The Intricate Relationship Between Rumination and Psychopathology: Insights from Recent Research


Rumination, a repetitive and often negative thought process, has been identified as a significant risk factor in various forms of psychopathology. This article delves into the nuances of rumination, exploring its connections to mental health issues, particularly in adolescent girls, and examines the neural mechanisms underlying these associations.

The Impact of Rumination Across Various Forms of Psychopathology

Extensive research has shown that rumination is linked to a myriad of psychological conditions. Studies by Nolen-Hoeksema and colleagues (2007, 2011) and McLaughlin and Nolen-Hoeksema (2011) highlight its strong association with depression and anxiety. Similarly, Grierson et al. (2016) and Luca (2019) demonstrated its role in substance abuse, while Ying et al. (2021) linked it to self-injury behaviors. Hilt et al. (2013) found a connection with disordered eating.

The pervasive effects of rumination extend to sleep disturbances (Jose and Vierling, 2018; Palmer et al., 2018; Li et al., 2019), aggressive behavior (Peled and Moretti, 2007; McLaughlin et al., 2014; Li et al., 2021), and experiences of peer victimization (McLaughlin and Nolen-Hoeksema, 2012), especially during adolescence.

Gender Differences in Rumination and Its Consequences

The prevalence and impact of rumination differ between genders. Research indicates that girls report higher levels of rumination than boys (Peled and Moretti, 2007; Jose and Brown, 2008; Hamilton et al., 2015a). This difference is critical as rumination has a stronger correlation with depression in girls compared to boys (Jose and Brown, 2008). Hankin’s (2008) work suggests that these gender differences in depression symptoms during adolescence are partially mediated by rumination. Identifying contexts and neurocognitive mechanisms behind these heightened levels of rumination in adolescent girls is vital for developing targeted clinical interventions.

Social Evaluation and Rumination

Negative social evaluation or social rejection plays a pivotal role in triggering maladaptive thought patterns, particularly in those prone to rumination. Zoccola et al. (2012) found that participants in a negative social evaluation setting exhibited increased rumination and anxiety. Kaiser et al. (2015) noted that individuals with higher trait rumination showed impaired cognitive performance following interpersonal criticism. Physiological responses, such as heart rate recovery (Aldao et al., 2014), cortisol activation (Shull et al., 2016; Zoccola and Dickerson, 2015), and altered cortisol patterns, are also prolonged in those with high dispositional rumination.

Adolescent Girls: A Focus on Rumination and Rejection-Reactivity

Adolescent girls display heightened sensitivity to social evaluation and rejection, influenced by increased social sensitivity, self-conscious emotions, and rumination during this developmental phase (Somerville, 2013; Guyer et al., 2016; Schriber and Guyer, 2016; Sequeira et al., 2021). This sensitivity is evidenced by greater biological responses to social evaluation (Stroud et al., 2009; van den Bos et al., 2014) and heightened neural activity in emotion-related brain regions (Gunther Moor et al., 2010; Guyer et al., 2012). Girls with higher rumination levels also exhibit more significant arousal in response to simulated peer rejection (Stone et al., 2016).

Neural Correlates of Rumination

A meta-analysis by Makovac et al. (2020) identified key brain regions associated with rumination, including the medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC)/precuneus, and subgenual anterior cingulate cortex (sgACC). These areas are known for their roles in self-related processing and emotional regulation. High ruminators tend to have heightened activity in these regions, contributing to their prolonged processing of negative information and increased autonomic activity.

The Role of Connectivity in Rumination

The neurobiological model of rumination posits that maladaptive thought patterns may arise from the interaction between psychological processes within core regions of the Default Mode Network (DMN) and the sgACC. Resting-state functional connectivity studies have shown that altered connectivity patterns between these regions are associated with a biased attention toward negative stimuli and trait rumination (Kaiser et al., 2018, 2019).

Exploring Rumination in Adolescent Girls Through Neuroimaging

Recent studies have employed the Chatroom fMRI Task to investigate the neural response to social rejection in adolescent girls. This task measures emotional responses to social feedback and has shown that girls with higher rumination levels demonstrate greater neural activity in key regions like the sgACC, mPFC, and PCC/precuneus. They also show increased connectivity between the sgACC and core DMN regions when receiving negative feedback, indicating a heightened neural sensitivity to social evaluation.

Discussion: Understanding the Neural Correlates of Rumination in Response to Social Rejection in Adolescent Girls

Contextualizing Rumination in Adolescent Girls

This groundbreaking study offers an unparalleled look into how self-reported rumination in adolescent girls correlates with neural responses to rejection, especially from peers they liked. Our findings reveal that higher levels of rumination are linked to increased activity in areas like the precuneus, IPL, DLPFC, and SMA, alongside a decreased sgACC connectivity with core DMN regions. This suggests a unique neural processing pattern in affective, cognitive, and self-relevant circuits among girls with a ruminative predisposition. This study interprets these observations in the context of cognitive functions associated with the observed brain regions, slower response times (RT) during tasks, and known psychological processes characteristic of ruminators.

Interpretation of Key Findings

Precuneus Activity and Rumination:

  • The enhanced activity in the precuneus for girls with higher rumination levels underscores a deep encoding and internalization of negative feedback, impacting self-concept.
  • This finding might also reflect a heightened analytical process concerning the reasons behind peers’ negative feedback, a characteristic trait of ruminative thought patterns.

Working Memory Network Engagement:

  • Heightened activity in the DLPFC, IPG, and SMA points to a possible allocation of more working memory resources to negative social feedback in high ruminators, potentially impacting cognitive task performance.
  • This aligns with previous studies showing a correlation between rumination and improved recollection of negative stimuli.

Slower Response Time and Neural Mediators:

  • The slower RT in responding to emotional state questions post-rejection correlates with higher SMA and precuneus activity.
  • This could indicate a conflict in self-worth evaluation, particularly following rejection from favored peers, necessitating more extensive mental processing.

sgACC Connectivity and Rumination:

  • Contrary to expectations, greater rumination was associated with reduced sgACC connectivity with core DMN regions.
  • This could reflect difficulties in integrating emotional processing with positive self-referential cognitions, hinting at a struggle to maintain positive self-views in the face of rejection.

Distinctive Processing of High-Salience Rejection Events:

  • Notably, the significant neural patterns were specific to negative feedback from liked peers, underscoring the context-specific nature of cognitive processing in high ruminators.

Considerations and Implications

  • Measure of Rumination: The Rumination Subscale of the Perfectionism Inventory, focusing on performance, might have influenced the reactivity to social evaluation observed.
  • Heterogeneity of Rumination: Rumination is a multifaceted construct; thus, different aspects or measures of rumination might reveal varied neural correlates.
  • Clinical Implications: Understanding these neural correlates can inform interventions like rumination-focused cognitive behavioral therapy, tailoring them more effectively for adolescents with high rumination levels.


This study significantly contributes to our understanding of rumination’s developmental and neurocognitive underpinnings, particularly in the context of adolescent girls’ responses to social rejection. By shedding light on the specific neural mechanisms at play, this research paves the way for more nuanced and effective clinical interventions aimed at mitigating the psychological impact of rumination in this vulnerable demographic.

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