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Ce projet de mémoire porte sur l'étude du concept de rumination mentale, plus particulièrement sur les ruminations de la colère et de la tristesse. Actuellement, l'état des connaissances établit avec évidence le lien entre la rumination et les problèmes internalisés, autant à l'âge adulte, à l'adolescence qu'à l'enfance (Ingram, 1990 ; Mor et Winquist, 2002 ; Papageorgiou et Wells, 2004 ; Segerstrom et Miller, 2004 ; Thomsen, 2006 ; Nolen-Hoeksema, Wisco et Lyubomirsky, 2008). Toutefois, peu d'études se sont attardées aux relations entre la rumination et les comportements extériorisés, dont l'agression. Malgré tout, les liens possibles entre la rumination et les conduites agressives suscitent d'importants questionnements. La présente recherche s'inscrit donc dans la lignée de ces questionnements. À cet effet, ce mémoire a pour objectif général de vérifier si la rumination de la tristesse et de la colère est liée de façon unique et distinctive à des affects et comportements spécifiques. Cette étude a donc cherché à vérifier si la rumination de la tristesse est uniquement associée aux symptômes de la dépression ou si elle peut être associée aux comportements agressifs et à vérifier si la rumination de la colère est uniquement associée aux comportements agressifs ou si elle peut être associée aux symptômes de la dépression. Considérant le fait que la majorité des études qui ont traité les ruminations l'ont effectué auprès d'échantillons adultes, nous avons proposé d'étendre l'étude de ce concept auprès d'une clientèle adolescente. Plus particulièrement, l'échantillon est constitué d'adolescentes hébergées des unités de réadaptation du Centre Jeunesse de Montréal - Institut Universitaire et du Centre Jeunesse de Laval (N= 319). Cette étude propose donc plus spécifiquement de mesurer : la force des associations entre la rumination de la colère et de la tristesse et les différentes formes de comportements agressifs (physique, verbale et indirecte) chez les adolescentes en difficulté, la force des associations entre la rumination de la colère et de la tristesse et les symptômes de dépression chez les adolescentes en difficulté ainsi que l'influence spécifique des ruminations (de la colère et de la tristesse) au-delà de la contribution des sentiments de colère dans leur association avec les trois formes de comportements agressifs (physiques, verbaux et indirects) et les symptômes de dépression. Avant de réaliser ces objectifs, une validation du questionnaire portant sur les ruminations le Sadness and Anger Rumination Scale (SARI) de Peled et Moretti (2007) a été réalisée. Ensuite, des corrélations, des analyses de régression multiple et des analyses de régression hiérarchique ont été réalisées avec les données de nos différents instruments de mesure. Les principaux résultats obtenus dans cette étude indiquent que la rumination de la colère améliore notre capacité à comprendre l'adoption de certains comportements agressifs (physiques, verbaux et indirects) et la présence de symptômes de la dépression au-delà des sentiments de la colère. La rumination de la tristesse contribue pour sa part dans la compréhension des symptômes de dépression chez les adolescentes de notre échantillon. Sommairement, ceci vient donc mettre en lumière l'importance des cognitions dans la compréhension de la présence de certaines difficultés puisqu'elles ont une influence qui leur est spécifique, et ce, au-delà des émotions que présentent les adolescentes hébergées en Centre Jeunesse. Comme le concept de rumination mentale demeurait peu documenté lorsqu'il est mis en relation avec les conduites agressives à l'adolescence, notre projet de recherche a permis un certain avancement des connaissances en ce qui a trait à l'implication de ce concept dans ces relations. De plus, cette étude est venue enrichir la compréhension de la régulation cognitive des émotions dans un contexte clinique et a mis en lumière l'importance d'intervenir sur ce type de cognitions.

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The overarching aim of this research was to understand factors implicated in the maintenance of rumination and worry, conceptualised as a transdiagnostic process of repetitive negative thought (RNT), through the use of cross-sectional, prospective, and experimental research designs. Rumination and worry have been repeatedly implicated in the development and maintenance of various forms of psychopathology, in particular, depression and anxiety disorders. Given the negative outcomes for mood and psychopathology, there is a need for a better understanding of vulnerability factors that maintain this unconstructive thinking. Based on a review of the literature, an integrative theoretical model was developed and tested using structural equation modelling. Using cross-sectional data, the model was tested in a large sample of adults (n = 506). Of the broad range of proximal and distal vulnerability factors examined, only neuroticism and beliefs about the function of repetitive thought remained significantly associated with RNT once current symptoms were statistically controlled. Emotional abuse and abstract processing were indirectly associated with RNT. Following on from this, a prospective study examined which of these vulnerability factors prospectively predicted change in RNT over six to eight weeks. Only neuroticism and the specific belief that repetitive thought aids instrumental understanding predicted change in RNT, after controlling for depression and anxiety symptoms. Next, two experimental studies were conducted to explore the causal relationship between RNT and the belief that RNT aids insight and understanding, by experimentally manipulating this appraisal and measuring the impact on state RNT. Whilst methodological issues with the first experimental study precluded clear conclusions being drawn about the nature of the relationship, the second experimental study demonstrated that participants manipulated to believe that RNT is helpful for increasing insight and understanding had greater levels of state RNT after exposure to a stressor, relative to participants manipulated to believe that RNT is unhelpful. Finally, in order to see whether rumination has any consequences that may potentially reinforce its further use, an experimental study was conducted to manipulate processing mode (abstract rumination versus concrete thinking) and examine the effect on a range of outcomes relating to insightfulness and avoidance. Whilst rumination did not lead to increased insight, it did afford more justification for avoidance, relative to concrete thinking. The clinical and theoretical implications of these findings are discussed with respect to existing theories of repetitive negative thought.

