Event Related Rumination Inventory Research Articles

The current situation and influencing factors of depersonalization in clinical nurses

Objective: To investigate the depersonalization status and to analyze the effect of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization in clinical nurses. Methods: In May 2019, 10 cities were selected as sampling cities by the method of grabbing random ball in Henan Province and Fujian Province. Using the stratified sampling, clinical nurses were selected as the research objects for a questionnaire survey in 22 tertiary hospitals and 23 secondary hospitals, included 1200 nurses. A total of 1200 questionnaires were issued and collected, and 1159 valid questionnaires were collected with effective recovery of 96.6%. Clinical nurses were investigated by Workplace Incivility Scale, Event Related Rumination Inventory, Fear of Negative Evaluation Scale, Maslach Burnout Inventory-General Survey. The demographic characteristics of nurses' depersonalization were compared and analyzed with t test and single factor analysis of variance. The influence mechanism of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization was analyzed with Bootstrap. Results: Depersonalization scores were (9.3±2.6) points, 467 of those had depersonalization symptoms in clinical nurses (40.3%). The scores of depersonalization of those with <3 years of service [ (10.5±2.9) points] was higher than those with 3-10 years [ (9.1±2.8) points] and 11-31 years [ (9.0±2.9) points]. The scores of depersonalization of those with monthly earning of <3000 yuan [ (10.1±2.8) points] was higher than those with 3000-7999 yuan [ (8.4±2.7) points] and 8000-12000 yuan [ (8.0±2.9) points]. The scores of depersonalization of clinical nurses in surgical departments [ (10.0±2.9) points] was higher than those in non-surgical departments [ (8.7±2.6) points]. The scores of depersonalization of clinical nurses in tertiary hospitals [ (10.0±2.7) points] was higher than those in secondary hospitals [ (8.6±2.8) points]. The differences were statistically significant (P<0.05). Workplace incivility perception affected depersonalization through the single mediating role of intrusive rumination, fear of negative evaluation and the chain mediating role of intrusive rumination and fear of negative evaluation (β=0.16, 0.17, 0.07, 95%CI: 0.15-0.20, 0.15-0.21, 0.03-0.09, P<0.05) . Conclusion: Workplace incivility perception directly or through the independent mediating effects of intrusive rumination or fear of negative evaluation, and the chain mediating effects of intrusive rumination and fear of negative evaluation influences the depersonalization of clinical nurses.

Mediating Role of Rumination in Second Victim Experience to Turnover Intention in Psychiatric Nurses.

Psychiatric nurses often face patient safety incidents that can cause physical and emotional harm, even leading to s econd victim syndrome and staff shortages. Rumination-a common response after nurses suffer a patient safety event-may play a specific role between the second victim experience and turnover intention. Understanding these mechanisms is crucial for supporting psychiatric nurses and retaining psychiatric nursing resources. The study aimed to explore the associations among second victim experience, rumination, and turnover intention in psychiatric nurses and confirm how second victim experience influences turnover intention through rumination and its subtypes. A descriptive, cross-sectional study was adapted to survey 252 psychiatric nurses who experienced a patient safety incident at three hospitals in China between March and April 2023. We used the Sociodemographic and Patient Safety Incident Characteristics Questionnaire (the Chinese version of the Second Victim Experience and Support Tool), the Event-Related Rumination Inventory, and the Turnover Intention Scale. Path analysis with bootstrapping was employed to accurately analyze and estimate relationships among the study variables. There was a positive association between second victim experience and turnover intention. In addition, both invasive and deliberate rumination showed significant associations with second victim experience and turnover intention. Notably, our results revealed that invasive and deliberate rumination played partial mediating roles in the relationship between second victim experience and turnover intention in psychiatric nurses. The negative experience and turnover intention of the psychiatric nurse second victims are at a high level. Our results showed that invasive rumination positively mediated the relationship between second victim experience and turnover intention, and deliberate rumination could weaken this effect. This study expands the knowledge of the mechanisms underlying the effect of the second victim experience on turnover intention. Organizations must attach importance to the professional dilemmas of the psychiatric nurses' second victims. Nurse managers can reduce nurses' turnover intention by taking measures to reduce invasive rumination and fostering deliberate meditation to help second victims recover from negative experiences.

