Cogn Ther Res (2008) 32:471–473
DOI 10.1007/s10608-008-9207-9
INTRODUCTION
Introduction to Special Issue on Rumination:
From Mechanisms to Treatment
Greg Siegle
Published online: 8 August 2008
Ó Springer Science+Business Media, LLC 2008
This special issue arose when, without a motivating
act of editorial savvy, a number of excellent manu-
scripts, all on the topic of rumination, were submitted
to Cognitive Therapy and Research. All articles in
this special issue went through the regular peer
review process. Having these articles together, which
span themes from basic science to treatment predic-
tion and make use of the most modern theories of the
nature and role of this construct, is particularly
exciting. I submit that this occurrence is probably not
by chance. Rather, in the past 10 years, rumination,
or broadly, the tendency to think repetitively about
emotional topics, has emerged as a central mecha-
nistic concept in psychopathology. Briefly, the
importance, magnitude, and some central issues in
rumination research are highlighted below as a way
to set the stage for the articles to follow.
The importance of the construct of rumination has
increasingly become evident as rumination has been
associated with many disorders, from depression and
anxiety to eating disorders, alcohol use disorders,
pain disorders and other physical conditions (Con-
nolly et al. 2007; Fritz 1999; Garnefski et al. 2002;
Gracie et al. 2006; Nolen-Hoeksema 2000; Nolen-
G. Siegle (&)
Western Psychiatric Institute and Clinic, University
of Pittsburgh School of Medicine, 3811 O’Hara St.,
Pittsburgh, PA 15213-2593, USA
e-mail: sieglegj@upmc.edu
Hoeksema and Harrell 2002; Tremblay et al. 2008).
In parallel, a translational pathway has emerged,
beginning with identification of brain and physiolog-
ical mechanisms of rumination (Brosschot et al.
2006; Ray et al. 2005; Siegle and Thayer 2004) and
relationships of rumination to other aspects of
cognition (Bagby and Parker 2001; Ciesla and
Roberts 2007; Moulds et al. 2008). Such basic
science has both prompted, and given a basis for
understanding associations of rumination with vul-
nerability (Ito and Agari 2002; Spasojevic and Alloy
2001) and recovery (Bagby et al. 1999; Beevers et al.
2007; Gracie et al. 2006; Kleim et al. 2007; Morrow
and Nolen-Hoeksema 1990). This trajectory has
made rumination a strong candidate for consideration
in development of personalized treatments. Interven-
tions specifically created to target at addressing
rumination have, in fact, recently begun to crop up
(Gortner et al. 2006; Siegle et al. 2007; Watkins
et al. 2007).
This trajectory has spawned an explosion of
papers. A quick survey of the PubMed databse
suggested that from 1985 to 1989 there were between
7 and 18 papers published with rumination in the
abstract or title every year (M = 13.4). From 1990 to
1995 this increased to M = 15.1. From 1996 to 2000
it again increased to 21.1, with 28 papers in 2001, 36
in 2002, 39 in 2003, 40 in 2004, 45 in 2005, 80 in
2006 and 101 in 2007. The past decade has seen
books on the topic (Davey and Wells 2006; Papa-
georgiou and Wells 2004) as well as guest-edited
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special issues of relevant journals (Alloy 2002; Hertel
2006; Papageorgiou and Siegle 2003). This exponen-
tial growth reflects not only increased integration of
research on rumination but a growing recognition of
the nature, influences and causal importance of this
phenomenon.
Of course, rumination research is not without its
arguments, which also continue to fuel the field. In
particular, there are many definitions and very
different measures of rumination (for reviews see
Segerstrom et al. 2003; Siegle et al. 2004), spanning
assessment of the frequency of thinking about
depressive symptoms (Nolen-Hoeksema et al.
1993), the intrusiveness of thoughts about a distress-
ing event (Horowitz et al. 1979), to the degree to
which individuals search for meaning of negative
experiences (Fritz 1999). This variety has yielded a
lack of clarity in the field regarding the actual nature
and functional/causal importance of a central rumi-
native construct. In particular, divisions between
aspects of rumination which seem more benign (non-
emotional ‘‘reflection’’) and specifically centred on
negative or maladaptive thoughts have begun to be
assessed (Joormann et al. 2006; Trapnell and Camp-
bell 1999; Treynor et al. 2003). Thus, specifying the
nature of rumination being measured in a particular
article as well as using and aggregating multiple
measures in empirical studies may be increasingly
important in allowing the field to progress linearly.
Thus, as illustrated in the articles in this special
issue, this field continues to grow in exciting
directions. Questions on the horizon, from the true
nature of rumination, the best ways to assess it, the
extent to which its role in vulnerability and treatment
outcome is causal, and how to best address the
phenomenon in treatment are actively being
addressed. Future research spanning multiple levels,
for example, simultaneously assessing biological and
self-report measures in the context of treatment
studies, could help to integrate and explicate these
domains. For example, we do not yet know whether
neural and physiological substrates of rumination are
associated with both reflection and more negative
aspects of rumination, which aspects (or definitions
or measures) of rumination best predict or most
reliably change in treatment, whether rumination is
truly distinct from other aspects of depression and
anxiety, and how, assessing rumination before treat-
ment should best be used to inform the nature of
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Cogn Ther Res (2008) 32:471–473
treatment. We also do not yet know where specifi-
cally treating rumination, which is not, itself, a
diagnostic condition, fits into the broader goal of
treating psychological disorder.
Answering these questions will help to understand
the role and continued relevance of the construct of
rumination as the field moves increasingly towards
targeted and personalized treatment (NIH 2006).
Current roads point to an important continued role
for rumination in conceptualizing disorder, response
prediction and treatment development.
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