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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 -
Comprehensive Psychiatry Jul 2024This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD).
BACKGROUND
This study aimed to explore the longitudinal associations of rumination with suicidal ideation and suicide attempts in individuals with major depressive disorder (MDD).
METHODS
Participants were derived from the Depression Cohort in China study (DCC). Those who completed at least one follow-up visit during the 12 months were included in the analysis. Dimensions of rumination including brooding and reflection were each measured using five items of the Ruminative Responses Scale. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. Suicide attempts were also assessed and all were analyzed with generalized estimating equations.
RESULTS
Our final sample included 532 participants aged 18 to 59 years (mean [SD], 26.91 [6.94] years) consisting of 148 (27.8%) males and 384 (72.2%) females. After adjusting for temporal trend and potential confounders, individuals with higher levels of reflection were more likely to report suicidal ideation (AOR =1.11, 95% CI:1.01-1.22). However, no statistically significant association was found between brooding and suicidal ideation (AOR =1.06, 95% CI:0.96-1.17). Conversely, individuals with higher levels of brooding were more likely to report suicide attempts (AOR =1.13, 95% CI:1.02-1.24), while no statistically significant association was observed between reflection and suicide attempts (AOR =0.91, 95% CI:0.82-1.01).
CONCLUSION
Rumination reflects a disturbance in cognitive emotional processing and manifests in different dimensions. Our findings suggest that high levels of reflection and brooding may be associated with a higher likelihood of having suicidal ideation and suicide attempts, respectively. However, it should be interpreted with caution, given that effect sizes are small.
Topics: Humans; Depressive Disorder, Major; Suicidal Ideation; Female; Male; Suicide, Attempted; Adult; China; Rumination, Cognitive; Longitudinal Studies; Adolescent; Young Adult; Middle Aged
PubMed: 38513451
DOI: 10.1016/j.comppsych.2024.152472 -
Anales de Pediatria Feb 2018Rumination syndrome is an uncommon gastrointestinal functional disorder that may be difficult to diagnose, as not many physicians are aware of this condition. In many...
INTRODUCTION
Rumination syndrome is an uncommon gastrointestinal functional disorder that may be difficult to diagnose, as not many physicians are aware of this condition. In many cases, patients undergo numerous tests and are prescribed several treatments based on erroneous diagnoses. When the correct diagnosis is eventually made, therapy for the syndrome can be difficult and complex because of its multifactorial nature. The aim of this study was to present our experience with this condition, by presenting an analysis of the clinical, diagnostic, and therapeutic data of our patients.
PATIENTS AND METHOD
A prospective and retrospective study was conducted on all cases of rumination syndrome diagnosed between January 2010 and May 2016 in patients attending the Paediatric Gastroenterology Departments of two hospitals: Consorci Sanitari de Terrassa and Hospital Materno-Infantil Vall d'Hebron (Barcelona, Spain).
RESULTS
The analysis included 12 patients, with a mean age at the onset of symptoms of 9 years and 1 month, and the mean time period to make the diagnosis was 2 years and 3 months. A mean of 8.1 complementary tests were carried out before establishing the diagnosis. In 10 of the 12 patients, some type of treatment had been given before the diagnosis of rumination syndrome, but was unsuccessful in all cases. Ten of our patients underwent the novel, experimental biofeedback therapy.
CONCLUSIONS
Due to the limited knowledge of this condition among attending professionals in terms of the clinical presentation, diagnosis, and treatment, patients with rumination syndrome are often misdiagnosed and undergo numerous avoidable complementary tests, and invasive, costly treatments.
Topics: Adolescent; Child; Child, Preschool; Feeding and Eating Disorders of Childhood; Female; Humans; Infant; Male; Retrospective Studies; Syndrome
PubMed: 28460821
DOI: 10.1016/j.anpedi.2017.03.011 -
Journal of Eating Disorders Feb 2023Disorders of gut-brain interaction (DBGI), also known as functional gastrointestinal disorders, are common in individuals with eating disorders, and may precede or... (Review)
Review
Disorders of gut-brain interaction (DBGI), also known as functional gastrointestinal disorders, are common in individuals with eating disorders, and may precede or perpetuate disordered eating. Understanding the pathophysiology of common gastrointestinal symptoms in DGBI can be important for the care of many patients with eating disorders. In this review, we summarize the literature to date on the complex relationship between DBGI and eating disorders and provide guidance on the assessment and management of the most common symptoms of DBGI by anatomic region: esophageal symptoms (globus and functional dysphagia), gastroduodenal symptoms (functional dyspepsia and nausea), and bowel symptoms (abdominal pain, bloating and constipation).
