Improvement In Rumination Research Articles

Golden steps: A nursing approach for vitality, agility, and rumination in geriatric clients with depressive disorders through mindful walking

BackgroundDepression is a prevalent issue among older adults and can significantly impact their overall quality of life. While traditional treatments may not always be sufficient or suitable for all individuals, the potential of alternative interventions, such as mindful walking, offers a ray of hope. This study aimed to evaluate the impact of mindful walking on rumination, agility, vitality, and mindfulness in geriatric patients with depressive disorders. MethodA prospective quasi-experimental design was employed with a purposive sample of 35 clients in the intervention group and 33 in the control group. This study utilized the Ruminative Responses Scale – Short Form (RRS-SF) and Five Facet Mindfulness Questionnaire (FFMQ) to measure the primary outcome. The Timed Up and Go Test (TUG) and State-Level Version of the Subjective Vitality Scale (SVS) were used to measure the secondary outcomes. ResultsMindful walking significantly affected vitality, mindfulness, and rumination, with effect sizes (ղ2 = 0.168, 0.137, and 0.127), respectively. On the other hand, the intervention had a less significant effect on agility, with an effect size (ղ2 = 0.047). ConclusionThis study revealed that geriatric clients with depressive disorders showed more significant improvements in vitality, followed by improvement in rumination and agility. Integrating mindful walking as a part of care plans for those clients would promote their physical activity and mental well-being.

Rumination symptoms in treatment-resistant major depressive disorder, and outcomes of repetitive Transcranial Magnetic Stimulation (rTMS) treatment

Rumination is a maladaptive style of regulating thoughts and emotions. It is a common symptom of Major Depressive Disorder (MDD), and more severe rumination is associated with poorer medication and psychotherapy treatment outcomes, particularly among women. It is unclear to what extent rumination may influence the outcomes of, or be responsive to, repetitive Transcranial Magnetic Stimulation (rTMS) treatment of MDD. We retrospectively examined data collected during rTMS treatment of 155 patients (age 42.52 ± 14.22, 79 female) with moderately severe treatment-resistant MDD. The severity of rumination and depression was assessed before and during a course of 30 sessions of measurement-based rTMS treatment using the Ruminative Responses Scale (RSS) and the Patient Health Questionnaire (PHQ-9), respectively. Relationships among baseline levels of rumination, depression, and treatment outcome were assessed using a series of repeated measures linear mixed effects models. Both depression and rumination symptoms significantly improved after treatment, but improvement in depression was not a significant mediator of rumination improvement. Higher baseline rumination (but not depression severity) was associated with poorer depression outcomes independently of depression severity. Female gender was a significant predictor of worse outcomes for all RRS subscales. Both depressive and ruminative symptoms in MDD improved following rTMS treatment. These improvements were correlated, but improvement in rumination was not fully explained by reduction in depressive symptoms. These findings suggest that while improvement in rumination and depression severity during rTMS treatment are correlated, they are partly independent processes. Future studies should examine whether rumination symptoms should be specifically targeted with different rTMS treatment parameters.

White matter microstructural perturbations after total sleep deprivation in depression.

