age of people with rumination syndrome was 44.5 years (standard deviation, 15.6) and it was more common in females (54.5% vs 45.5%). Factors independently associated with rumination syndrome were depression (odds ratio [OR], 1.46), anxiety (OR, 1.8), body mass index (OR, 1.04), and female sex (OR, 1.19). Subjects with multiple DGBI were at increased risk of having rumination syndrome, with the highest risk in subjects with 4 gastrointestinal regions with DGBI (OR, 15.9 compared with none). Quality of life (QoL) was lower in subjects with rumination syndrome compared with the rest of the cohort (PROMIS-10 score: physical QoL mean 12.9 vs 14.5; mental QoL mean 12.0 vs 13.6).
CONCLUSIONS
The prevalence of rumination syndrome is higher than reported in most previous population studies and is likely underdiagnosed in clinical practice. Awareness of rumination syndrome should be raised among clinicians to improve care for these patients.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Body Mass Index; Brain-Gut Axis; Depression; Female; Gastroesophageal Reflux; Health Resources; Health Surveys; Humans; Internationality; Male; Middle Aged; Prevalence; Quality of Life; Rumination Syndrome; Sex Factors; Young Adult
PubMed: 34774539
DOI: 10.1053/j.gastro.2021.11.008 -
Revista Brasileira de Psiquiatria (Sao... 2015To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD). (Review)
Review
OBJECTIVE
To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).
METHODS
We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors "rumination" and "bipolar disorder" and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review.
RESULTS
Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD.
CONCLUSIONS
Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.
Topics: Adult; Affect; Anxiety Disorders; Bipolar Disorder; Child; Cognition; Depressive Disorder; Feeding and Eating Disorders of Childhood; Female; Humans; Male; Psychiatric Status Rating Scales
PubMed: 26176599
DOI: 10.1590/1516-4446-2014-1556 -
Ideggyogyaszati Szemle May 2023
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small...
BACKGROUND AND PURPOSE
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small number of research has been carried out on the topic involving both patient and non clinical participants. The aim of this study is to examine the relationship between schizotypal traits and rumination using a transdiagnostic approach, involving participants living with psychotic disorders and sine morbo individuals.
.METHODS
We recruited participants living with psychotic disorders (paranoid schizophrenia, hebephrenia, schizoaffective disorder, etc.) (n = 30) and controls who had not been diagnosed with any mental illnesses (n = 67). The connection between rumination and schizotypal traits was examined by self-report questionnaire method in a cross-sectional arrangement. The Oxford-Liverpool Inventory was used to measure schizotypal traits, and the Ruminative Thought Style Questionnaire was used to determine the level of rumination.
.RESULTS
Schizotypal symptoms (β = 0.575; p < 0.001), especially cognitive disorganization (β = 0.459; p < 0.001) and unusual experiences (β = 0.221; p = 0.029) significantly explained the degree of rumination.
.CONCLUSION
Our results support the hypothesis that the association between rumination and schizotypic traits is due to decreased cognitive inhibitory functions.
.Topics: Humans; Schizotypal Personality Disorder; Cross-Sectional Studies; Psychotic Disorders; Surveys and Questionnaires; Personality
PubMed: 37294028
DOI: 10.18071/isz.76.0149 -
Diseases of the Esophagus : Official... May 2024Rumination syndrome (RS) is an underdiagnosed behavioral disorder of recurrent regurgitation. Regurgitation occurs in RS due to increased gastric pressure achieved by...
