Levels of Rumination and Distraction Can Predict Levels of Depression

When we’re feeling down, we can focus our attention on our mood or try to distract ourselves from our mood by thinking about happy memories or becoming engrossed in an activity. These two courses of action are two types of coping styles: rumination and distraction.

Ruminative coping refers to “passively focusing on one’s depressive symptoms and their possible causes and consequences,” while distractive coping refers “to shifting one’s attention away from depressive symptoms and onto pleasant thoughts.”

These two coping styles were the subject of a study published in the Journal of Abnormal Psychology in 2009.

The study was conducted by Silke Huffziger, Iris Reinhard, and Christine Kuehner from the Central Institute of Mental Health in Mannheim, Germany.

For their longitudinal study on the effect of coping styles on depression, Huffziger and her colleagues recruited two groups of participants.

The first group of participants consisted of 82 patients who had recently been discharged from the Central Institute of Mental Health following treatment for depression.

The second group was composed of 76 participants recruited from the general population of Mannheim and matched with the first group for age and gender.

Both groups of participants received standardized interviews to assess their levels of depressive symptoms and completed the Response Styles Questionnaire to assessed their coping styles at three different times. The interviews and questionnaires were administered four weeks, six months, and three and half years after the patients were discharged.

Huffziger and her colleagues found differences between the two groups in the ability of coping styles to predict depressive symptoms.

In the group of participants who had recently been discharged, rumination did not predict future depressive symptoms, but depressive symptoms could predict levels of rumination.

In the group of participants from the general population of Mannheim, on the other hand, there was a reciprocal relationship found between rumination and depression. Higher levels of rumination predicted future depressive symptoms and depressive symptoms also predicted future increases in rumination.

DepressionIn other words, although rumination appears to be a risk factor for depressive symptoms in the general population, once a clinical level of depression has been reached, ruminative coping seems to lose its ability to predict the course of depression.

Similarly, there was a difference found between the effects of distractive coping in the two groups.

For the group of patients recently treated for depression, distractive coping predicted lower levels of depression, while no evidence was found that distractive coping could predict levels of depression in the group from the general population.

“Our study revealed clear protective effects of habitual distraction for the long-term course of depressive symptoms in formerly depressed inpatients,” as Huffziger and her colleagues concluded.

“Consequently, we suggest that treatment programs for depressed patients, particularly for those with a more unfavorable illness history, should incorporate specific intervention approaches to strengthen distractive coping. In our opinion, behavioral activation interventions, which involve focused activation strategies and teaching the patients to move their attention away from ruminative thoughts and toward direct and immediate experience, are particularly suitable for this purpose.”


Huffziger, S., Reinhard, I. & Kuehner, C. (2009). A longitudinal study of rumination and distraction in formerly depressed inpatients and community controls. Journal of Abnormal Psychology, Vol. 118, No. 4: 746–756.