Rumination is generally defined as a repetition of a theme in thoughts. Rumination has been consistently associated with psychopathologies. Among these psychopathologies, the relationship between depression and rumination is likely the most widely researched. Rumination was found able to predict onset of depression and duration of depressive symptoms. Rumination was also suggested to be a maladaptive coping to stress and distress, which enhance avoidant coping strategies and then further increase depression. Hence, understanding the neural basis of rumination would shed important insight into the mechanisms underpinning the regulation and dysregulation of emotion that would guide the development of cost-effective interventions. Study One was conducted to understand the sex-related differences in the rumination subtypes’ relationships with negative affect and avoidance. Thirty-six healthy participants (23 females, 13 males) were recruited in the community. We found a positive association between brooding and negative affect in both males and females. We also found, as hypothesized, a positive association between brooding and avoidance, and a negative association between reflective pondering and depression in females. A negative association between reflective pondering and avoidance was also found in males. However, reflective pondering was found to be positively associated with depression in males in this study. The findings suggest a gender difference in their emotional regulation. The brain structural correlation with this sex-related behavioral data was investigated through a voxel-based morphometry study. The sex-related difference of rumination subtypes and their relationship with negative affect, avoidance and brain volumes were explored. We found males having a larger gray matter volume over left anterior cingulate than females, and gray matter volume of this region was found to be associated with brooding in the literature. A significant interaction effect of gender and brooding was found over gray matter volume of left lateral parietal, while a significant interaction effect of gender and reflective pondering was found over gray matter volume of the several frontal regions. Consistent with the behavioral study findings, the left inferior temporal, left postcentral and right anterior cingulate were found to be associated with the significant associations between rumination and negative affect found in Study One. We also found the left inferior temporal and right precentral positively associated with brooding and behavioral-nonsocial avoidance in females. This was also found to be consistent with results from Study One. In this study, the sex-related differences among rumination, negative affect and avoidant coping strategies were found to be correlated to the regional gray matter volumes. These findings do not only help us better understand the neural associates behind the sex-related behavioral differences often discussed and found in previous studies, they also give us further information and direction on the management plans of the emotional and avoidance problems associated with rumination. / published_or_final_version / Psychology / Doctoral / Doctor of Philosophy

Rumination is known as compulsive and recurrent self-focused thoughts concerning symptoms, causes and consequences of personal distress. Previous research suggested that the habitual use of rumination in daily life, especially among depressed patients, was related to working memory impairment. Here we examined how induced rumination affects the functioning of working memory. In our experiment, participants were randomly assigned to go through either rumination or distraction induction procedures. Then, they were assessed by a computer task in which they were asked to sort three words in either forward or backward order. The three words were either of negative or neutral valence. Accuracy and response latency were recorded to estimate the functioning of their working memory. To examine the pure impact of state rumination on working memory, we recruited participants from healthy population in experiment 1. Recruiting non-depressed people helps isolate rumination from Major Depressive Disorder (MDD) so that the effect of rumination state can be explored in the absence of the mood problems and cognitive deficits related to MDD. The relationship between trait rumination and working memory performance among non‐depressed people was also reviewed. It was found that participants’ accuracy in sorting negative words was lower than neutral words in forward sorting trials after rumination induction. This performance pattern was not observed in distraction group, implicating that rumination caused an increased difficulty for non‐depressed people to encode negative information when they were ruminating. In experiment 2, we aimed at investigating the working memory performance when depressed patients were ruminating. Depressed patients and matched healthy control were recruited to go through the same experimental procedures as in experiment 1. An elevated accuracy for negative words and an improved performance, in terms of higher accuracy and lower response latency, for forward sorting trials after rumination induction were observed. The finding suggested that state rumination caused depressed patients’ working memory to be more prepared to encode information, especially negative one. The results demonstrated that the impact of rumination state on working memory is consistent with the principle of cognitive congruency. Information that is congruent with the self‐related representation tends to have preferential access to the working memory. Implication of our findings on MDD would be discussed in the light of the observed influence of rumination on working memory functioning. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