Rumination syndrome (RS) is an underdiagnosed behavioral disorder of recurrent regurgitation. Regurgitation occurs in RS due to increased gastric pressure achieved by subconscious contraction of the abdominal musculature wall, reversing the pressure gradient between the esophagus and the stomach. RS is mainly diagnosed clinically by the Rome Criteria with symptoms of regurgitation without retching of recently ingested food into the mouth and subsequent spitting or re-mastication. When the diagnosis is unable to be made clinically, supportive testing including fed impedance manometry can be considered. RS occurs worldwide, affecting patients of all ages, races, and genders with a prevalence of 3.1-5.8%. There is significant overlap with RS and disorders of a gut-brain interaction and upright gastroesophageal reflux driven by aerophagia and supragastric belching. There is also an association with mood disorder, fibromyalgia, and eating disorders. RS may be misdiagnosed as a variety of other syndromes including gastroesophageal reflux disease, gastroparesis, achalasia, and bulimia nervosa. Once RS is diagnosed, the mainstay of treatment is diaphragmatic breathing to lower the intragastric pressure and increase the lower esophageal pressure. Diaphragmatic breathing can be supported with biofeedback and cognitive behavioral therapy as well as medication options for more refractory cases. Response to therapy overtime and changes in symptoms overtime can now be tracked with a validated questionnaire.
PubMed: 38741462
DOI: 10.1093/dote/doae041 -
Pediatric Annals Jun 2018Recognizing eating disorders in the pediatric population can be challenging for outpatient providers. With the high prevalence of these disorders in children and... (Review)
Review
Recognizing eating disorders in the pediatric population can be challenging for outpatient providers. With the high prevalence of these disorders in children and adolescents, it is critical that pediatricians recognize these disorders and connect these children and families with available treatments. This article provides a review of the current diagnostic criteria for pica, rumination disorder, anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder, binge-eating disorder, other specified feeding or eating disorder, and unspecified feeding or eating disorder as described in The Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Recommendations for initial medical evaluation and helpful screening measures are discussed. [Pediatr Ann. 2018;47(6):e244-e249.].
Topics: Adolescent; Child; Diagnostic and Statistical Manual of Mental Disorders; Feeding and Eating Disorders; Female; Humans; Male; Prevalence
PubMed: 29898236
DOI: 10.3928/19382359-20180523-02 -
Journal of Personality Disorders Aug 2022Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability, specifically rumination. Despite this, inconsistencies... (Meta-Analysis)
Meta-Analysis
Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability, specifically rumination. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in BPD. Taking this into consideration, a meta-analysis was performed to look at how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, comorbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of rumination domains for the entire sample revealed a medium correlation between BPD symptoms and rumination. When types of rumination were assessed, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/impulsivity. Demographic variables showed no significance. Clinical implications and further therapeutic interventions are discussed considering rumination.
Topics: Anger; Anxiety; Borderline Personality Disorder; Emotional Regulation; Humans
PubMed: 35913769
DOI: 10.1521/pedi.2022.36.4.399 -
Human Brain Mapping Dec 2023Rumination is closely linked to the onset and maintenance of major depressive disorder (MDD). Prior neuroimaging studies have identified the association between...
Rumination is closely linked to the onset and maintenance of major depressive disorder (MDD). Prior neuroimaging studies have identified the association between self-reported rumination trait and the functional coupling among a network of brain regions using resting-state functional magnetic resonance imaging (MRI). However, little is known about the underlying neural circuitry mechanism during active rumination in MDD. Degree centrality (DC) is a simple metric to denote network integration, which is critical for higher-order psychological processes such as rumination. During an MRI scan, individuals with MDD (N = 45) and healthy controls (HC, N = 46) completed a rumination state task. We examined the interaction effect between the group (MDD vs. HC) and condition (rumination vs. distraction) on vertex-wise DC. We further characterized the identified brain region's functional involvement with Neurosynth and BrainMap. Network-wise seed-based functional connectivity (FC) analysis was also conducted for the identified region of interest. Finally, exploratory correlation analysis was conducted between the identified region of interest's network FCs and self-reported in-scanner affect levels. We found that a left superior frontal gyrus (SFG) region, generally overlapped with the frontal eye field, showed a significant interaction effect. Further analysis revealed its involvement with executive functions. FCs between this region, the frontoparietal, and the dorsal attention network (DAN) also showed significant interaction effects. Furthermore, its FC to DAN during distraction showed a marginally significant negative association with in-scanner affect level at the baseline. Our results implicated an essential role of the left SFG in the rumination's underlying neural circuitry mechanism in MDD and provided novel evidence for the conceptualization of rumination in terms of impaired executive control.