성인의 의도적 반추와 외상후 스트레스 증상 및 외상후 성장의 관계

Objectives This study aimed to investigate the mediating role of cognitive emotion regulation(CER) in the relation-ship between deliberate rumination(DR), posttraumatic stress symptoms(PTSS) and posttraumatic growth(PTG).&#x0D; Methods 496 people completed self-reporting questionnaires: a Trauma Events Checklist, the Korean Version of Event Related Rumination Inventory(K-ERRI), the Korean Version of Impact of Event Scale-Revised(IES-R-K), the Korean Version of Posttraumatic Growth Inventory(K-PTGI), the Korean Version of Cognitive Emotion Regulation Questionnaire(K-CERQ).&#x0D; Results The results showed significant positive correlations among deliberate rumination, maladaptive CER, adap-tive CER, PTSS and PTG, although adaptive CER was not significantly correlated with PTSS. As a result of the me-diating effect test, a significant partial mediating effect of maladaptive CER was found in the relationship between deliberate rumination and PTSS. In the relationship between deliberate rumination and PTSS, a significant partial mediating effect of adaptive CER was found. The suppression effect of adaptive CER was suggested in the rela-tionship between deliberate rumination and PTSS. In the relationship between deliberate rumination and PTG, a significant partial mediating effect of adaptive CER was found.&#x0D; Conclusions These results suggest that the experience of PTSS or PTG after deliberate rumination depends on the type of cognitive emotion regulation strategies being used.

Trajectories of intrusive and deliberate rumination in young and middle-aged stroke survivors: A growth mixture modeling approach.

This study aimed to explore the relationship between intrusive and deliberate rumination, to identify distinct trajectories of intrusive and deliberate rumination, and to examine their predictors in young and middle-aged stroke survivors. This study employed a longitudinal design in which 200 young and middle-aged stroke survivors were investigated at 1-week pre-discharge (T0), 1 month (T1), 3 months (T2), and 6 months (T3) post-discharge. The Event-Related Rumination Inventory, Simplified Coping Style Questionnaire, and Perceived Social Support Scale were used for data collection. The results showed that intrusive rumination was positively correlated with deliberate rumination at T0 and T1, and negatively correlated with deliberate rumination at T3. Growth mixture modeling identified three classes of intrusive rumination: Stable-low, Declined, and Elevated group, and two classes of deliberate rumination: High-level and Low-level group. Furthermore, number of children or dysfunctions, type of stroke, family history of stroke, negative coping, and social support were found to predict intrusive rumination. These findings can help healthcare providers timely intervene on survivors in the Elevated and Stable-low intrusive rumination groups, and the Low-level deliberate rumination group.

Contribution of rumination and psychological resilience to post-traumatic growth of front-line healthcare workers in mobile cabin hospitals under Normalized epidemic Prevention and Control Requirements

To understand the level of post-traumatic growth (PTG) and influencing factors among front-line healthcare workers (HCWs) working in mobile cabin hospitals treating patients with Coronavirus Disease 2019 (COVID-19) under the Normalized Epidemic Prevention and Control Requirements adopted in China. A random sampling method was used to select 540 HCWs of the Chongqing-aid-Shanghai medical team from April to May 2022 as the study participants. Participants completed a general information questionnaire, the Post-traumatic Growth Inventory-Chinese version (PTGI-C), the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) and the Chinese Event Related Rumination Inventory (C-ERRI). Among the 540 included HCWs, 83.15 % were nurses and 78.89 % were women. The average scores for PTG (62.25 ± 16.73) and psychological resilience (64.22 ± 15.38) were at moderate levels, and the average score for rumination was low (21.62 ± 10.77). Pearson correlation analysis showed that CD-RISC and C-ERRI scores were positive with the PTGI-C score (r = 0.528, 0.316, P < 0.001). Multiple linear regression analysis identified psychological training or intervention during the COVID-19 epidemic (β = 2.353, P = 0.044), psychological resilience (β = 0.525, P < 0.001) and deliberate rumination (β = 0.732, P < 0.001) as factors significantly associated with the PTG of front-line HCWs, which together explained 36.8 % of the total variance in PTG (F[5,539] = 63.866, P < 0.001). In general, psychological resilience and deliberate rumination can promote PTG among HCWs and can be improved by strengthening psychological training and interventions for HCWs working under the Normalized Epidemic Prevention and Control Requirements.

