LONGITUDINAL PREDICTIONS OF THE BROODING AND REFLECTION SUBSCALES OF THE JAPANESE RUMINATIVE RESPONSES SCALE FOR DEPRESSION 1

Transcription

1 Psychological Reports: Mental & Physical Health 2013, 113, 2, Psychological Reports 2013 LONGITUDINAL PREDICTIONS OF THE BROODING AND REFLECTION SUBSCALES OF THE JAPANESE RUMINATIVE RESPONSES SCALE FOR DEPRESSION 1 AKIRA HASEGAWA Faculty of Human Relations Tokai Gakuin University, Japan MUNENAGA KODA Graduate School of Medicine University of the Ryukyus, Japan YOSUKE HATTORI Graduate School of Arts and Sciences The University of Tokyo, Japan TSUYOSHI KONDO Graduate School of Medicine University of the Ryukyus, Japan JUN KAWAGUCHI Department of Psychology Nagoya University, Japan Summary. The Ruminative Responses Scale (RRS) is a measure of depressive rumination which has two subscales: Brooding and Reflection. This article examines the longitudinal predictions for depression and the test-retest reliability of the Brooding and Reflection of the Japanese RRS. Japanese university students ( N = 378) completed the RRS, the Center for Epidemiologic Studies Depression Scale (CES D), and the Inventory to Diagnose Depression, Lifetime Version (IDDL) which was modified to assess symptoms experienced in the 8-wk. follow-up period. The standardized betas of the initial Brooding and Reflection subscales for the IDDL scores were significant and positive after controlling for baseline CES D scores, but those for the CES D scores at Time 2 were not significant. Longitudinal predictions of Brooding were partially consistent with those of other language versions (significant in almost all studies); however, longitudinal predictions of Reflection were not consistent with those of other language versions (negative in previous studies). The test-retest correlations of both subscales were similar to those obtained in Western countries. The Ruminative Responses Scale (RRS; Nolen-Hoeksema & Morrow, 1991 ) is a measure of depressive rumination, which is defined as repetitive and passive thinking about one's symptoms of depression and the possible causes and consequences of these symptoms ( Nolen-Hoeksema, 2004 ). People with current or remitted major depression scored higher on the RRS than those who had never been depressed ( Joormann, Dkane, & Gotlib, 2006 ; Beevers, Rohde, Stice, & Nolen-Hoeksema, 2007 ). Numerous 1 Address correspondence to Akira Hasegawa, Tokai Gakuin University, East Campus 360, 5-68 Naka-kirino, Kakamigahara City, Gifu, , Japan or ( mail-ad.of.hasse@ tokaigakuin-u.ac.jp ). DOI /02.15.PR0.113x24z5 ISSN