Topics: Humans; Depressive Disorder, Major; Brain; Prefrontal Cortex; Executive Function; Frontal Lobe; Magnetic Resonance Imaging; Brain Mapping
PubMed: 37837649
DOI: 10.1002/hbm.26510 -
Journal of Affective Disorders Oct 2023Borderline Personality Disorder (BPD) is characterized by impulsiveness, interpersonal difficulties, emotional instability and dysfunctional cognitive processes. In... (Review)
Review
INTRODUCTION
Borderline Personality Disorder (BPD) is characterized by impulsiveness, interpersonal difficulties, emotional instability and dysfunctional cognitive processes. In addition to these symptoms, anger rumination is a cognitive mechanism often prominent in BPD patients and it has been found to be associated with maladaptive outcomes, such as increasing anger feelings, aggressive and impulsive behaviors. In this context, the aim of our review is to synthesize results on the relationship between emotional dysregulation and anger rumination in BPD with the final goal to get more information about possible psychotherapeutic methods in the treatment of BPD.
METHODS
A comprehensive search on BPD and anger rumination was performed on PubMed, Embase and Scopus. The search identified 8 articles meeting our inclusion criteria.
RESULTS
Most of the studies reported a correlation between BPD emotional instability and dyscontrolled behaviors, anger and depressive rumination. Specifically, from the reviewed studies, it emerged that the tendency to use dysfunctional cognitive strategies, such as anger rumination, predicted aggressive behavior above and beyond emotion dysregulation, ultimately suggesting that anger rumination mediates the relationship between emotional dysregulation and aggression proneness.
LIMITATIONS
The cross-sectional design and the inclusion of subjects without a definite diagnosis of BPD (e.g., university students), may have decreased the generalizability of the results to the clinical populations and limited the possibility to explore the effect of anger rumination over time in BPD.
CONCLUSIONS
From the reviewed studies emerged that the identification of anger rumination as a proximal process with respect to BPD may have the potential to expand and support psychotherapeutic treatment.
Topics: Humans; Borderline Personality Disorder; Cross-Sectional Studies; Anger; Emotions; Aggression
PubMed: 37348655
DOI: 10.1016/j.jad.2023.06.036 -
Emotion (Washington, D.C.) Feb 2020The current article addresses the consequences of emotion regulation (ER) for mental health. A large body of research has shown that alterations in ER are related to... (Review)
Review
The current article addresses the consequences of emotion regulation (ER) for mental health. A large body of research has shown that alterations in ER are related to psychological disorders across different diagnostic categories. Because of the apparent ubiquity of ER difficulties in psychopathology, several authors have proposed that ER should be regarded as a transdiagnostic process. This article critically examines evidence regarding alterations in the use of cognitive ER strategies as a transdiagnostic process. Cognitive ER strategies are examined as 1 example of several possible ER-related processes that could be involved in psychopathology. There is consistent evidence showing that a reduced use of cognitive reappraisal and an increased use of negative rumination are present across a number of disorders, whereas increased levels of positive rumination appear to be confined to bipolar disorder. However, there is only preliminary evidence from prospective and/or experimental studies on the causal nature of altered ER strategy use in the development or maintenance of psychopathology. The article concludes by discussing future directions, including methodological and design issues, as well as implications for assessment and treatment when studying alterations in ER from a transdiagnostic perspective. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Bipolar Disorder; Emotional Regulation; Humans; Mental Disorders; Prospective Studies; Psychopathology; Rumination, Cognitive
PubMed: 31961175
DOI: 10.1037/emo0000646