4.6 Article

Rumination and executive function in depression: an experimental study

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BRITISH MED JOURNAL PUBL GROUP
DOI: 10.1136/jnnp.72.3.400

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Background: Major depression is associated with cognitive deficits, particularly those requiring central executive functioning. Depressed patients also tend to focus on and think about their symptoms and problems (ruminate) more-than non-depressed controls. Although an association has been found between rumination and impaired performance on a central executive processing task, the causal relation between impaired executive functioning and rumination has not been determined. This study sought to directly manipulate rumination and assess the impact on,executive functioning in depression as measured by random number generation. Methods: Depressed patients (n=14) and non-depressed controls (n=14) were compared on a random number generation task, performed after both a rumination induction and after a distraction induction, with order of inductions counter balanced within each group. Results: Compared with the distraction induction, the rumination induction produced a significant increase in both ruminations and the tendency towards stereotyped counting responses (thought to reflect a failure of inhibitory executive control) in depressed patients but not in controls, However, after distraction, no difference in random number generation or rumination was found between the two groups. Conclusions: The aspects of executive function involved in random number generation are not fundamentally impaired in depressed patients. In depressed patients, the rumination induction seems to trigger the continued Orion of ruminative stimulus independent thoughts, interferes with concurrent executive processing.

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