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NeuroImage Feb 2020Rumination is strongly and consistently correlated with depression. Although multiple studies have explored the neural correlates of rumination, findings have been... (Meta-Analysis)
Meta-Analysis Review
Rumination is strongly and consistently correlated with depression. Although multiple studies have explored the neural correlates of rumination, findings have been inconsistent and the mechanisms underlying rumination remain elusive. Functional brain imaging studies have identified areas in the default mode network (DMN) that appear to be critically involved in ruminative processes. However, a meta-analysis to synthesize the findings of brain regions underlying rumination is currently lacking. Here, we conducted a meta-analysis consisting of experimental tasks that investigate rumination by using Signed Differential Mapping of 14 fMRI studies comprising 286 healthy participants. Furthermore, rather than treat the DMN as a unitary network, we examined the contribution of three DMN subsystems to rumination. Results confirm the suspected association between rumination and DMN activation, specifically implicating the DMN core regions and the dorsal medial prefrontal cortex subsystem. Based on these findings, we suggest a hypothesis of how DMN regions support rumination and present the implications of this model for treating major depressive disorder characterized by rumination.
Topics: Brain Mapping; Depression; Humans; Nerve Net; Prefrontal Cortex; Rumination, Cognitive
PubMed: 31655111
DOI: 10.1016/j.neuroimage.2019.116287 -
The International Journal of Eating... Apr 2019Avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder (RD) were added to the revised DSM-5 Feeding and Eating Disorders chapter in 2013. We...
Development of the Pica, ARFID, and Rumination Disorder Interview, a multi-informant, semi-structured interview of feeding disorders across the lifespan: A pilot study for ages 10-22.
OBJECTIVE
Avoidant/restrictive food intake disorder (ARFID), pica, and rumination disorder (RD) were added to the revised DSM-5 Feeding and Eating Disorders chapter in 2013. We developed a structured interview-the Pica, ARFID, and Rumination Disorder Interview (PARDI)-to assess the presence and severity of these diagnoses for evaluation and treatment planning in clinical and research settings. Here, we describe the development of the PARDI and provide a preliminary report on feasibility, acceptability, reliability, and validity in relation to ARFID.
METHOD
We created an initial item pool from existing measures of similar constructs and clinical experience. The PARDI includes items assessing the level of endorsement and overall severity of common ARFID features organized into profiles (i.e., sensory sensitivity, lack of interest in eating, and fear of aversive consequences) and algorithms for diagnosing ARFID, pica, and RD. We collected initial psychometric data from participants (10-22 years) with ARFID (n = 39), clinically significant avoidant/restrictive eating (n = 8), and healthy controls (n = 10).
RESULTS
On average, the PARDI took 39 min to complete and was acceptable to participants. All subscales achieved internal consistency greater ≥0.77, and inter-rater reliability for the ARFID diagnosis was moderate (κ = 0.75). Individuals with ARFID scored significantly higher than healthy controls on ARFID severity and ARFID profiles.
DISCUSSION
The PARDI appears acceptable to respondents and preliminary evidence of reliability and validity has been demonstrated in an initial sample. Larger-scale validation studies are currently underway. The PARDI is freely available to clinicians and researchers.
Topics: Adolescent; Adult; Child; Feeding and Eating Disorders of Childhood; Female; Humans; Interviews as Topic; Male; Pica; Pilot Projects; Reproducibility of Results; Young Adult
PubMed: 30312485
DOI: 10.1002/eat.22958 -
Tijdschrift Voor Psychiatrie 2014In the DSM-5, feeding disorders and eating disorders have been integrated into one single category. (Review)
Review
BACKGROUND
In the DSM-5, feeding disorders and eating disorders have been integrated into one single category.
AIM
To review the rationale for changes in the criteria for feeding and eating disorders in DSM-5.
METHOD
The revised criteria were drafted and formulated by a DSM-5 workgroup. Next, professionals were given the opportunity to react to the proposed revisions by participating in several discussion rounds.
RESULTS
The criteria for anorexia nervosa have been reworded and the amenorrhea criterion has been removed. The threshold for the diagnosis of bulimia nervosa has been lowered so that once-a-week binge eating and complementary behaviours are now sufficient for a patient to be diagnosed as having bulimia nervosa. Subtyping of bulimia nervosa has been removed. There are hardly any changes in the criteria for pica and rumination disorder. Two new official feeding and eating disorders have been introduced into DSM-5: avoidant/restrictive food intake disorder and binge eating disorder.
