Prospective Relation between Ruminative Subtypes and Suicide Ideation: Moderating Role of Problem Solving

Cognit Ther Res. 2023 Aug;47(4):574-586. doi: 10.1007/s10608-023-10373-w. Epub 2023 May 8.

Abstract

Background: Although reflection has been characterized as a more adaptive subtype of rumination than brooding, evidence suggests that reflection is associated with suicide ideation. The present longitudinal study investigated the mediating role of hopelessness and depressive symptoms and the moderating role of problem solving in explaining why reflection may lead to suicide ideation.

Methods: Two hundred ninety-four undergraduates participated in the study and were followed up every 6 months over 18 months. Participants completed measures of brooding and reflection, hopelessness, depressive symptoms, problem solving, and suicide ideation.

Results: Results revealed that after adjusting for baseline suicide ideation, the serial mediation path from brooding (but not reflection) to suicide ideation via hopelessness and depressive symptoms was significant. Baseline reflection predicted suicide ideation 18 months later through depressive symptoms at 12 months for people average in passive problem solving, and for those low or average in active problem solving. Brooding predicted suicide ideation through depressive symptoms, regardless of problem-solving.

Conclusions: Reflection may result in suicide ideation via depressive symptoms among people with poor problem-solving skills. Clinical and theoretical implications are discussed.

Keywords: brooding; problem solving; reflection; rumination; suicide ideation.