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Analytical rumination hypothesis

Author: Dr Simon Moss

Overview

The analytical rumination hypothesis was formulated by Andrews and Thompson (2009). In essence, this theory highlights many of the adaptive features of depression as well as reconciles some of the apparent paradoxes that relate to this mood disorder. In particular, this theory can accommodate the supposed paradox that:

To resolve these paradoxes, the analytical rumination hypothesis assumes, and then substantiates tentatively, several propositions. First, depression is incited by complex problems, often in the social domain, which demand careful analysis and planning. Second, depression induces a variety or biological changes that enable individuals to maintain their attention on this complex problem, resisting possible distractions. Third, the depressive state elicits rumination and related cognitive processes, all of which facilitate the resolution of the target problem. Fourth, depression often impairs performance in laboratory settings, merely because attention is allotted to complex, personal problems rather than contrived activities.

Evidential support of the analytical rumination hypothesis

Depression is induced by complex problems

According to Andrews and Thompson (2009), depression is evoked whenever individuals need to resolve complex problems--problems in which simple or reflexive solutions are likely to be inadequate. To justify this proposition, Andrews and Thompson (2009) mount several distinct arguments.

First, they present an intriguing rationale. Treatments of causes, rather than symptoms, tend to elicit more enduring benefits. Thus, treatments that are effective, over an extended duration, must have redressed the cause instead of a symptom. The mechanisms these effective treatments putatively redress are likely to represent the cause of some disorder.

To illustrate, as controlled experiments have shown, antidepressants do not tend to prevent relapse--which indicates this intervention might redress a symptom rather than a cause (Hollon, Thase, & Markovitz, 2002). In contrast, some psychotherapies do ensure more enduring improvements in mood (Holton, Thase, & Markovitz, 2002). These therapies thus may be redressing an underlying cause.

The key question, then, becomes which facets of these effective paradigms, such as cognitive behavioral therapy, enhanced behavioral activation therapy, and interpersonal therapy, are especially pertinent to these effects. According to Andrews and Thompson (2009), one key theme underpins all the therapies that ameliorate depression over enduring periods: they enable individuals to solve problems, especially social difficulties.

Gortner, Gollan, Dobson, and Jackson (1998), for example, showed that not all the traditional facets of cognitive behavioral therapy are essential to the treatment of depression. Traditionally, cognitive behavioral therapy entails both challenging the automatic, maladaptive thoughts of patients as well as encouraging these individuals to become engaged in their social environment--partly to assess the veracity of their cognitions. Nevertheless, even when automatic thoughts are not challenged, the efficacy of cognitive behavior therapy does not diminish. Engagement with the social environment was sufficient to ameliorate depression (Gortner, Gollan, Dobson, & Jackson, 1998).

Similarly, interpersonal therapy, in which patients develop the skills to manage and to resolve social problems, has been found to be as effective, if not more effective, than cognitive behavioral therapy (Cuijpers, van Straten, Andersson, & van Oppen, 2008). Indeed, enhanced behavioral activation therapy, in which individuals learn how to conceptualize aversive features of the environment as more rewarding, is approximately as effective, and sometimes even more effective, than cognitive behavioral therapy (e.g., Coffman, Martell, Gallop, Dimidjian, & Hollon, 2007). In short, therapeutic attempts to solve problems, especially social difficulties, seem to alleviate depression over an extended period. Hence, these complex difficulties might represent the cardinal causes of depression.

Furthermore, consistent with the proposition that complex problems elicit depression, depressed patients tend to perceive their difficulties as overwhelming, beyond their control. They perceive their predicament as hopeless (Abramson, Alloy, & Metalsky, 1989).

In addition, many of the problems that seem to incite depression revolve around social dilemmas, which are inherently complex. To demonstrate, individuals often experience depression when they feel subordinate--when they feel they will not prevail in competitions to seek a dominant position. These subordinate positions demand complex analysis, to ensure they can thrive despite their restricted power. Similarly, conflict with close relatives and friends, rather than more remote acquaintances or strangers, is especially likely to provoke depression. Presumably, social dilemmas, in which individuals need to reconcile conflicting personal and communal goals, are especially complex, demanding careful analysis, if they unfold within social collectives.