CONCLUSION
The definition of and the criteria for feeding and eating disorders given in DSM-5 are an improvement on those used in dsm-iv and should help to reduce the eating disorders not otherwise specified (EDNOS).
Topics: Anorexia Nervosa; Binge-Eating Disorder; Bulimia Nervosa; Diagnostic and Statistical Manual of Mental Disorders; Feeding and Eating Disorders; Humans
PubMed: 24643829
DOI: No ID Found -
Biological Psychiatry Feb 2023Depression is a leading cause of disability worldwide and its prevalence is on the rise. One of the most debilitating aspects of depression is the dominance and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Depression is a leading cause of disability worldwide and its prevalence is on the rise. One of the most debilitating aspects of depression is the dominance and persistence of depressive rumination, a state of mind that is linked to onset and recurrence of depression. Mindfulness meditation trains adaptive attention regulation and present-moment embodied awareness, skills that may be particularly useful during depressive mind states characterized by negative ruminative thoughts.
METHODS
In a randomized controlled functional magnetic resonance imaging study (N = 80), we looked at the neurocognitive mechanisms behind mindfulness-based cognitive therapy (n = 50) for recurrent depression compared with treatment as usual (n = 30) across experimentally induced states of rest, mindfulness practice and rumination, and the relationship with dispositional psychological processes.
RESULTS
Mindfulness-based cognitive therapy compared with treatment as usual led to decreased salience network connectivity to the lingual gyrus during a ruminative state, and this change in salience network connectivity mediated improvements in the ability to sustain and control attention to body sensations.
CONCLUSIONS
These findings showed that a clinically effective mindfulness intervention modulates neurocognitive functioning during depressive rumination and the ability to sustain attention to the body.
Topics: Humans; Mindfulness; Brain; Cognitive Behavioral Therapy; Depressive Disorder, Major; Cognition
PubMed: 36328822
DOI: 10.1016/j.biopsych.2022.06.038 -
Clinical Psychology Review Apr 2018Rumination is a cognitive process involving repetitive thoughts about negative experiences and emotions and is associated with psychopathology. Rumination has been... (Meta-Analysis)
Meta-Analysis Review
Rumination is a cognitive process involving repetitive thoughts about negative experiences and emotions and is associated with psychopathology. Rumination has been implicated in mood and anxiety disorders, and there is a growing body of research on rumination in relation to eating disorder (ED) psychopathology. The current meta-analytic review focused on the literature addressing rumination and ED psychopathology. A comprehensive search process identified 38 studies, which primarily used cross-sectional designs with non-clinical samples. Results demonstrated that rumination was concurrently (r = 0.33) and prospectively (r = 0.22-0.23) associated with ED psychopathology, and that groups with ED psychopathology evidenced higher levels of rumination compared to non-ED control groups (g = 0.95), though no significant differences in rumination were observed when comparing anorexia nervosa to bulimia nervosa groups (g = 0.09). In addition, a narrative review of five experimental studies suggested that rumination in response to ED-related stimuli was related to increased negative affect and negative body-related cognitions across clinical and non-clinical samples. The type of rumination and sample population emerged as moderators of effect sizes, such that larger effects were observed among samples using ED-specific measures of rumination and heterogeneous samples compared to only non-clinical samples. Taken together, this literature demonstrates that rumination is a salient process in ED psychopathology, though the literature is characterized by methodological limitations and the need for more fully elaborated theories on the role of rumination in EDs. Findings are discussed in the context of existing models of rumination and ED psychopathology, with suggestions for future research in this area.
Topics: Feeding and Eating Disorders; Humans; Obsessive Behavior; Rumination, Cognitive
PubMed: 29703429
DOI: 10.1016/j.cpr.2018.03.004 -
The Korean Journal of Gastroenterology... Dec 2017Rumination syndrome is one of the functional gastroduodenal disorders. Effortless and repetitive regurgitation of recently ingested food from the stomach to the oral... (Review)
Review
Rumination syndrome is one of the functional gastroduodenal disorders. Effortless and repetitive regurgitation of recently ingested food from the stomach to the oral cavity followed by rechewing and reswallowing or spitting are the characteristic clinical features. This disorder is believed to be uncommon, but many patients with this disorder are overlooked by their physicians. Rumination might be caused by a reversal of the gastric contents through the esophagogastric junction, which is initiated by an increase in intragastric pressure. The characteristic symptoms are sufficient for the diagnosis of rumination syndrome. Postprandial high resolution esophageal impedance manometry can detect gastric pressurization exceeding 30 mmHg associated with the return of ingested material into the proximal esophagus, which is a pathognomonic finding of rumination syndrome. An extensive explanation of the condition and the underlying mechanism is the first step of the treatment of rumination syndrome. Behavioral therapy through diaphragmatic breathing is the mainstay of treatment. Further studies on the long term effects of biofeedback therapy as well as a proper strategy for refractory rumination syndrome are needed.