2 BROODING, REFLECTION, AND DEPRESSION 567 studies have shown that higher scores on the RRS total scale are predictive of more severe depression ( Nolen-Hoeksema & Morrow, 1991 ; Butler & Nolen-Hoeksema, 1994 ), as well as the onset and relapse of major depressive episodes ( Nolen-Hoeksema, 2000 ; Spasojevic & Alloy, 2001 ). Consistent with these findings, many experimental studies have shown that rumination increases depression. For example, negative mood increased in dysphoric and depressed participants that were asked to focus on the meanings, causes, and consequences of their current feelings for eight minutes (i.e., induced to ruminate), whereas participants with the identical mood status that were induced to distract from negative thoughts or feelings for eight minutes improved their mood ( Nolen-Hoeksema & Morrow, 1993 ). Induced rumination is considered to lead to various outcomes, such as impaired social problem solving ( Lyubomirsky & Nolen-Hoeksema, 1995 ; Lyubomirsky, Tucker, Caldwell, & Berg, 1999 ; Donaldson & Lam, 2004 ), negative interpretations about oneself, one's situation, and future events ( Lyubomirsky & Nolen-Hoeksema, 1995 ; Lyubomirsky, et al., 1999 ; Lavender & Watkins, 2004 ), frequent retrieval of negative autobiographical memories and increased memory-related distress ( Lyubomirsky, Caldwell, & Nolen- Hoeksema, 1998 ; Williams & Moulds, 2010 ), overgeneral autobiographical memories ( Park, Goodyer, & Teasdale, 2004 ; Sutherland & Bryant, 2007 ), and deficits in cognitive control ( Philippot & Brutoux, 2008 ; Whitmer & Gotlib, 2012 ). These findings suggest that depressive rumination is a vulnerability factor for depression and one of the core cognitive processes in the pathology of depressive disorders. Although several versions of the RRS, which differ in terms of item composition, have been proposed ( Nolen-Hoeksema & Morrow, 1991 ; Butler & Nolen-Hoeksema, 1994 ), in recent studies most researchers have used the version of the RRS revised by Treynor, Gonzalez, and Nolen-Hoeksema (2003) with 22 standard items. Because Treynor, et al. (2003) suggested that 12 items of the RRS could be confounded with depressive symptoms, these items were considered unsuitable for investigating the relationships between rumination and depression. The remaining 10 items were subjected to an exploratory factor analysis, yielding two factors: Brooding (i.e., a passive comparison of one's current situation with some unachieved standard ) and Reflective pondering or Reflection (i.e., a purposeful turning inward to engage in cognitive problem solving to alleviate one's depressive symptoms ) ( Treynor, et al., 2003, p. 256). Both subscales are composed of five items. The validity of the two-factor structure of the RRS has been supported by other researchers ( Schoofs, Hermans, & Raes, 2010 ). These two factors appear to be distinct subcomponents, since Brooding and Reflection have different longitudinal predictions for depression. Treynor, et al. (2003) conducted a longitudinal study over one year with a

3 568 A. HASEGAWA, ET AL. community sample. They assessed Brooding and Reflection, and depression as measured with the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961 ) at baseline and 1 yr. later. They demonstrated that while the standardized beta of Brooding for depression at follow-up was positive ( β =.15, p <.001) after controlling for baseline depression scores, that of Reflection was negative ( β =.05, p <.05). This pattern, as noted by the authors, suggests that Brooding may represent a maladaptive aspect of rumination and Reflection may represent an adaptive aspect. In the subsequent studies, Schoofs, et al. (2010) conducted a longitudinal study over 6 mo. with undergraduate students, and Pearson, Watkins, & Mullan (2010) conducted a 6-mo. study with currently depressed, previously depressed, and never depressed individuals. They assessed Brooding, Reflection, and depression as measured with the BDI- II ( Beck, Steer, & Brown, 1996 ) at baseline and follow-up tests. Both studies showed that the standardized betas of Brooding for depression at a 6-mo. follow-up were positive ( β =.18, p <.001; Schoofs, et al., 2010 ) after controlling for baseline depression scores, and that of Reflection were not statistically significant ( β =.01, ns; Schoofs, et al., 2010 ).2 Raes, Smets, Nelis, and Schoofs (2012) conducted two longitudinal studies. The first study that was conducted with secondary school students indicated that the standardized betas of Brooding and Reflection scores for depression assessed by the Depression subscale of the Depression Anxiety Stress Scale ( Lovibond & Lovibond, 1995 ) at 3-mo. follow-up were not significant ( β s =.11 and.06, respectively, ns). In their other study, conducted with university students, the standardized betas of the Brooding score for the Affective and Cognitive subscale scores of the BDI-II at 5-mo. follow-up were positive and significant ( β s =.14 and.11, respectively, p s <.05), after controlling for the baseline scores on each scale. The standardized beta of the Brooding score for the Somatic subscale score of the BDI-II was not statistically significant ( β =.09, ns), Moreover, the standardized betas of the Reflection score for the BDI-II subscale scores were not significant (range of β s = from.05 to.02, ns). The overall results of their studies, with the exception of the secondary school student sample in Raes, et al., (2012) suggested that the Brooding of the RRS assesses a maladaptive aspect of rumination, whereas the Reflection assesses an adaptive or relatively less maladaptive aspect of rumination, at least with respect to the longitudinal prediction 2Pearson, et al. (2010) stated that Time 1 brooding was a significant predictor of Time 2 depressive symptoms (p. 970); however, the standardized beta of Brooding obtained in their study was.03. It is possible that this beta value is not accurate, because the value does not reach significance in their sample size ( n = 92), even though the t value was high enough to reach significance ( t = 2.38). Therefore, we have not discussed the standardized beta of Brooding and Reflection obtained by Pearson, et al. (2010) in detail.