PubMed: 36782302
DOI: 10.1186/s40337-022-00731-6 -
Clinical Neuropsychiatry Oct 2023Internalizing and externalizing disorders are developmentally complex entities with multifactorial pathogenesis. The findings from recent research on the transdiagnostic...
OBJECTIVE
Internalizing and externalizing disorders are developmentally complex entities with multifactorial pathogenesis. The findings from recent research on the transdiagnostic responsibility of self-regulation and rumination suggest that their deficits underlie all psychiatric disorders in adults, and yet only a small number of studies have been conducted on the population of adolescents.
METHOD
The clinical study included 162 adolescents, divided into two clinical groups, treated in the Department of Child and Adolescent Psychiatry in Hospital. The first clinical group consisted of 91 adolescents with internalizing mental disorders, with the second clinical group consisting of 71 adolescents with externalizing mental disorders. They had been referred for psychodiagnostic assessment after their first psychiatric examination, and were diagnosed according to the International Classification of Diseases (ICD-)10 criteria, the diagnoses confirmed through structured clinical interviews. They additionally met the inclusion and exclusion criteria for participating in this study.
RESULTS
The results suggest that self-regulation significantly and negatively predicted symptoms of mental disorder in both clinical groups, and rumination significantly predicted symptoms of anxiety and depression in the group of adolescents suffering from internalizing disorders.
CONCLUSIONS
The findings emphasize the importance of maladaptive self-regulation as a transdiagnostic factor underlying various forms of psychopathology in adolescents, and the importance of rumination as a unique transdiagnostic process related to different disorders in the internalizing dimension.
PubMed: 38089740
DOI: 10.36131/cnfioritieditore20230503 -
Journal of Anxiety Disorders Mar 2023The Contrast Avoidance Model (CAM) suggests that worry increases negative affect and decreases positive affect. CAM also suggests that in response to a positive event,...
The Contrast Avoidance Model (CAM) suggests that worry increases negative affect and decreases positive affect. CAM also suggests that in response to a positive event, higher worry enhances the probability of experiencing greater decreased negative affect and increased positive affect (positive emotional contrasts; PECs). Consequently, worrying may be reinforced by repeated PECs. However, no study has tested whether rumination enhances PECs. Also, emotional specificity in these processes has not been considered. Therefore, we tested whether both rumination and worry enhanced PECs related to specific emotions. After resting baseline, participants with pure generalized anxiety disorder (GAD group, n = 91), pure depression symptoms (depression group, n = 91), and non-GAD and non-depressed healthy controls (HCs, n = 93) engaged with randomly assigned induction tasks (either worry, rumination, or relaxation), and then watched an amusement video. Regardless of group, both worry and rumination increased sadness and fear and decreased amusement more than relaxation from baseline. However, worry increased fear more than rumination, and rumination increased sadness more than worry. Although all inductions led to PECs during the video, worry enhanced fear PECs more than rumination, and rumination enhanced sadnessPECs more than worry. The GAD group who worried experienced the most salient PEC of amusement relative to other groups.
Topics: Humans; Emotions; Anxiety; Anxiety Disorders; Fear
PubMed: 36681058
DOI: 10.1016/j.janxdis.2023.102671 -
Psychiatria Polska 2016The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). (Review)
Review
AIM
The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa).
METHOD
The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbidities, clinical implications and treatment.
RESULTS
All of the included disorders may have dangerous consequences, both somatic and psychological. They are often comorbid with other psychiatric disorders. Approximately a few percent of general population can be diagnosed with each disorder, from 0.5-4.7% (SRED) to about 7% (orthorexia). With the growing literature on the subject and changes in DSM-5, clinicians recognise and treat those disorders more often.
CONCLUSIONS
More studies have to be conducted in order to differentiate disorders and treat or prevent them appropriately.