Association of Rumination and Metacognition with Posttraumatic Growth in Parents of Children with Cancer

ObjectiveThe primary objective of this study was to examine the association of rumination, metacognition, and posttraumatic with growth in parents of children diagnosed with cancer. Data SourcesThe study adopted a descriptive correlational design, and participants (N = 103) were parents of children with cancer. The study was conducted online through the social media platforms of three cancer associations. Data were collected using the Metacognitions Questionnaire-30, the Event Related Rumination Inventory, and the Posttraumatic Growth Inventory. ConclusionThe findings revealed a positive correlation between deliberate rumination and metacognition with posttraumatic growth, while a negative correlation was observed between intrusive rumination and posttraumatic growth. Furthermore, deliberate rumination, intrusive rumination, and metacognition collectively accounted for 30% of the variance in posttraumatic growth among parents of children with cancer. These results underscore the significant influence of rumination and metacognition in facilitating posttraumatic growth in this specific population. Consequently, interventions aimed at fostering deliberate rumination hold substantial potential for promoting posttraumatic growth among parents of children diagnosed with cancer. Implications for Nursing PracticeThis research guides nurses in addressing rumination, metacognition, and posttraumatic growth in parents of children with cancer. By adopting a holistic approach, nurses can enhance parents' well-being and resilience in the face of a child's cancer diagnosis.

Predictors of posttraumatic growth in 475 Chinese parents of children newly diagnosed with autism spectrum disorder

PurposeTo examine the predictive effects of children's symptom severity, rumination, parental self-efficacy, and social support on posttraumatic growth (PTG) in parents of autistic children. Design and methodsParents (n = 475) completed the demographic questionnaire, Posttraumatic Growth Inventory, Autism Behavior Checklist, Event Related Rumination Inventory, Parenting Sense of Competence, and Social Support Rating Scale in a cross-sectional survey conducted in a tertiary hospital in Guangzhou, China, between September 2019 and January 2021. Multiple linear regression analyses were conducted using SPSS version 25.0. ResultsThe PTG score was positively associated with rumination (r = 0.325, P < 0.05), parental self-efficacy (r = 0.219, P < 0.05), and social support (r = 0.374, P < 0.05). Multiple linear regression analysis revealed that household income (β = 0.095, P < 0.05), intrusive rumination (β = −0.100, P < 0.05), deliberate rumination (β = 0.391, P < 0.001), subjective support (β = 0.239, P < 0.001), and children's daily living skills deficiencies as perceived by parents (β = 0.107, P < 0.05) significantly predicted PTG, accounting for 33.3% of the variance [F(P) = 13.444, P < 0.001]. ConclusionsPsychosocial factors (rumination and subjective support) are essential to facilitate PTG in parents whose children are newly diagnosed with autism. Practice and implicationsWith the consideration of different sociodemographic features, clinicians and researchers are encouraged to explore cognitive-based psychosocial interventions targeting parents' psychological growth and parenting training programs targeting autistic children's self-care ability.

Rumination about the death of a spouse versus the severity of somatic symptom disorder and sleep disturbances in widowed individuals in late adulthood

Introduction: The aim of the study was to gain a better understanding of the role of emotion regulation (understood in terms of the intensity of intrusive and deliberate rumination about the death of a spouse) in the etiology of sleep disturbances and somatic symptom disorder in widowed people in late adulthood. Material and methods: The study involved 82 older people (66 women and 16 men) whose spouses had died at least six months before the study. The following measures were used: the Event Related Rumination Inventory (ERRI) to assess the intensity of intrusive and deliberate rumination; the General Health Questionnaire (GHQ-28) (somatic symptoms scale) to assess the intensity of somatic symptom disorder; two items of the arousal subscale from the Event Impact Scale – Revised (IES-R) for evaluating the severity of sleep disorder symptoms; as well as a self-designed demographic data questionnaire. Results: The study showed that the intensity of somatic symptom disorder and sleep disturbances can be explained by intrusive rumination. No relationship was found between deliberate rumination and the severity of these disorders. Additionally, there is a positive relationship between the severity of somatic symptom disorder and the age of the study participants. Conclusions: The present findings can potentially be applied in therapeutic programs for widowed individuals who experience sleep disturbances and somatic symptom disorder as a result of unresolved grief. Keywords: somatic symptom disorder, insomnia, grief, death of a spouse, rumination

