Lori M. Hilt

The Children's Attributional Style Interview: developmental tests of cognitive diathesis-stress theories of depression.

This paper presents an initial assessment of the Childrens Attributional Style Interview (CASI), a newly designed measure for assessing attributional style in young children (age 5 and up). The CASI was used to conduct prospective tests of the reformulated helplessness (L. Y. Abramson, M. Seligman, & J. Teasdale, 1978) and the integrated hopelessness/self-esteem (G. I. Metalsky, T. E. Joiner, Jr., T. S. Hardin, & L. Y. Abramson, 1993) theories of depression in a sample of 147 5–10-year-old children. For comparison, the same tests were also conducted with the Childrens Attributional Style Questionnaire-Revised (CASQ-R; N. J. Kaslow & S. Nolen-Hoeksema, 1991), a commonly used measure for assessing attributional style in older children (age 8 and up). The CASI evidenced support of the reformulated helplessness theory and partial support of the integrated hopelessness/self-esteem theory. The CASI also demonstrated good internal consistency. Thus, our findings provide initial support for the CASI as a methodologically sound measure of attributional style for children as young as 5 years old. Although preliminary, our findings also suggest possible developmental differences in how attributional style interacts with self-esteem and negative life stress. The CASI should prove to be a useful tool in furthering the understanding of the origins and development of attributional style in childhood, as well as its contribution to the understanding of the development and prevention of depressive symptomatology in children.

Early family context and development of adolescent ruminative style: Moderation by temperament

We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool (ages 3½ and 4½ years) and early adolescence (ages 13 and 15 years). Results indicated that family context and child temperament, assessed during the preschool period, were risk factors for a ruminative style in adolescence. Specifically, early family contexts characterised by over-controlling parenting and a family style of negative-submissive expressivity predicted higher levels of later rumination. These associations were moderated by childrens temperamental characteristics of negative affect and effortful control. Further, the interaction of these temperament factors exerted an additional influence on later rumination. Implications for prevention and intervention efforts are discussed.

Rumination as a transdiagnostic factor underlying transitions between internalizing symptoms and aggressive behavior in early adolescents

The high degree of comorbidity among mental disorders has generated interest in identifying transdiagnostic processes associated with multiple types of psychopathology. Susan Nolen-Hoeksema conceptualized rumination as one such transdiagnostic process associated with depression, anxiety, substance abuse, binge eating, and self-injurious behavior. The degree to which rumination accounts for the co-occurrence of internalizing and externalizing psychopathology, however, has never been tested. We used a sample of early adolescents (N = 1,065) assessed at 3 time points spanning 7 months to examine (a) the reciprocal prospective associations between rumination and aggressive behavior in adolescents, (b) whether rumination explained the longitudinal associations of aggressive behavior with depression and anxiety symptoms, and (c) gender differences in these associations. Rumination predicted increases over time in aggressive behavior, and aggression was associated with increases in rumination over time only for boys. Rumination fully mediated the longitudinal association of aggression with subsequent anxiety symptoms and of both depression and anxiety symptoms with subsequent aggression in boys but not girls. Rumination did not explain the association between aggression and subsequent depressive symptoms for either boys or girls. These findings provide novel evidence for the role of rumination as a transdiagnostic factor underlying transitions between internalizing and externalizing symptoms among males during early adolescence. Interventions aimed at reducing rumination may have beneficial influences on multiple forms of psychopathology and on the development of comorbidity. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Characterizing the Ruminative Process in Young Adolescents

Rumination involves repeatedly and passively dwelling on negative feelings and brooding about their causes and consequences. Prior work has found that rumination predicts many forms of psychopathology including anxiety, binge eating, binge drinking, self-injury, and especially depression (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008). In the present study, we attempt to characterize the ruminative process in real time in young adolescents, specifically by examining factors that predict rumination following an interpersonal stressor. A community sample of 105 youth ages 9 to 14 (70% girls; 66% Caucasian) completed questionnaires regarding depressive symptoms and trait rumination along with an assessment of selective attention using an emotional faces dot-probe task. Participants then underwent an interpersonal stressor and audio rumination induction in the laboratory during which time thoughts were sampled regularly and coded. Results indicate that negative self-referential thought is a common response to the stressor and is predicted by trait rumination scores. Although most participants were able to disengage from this type of thinking, 10.5% persisted through (i.e., ruminated) until the end of the study. These individuals were characterized by higher depressive symptoms and an attentional bias away from happy (relative to neutral) faces. Differences in attentional processes may characterize rumination in youth. Implications for the measurement of rumination as well as treatment are discussed.

Cognitive Control and Rumination in Youth: The Importance of Emotion

Rumination involves the tendency to passively dwell on negative emotions along with their meanings and consequences. Susan Nolen–Hoeksema demonstrated the role of rumination in the development of several forms of psychopathology and suggested that cognitive control may be one factor that makes some individuals more prone to ruminate than others. Studies with adults have consistently found that rumination is associated with cognitive control difficulties, especially related to switching and inhibiting emotional information. Because rumination predicts psychopathology by adolescence, the present study examined whether ruminating youth would show similar cognitive control difficulties. Fifty–two adolescents completed two tasks from the Cambridge Neuropsychological Test Automated Battery and reported on their depressive symptoms and tendency to ruminate. There was no effect of rumination on a task measuring general cognitive flexibility. However, rumination was associated with difficulty inhibiting negative information when switching from negative to positive blocks on an Affective Go/No–go task. Results suggest both similarities and differences compared to adult studies and are discussed in terms of clinical implications for the prevention and treatment of psychopathology.