Topics: Feeding Behavior; Feeding and Eating Disorders; Female; Health Status; Humans; Male; Psychiatric Status Rating Scales
PubMed: 27556109
DOI: 10.12740/PP/59217 -
Gut Sep 1999The functional esophageal disorders include globus, rumination syndrome, and symptoms that typify esophageal diseases (chest pain, heartburn, and dysphagia). Factors... (Review)
Review
The functional esophageal disorders include globus, rumination syndrome, and symptoms that typify esophageal diseases (chest pain, heartburn, and dysphagia). Factors responsible for symptom production are poorly understood. The criteria for diagnosis rest not only on compatible symptoms but also on exclusion of structural and metabolic disorders that might mimic the functional disorders. Additionally, a functional diagnosis is precluded by the presence of a pathology-based motor disorder or pathological reflux, defined by evidence of reflux esophagitis or abnormal acid exposure time during ambulatory esophageal pH monitoring. Management is largely empirical, although efficacy of psychopharmacological agents and psychological or behavioral approaches has been established for several of the functional esophageal disorders. As gastroesophageal reflux disease overlaps in presentation with most of these disorders and because symptoms are at least partially provoked by acid reflux events in many patients, antireflux therapy also plays an important role both in diagnosis and management. Further understanding of the fundamental mechanisms responsible for symptoms is a priority for future research efforts, as is the consideration of treatment outcome in a broader sense than reduction in esophageal symptoms alone. Likewise, the value of inclusive rather than restrictive diagnostic criteria that encompass other gastrointestinal and non-gastrointestinal symptoms should be examined to improve the accuracy of symptom-based criteria and reduce the dependence on objective testing.
Topics: Esophageal Motility Disorders; Humans
PubMed: 10457042
DOI: 10.1136/gut.45.2008.ii31 -
Clinical Psychology & Psychotherapy Mar 2022In the ICD-11 diagnostic guidelines, preoccupation has been introduced as the new core symptom of adjustment disorder. Despite this essential innovation, preoccupation... (Review)
Review
In the ICD-11 diagnostic guidelines, preoccupation has been introduced as the new core symptom of adjustment disorder. Despite this essential innovation, preoccupation has so far largely been defined as rumination and worry and does not feature a distinct character as an independent symptom. In order to investigate the nature of preoccupation, various cognitive approaches are evaluated and linked to preoccupation. Furthermore, the aim of this review is to define preoccupation more precisely and to distinguish it from other symptoms in psychopathology. The evaluation of key features of cognitive dissonance theory, attention bias theory, memory theories, and other cognitive paradigms indicates that preoccupation is constituted by a complex interaction of cognitive-emotional mechanisms. In addition, this review implies that preoccupation in AjD can be defined as stressor-related factual thinking, which is time-consuming and often associated with negative emotions. It is assumed that rumination and dysfunctional worry serve as reactive processes to cope with preoccupation. For further distinction, this review presents similarities and differences of preoccupation and other symptoms, including negative automatic thoughts, flashbacks, and yearning. Finally, implications and suggestions for future research on preoccupation are offered. Overall, it is plausible that preoccupation is not only associated with adjustment disorder but also possesses a transdiagnostic character.
Topics: Adjustment Disorders; Anxiety; Anxiety Disorders; Cognitive Behavioral Therapy; Emotions; Humans
PubMed: 34355464
DOI: 10.1002/cpp.2657 -
Epidemiology and Psychiatric Sciences Jun 2022Pica and rumination disorder are known as feeding disorder diagnoses in childhood, but little is known about their occurrence in adulthood. This study aimed to assess...
AIMS
Pica and rumination disorder are known as feeding disorder diagnoses in childhood, but little is known about their occurrence in adulthood. This study aimed to assess prevalence rates of one-time and recurrent pica and rumination behaviours (PB and RB) in adults, including sociodemographic subgroups, and to examine associations with other eating disorder and general psychopathology.
METHODS
The representative population sample ( = 2403) completed measures on PB and RB, symptoms of avoidant/restrictive food intake disorder (ARFID), body image and symptoms of depression and anxiety.
RESULTS
Any PB and RB were reported in 5.33 and 5.49%, respectively, while recurrent PB or RB occurred in 1.08 and 0.71%, respectively. Co-occurrence was high, with 35.29% of recurrent PB in RB, and 23.08% vice versa. Prevalence rates of recurrent PB or RB did not differ by gender, weight status, educational or migration history from those without recurrent behaviours. Adults with . without recurrent PB and RB showed more symptoms of ARFID, general eating disorders depression and anxiety, and behavioural symptoms of eating disorders (with the exception of compensatory behaviours in recurrent PB), and less positive body image. However, there were no differences regarding age and body mass index.
CONCLUSIONS
Our findings highlight the clinical significance of PB and RB in adults regarding both prevalence and associations with other psychopathological symptoms. In particular, associations with body image need to be investigated further, as in contrast to other eating disorders, body image disturbance is not yet represented in the diagnostic criteria for pica and rumination disorder. In sum, the findings highlight the need for clinical attention for these disorders and related behaviours in adults.
Topics: Adult; Feeding and Eating Disorders; Humans; Pica; Prevalence; Psychopathology; Rumination Syndrome
PubMed: 35678377
DOI: 10.1017/S2045796022000208