Call number: LD2668 .T4 1985 S38 / Master of Science

The aim of this thesis was to increase understanding of how rumination, defined as the behaviours and thoughts that focus an individual’s attention on their depressive symptoms and on the implications of these symptoms (Nolen-Hoeksema, 1991), affects the relationship between postnatal depressive symptoms and maternal sensitivity. Study 1 examined the impact of self-reported maternal rumination on perceived maternal attunement and mood, and the role of perceived social support and infant temperament in this relationship in a community sample of mothers (N = 203). Rumination mediated the relationship between maternal depressive symptoms and maternal responsiveness when infant negative affect was low but not high. Contrary to predictions, rumination did not mediate the relationship between social support and maternal attunement. Study 2 incorporated a second assessment point approximately six months later with the same sample. Prospective analyses were undertaken to examine the directional relationship between rumination and maternal attunement in the context of depressive symptoms. Unexpectedly, analyses revealed that maternal bonding prospectively predicted rumination at six months, after controlling for rumination at baseline. The converse relationship was not significant. This was contrary to the thesis hypothesis that increased rumination would predict impaired attunement at six months. Partially consistent with the thesis hypotheses, the relationship between rumination and maternal attunement was moderated by depressive symptoms at baseline; such that mothers who were low in depressive symptoms and had lower bonding at baseline reported higher levels of rumination at 6 months. Study 3 also explored the directional relationships between maternal mood, rumination and maternal attunement at a state level in a daily diary study with a community sample of mothers (N = 94) with infants aged between 3 and 14 months. Consistent with the findings of study 2, state maternal bonding at Time 1 predicted both state maternal rumination and state maternal mood at Time 2, and state rumination at Time 2 mediated the relationship between state bonding at Time 1 and state mood at Time 2. In the final study, the causal relationships between an experimentally induced state of ruminative thinking and observed maternal behaviours in a mother-infant interaction task were examined in a sample of dysphoric and non-dysphoric mothers (N = 79) and their infants. The analyses examined change in mother-infant interaction quality from baseline to post rumination induction, and subsequent change following an infant stressor task. Findings revealed a significant reduction in maternal sensitivity and mother-infant dyadic synchrony in the rumination group, but not the control group. For maternal sensitivity, the effect of rumination was exacerbated following the stressor task. Contrary to predictions, this relationship was not moderated by dysphoric symptoms. The findings of this thesis indicate that ruminative thinking directly impairs observed maternal behaviours, but that perceived poorer maternal attunement also increases self-reported ruminative thinking. The significance of these findings for theoretical explanations of rumination in a postnatal context are considered, and the clinical implications for parenting programmes and interventions for both mothers in the community as well as those considered at risk are discussed.

Background and Objectives: Rumination may contribute to depression by impairing the most effective allocation of time across activities. An experiment tested the role of rumination in time allocation across tasks. Methods: State rumination was manipulated by cueing an unresolved goal in one condition (32 participants) and cueing a resolved goal in another condition (32 participants). Trait rumination and depressive symptoms were also measured. All participants completed two word generation tasks and allocated a fixed overall time budget between the tasks by interleaving between them. Results: No difference was found in task performance or time allocation following the manipulation of state rumination. Self-reported rumination did not differ between conditions throughout the experimental task. Differences in time allocation behaviour were associated with trait rumination. Limitations: Use of a non-clinical population and tasks that are unrepresentative of everyday problem solving limited the generalisability of the results and may have limited the effect of the state rumination manipulation on task performance. Conclusions: The absence of a difference in self-reported rumination throughout the task suggests that either the word generation task reduced levels of rumination or that the level of rumination induced did not have a large effect on the cognitive processes required to complete the word generation task.

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

As a GWR research project joint funded by Hospiscare, the main objective of this research was to examine the nature of psychological distress in palliative care, with the specific purpose of developing and evaluating accessible psychological interventions suitable for Hospiscare staff to use with clients. There is evidence that palliative care patients and their caregivers experience psychological difficulties including (a) studies of depression and anxiety in palliative care; (b) the concerns expressed by palliative care patients and their caregivers. However, the studies are generally qualitative in nature based on interviews of small samples of participants. Therefore, Study 1 and Study 2 adopted a cross-sectional design to examine psychological distress and rumination in samples of palliative care patients, their caregivers and an age-matched control group. The results from Study 1 and Study 2 indicated that psychological distress and rumination on existential concerns were elevated in palliative care patients and their caregivers. Furthermore, findings suggested an association between psychological distress and abstract rumination. Study 3 reported a case series piloting an intervention developed from concreteness training (CT) designed to address abstract rumination in palliative care. The case series indicated that with some modification to the identification and screening of patients, the treatment could be acceptable and feasible for palliative care patients. Study 4 examined the effectiveness of the CT guided self-help intervention in a randomized controlled trial. Findings indicated that the intervention could be effective for reducing anxiety, but not depression in palliative care patients. Moreover, Study 5’s findings also raised the possibility that abstractness was a partial mediator of the effects of the intervention on self-reported symptoms of anxiety in palliative care patients. Study 5 utilised a cluster randomized controlled design to evaluate a training programme designed to teach hospice staff how to deliver the CT guided self-help intervention. Results indicated that there was a more positive impact of routine care on patient distress for nurses attending training, when compared to nurses not attending the training. However, the training did not impact on nurses’ self-reported confidence or behaviour in addressing patients’ distress.