Total sleep deprivation (TSD) transiently reverses depressive symptoms in a majority of patients with depression. How TSD modulates diffusion tensor imaging (DTI) measures of white matter (WM) microstructure, which may be linked with TSD's rapid antidepressant effects, remains uncharacterized. Patients with depression (N = 48, mean age = 33, 26 women) completed diffusion-weighted imaging and Hamilton Depression Rating (HDRS) and rumination scales before and after >24 h of TSD. Healthy controls (HC) (N = 53, 23 women) completed the same assessments at baseline, and after receiving TSD in a subset of HCs (N = 15). Tract based spatial statistics (TBSS) investigated voxelwise changes in fractional anisotropy (FA) across major WM pathways pre-to-post TSD in patients and HCs and between patients and HCs at baseline. Post hoc analyses tested for TSD effects for other diffusion metrics, and the relationships between change in diffusion measures with change in mood and rumination symptoms. Significant improvements in mood and rumination occurred in patients with depression (both p < 0.001), but not in HCs following TSD. Patients showed significant (p < 0.05, corrected) decreases in FA values in multiple WM tracts, including the body of the corpus callosum and anterior corona radiata post-TSD. Significant voxel-level changes in FA were not observed in HCs who received TSD (p > 0.05). However, differential effects of TSD between HCs and patients were found in the superior corona radiata, frontal WM and the posterior thalamic radiation (p < 0.05, corrected). A significant (p < 0.05) association between change in FA and axial diffusivity within the right superior corona radiata and improvement in rumination was found post-TSD in patients. Total sleep deprivation leads to rapid microstructural changes in WM pathways in patients with depression that are distinct from WM changes associated with TSD observed in HCs. WM tracts including the superior corona radiata and posterior thalamic radiation could be potential biomarkers of the rapid therapeutic effects of TSD. Changes in superior corona radiata FA, in particular, may relate to improvements in maladaptive rumination.

Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objective: To systematically evaluate the effectiveness of mindfulness-based interventions (MBIs) on rumination among patients with depression and their efficacy across countries and year of publication and control conditions. Methods: Web of Science Core Collection, Medline, BIOSIS Citation Index, KCI-Korean Journal Database, SciELO Citation Index, PubMed, Cochrane Library, and Embase were searched to include randomized controlled trials of MBIs for depressive rumination that met the criteria. The Rumination Scale was used as the primary outcome indicator; Depression, mindfulness, and anxiety indexes were selected as the secondary outcome indicators. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. RevMan5.3 software was used to perform a meta-analysis of the extracted data. Results: Nineteen studies with 1138 patients were included. Meta-analysis showed that MBIs could significantly reduce rumination levels in patients with depression (standardized mean difference (SMD) = −0.46; 95% confidence interval (CI): −0.58, −0.34; p < 0.001), notably improve depression (SMD = −0.58; 95% CI: −0.83, −0.32; p < 0.001), enhance mindfulness ability (SMD = 0.95; 95% CI: 0.57, 1.32; p < 0.001), and reduce the anxiety of patients with depression (SMD = −0.45, 95% CI: −0.62, −0.27; p < 0.001). MBIs conducted in Asia improved rumination better than studies in Europe and North America (SMD = −2.05 95% CI: −4.08, −0.01; p < 0.001) but had no greater effect than behavior activation on depression. The interventions carried out in the past 5 years were significantly better than earlier studies in improving mindfulness levels (SMD = 2.74; 95% CI: 0.81, 4.66; p = 0.005). Conclusions: MBIs are effective in the treatment of depression as they produce pleasant improvement in rumination and depression, decrease the degree of anxiety, and enhance mindfulness levels compared to controls. In newer forms of MBIs, regional differences need to be considered when designing the intervention program. More large, high-quality randomized controlled studies are needed to confirm the conclusion that the effectiveness of MBIs has differences in terms of the trial area and year of publication.

Is the combination of behavioral activation and attention training technique effective to reduce depressive symptomatology? A multiple case study.