4 BROODING, REFLECTION, AND DEPRESSION 569 of depression. 3, 4 This notion is consistent with the findings that Brooding is generally related to pathological cognitive and behavioral factors including attentional bias, overgeneral autobiographical memory, concern over mistakes in perfectionism, and passive coping responses, whereas Reflection typically is not (e.g., Joormann, et al., 2006 ; Harris, Pepper, & Maack, 2008 ; Debeer, Hermans, & Raes, 2009 ; Marroquin, Fontes, Scilletta, & Miranda, 2010 ). 5 Hasegawa (2013) translated the 22-item version of the RRS based on the item composition of Treynor, et al. (2003) into Japanese, and examined the two-factor model of the RRS with a sample of 299 university students (124 women, 162 men; M age = 20.4 yr., SD = 2.3; sex and age data were missing for 13 participants). Confirmatory factor analysis indicated that the two-factor model of the RRS showed a moderate to good fit to the data (CFI =.92, NFI =.89, NNFI =.89, and RMSEA =.08). The fit indices of the two-factor model were better than those of a unidimensional model in which the 10 items assessing Brooding and Reflection comprised one factor. In addition, the Japanese version of RRS has good construct validity. Hasegawa (2013) also demonstrated that Brooding was correlated more strongly with current depression, assessed with the Center for Epidemiologic Studies Depression Scale (CES D; Radloff, 1977 ) than was Reflection ( r =.55 for Brooding; r =.36 for Reflection). However, the longitudinal predictions of the Japanese RRS subscales have not yet been examined. This examination would also indicate whether the Japanese version of the RRS has similar psychometric properties as other language versions. Because the RRS has been utilized in numerous studies, including clinical outcome studies, the standardized betas of Brooding and Reflection subscales of the Japanese version of the RRS for depression assessed after an interval of a few months is important for research on depression conducted in Japan, and valuable for the comparison of findings obtained in Japan with that of other countries. For the same reasons, it is important to accumulate data on the reliability of the Japanese version of the RRS. 3 There were other studies comparing predictive powers of Brooding and Reflection for future depression. However, they examined this after controlling for other cognitive variables related to rumination, so no direct comparison between the present study and these other studies is possible. 4 With the exception of the sample of secondary school students in Raes, et al. (2012), showing that Brooding was not significantly related to depression at follow-up, longitudinal studies have utilized the BDI or BDI-II as dependent variables. It is possible that the longitudinal relationship between Brooding and depression depends on the depression measure that was utilized (see Discussion section for a detailed analysis). 5 It is known that Reflection has some detrimental consequences, including suicidal ideation ( Miranda & Nolen-Hoeksema, 2007 ; Surrence, Miranda, Marroquin, & Chan, 2009 ). With current knowledge, we cannot fully explain why Reflection decreases, or is unrelated to depression, but simultaneously leads to increased suicidal ideation. Therefore, in the present study, we focused mainly on the relationship between rumination and depression.