외상신념과 이차적 외상 스트레스의 관계에서 침투적 반추의 매개효과

Objectives The purpose of this study was to examine the relationship between traumatic beliefs, invasive rumination, and secondary traumatic stress in adults who experienced indirect trauma, and to verify the mediating effect of invasive rumination in the relationship between traumatic beliefs and secondary traumatic stress.&#x0D; Methods In order to verify the research hypothesis, a questionnaire survey was conducted on a total of 354 people. Among them, 33 copies were excluded and analyzed based on 321 copies. The scales used were the Trauma and Attachment Belief Scale (TABS), the Korean Event Related Rumination Inventory (ERRI), and the Invasive Rumin Scale, the Secondary Traumatic Stress Scale (KSTSS). Based on the collected data, it was analyzed through SPSS 21.O and PROCESS macro 3.4 program. The results of this study are as follows.&#x0D; Results First, as a result of examining the demographic variables of this study, most people (20.2%) experienced ‘accidents and injuries (traffic accidents, industrial accidents, fires, explosions, etc.)’ as indirect trauma, and ‘Most people answered (35.2%) because they felt sorry for their family or neighbors. In addition to trauma survivors, this is significant in that it helps in the treatment and counseling strategies of family and acquaintances exposed indirectly. Second, this study was targeted at general adults considering that indirect trauma studies targeting general adults were insufficient, including domestic studies, because prior work on the subject of indirect trauma was mainly targeted at practitioners related to trauma. Is meaningful in that respect. Third, it is significant in that the study results provide information about the main symptoms and the effects of secondary trauma stress in a counseling scene with a client who has experienced indirect trauma and suggests that it is a cognitive direction.&#x0D; Conclusions Based on the above results, we can examine the characteristics of adults who experienced indirect trauma and the main variables affecting secondary trauma stress, and posttraumatic stress disorder (PTSD), which can occur in trauma survivors, indirectly injuries trauma. It was found that even those who experienced it could occur with secondary traumatic stress. Finally, limitations were discussed for further study.

A latent profile analysis of emotional expression among patients with unintentional injuries

BackgroundEmotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder.MethodsA cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version. ResultsThree unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership.ConclusionsMost patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.

Posttraumatic growth among childhood cancer survivors and their caregivers: associations with rumination and beliefs challenge

The main purpose of the study was to assess the relationship between PTG, challenge to core beliefs, intrusive and deliberate rumination in a sample of 43 dyads of childhood cancer survivors and their caregivers. Methods: Survivors (mean age = 17.04; SD=3.67) and caregivers (mean age = 46.84; SD = 8.32) completed the Posttraumatic Growth Inventory (PTGI), the Core Beliefs Inventory (CBI) and the Event-related Rumination Inventory (ERRI). Results: Results showed a positive and high correlation among PTG, CBI, and ERRI in both groups, separately. CBI was the main predictor of PTG both among survivors (β=0.826; t=9.393; R²=0.683; p≤0.001) and caregivers (β=0.552; t=4.235; R²=0.304; p≤0.001). Caregivers reported higher scores than survivors in PTG (t=-2.999 p≤0.01) and its dimensions Relationship with others (t=2.498; p≤0.05), Spiritual change (t=-15.823; p≤0.001), Life appreciation (t=-3.129; &lt;p≤0.01), as well as the means for intrusive (t=-3.862; p≤0.001) and deliberate rumination (t=-3.113; p≤0.01). Discussion: Caregivers are more involved in cognitive processes and reported higher PTG than survivors. This can be probably related to the concomitance between the period of disease and the cognitive development process of the survivors.

Impact of caregiver burden on caregiver mental health in patients with esophageal cancer: chain mediating effects of benefit finding and rumination, a cross-sectional study.

Cancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined. The study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the non-conforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model. The study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=-0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=-0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients. The findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver's level of benefit finding and promote deliberate ruminative thinking.

Relationship between World Assumptions and Post-Traumatic Growth among Polish Cancer Patients: Moderating Effect of Rumination.

Background: Although post-traumatic growth is believed to be the result of complex interplays between various factors, cognitive variables appear to play a special role in these interactions. Yet, research on this topic is scant. Therefore, the first purpose of this study was to verify whether there is a direct relationship between world assumptions and post-traumatic growth among Polish cancer patients. As the effect of psychological change in post-traumatic growth may be affected by basic beliefs about the world and oneself, the second goal was to assess whether this association is moderated by rumination. Methods: The study included 215 Polish cancer patients. The Post-traumatic Growth and Depreciation Inventory—Expanded version—(intrusive and deliberate rumination), the World Assumption Scale, and the Event-related Rumination Inventory were applied. Results: Positive, albeit weak, correlations were found between the dimensions of world assumptions and post-traumatic growth. Post-traumatic growth correlated negatively with intrusive rumination and positively with deliberate rumination. The outcomes show that the level of post-traumatic growth resulting from world assumptions is significantly different at various levels of intrusive and deliberate rumination. Conclusion: Lower/medium intrusive rumination seems to strengthen the relationship between benevolence of the world/worthiness of the self and post-traumatic growth, and higher deliberate rumination tends to reinforce the relationship between meaningfulness and post-traumatic growth.

