Rumination in posttraumatic stress disorder: A systematic review

Michelle L Moulds; Madelyne A Bisby; Jennifer Wild; Richard A Bryant

doi:10.1016/j.cpr.2020.101910

Rumination in posttraumatic stress disorder: A systematic review

Clin Psychol Rev. 2020 Dec:82:101910. doi: 10.1016/j.cpr.2020.101910. Epub 2020 Sep 11.

Authors

Michelle L Moulds¹, Madelyne A Bisby², Jennifer Wild³, Richard A Bryant²

Affiliations

¹ School of Psychology, The University of New South Wales, UNSW, Sydney, Australia. Electronic address: m.moulds@unsw.edu.au.
² School of Psychology, The University of New South Wales, UNSW, Sydney, Australia.
³ Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.

PMID: 32971312
DOI: 10.1016/j.cpr.2020.101910

Abstract

Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.

Keywords: PTSD; Repetitive thinking; Rumination; Trauma.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Humans
Stress Disorders, Post-Traumatic*