title: The relationships between dysfunctional attitudes, rumination, and non-somatic depressive symptomatology in newly diagnosed Asian cancer patients.
abstract: BACKGROUND
  Given the high prevalence of cancer patients with comorbid depression, the present study sought to elucidate the relationships between two vulnerability factors, dysfunctional attitudes and rumination, and their influence on non-somatic depressive symptomatology in an Asian cohort of cancer patients. It was hypothesized that all variables of interest would be inter-correlated, and that both dysfunctional attitudes and rumination would mediate one another in influencing non-somatic depressive symptoms.
  
  
  METHODS
  A total of 194 recently diagnosed mixed-cancer patients in Singapore (Mage=49.2±9.2years; 68% women; 61% ethnically Chinese), without any comorbid psychiatric diagnosis, completed the Dysfunctional Attitudes Scale Form A, Rumination Responses Scale (comprising brooding and reflective rumination), and Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Correlational analyses revealed that all variables were inter-correlated (rhos[194]=.35-.52). Bootstrapping mediation analyses controlling for gender and treatment received revealed that both brooding and reflective rumination mediated the relationship between dysfunctional attitudes and non-somatic depressive symptoms, and that dysfunctional attitudes also mediated the relationship between both brooding and reflective rumination and non-somatic depressive symptoms.
  
  
  CONCLUSIONS
  Findings suggest that, in cancer patients, both dysfunctional attitudes and rumination seem to act upon one other, in a feedback loop, to influence non-somatic depressive symptomatology. Clinicians may therefore have a wider range of treatments to choose from in managing cancer patients with depressive symptomatology.
authors.affiliation: Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore.
authors.forename: Kevin F Y
authors.initials: KF
authors.lastname: Lam
authors.affiliation: Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore.
authors.forename: Haikel A
authors.initials: HA
authors.lastname: Lim
authors.affiliation: Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore.
authors.forename: Joyce Y S
authors.initials: JY
authors.lastname: Tan
authors.affiliation: Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore; Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228, Singapore; Duke-NUS Graduate Medical School Singapore, 8 College Road, 169857, Singapore. Electronic address: rathi_mahendran@nuhs.edu.sg.
authors.forename: Rathi
authors.initials: R
authors.lastname: Mahendran
mesh_terms: D001007:Anxiety / Q000523:psychology*; D044466:Asian People / Q000523:psychology*; D001290:Attitude; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D012307:Risk Factors; D012846:Singapore