5 570 A. HASEGAWA, ET AL. The first purpose of the present study is to examine whether Brooding is associated positively with future depression, and whether Reflection is associated negatively with depression, as had been shown in previous studies conducted in Western countries. Also, the standardized beta of the total score on the Japanese RRS for depression assessed 8 wk. later was examined, after controlling for baseline depression scores, since the total scores, as well as RRS subscale scores, had been calculated and analyzed in many of the previous research studies. The second purpose is to examine test-retest reliability of the Japanese RRS with a large sample. To our knowledge, only a few studies have examined the test-retest reliability of the Brooding and Reflection subscales of the RRS (see Table 1 ). In studies conducted in Western countries, the range of the test-retest correlations has varied from.53 to.74 for the Brooding and from.35 to.60 for the Reflection. The test-retest correlations of both subscales were generally in the moderate range (.40 r <.70), with the exception of the low correlation ( r =.35) for Reflection reported by Zetsche and Joormann (2011). These results are consistent with the general idea that response styles, as assessed with the Brooding and Reflection subscales, represent relatively trait-like characteristics, but with the possibility of changing according to depressive states (see Beevers, et al., 2007 ). Hasegawa (2013) examined the test-retest correlations for the Brooding and Reflection subscales of the Japanese RRS, and found that these correlations for each subscale are similar to versions in other languages. However, because the sample size in Hasegawa (2013) was small ( n = 56), in the TABLE 1 S UMMARY OF TEST-RETEST RELIABILITY ESTIMATES FOR THE RUMINATIVE RESPONSE SCALE'S SUBSCALES Study Sample n Interval r Treynor, Gonzalez, & Nolen-Hoeksema (2003) Pearson, Watkins, & Mullan (2011) Community sample yr. Brooding Reflection Patients and Community sample 92 6 mo. Brooding Reflection Zetsche & Joormann (2011) University students 40 6 mo. Brooding Reflection Raes, Smets, Nelis, & Schoofs (2012) Raes, Smets, Nelis, & Schoofs (2012) Secondary school students mo. Brooding Reflection University students mo. Brooding Reflection Hasegawa (2013) University students 56 6 wk. Brooding Reflection The present study University students wk. Brooding Reflection

6 BROODING, REFLECTION, AND DEPRESSION 571 present study the test-retest reliability of the RRS subscales was examined with a larger sample. To assess whether Brooding and Reflection were distinct constructs, Treynor, et al. (2003) conducted multiple regression analyses and found that variances of scores on the Brooding and Reflection subscales at follow-up were best predicted by their own initial subscale scores, even after controlling for the other RRS subscale and BDI scores at baseline. These results indicated that Brooding and Reflection are distinct constructs. The present study tries to replicate these findings with a Japanese sample. Hypothesis 1. Brooding will be positively associated, and Reflection negatively associated, with future depression scores. Hypothesis 2. The test-retest reliability of the Brooding and Reflection scales in the Japanese version will be in the moderate range. Hypothesis 3. Brooding and Reflection subscale scores at followup will be best predicted by their own initial subscale scores, even after controlling for the other RRS subscale and depression scores at baseline. M ETHOD Participants At the beginning of the academic year, 437 undergraduate students (241 women) at the Nagoya University, Tokai Gakuin University, and University of the Ryukyus participated in a questionnaire study (Time 1). Participants were recruited in their classes, mainly psychology classes, and completed the questionnaires there. The mean age of the participants who answered the questionnaire batteries at Time 1 was 19.3 yr. ( SD = 2.8). Eight weeks later (Time 2), the same questionnaire battery was administered to 378 of these students (215 women). The mean age of the participants who completed both questionnaire batteries was 19.3 yr. ( SD = 2.9) at Time 1. To verify whether there were differences between the completed and the dropout participants on age and the questionnaire measures, the means for the completed participants and the drop-out participants were compared. There were no differences at Time 1 using independent t tests ( t 435 < 1.33, p >.18). Measures Ruminative Responses Scale (RRS; Treynor, et al., 2003 ). The RRS includes 22 items, each rated on a 4-point rating scale with anchors 1: Almost never and 4: Almost always. The RRS contains five items comprising the Brooding, five items comprising the Reflection, and 12 depression-related items. Brooding and Reflection subscale scores and the total RRS score were com-