School-aged children's depressive rumination is associated with their reactivity to sadness but not fear

It is well documented that a ruminative response style is associated with greater risk for depression in children and adults. Less is known about the association between rumination and stress reactivity, particularly among children. Similarly, the extent to which depressive rumination is associated with general reactivity to negative emotion, or more specifically to sadness, has not received sufficient attention. The current study examines the association between depressive rumination and stress reactivity in response to a mild laboratory stressor in school-aged children. A diverse sample of 94 children between the ages of 8 and 12 participated in this 2-session study in which they reported on their tendency to engage in depressive rumination. Childrens cardiovascular reactivity (operationalized as respiratory sinus arrhythmia) was assessed while they completed a task in which they read vignettes depicting children experiencing sadness and fear. Children also reported on their emotional reaction to the sad and fear vignettes, and we assessed the length of time it took them to respond to these questions (reaction time). Rumination was associated with greater decreases in respiratory sinus arrhythmia and greater increases in self-reported negative emotion in response to the sad but not the fear vignettes, suggesting that children higher in depressive rumination experienced more subjective arousal and showed evidence of greater regulatory effort when contemplating sadness. Rumination was associated with slower reaction time to both types of vignettes in one condition of the paradigm only. Results are discussed in terms of their implications for rumination and stress reactivity.

Maltreated Youth Display a Blunted Blood Pressure Response to an Acute Interpersonal Stressor

Although there is much evidence of hypothalamic-pituitary-adrenal axis dysfunction among individuals who have experienced child maltreatment, dysregulation of the autonomic nervous system (ANS) has received less attention. Understanding the role of the ANS in maltreated children may help clarify how these children respond to subsequent life stress. We explored ANS reactivity among 111 youth (ages 9–14), 34 of whom had experienced verified child maltreatment. ANS activity was assessed via blood pressure—a convenient, noninvasive physiological index—while youth underwent a social stress task. Blood pressure and subjective mood ratings were obtained prior to and following the task. Nonmaltreated youth experienced an increase in systolic blood pressure following the stressor, whereas maltreated youth did not. Self-reported subjective mood worsened for both groups. The current data suggest that children who experienced early stress exposure demonstrate blunted ANS reactivity. Results are discussed in terms of childrens healthy adaptations to transient social stressors. In addition, we discuss the cost-effectiveness and benefits of physiological measures such as blood pressure for understanding risk for psychopathology.

Rumination and multi-modal emotional reactivity

Rumination, a cognitive process that involves passively and repetitively focusing on negative feelings and their consequences, has been linked to negative emotional outcomes. Previous research suggests that rumination may lead to deleterious outcomes through prolonging emotional reactivity; however, evidence supporting the link between rumination and reactivity has been mixed. In the present study, we examined the relationship between state and trait rumination and multi-modal emotional reactivity (i.e., hypothalamic-pituitary-adrenal axis, autonomic nervous system, subjective experience). Fifty undergraduates participated in a social evaluative laboratory stressor. They also reported on their general tendency to ruminate and their use of rumination in response to this particular laboratory stressor. State, but not trait, rumination was associated with increases in cortisol and negative affect. Findings underscore the importance of multi-modal assessment of emotional reactivity and suggest important implications for rumination following a stressor.

Affective Neural Responses Modulated by Serotonin Transporter Genotype in Clinical Anxiety and Depression

Serotonin transporter gene variants are known to interact with stressful life experiences to increase chances of developing affective symptoms, and these same variants have been shown to influence amygdala reactivity to affective stimuli in non-psychiatric populations. The impact of these gene variants on affective neurocircuitry in anxiety and mood disorders has been studied less extensively. Utilizing a triallelic assay (5-HTTLPR and rs25531) to assess genetic variation linked with altered serotonin signaling, this fMRI study investigated genetic influences on amygdala and anterior insula activity in 50 generalized anxiety disorder patients, 26 of whom also met DSM-IV criteria for social anxiety disorder and/or major depressive disorder, and 39 healthy comparison subjects. A Group x Genotype interaction was observed for both the amygdala and anterior insula in a paradigm designed to elicit responses in these brain areas during the anticipation of and response to aversive pictures. Patients who are S/LG carriers showed less activity than their LA/LA counterparts in both regions and less activity than S/LG healthy comparison subjects in the amygdala. Moreover, patients with greater insula responses reported higher levels of intolerance of uncertainty, an association that was particularly pronounced for patients with two LA alleles. A genotype effect was not established in healthy controls. These findings link the serotonin transporter gene to affective circuitry findings in anxiety and depression psychopathology and further suggest that its impact on patients may be different from effects typically observed in healthy populations.

Daily and trait rumination: diurnal cortisol patterns in adolescent girls

ABSTRACT Rumination is a maladaptive form of emotion regulation associated with psychopathology. Research with adults suggests that rumination covaries with diurnal cortisol rhythms, yet this has not been examined among adolescents. Here, we examine the day-to-day covariation between rumination and cortisol, and explore whether trait rumination is associated with alterations in diurnal cortisol rhythms among adolescent girls. Participants (N = 122) provided saliva samples 3 times per day over 3 days, along with daily reports of stress and rumination, questionnaires assessing trait rumination related to peer stress, and diagnostic interviews assessing depression and anxiety. Greater rumination than usual during the day was associated with lower cortisol awakening responses the following morning, but this effect was not significant after accounting for wake time and an objective measure of adherence to the saliva sampling protocol. Trait rumination was associated with lower average cortisol levels at waking and flatter diurnal slopes, accounting for wake time, protocol compliance, and other factors. These patterns may help to explain why rumination is related to the development of psychopathology.