BackgroundThis study tested whether the combination of BATD and Attention Training Technique (ATT) is effective to reduce depressive symptomatology and investigate the mechanisms of action underlying the effectiveness of treatment with a multiple N-of-1 trials.MethodsNine adults with depressive symptoms were randomly included in three different combinations of BATD and ATT, concurrent in Condition 1 and sequential in Conditions 2 and 3 (ATT followed by BATD and BATD followed by ATT, respectively). The sequential components allow investigating the specific changes that occur during the two distinct treatment phases. Multiple self-report and pre–post-assessments were conducted on generic mental health measures (depressive symptoms, life functioning, mood, and well-being) and intervention-specific measures (behavioral activation, behavioral avoidance, self-focused attention, cognitive control and rumination), with two-week and three-month follow-up assessments. We also measured treatment adherence with treatment attendance, homework compliance and a clinical interview.ResultsParticipants’ attendance, homework compliance and satisfaction were acceptable in the three conditions, with higher adherence in Condition 1 and Condition 3. Eight participants out of nine reported a reduction in depressive symptomatology and five an improvement in well-being. Most of their progress was maintained 2 weeks after the intervention but not 3 months later. Conditions 1 and 2 seemed to be associated with a higher response to generic mental health measures in comparison with Condition 3. The three conditions were not associated with consistent changes in intervention-specific measures, except for rumination with five participants out of nine reporting an improvement in rumination immediately after the intervention and eight participants 2 weeks after the intervention. The concurrent format was associated with a better improvement in rumination immediately after the intervention. No specific changes of self-focused attention and rumination characterized ATT, and no specific changes of behavioral activation, behavioral avoidance and rumination characterized BATD.ConclusionOur three interventions were judged acceptable and showed positive short-term benefit for generic mental health measures and rumination maintained 2 weeks later, but not 3 months later. Results suggest that five sessions of concurrent treatment could be a better option than sequential formats. However, our data did not support the specificity of ATT and BATD treatments.Clinical Trial Registration: This trial was previously registered with the ClinicalTrials.gov NCT04595539 registration number and the title “Does Attention Training Technique Enhance the Effectiveness of Behavioral Activation Treatment for Depression: A Multiple Baseline Study.”

A Comparison of Metacognitive Therapy in Current Versus Persistent Depressive Disorder - A Pilot Outpatient Study.

Background: Metacognitive therapy (MCT) is a modern approach with demonstrated efficacy in current major depressive disorder (MDD). The treatment aims to modify thinking styles of rumination and worry and their underlying metacognitions, which have been shown to be involved in the initiation and perpetuation of MDD. We hypothesized that metacognitive therapy may also be effective in treating persistent depressive disorder (PDD).Methods: Thirty depressed patients (15 with MDD; 15 with PDD) were included. Patients in both groups were comparable on depression severity and sociodemographic characteristics, but PDD was associated with more former treatments. Metacognitive therapy was applied by trained psychotherapists for a mean of 16 weeks.Results: We observed a significant improvement of depressive symptoms in both groups, and comparable remission rates at the end of treatment and after 6 months follow-up. Furthermore, we observed significant and similar levels of improvement in rumination, dysfunctional metacognitions, and anxiety symptoms in both groups.Limitations: The study is limited by the small sample size and a missing independent control group. The effect of the therapeutic alliance was not controlled. The quality of depression rating could have been higher.Conclusions: We demonstrated that metacognitive therapy can successfully be applied to patients with PDD. The observed results were comparable to those obtained for patients with current major depressive disorder. Further studies with larger groups and a randomized design are needed to confirm these promising initial findings.

Default mode network global connectivity predicts improvement in rumination in elderly depressed patients treated with escitalopram

Default mode network global connectivity predicts improvement in rumination in elderly depressed patients treated with escitalopram

Forage growing as an incentive to improve smallholder beef production in Cambodia

A major challenge for large ruminant improvement projects in developing countries is smallholder farmer engagement that promotes the value of knowledge in informed decision making. Most large ruminant smallholder farmers in Cambodia are considered to be livestock keepers and will become livestock producers only if they recognise the production and financial benefits from improved health and management practices. The benefits of growing and feeding five introduced forage species was investigated as a potential entry point for smallholder farmer engagement in southern Cambodia. The mean chemical composition, digestibility and estimated metabolisable energy (ME; MJ/kg DM) of introduced forages at 30 days after first harvest were comparable to published values. An initial establishment of 52 fodder plots covering 2.6 ha in 2008 expanded to 1306 plots covering 45 ha, including non-project farmers from surrounding areas. The establishment of forage plots in high-intervention project villages provided an improvement in average daily liveweight gain of cattle and saved farmers up to 2 h labour per day. This strategy provided a platform for increased uptake and adoption of livestock health and production interventions.