Rumination, Brooding, and Reflection: Prospective Associations with Suicide Ideation and Suicide Attempts

Adam G. Horwitz*, Ewa K. Czyz, Johnny Berona, Cheryl A. King

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Objective: Rumination is often cited as a risk factor for suicide, yet few studies of rumination have utilized clinical samples, and no studies have examined its prospective association with suicide attempts. The purpose of this study was to examine concurrent and prospective associations of brooding and reflection (the two components of rumination) with suicide ideation and suicide attempts among a high-risk clinical sample. Method: Participants were 286 adolescents and young adults (77% Caucasian, 59% female) aged 13–25 seeking psychiatric emergency services. A majority (71%) were presenting with a primary complaint of suicide ideation or recent suicide attempt. Participants completed a baseline assessment at the index visit; 226 participants (79%) completed a 4-month follow-up assessment of suicidal thoughts and behaviors. Results: Brooding was associated with lifetime history of one or more suicide attempts, but not concurrent suicide ideation. Reflection was not associated with lifetime suicide attempts or concurrent suicide ideation. Furthermore, prospective associations of brooding and reflection with suicide ideation and suicide attempts were weak-to-small in magnitude and statistically nonsignificant. Conclusions: Rumination appears to have a limited association with suicide-related outcomes within a high-risk clinical sample. Additional longitudinal studies utilizing clinical samples are critically needed to better understand these associations.

Original languageEnglish (US)
Pages (from-to)1085-1093
Number of pages9
JournalSuicide and Life-Threatening Behavior
Volume49
Issue number4
DOIs
StatePublished - 2019

Funding

All authors are affiliated with the University of Michigan, Department of Psychiatry. Funding for this project was provided by University of Michigan Rackham Graduate Student Research Grants to Adam Horwitz and Ewa Czyz, an Institute for Research on Women and Gender grant to Johnny Berona, a Blue Cross Blue Shield of Michigan Foundation Student Award to Adam Horwitz, and an Active Minds grant to Johnny Berona. We gratefully acknowledge the physicians, nurses, social workers, and administrative staff in Psychiatric Emergency Services at the University of Michigan and especially thank Dr. Rachel Glick, M.D., and John Kettley, ACSW for their support. We wish to acknowledge Alejandra Arango, Yasmin Cole-Lewis, and the ED-MACS team of research assistants. We also wish to thank all participating patients and their families.

ASJC Scopus subject areas

  • Clinical Psychology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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