Explore the vast range of titles available.

Repetitive negative thinking (RNT) is a transdiagnostic process and a promising target for prevention and treatment of mental disorders. RNT is typically assessed via self-report questionnaires with most studies focusing on one type of RNT (i.e., worry or rumination) and one specific disorder (i.e., anxiety or depression). However, responses to such questionnaires may be biased by memory and metacognitive beliefs. Recently, Ecological Momentary Assessment (EMA) has been employed to minimize these biases. This study aims to develop an EMA paradigm to measure RNT as a transdiagnostic process in natural settings. Based on empirical and theoretical considerations, an item pool was created encompassing RNT content and processes. We then (1) tested model fit of a content-related and a process-related model for assessing RNT as an individual difference variable, (2) investigated the reliability and construct validity of the proposed scale(s), and (3) determined the optimal sampling design. One hundred fifty healthy participants aged 18 to 40 years filled out baseline questionnaires on rumination, worry, RNT, symptoms of depression, anxiety, and stress. Participants received 8 semi-random daily prompts assessing RNT over 14 days. After the EMA phase, participants answered questionnaires on depression, anxiety, and stress again. Multilevel confirmatory factor analysis revealed excellent model fit for the process-related model but unsatisfactory fit for the content-related model. Different hybrid models were additionally explored, yielding one model with satisfactory fit. Both the process-related and the hybrid scale showed good reliability and good convergent validity and were significantly associated with symptoms of depression, anxiety, and stress after the EMA phase when controlling for baseline scores. Further analyses found that a sampling design of 5 daily assessments across 10 days yielded the best tradeoff between participant burden and information retained by EMA. In sum, this paper presents a promising paradigm for assessing RNT in daily life.

This pilot randomized control trial was designed to examine whether Rumination-Focused Cognitive Behavior Therapy (RFCBT) reduces rumination and residual depressive symptoms among adolescents with a history of Major Depressive Disorder (MDD) who are at risk for relapse. We also examined whether these changes in symptoms were associated with changes in functional connectivity of the posterior cingulate cortex (PCC), a key node in the default mode network (DMN). Thirty-three adolescents (ages 12-18) were randomized to eight weeks of RFCBT or an assessment only (AO) control. Twenty two adolescents successfully completed fMRI scans pre- and post-intervention. Adolescents were recruited from the clinic and community and met criteria for at least one previous episode of MDD and were currently in full or partial remission. An Independent Evaluator interviewed parent and child before and after the eight-week intervention. The left PCC (-5, -50, 36) seed was used to probe resting state functional connectivity of the DMN. Adolescents who received RFCBT demonstrated reduced rumination (F = -2.76, df = 112, p < .01, 95% CI [-4.72,-0.80]) and self-report depression across eight weeks (F = -2.58, df = 113, p < .01, 95% CI [-4.21, -0.94]). Youth who received RFCBT also demonstrated significant decreases in connectivity between the left PCC and the right inferior frontal gyrus (IFG) and bilateral inferior temporal gyri (ITG). Degree of change in connectivity was correlated with changes in self-report depression and rumination. These data suggest that rumination can be reduced over eight weeks and that this reduction is associated with parallel decreases in residual depressive symptoms and decreased functional connectivity of the left PCC with cognitive control nodes. These changes may enhance the ability of vulnerable youth to stay well during the transition to adulthood. ClinicalTrials.gov NCT01905267.

Background Extensive evidence links higher body mass index (BMI) to higher odds of depression in people of European ancestry. However, our understanding of the relationship across different settings and ancestries is limited. Here, we test the relationship between body composition and depression in people of East Asian ancestry. Methods Multiple Mendelian randomisation (MR) methods were used to test the relationship between (a) BMI and (b) waist-hip ratio (WHR) with depression. Firstly, we performed two-sample MR using genetic summary statistics from a recent genome-wide association study (GWAS) of depression (with 15,771 cases and 178,777 controls) in people of East Asian ancestry. We selected 838 single nucleotide polymorphisms (SNPs) correlated with BMI and 263 SNPs correlated with WHR as genetic instrumental variables to estimate the causal effect of BMI and WHR on depression using the inverse-variance weighted (IVW) method. We repeated these analyses stratifying by home location status: China versus UK or USA. Secondly, we performed one-sample MR in the China Kadoorie Biobank (CKB) in 100,377 participants. This allowed us to test the relationship separately in (a) males and females and (b) urban and rural dwellers. We also examined (c) the linearity of the BMI-depression relationship. Results Both MR analyses provided evidence that higher BMI was associated with lower odds of depression. For example, a genetically-instrumented 1-SD higher BMI in the CKB was associated with lower odds of depressive symptoms [OR: 0.77, 95% CI: 0.63, 0.95]. There was evidence of differences according to place of residence. Using the IVW method, higher BMI was associated with lower odds of depression in people of East Asian ancestry living in China but there was no evidence for an association in people of East Asian ancestry living in the USA or UK. Furthermore, higher genetic BMI was associated with differential effects in urban and rural dwellers within China. Conclusions This study provides the first MR evidence for an inverse relationship between BMI and depression in people of East Asian ancestry. This contrasts with previous findings in European populations and therefore the public health response to obesity and depression is likely to need to differ based on sociocultural factors for example, ancestry and place of residence. This highlights the importance of setting-specific causality when using genetic causal inference approaches and data from diverse populations to test hypotheses. This is especially important when the relationship tested is not purely biological and may involve sociocultural factors.