The role of repetitive thinking and spirituality in the development of posttraumatic growth and symptoms of posttraumatic stress disorder.

Both post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) are associated with spirituality and different kinds of repetitive thinking, such as deliberate rumination (DR) and intrusive rumination (IR), respectively. This study aimed to examine if spirituality modifies the relationship between types of rumination and trauma outcomes. Ninety-six students completed an online survey of four questionnaires in a cross-sectional online survey: The Posttraumatic Stress Diagnostic Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory-Short form and the Expressions of Spirituality Inventory- Revised. Findings revealed that spirituality was related to DR and PTG, but not to IR or PTSD symptoms. Moderation analysis showed that spirituality significantly moderated the relationship between PTG and DR, but not the relationship between PTSD and IR. These findings indicate that while spirituality has no relationship with negative outcomes of trauma, it may help individuals to ruminate in a constructive manner in order to develop positive outcomes.

Posttraumatic growth and rumination among parents of children with autism spectrum disorder: The mediating role of social support

Although rumination and social support are regarded as essential predictors of posttraumatic growth (PTG), few studies have explored the associations among PTG, rumination, and social support in parents of children with autism spectrum disorder (ASD). This study examined whether social support mediates the relationship between rumination and PTG. Cross-sectional questionnaire data were collected from 385 parents of children with ASD from September 2019 to November 2020 by convenience sampling. Participants completed the Posttraumatic Growth Inventory, Event Related Rumination Inventory, and Social Support Rating Scale. Path analyses showed that subjective support partially mediates the relationship between deliberate rumination and PTG (β = 0.073, P < 0.001), and indirect effects account for 15.30% of the total effects. In addition, a negative direct path was found between intrusive and PTG because of the suppression effect of subjective support (β = −0.110, P < 0.01), and indirect effects accounted for 80% of the direct effects. For future studies, it underscores the essential role of subjective support and rumination in promoting PTG in parents of children with ASD.

The impact of non-infection pandemic stress on depression and anxiety severity: Investigating mediation by intrusive and deliberate rumination

BackgroundSocial restrictions to curb COVID-19's spread have had adverse effects on population mental health. Rumination is one mechanism through which pandemic stress (PS) might translate into psychopathology. In particular, intrusive rumination (IR) is believed to be problematic. In this study, we investigated whether IR and deliberate rumination (DR) mediated the associations between PS and both depression and anxiety severity. Methods1090 participants recruited online and from an undergraduate psychology participation pool completed an assessment of COVID-19 PS, as well as the Event-Related Rumination Inventory, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Total scores for PS, IR, DR, depression, and anxiety severity were tested in a parallel mediation model. ResultsPS positively predicted IR, DR, depression, and anxiety severity. IR positively predicted 1depression and anxiety severity, whereas DR did not. Indirect effects of PS on depression and anxiety severity were significant for IR, but not DR. Direct effects of PS on anxiety and depression severity were significant. Taken together, IR partially mediated the association between PS and both measures of psychopathology, and DR did not. LimitationsThis study was limited by its cross-sectional design and the lack of assessment of when PS exposure occurred. ConclusionsRegarding PS that is unrelated to infection by COVID-19, IR is one mechanism through which psychopathology may emerge, whereas DR appears to be benign. Promoting a shift from IR to DR may therefore be one strategy for mitigating the negative effects of PS and other stressors on mental health.

The Impact of Intrusive Rumination on College Students’ Creativity During the COVID-19 Pandemic: The Mediating Effect of Post-traumatic Growth and the Moderating Role of Psychological Resilience

PurposeCollege students in the pandemic area are experiencing the problems caused by COVID-19 by themselves or people around them, how to cope with the sudden changes and adjust the psychological stress response, and get experience and grow in the fight against the pandemic is a question worth in-depth discussion. The researchers constructed a mediated regulation model to examine the effects of intrusive rumination on the creativity of college students during the COVID-19 pandemic, as well as the mediating effect of post-traumatic growth and the moderating role of psychological resilience.MethodsA sample of 475 university students from Guangdong Province, China, were surveyed with the Runco Ideational Behavior Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory, and the Psychological Resilience Scale. SPSS (version 23) and PROCESS (version 3.3) were used for correlation analysis, mediation analysis, and mediated moderation analysis.Results(1) Intrusive rumination was positively correlated with post-traumatic growth and creativity but negatively correlated with psychological resilience. Psychological resilience was positively correlated with post-traumatic growth and creativity. Post-traumatic growth and creativity were positively correlated. (2) Post-traumatic growth played a mediating role in the relationship between intrusive rumination and creativity. (3) Psychological resilience moderated the first half of the pathway “intrusive rumination → post-traumatic growth → creativity.”ConclusionIntrusive rumination affected creativity directly and also indirectly through post-traumatic growth. At the same time, psychological resilience played a moderating role between intrusive rumination and creativity. The correlation between intrusive rumination and post-traumatic growth was stronger when levels of psychological resilience levels were higher.