Depression evokes biological responses that maintain sustained analysis

As Andrews and Thompson (2009) contend, depression elicits a series of biological changes, such as activation of the left ventrolateral prefrontal cortex, all of which are intended to maintain attention towards the target problem and to preclude distractions. That is, when individuals experience depression, the left ventrolateral prefrontal cortex is more likely to be activated (Drevets, 1999, 2000& Pardo, Pardo, & Raichle, 1993). This region seems to enhance the capacity of individuals to withstand distractions and to maintain concentration (Kane, 2005& Kane & Engle, 2002& see ventrolateral prefrontal cortex).

Depression also elicits mechanisms that override some of the toxic consequences that can ensue when the left ventrolateral prefrontal cortex is activated over a sustained duration. Specifically, according to Andrews and Thompson (2009), the serotonergic transmission from the dorsal raphe nucleus to the left ventrolateral prefrontal cortex might also facilitate the operation of astrocytes. Specifically, activation of the left ventrolateral prefrontal cortex might enable these astrocytes to convert glycogen--a stored form of glucose--to lactate. This conversation of glycogen to lactate, in essence, releases energy, effectively enhancing the utility of astrocytes. Accordingly, these astrocytes are able to reduce the level of glutamate in the synaptic cleft (Magistretti & Ransom, 2002)--a neurotransmitter that is released by the ventrolateral prefrontal cortex and, at high levels, can elicit cell death (see also Pellerin, Bouzier-Sore, Aubert, Serres, Merle, Costalat, et al., 2007).

Hence, according to Andrews and Thompson (2009), depression, in essence, can facilitate the utility of astrocytes. These astrocytes can diminish the adverse effects of sustained activity in the ventrolateral prefrontal cortex.

Depressive rumination often helps people solve the triggering problem

Andrews and Thompson (2009) maintains that symptoms of depression, and the concomitant biological responses that maintain sustained analysis, enable individuals to resolve the problems that elicited these symptoms. That is, depression enhances the capacity of individuals to solve key difficulties in their lives, especially difficulties that revolve around social conflict.

Studies have shown that depression can enhance performance on a specific range of tasks. Au, Chan, Wang, and Vertisky (2003), for example, showed that sad moods were more likely than happy moods to enhance performance on a simulation task involving the trading of foreign exchange. Furthermore, Andrews and Thompson (2009) reviewed evidence highlighting that symptoms of depression can enhance performance in some prisoner dilemmas (e.g., Kirchsteiger, Rigotti & Rustichini, 2006& Pietromonaco & Rook, 1987). In this paradigm, participants need to decide whether they will cooperate or defect with another person. If both individuals cooperate, they both receive a moderate reward. If one individual cooperates, but the other individual defects, only the defector will receive a reward--and this reward is especially steep. If both individuals defect, neither person receives a reward.

In the usual paradigm, these individuals arrive at a choice simultaneously, unaware of which alternative the other person will select. Sometimes, however, the individuals are asked to reach a decision in sequence. The second person, thus, is bestowed an obvious example.

When the first person cooperates, the second person should defect, to optimize the reward. In comparison to other participants, depressed individuals are especially likely to optimize the reward. Other participants often cooperate, regardless of the alternative the other person chooses--and thus seem less sensitive to the context.

Furthermore, depressed individuals are less inclined to demonstrate positive illusion biases (e.g., Ahrens, Zeiss, & Kanfer, 1988). That is, many individuals tend to ascribe their own failures or difficulties to factors they could not control--misfortune, inadequate instructions, and so forth. In contrast, depressed individuals tend to ascribe their failures, but not their achievements, to their own characteristics, such as limited ability or flawed strategies (e.g, Sweeney, Anderson, & Bailey, 1986). Presumably, any attempts to attribute these problems to factors they can control might diminish mood but nevertheless grant these individuals an opportunity to solve these difficulties.

Depressive symptoms impair ability on extraneous activities, such as laboratory tasks

The argument that depression enables individuals to resolve problems contradicts the observation that such symptoms, as Andrews and Thompson (2009) recognize, compromise performance on tasks in some laboratory settings. Nevertheless, these laboratory tasks did not elicit the depression. Instead, depression directs attention only to the activities that did evoke these emotions--and thus does impair performance on other activities.

This premise is consistent with the resource allocation hypothesis (e.g., Seibert & Ellis, 1991). This hypothesis also assumes that rumination, a key facet of depression, distracts resources or attention from other competing activities.

