Rumination and co-rumination as moderators of the relationship between stress and depressive symptoms: examining different domains of life events and hassles [volume 1: a systematic literature review; volume 2: main research project]

Student thesis: Doctoral ThesisDoctor of Clinical Psychology


There is a sharp rise in prevalence rates of depressive symptoms and depressive disorders during adolescence. Given that depression and depressive symptoms during adolescence are associated with impaired functioning in several areas of life and continuity into adulthood, a key priority for research is to understand the risk factors for depressive disorders during this period. Rumination, defined as passively and repetitively focusing attention on one’s own depressive symptoms and on understanding their causes and consequences, has been consistently associated with prospective symptoms of depression in adults and youth, in clinical and community populations. In the last decade researchers have begun to explore vulnerability-stress models of depression, examining rumination in response to stressful events. The current review sought to identify and evaluate studies that explore rumination as a moderator or mediator of the relationship between stressors and prospective depressive symptoms.
A systematic search for relevant articles of three databases (Embase, Medline and Psychinfo) was conducted in line with PRISMA guidance. Seventeen studies were included in the review and a qualitative synthesis of the results was produced. Fourteen studies explored rumination as a moderator and three studies tested rumination as a mediator. There was mixed support for rumination as a moderator of the longitudinal stressor-depressive symptom association in adolescents. Although all studies rated as ‘good’ quality found a significant moderating effect of rumination. Whereas studies rated as ‘fair’ quality demonstrated mixed findings. There was a lack of evidence for rumination as a mediator of the stressor-prospective depressive symptoms association in adolescents. Further research into rumination as a mediator of the stressor-depressive symptoms relationship is necessary for conclusions to be drawn. Limitations and clinical and research implications of the findings are discussed.
Date of Award1 Oct 2018
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorPatrick Smith (Supervisor)

Cite this