Rumination and distraction in major depression: assessing response to pharmacological treatment

Background: Response style theory of depression (RST) predicts that individ uals who ruminate in response to their depressed mood will suffer an amplif ication and prolongation of that mood, whereas individuals who engage in di straction responses will alleviate and attenuate their depressed mood. RST has been shown to predict prolonged depression in samples of non-clinical, untreated individuals with mild to moderate depression but has not been tes ted in samples of depressed patients undergoing treatment. Objective: In th is preliminary investigation we examined: (1) whether RST predicts non-resp onse to pharmacotherapy with outpatients suffering from major depression, a nd (2) whether distractive and ruminative responses are associated with cli nical variables hypothesized to be associated with them. Methods: Eighty-ni ne depressed outpatients being treated with standard antidepressant pharmac otherapy were administered the Response Style Questionnaire, a scale design ed to measure rumination and distraction, prior to treatment. Results: Dist raction, but not rumination, predicted change in depression severity over t he course of treatment and overall treatment outcome. Neither rumination no r distraction was associated with previous number of depressive episodes or duration of current depressive episode. Discussion: These results provide only partial support for RST as a predictor of treatment response. Future i nvestigations are needed to determine if rumination and distraction are pre dictive of recurrent depressive episodes in recovered depressed patients. L imitations: As the data in this study was retrieved from a clinical databas e: the conclusions of this report must be viewed tentatively. Replication w ith other clinical samples is needed. (C) 1999 Elsevier Science B.V. All ri ghts reserved.