Topics: Behavior Therapy; Child; Electric Impedance; Esophagus; Feeding and Eating Disorders of Childhood; Humans; Sulpiride
PubMed: 29277089
DOI: 10.4166/kjg.2017.70.6.278 -
Journal of Affective Disorders Sep 2024Rumination is a maladaptive response to distress characteristic of Major Depressive Disorder (MDD). It is unclear to what degree rumination is associated with depression...
BACKGROUND
Rumination is a maladaptive response to distress characteristic of Major Depressive Disorder (MDD). It is unclear to what degree rumination is associated with depression severity prior to treatment and how it responds to antidepressant treatment. Therefore, we evaluated the association between rumination and depression severity in 92 untreated patients with MDD and explored the changes in rumination after initiation of antidepressant medication.
METHOD
We measured rumination using the Rumination Response Scale (RRS) and depression severity with the Hamilton Depression Rating Scale (HDRS or HDRS) before and after initiation of 12 weeks of antidepressant treatment. The association between RRS and pre-treatment HDRS was evaluated using a linear regression model. RRS at week 4, 8, and 12 across treatment response categories (remission vs. non-response) were evaluated using a mixed effect model.
RESULTS
RRS was positively associated with depression severity prior to treatment at a trend level (p = 0.06). After initiation of treatment RRS decreased significantly (p < 0.0001) and remitters exhibited lower rumination compared to non-responders at week 4 (p = 0.03), 8 (p = 0.01), and 12 (p = 0.007).
LIMITATIONS
The study had no placebo group.
CONCLUSIONS
Although pre-treatment rumination did not significantly associate with depressive symptoms, rumination was closely connected to change in depressive symptoms. Tormented patients could be reassured that rumination symptoms may be alleviated over the course of antidepressant treatment.
Topics: Humans; Depressive Disorder, Major; Female; Male; Adult; Antidepressive Agents; Rumination, Cognitive; Middle Aged; Severity of Illness Index; Psychiatric Status Rating Scales; Treatment Outcome
PubMed: 38810785
DOI: 10.1016/j.jad.2024.05.135 -
Journal of Affective Disorders Nov 2020rumination, defined as repetitive thoughts about emotionally relevant experiences, has been linked extensively with mood disorders, especially major depressive disorder... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
rumination, defined as repetitive thoughts about emotionally relevant experiences, has been linked extensively with mood disorders, especially major depressive disorder (MDD). However, there is a growing body of evidence suggesting the importance of rumination in bipolar disorder (BD) as well.
METHODS
we searched for studies that investigated rumination in both BD and MDD in four databases. Our systematic search identified 12 studies with an overall sample size of 2071 clinical patients.
RESULTS
results demonstrated no significant difference in the ruminative tendencies of the two patient groups when all rumination measures were included. We tested for the effect of rumination subtype, BD subgroups, and the current mood state of BD and MDD patients. There were no significant differences in terms of depressive rumination, however, BD patients reported more rumination on positive affect. This difference remained significant when examining in BD-I and BD-II patient groups, with similar effect sizes.
LIMITATIONS
due to the lack of sufficient data in the literature, only a few self-report studies qualified to be included in our analysis. Thus additional moderating factors, such as the current mood state of the two patient groups could not be analyzed.
CONCLUSIONS
this review demonstrates that rumination is a significant process in both MDD and BD, highlighting the importance of interventions to reduce rumination in mood disorders. The two patient groups share several commonalities in terms of rumination, however, rumination subtype was found to be an important moderating variable underlining a difference in rumination on positive affect.
Topics: Affect; Bipolar Disorder; Depressive Disorder, Major; Humans; Mood Disorders; Self Report
PubMed: 32777651
DOI: 10.1016/j.jad.2020.07.131