Implications

Analytical rumination hypothesis implies that practitioners should assist clients in their attempts to identify the main source of their depression. Clients at first might not concede these problems, perhaps because of shame or because the problem, on some level, might seem trivial. This disinclination to concede their problems could explain why depression sometimes seems endogenous (Andrews & Thompson, 2009). Practitioners thus attempt to cultivate a safe and supportive environment to explore the origin of these feelings.

Second, practitioners should facilitate the resolution of these problems. Antidepressants, in some circumstances, might obstruct this pursuit. Writing about the most salient problems, to facilitate insight, might be more applicable instead, for example.

Analytical rumination hypothesis could also be germane to studies that manipulate mood. A variety of techniques are used to induce sad states. Conceivably, according to Andrews and Thompson (2009), music, film clips, or other techniques that do not relate to the lives of participants might not generate the usual processes that depression elicits& these techniques, because they do not emphasize a genuine problem, for example, might not evoke rumination.

Other features of depression

Impairments in perspective taking

Depression also impairs the capacity of people, during conversations, to adopt the perspective of other individuals. This possibility was explored by Nilsen and Duong (2013). In their study, participants first completed a measure that gauges level of depression. Next, they completed a task that assesses the capacity of people to adopt the perspective of the individuals with whom they are conversing. In particular, on a computer screen, participants observed a shelf, comprising 4 rows and 4 columns of slots--16 slots altogether. In some of the slots was an object, such as a kettle, a large hammer, a small hammer, a drum, and a table tennis paddle. Furthermore, on the back of some, but not all, the slots was a piece of wood. In other words, participants could see through some but not all slots. Finally, behind the shelf was a figurine, designated as the speaker. Because some of the slots were covered, the speaker could, apparently, only see some of the objects.

The speaker then asked the participant to complete various tasks. On some trials, the participant needed to realize the perspective of the speaker differed from their own perspective. For example, the speaker might have asked the participant to "Click the mouse on the smallest hammer". Yet, the smallest hammer was actually obscured from the speaker& hence, the participant would need to click the mouse on another hammer--the smallest hammer the speaker could see. If participants reported elevated rather than negligible levels of depression, as measured by Beck's Depression Inventory, they were not as proficient on this task: reaction time or accuracy was impaired.

To complete this task, participants needed to both ascertain the perspective of another person, called mentalizing, and then apply this information to reach a decision. Past research indicates that depression does not necessarily impair mentalizing. Therefore, according to Nilsen and Duong (2013), these findings indicate that depression may diminish the capacity of people to integrate the mental state of other individuals into their decisions. That is, because their executive functioning is impaired, individuals who are depressed may not be able to shift their entrenched decisions to accommodate the perspectives of other people.

Impairments in differentiating moderate from severe problems

To reach decisions, individuals need to learn the extent to which various actions, events, or people are associated with punishments and rewards. For example, they might need to learn that some mistakes will be punished to a greater degree than other mistakes. As Whitmer, Frank, and Gotlib (2012) showed, when people ruminate, their capacity to learn the degree to which objects are associated with punishments declines.

In their study, participants completed a novel task. During the training phase, on each trial, one of three pairs of stimuli were presented: the Japanese characters for AB, CD, or EF. Participants had to choose one letter from each pair. One letter, such as A, tended to generate a "correct" response or reward. The other letter, such as B, tended to generate an "incorrect" response or punishment. That is, participants learned which of the letters of each pair was rewarded or punished. Yet, the extent to which one letter was punished more than another letter varied across the three pairs.

During the test phase, each letter, such as the Japanese character for A, was paired with another letter, such as the Japanese character for C. On some trials, participants needed to decide between two letters that tend to be rewarded& that is, they needed to decide which letter is more likely to be rewarded. On other trials, participants needed to decide between two letters than tend to be punished.

Before completing this task, participants were encouraged to reflect upon negative facets of themselves, to induce rumination, or to complete an enjoyable task, to induce distraction. Unlike other individuals, depressed participants who were also induced to ruminate could not readily distinguish between letters than tend to be punished. They could not accurately learn which letters would be punished severely and which letters would be punished moderately. Presumably, these individuals perceive all adverse stimuli as similarly detrimental.

References

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Last Update: 7/6/2016