RationaleRumination is a repetitive, negative, self-focused thinking style associated with various forms of psychopathology. Recent studies suggest that rumination increases craving for alcohol and predicts harmful drinking and alcohol-related problems. However, the acute effects of alcohol on rumination have not been previously studied. It is proposed that alcohol may reduce ruminative thinking through decreasing negative mood.ObjectivesIn the present study, we aimed to test the previously unexplored effects of acute alcohol consumption on rumination in a hazardous drinking population.MethodsWe conducted a randomised placebo-controlled laboratory study to examine the effect of low (0.4 g kg−1) and high doses (0.8 g kg−1) of alcohol on state rumination compared to placebo. Participants completed a rumination induction task prior to receiving drinks. We then measured state rumination and mood at repeated time points; 30 min, 60 min and 90 min post-drinks consumption.ResultsWe found a significant decrease in state rumination in the low-dose alcohol group compared to placebo at 30 min post-alcohol consumption, but no difference was observed between the high-dose alcohol and placebo groups. Mediation analysis provided evidence for an indirect effect of alcohol on state rumination through concurrent changes in negative mood.ConclusionsThese findings suggest that acute alcohol consumption can regulate negative mood and concurrently rumination, providing preliminary evidence for the role of rumination in alcohol use disorders. Rumination may be a treatment target in alcohol use disorders.

Transdiagnostic models of psychopathology are increasingly prominent because they focus on fundamental processes underlying multiple disorders, help to explain comorbidity among disorders, and may lead to more effective assessment and treatment of disorders. Current transdiagnostic models, however, have difficulty simultaneously explaining the mechanisms by which a transdiagnostic risk factor leads to multiple disorders (i.e., multifinality) and why one individual with a particular transdiagnostic risk factor develops one set of symptoms while another with the same transdiagnostic risk factor develops another set of symptoms (i.e., divergent trajectories). In this article, we propose a heuristic for developing transdiagnostic models that can guide theorists in explicating how a transdiagnostic risk factor results in both multifinality and divergent trajectories. We also (a) describe different levels of transdiagnostic factors and their relative theoretical and clinical usefulness, (b) suggest the types of mechanisms by which factors at I level may be related to factors at other levels, and (c) suggest the types of moderating factors that may determine whether a transdiagnostic factor leads to certain specific disorders or symptoms and not others. We illustrate this heuristic using research on rumination, a process for which there is evidence it is a transdiagnostic risk factor.

Early-onset depression is associated with increased lifespan chronicity, suicidality, and the functional burdens associated with recurrent episodes. Reduction of these negative long-term outcomes requires an understanding of what interventions reduce vulnerabilities or ameliorate their associated neural patterns. Rumination-Focused Cognitive Behavior Therapy (RFCBT), an evidence-based treatment which directly targets a well-known risk for depressive relapse (i.e., ruminative habit), has shown preliminary success for reducing relapse rates among adolescents and adults in remission from Major Depressive Disorder (rMDD). In the current pilot study, clinical outcomes and neuroimaging predictors are explored over two years following a randomized controlled trial of eight weeks of RFCBT (n = 17) or Assessment Only (AO; n = 16) to prevent depressive relapse among adolescents. Baseline neural activation during a rumination induction task, neural change during treatment, and treatment group are examined as predictors of relapse. Regions selected were based upon hyperactivation patterns in rMDD compared to healthy adolescents, and occurred largely in default mode, somatomotor, visual and salience network regions. Twenty-five adolescents successfully completed quality fMRI scans at Baseline and after eight weeks of RFCBT or AO. RFCBT-treated youth maintained lower depression scores over the two-year period, relapsed at slower and less frequent rates, and were hospitalized less often for suicidality than AO. Although both groups reported lower ruminative tendencies after one year, at two-year follow-up, RFCBT maintained reductions whereas AO reported a return of ruminative tendencies. Adolescents who demonstrated higher activation at Baseline in default mode and limbic regions during rumination induction reported reduced depressive symptoms over the follow-up period. These data offer preliminary evidence that targeting rumination can stave off depressive relapse among vulnerable adolescents, and that such targeted treatment may aid a compensation process for disease-related brain functioning reducing risk to further depressive episodes.

Background Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety. Method/design The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16–24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. Discussion This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people. Trial registration ClinicalTrials.gov , NCT04950257 . Registered 6 July 2021 – Retrospectively registered.