In support of Snyder’s cognitive theory, hope has been found to be a positive factor in psychological adjustment among adult cancer patients and non-cancer paediatric patients with various illnesses. Nonetheless, Snyder’s cognitive theory of hope has not been specifically examined among childhood cancer patients and survivors. Unlike adult cancer patients, childhood cancer patients and survivors are characterized by early onset age in their cancer diagnosis which may mean that they face different psychological and physiological challenges. The identification of positive factors that attenuate negative psychological adjustment outcomes may be crucial in the development of effective therapeutic interventions. Despite that previous studies support the correlation between hope and positive adjustment outcomes, the exact cognitive mechanism that underpins the cognitive theory of hope remains underexplored. Although Snyder postulated that hope is goal-directed thinking which comprises willpower and waypower, he failed to establish any association between hope and rumination. The role of rumination in predicting the onset of mood symptoms and maintaining psychopathology has been well-researched, but it is conceptually meaningful to investigate the potential association between hope and rumination and their respective roles in affecting psychological adjustments in cancer experiences. The current thesis improves on the understanding of relationships between hope, rumination and cancer adjustment, and expands on studies of cancer adjustment by tapping into both positive and negative psychological outcomes, and examines how these two juxtaposed outcomes are associated with hope as mediated by positive and negative ruminations respectively. Eighty-nine childhood cancer survivors from the Children’s Cancer Foundation in Hong Kong took part in questionnaires that measured their levels of hope, rumination, mood symptoms and self-perceived positive changes or post-traumatic growth (PTG). The findings suggest that hope is negatively correlated with depression and anxiety, which are specifically mediated by negative cancer-related rumination. Hope is also positively correlated with PTG, which is specifically mediated by positive cancer-related rumination. These results provide empirical evidence to support the postulation by Snyder that low hope individuals adjust poorly because they are more likely to have negative rumination. High hope individuals adjust better as they are more likely to engage in positive rumination which is associated with PTG. The overall findings provide a possible explanation for the cognitive mechanism that underlies hope. A supplementary pilot study conducted measuring 20 childhood cancer patients’ hope level and mood symptoms over a period of nine months post-acute treatment also suggests patients have fewer prospective depressive symptoms have higher hope level in early measurement. The findings of the current thesis have important clinical implications. The understanding of hope and its association with rumination and cancer adjustment may inform the specific development of hope-based therapeutic interventions for childhood cancer patients and survivors, such as the hope-based storybook developed in this study with the aim to increase the hope levels of childhood cancer patients. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Rumination has been consistently found to be a risk factor of depression. However, few studies examined rumination and its relationship with depression, and the protective role of such individual positive traits as hope, in a Hong Kong Chinese context. As opposed to western findings, a recent local study found that the two components of rumination (Treynor, Gonzalez, & Nolen-Hoeksema, 2003), namely brooding and reflective pondering, were not correlated, and the latter was rather adaptive in predicting depressive symptoms (Lo, Ho, & Hollen, 2008). Together with some psychometric issues revealed in the same study, it is unclear if the two-factor model of rumination is applicable in the Hong Kong Chinese context. In addition, given that hope only buffers against negative impact of risk factors of depression, whether the moderating effect of hope on the relationship of brooding and reflective pondering with depressive symptoms in Geiger and Kwon’s (2010) western sample can be replicated in Hong Kong Chinese populations is not clear. Therefore, the present study re-examines the two-factor model of rumination and its relationship with depressive symptoms, and the moderating role of hope in a Hong Kong Chinese sample using a longitudinal design. Adult Trait Hope Scale, Ruminative Response Scale, and Center for Epidemiologic Studies Depression Scale were administered to 189 Hong Kong Chinese university students at lectures with a four-week interval between the two time-points. Analyses using hierarchical linear regression were conducted to examine the relationship of brooding and reflective pondering, and their relationship with depressive symptoms and the role of hope, both concurrently and prospectively. Results confirmed the applicability of the two-factor model of rumination in the Hong Kong Chinese college sample. Rumination (total) and brooding consistently predicted depressive symptoms. Also, moderating effect of hope on the relationship of brooding and depressive symptoms was replicated using the time 1 data in the present study. Nonetheless, contrary to the recent local finding by Lo et al. (2008), brooding and reflective pondering were positively correlated as in western samples, and there was some evidence of one-way relationship from reflective pondering to brooding as shown by the longitudinal data. Reflective pondering itself was neither adaptive nor maladaptive, because there was no significant relationship between reflective pondering and depressive symptoms after controlling for level of brooding. Hence, hope had no interaction with reflective pondering in predicting depressive symptoms. For longitudinal data, after controlling for baseline level of the dependent variables, the one-way relationship from reflective pondering to brooding, the relationship of rumination (total) and brooding with depressive symptoms, and the moderating effect of hope on the relationship between brooding and depressive symptoms, all became nonsignificant. The findings of the present study support the use of the two-factor model of rumination in Hong Kong Chinese context, and suggest that the two components of rumination were correlated probably because reflective pondering tended to lead to brooding. This study also offers further empirical support for brooding being a more robust risk factor of depression than reflective pondering and the buffering impact of hope on psychological well-being. Implications of the results, limitations of this study and recommendations for further research were also addressed. / published_or_final_version / Psychology / Master / Master of Philosophy