title: Rumination in posttraumatic stress disorder.
abstract: Recent studies have shown that rumination is a powerful predictor of persistent posttraumatic stress disorder (PTSD). However, to date, the mechanisms by which rumination maintains PTSD symptoms are little understood. Two studies of assault survivors, a cross-sectional (N = 81) and a 6-month prospective longitudinal study (N = 73), examined several facets of ruminative thinking to establish which aspects of rumination provide the link to PTSD. The current investigation showed that rumination is not only used as a strategy to cope with intrusive memories but it also triggers such memories. Certain characteristics of rumination, such as compulsion to continue ruminating, occurrence of unproductive thoughts, and "why" and "what if" type questions, as well as negative emotions before and after rumination, were significantly associated with PTSD, concurrently and prospectively. These characteristics explained significantly more variance in PTSD severity than the mere presence of rumination, thereby indicating that not all ways of ruminative thinking are equally maladaptive.
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, United Kingdom. tanja.michael@unibas.ch
authors.forename: Tanja
authors.initials: T
authors.lastname: Michael
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Halligan
authors.forename: David M
authors.initials: DM
authors.lastname: Clark
authors.forename: Anke
authors.initials: A
authors.lastname: Ehlers
mesh_terms: D000328:Adult; D003192:Compulsive Behavior / Q000175:diagnosis / Q000523:psychology; D019548:Crime Victims / Q000523:psychology; D003469:Culture; D004644:Emotions; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010555:Personality Inventory; D013239:Stereotyped Behavior; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D013850:Thinking; D014754:Violence / Q000523:psychology*