Background Adolescent-onset depression often results in a chronic and recurrent course, and is associated with worse outcomes relative to adult-onset depression. Targeting habitual depressive rumination, a specific known risk factor for relapse, may improve clinical outcomes for adolescents who have experienced a depressive episode. Randomized controlled trials (RCTs) thus far have demonstrated that rumination-focused cognitive behavioral therapy (RFCBT) reduces depressive symptoms and relapse rates in patients with residual depression and adolescents and young adults with elevated rumination. This was also observed in a pilot RCT of adolescents at risk for depressive relapse. Rumination can be measured at the self-report, behavioral, and neural levels- using patterns of connectivity between the Default Mode Network (DMN) and Cognitive Control Network (CCN). Disrupted connectivity is a putative important mechanism for understanding reduced rumination via RFCBT. A feasibility trial in adolescents found that reductions in connectivity between DMN and CCN regions following RFCBT were correlated with change in rumination and depressive symptoms. Method This is a phase III two-arm, two-stage, RCT of depression prevention. The trial tests whether RFCBT reduces identified risk factors for depressive relapse (rumination, patterns of neural connectivity, and depressive symptoms) in adolescents with partially or fully remitted depression and elevated rumination. In the first stage, RFCBT is compared to treatment as usual within the community. In the second stage, the comparator condition is relaxation therapy. Primary outcomes will be (a) reductions in depressive rumination, assessed using the Rumination Response Scale, and (b) reductions in resting state functional magnetic resonance imaging connectivity of DMN (posterior cingulate cortex) to CCN (inferior frontal gyrus), at 16 weeks post-randomization. Secondary outcomes include change in symptoms of depression following treatment, recurrence of depression over 12 months post-intervention period, and whether engagement with therapy homework (as a dose measure) is related to changes in the primary outcomes. Discussion RFCBT will be evaluated as a putative preventive therapy to reduce the risk of depressive relapse in adolescents, and influence the identified self-report, behavioral, and neural mechanisms of change. Understanding mechanisms that underlie change in rumination is necessary to improve and further disseminate preventive interventions. Trial registration ClinicalTrials.gov Identifier: NCT03859297 , registered 01 March 2019.

Background Female university students face an elevated risk of developing common mental health problems, including depression and anxiety. Rumination, a specific form of repetitive negative thought (RNT), is a well-documented risk factor for these conditions. Rumination-focused cognitive-behavioral therapy (RFCBT) represents a promising intervention for the prevention and treatment of depression and anxiety, fostering mental well-being during young adulthood. Although RFCBT has demonstrated effectiveness in numerous randomized controlled trials (RCTs), cultural adaptation has emerged as a critical consideration. This study aims to evaluate the effectiveness of a culturally adapted, guided RFCBT self-help intervention in reducing RNT as well as symptoms of depression and anxiety among Japanese female university students, employing an RCT design. Methods This study is a single-site, assessor-blinded, parallel-group, two-arm randomized controlled trial (guided self-help vs. waitlist), employing block randomization in a 1:1 ratio. A total of 102 female university students with elevated levels of RNT will be recruited. Participants will be randomly assigned to either the intervention group receiving guided RFCBT self-help, or the waitlist control group. The primary outcome is rumination, assessed using the Ruminative Responses Scale. Measurements will be conducted at 4- and 8-week post-randomization. Discussion Empirical evidence regarding the effectiveness of culturally adapted RFCBT in mitigating RNT and symptoms of depression and anxiety among East Asian populations remains scarce. If proven effective, this study will provide empirical evidence supporting the effectiveness of RFCBT in reducing RNT, depression, and anxiety within an East Asian population. Trial registration Japan Registry of Clinical Trials (jRCT): jRCT1050240305, registered 27 March, 2025. (Initially registered with UMIN-CTR: UMIN000053430, on 24 January, 2024. Prospectively registered. Later transferred to jRCT.) Protocol version Ver. 1.3, February 9th 2026.

IntroductionUniversity life represents a critical period for young adults, providing opportunities for personal growth and development of coping skills but also posing significant mental health challenges. Recent trends indicate rising mental health concerns among university students, exacerbated by the COVID-19 pandemic and its aftermath. This study aims to address gaps in longitudinal data on student mental health in the UK and to identify risk and protective factors across diverse student populations.Methods and analysisThe current Nurture-U survey is developed from the U-Flourish biannual survey study piloted at Queen’s and Oxford universities in Canada and the UK, respectively. Nurture-U is a longitudinal survey study conducted at five UK universities, aiming to create a comprehensive data set from over 5000 students. The study will collect data at the start and completion of each academic year, using validated measures to assess well-being, mental health symptoms, lifestyle factors and access to support. Recruitment will target all students, with an emphasis on first-year students, to track their mental health trajectory from university entry through subsequent years.Ethics and disseminationEthical approval has been obtained from relevant committees at each participating university. Students will provide informed consent prior to participation, with risk messages and support information provided for those indicating self-harm or suicidal thoughts. Data will be de-identified and securely stored, with results disseminated through academic publications, social media and student engagement activities.