Development and effects of a post-traumatic growth program for patients with breast cancer.

This study aimed to develop a post-traumatic growth (PTG) program, based on the PTG promotion resources suggested by Cahlhoun, Cann, and Tedeschi, and to apply it to breast cancer patients to determine its effect. A non-equivalent control group pretest-posttest experimental design was used. In total, 74 participants were enrolled in this study, with 37 in the experimental group and 37 in the control group. The PTG program developed in this study consisted of writing and self-reflection for self-analysis, talking and sharing for self-disclosure, and participation in a self-help group for social support. The instruments used for this study were the Korean version of the Event Related Rumination Inventory, the Korean version of the Hospital Anxiety and Depression Scale, and the Korean version of the Post-traumatic Growth Inventory. The data were analyzed with the χ2test, t-test, Fisher's exact test and all analysis were conducted based on an intention-to-treat principle. The experimental group that underwent a PTG program had a lower emotional distress score than the control group (anxiety: t=-3.84, p=.001; depression: t=-3.22, p=.002). The experimental group had a lower intrusive rumination (t=-3.55, p=.001) and had higher deliberate rumination score than the control group (t=2.10, p=.039). The experimental group had a higher PTG score than the control group (t=2.34, p=.022). The PTG program developed in this study for breast cancer patients has the potential to contribute to the promotion of PTG in breast cancer patients.

Longitudinal relationships between guilt and suicide risk among adolescents in a postdisaster context: Mediating roles of rumination and posttraumatic stress disorder.

To analyze the pathways and mechanisms underlying the impact of guilt on suicide risk using a well-controlled longitudinal study, we examined the mediating roles of intrusive rumination, deliberate rumination, and posttraumatic stress disorder (PTSD) in this association. Four hundred and eight adolescent survivors (Mage =14.05years) were assessed using self-report questionnaires three and a half years and four and a half years after the Ya'an earthquake. The self-report questionnaires included the Trauma Exposures Questionnaire, the Interpersonal Guilt Questionnaire, the Event-Related Rumination Inventory, the PTSD Checklist for the DSM-5, and the Child Behavior Problems Questionnaire. The results indicated that guilt had a direct and positive effect on suicide risk. Intrusive rumination and PTSD mediated the relationship between guilt and suicide risk. Guilt could increase deliberate rumination, but deliberate rumination did not significantly predict PTSD and suicide risk. Negative postdisaster emotions, such as guilt, can enhance the combined effects of cognition and psychological disorders on suicide risk. Guilt affects suicide risk indirectly through intrusive rumination and PTSD but not through deliberate rumination.

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination.

BackgroundSpiritual well-being plays an important role in helping patients cope with disease. Previous studies have investigated the association between social support and spiritual well-being, whereas few studies have explored the relationship in patients with esophageal cancer (EC), and the mechanisms behind this pathway have not been thoroughly examined.ObjectiveThis study aimed to explore the relationship between social support and spiritual well-being of Chinese patients with EC aged over 50 years and to analyze whether the relationship was mediated by rumination.MethodsA cross-sectional survey was conducted with 197 EC patients. Participants completed the general information questionnaire, the Functional Assessment of Chronic Illness Therapy–Spiritual Scale, the Chinese Event Related Rumination Inventory, and the Perceived Social Support Scale (PSSS).ResultsResults demonstrated that social support of patients with EC aged over 50 years was positively correlated with spiritual well-being and deliberate rumination and negatively correlated with intrusive rumination; spiritual well-being was positively associated with deliberate rumination and negatively correlated with intrusive rumination. The effect of social support on spiritual well-being was partially mediated by deliberate rumination and intrusive rumination.ConclusionsThe findings suggest that interventions directed toward enhancing social support and deliberate rumination and reducing the level of intrusive rumination may help patients with EC aged over 50 years improve spiritual well-being.