Abstract
Research in developmental psychopathology and clinical staging models has increasingly sought to identify trans-diagnostic biomarkers or neurocognitive deficits that may play a role in the onset and trajectory of mental disorders and could represent modifiable treatment targets. Less attention has been directed at the potential role of cognitive-emotional regulation processes such as ruminative response style. Maladaptive rumination (toxic brooding) is a known mediator of the association between gender and internalizing disorders in adolescents and is increased in individuals with a history of early adversity. Furthermore, rumination shows moderate levels of genetic heritability and is linked to abnormalities in neural networks associated with emotional regulation and executive functioning. This review explores the potential role of rumination in exacerbating the symptoms of alcohol and substance misuse, and bipolar and psychotic disorders during the peak age range for illness onset. Evidence shows that rumination not only amplifies levels of distress and suicidal ideation, but also extends physiological responses to stress, which may partly explain the high prevalence of physical and mental co-morbidity in youth presenting to mental health services. In summary, the normative developmental trajectory of rumination and its role in the evolution of mental disorders and physical illness demonstrates that rumination presents a detectable, modifiable trans-diagnostic risk factor in youth.
Highlights
Developmental psychopathology explores illness trajectories from a life-course perspective, and as such it may be especially helpful for understanding the emergence of mental disorders in youth (Scott et al 2013)
We note that, of the two core components of rumination, it is the maladaptive rather than the adaptive element that is consistently associated with the development of psychopathology
We highlight the association between the development of a ruminative response style and traumatic and abusive experiences in childhood, which are risk factors linked to a range of psychological problems in adolescence including mood and psychotic disorders
Summary
Developmental psychopathology explores illness trajectories from a life-course perspective, and as such it may be especially helpful for understanding the emergence of mental disorders in youth (Scott et al 2013). Research in groups at high risk of psychosis indicate that transition is common in those who have experienced brief periods of psychosis or psychotic-like symptoms (Yung et al 2006), whilst the presence of depression and/or anxiety is associated with increased suicidality, self-harm, disorganized behaviour, disorganized speech, and anhedonia (Fusar-Poli et al 2014).
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