7 572 A. HASEGAWA, ET AL. puted. Only a few studies have utilized the depression-related items of the RRS as a unitary subscale; therefore, in the current study, these items were not considered a single subscale. Since the development of the RRS ( Nolen-Hoeksema & Morrow, 1991 ), numerous researchers have summed the scores of all the RRS items and analyzed the total RRS score, as reviewed by Nolen-Hoeksema, Wisco, and Lyubomirsky (2008). In line with such previous studies, the total score for the 22 items of the RRS was analyzed in the current study. Adequate psychometric properties were reported including good internal consistency, moderate test-retest reliability, and evidence for construct validity for the total score and subscale scores ( Treynor, et al., 2003 ; Schoofs, et al., 2010 ). The Japanese translation by Hasegawa (2013) was used, for which good reliability and validity were reported. Cronbach's alphas of the RRS total scale and subscales, and the other scales utilized in this study, are displayed in Table 2. Center for Epidemiologic Studies Depression Scale (CES D; Radloff, 1977 ). The CES D is a self-report scale designed to measure depressive symptomatology in the general population. The scale includes 20 items, each rated on a 4-point rating scale with anchors 0: Rarely or none of the time and 3: Most or all of the time. Participants indicated how they were feeling over the last week. Shima, Shikano, Kitamura, and Asai (1985) translated the CES D into Japanese, and confirmed adequate reliability and validity of the scale. Inventory to Diagnose Depression, Lifetime Version (IDDL: Zimmerman & Coryell 1987 ). The IDDL is a self-report scale designed to assess the severity of the worst lifetime depressive episode. The scale includes 22 items, each rated on a 5-point rating scale (0 to 4). As an example, the IDDL item for insomnia is: 0: I was not sleeping less than normal. 1: I occasionally had slight difficulty sleeping. 2: I clearly didn't sleep as well as usual. 3: I slept about half my normal amount of time. 4: I slept less than two hours per night. Uehara, Sato, Sakado, and Sato (1995) translated the IDDL into Japanese. The Japanese version has adequate reliability and validity ( Uehara, et al., 1995 ; Sakado, Sato, Uehara, Sato, & Kameda, 1996 ; Sato, Uehara, Sakado, Sato, Nishioka, & Kasahara, 1996 ). In the original instructions, participants were instructed to recall their worst lifetime episode of depression. However, this scale was used here to assess the severity of the worst episode of depression experienced by participants in the period from Time 1 through Time 2, and the instructions were modified accordingly. Modification of the instruction did not seem to increase the difficulty of rating, because participants merely responded to each item while recalling the worst episode of depression experienced in the followup period, instead of recalling the worst lifetime episode of depression. Participants only filled in the modified IDDL at Time 2.

8 BROODING, REFLECTION, AND DEPRESSION 573 Procedure This study was approved by the Ethics Committee of Tokai Gakuin University. Prior to their participation, all the students were given a complete description of the study, and participants provided written informed consent. They completed the RRS and CES D at Time 1, and the RRS, CES D, and IDDL 8 wk. later (Time 2). The 8-wk. interval was adopted so that the study could be completed in one semester for practical reasons to minimize attrition. The rate of attrition in this study was about 14%. Participants who completed both questionnaire batteries received a book card worth 500 yen (approximately $5 U.S.). Analysis Sex differences for scores on the RRS total scale and subscales, CES D, and IDDL were examined with a t test. Zero-order Pearson correlations were computed between each measure to examine the relationships between the total RRS score and subscale scores, as well as with measures of depression, and to examine the test-retest reliability of the RRS total scale and subscales. In line with Schoofs, et al. (2010) and Hasegawa (2013), t tests were conducted to examine statistically significant differences in the correlations between Brooding and Reflection subscale scores and measures of depression at identical points in time (i.e., the CES D at the present study). In addition, to reexamine the factor structure of the two-factor model of the Japanese RRS, Confirmatory Factor Analysis (CFA) was conducted with maximum likelihood estimation using data at Time 1 from the participants who completed the two assessments ( N = 378). The factor structure of the two-factor model of the Japanese RRS was re-examined, because the fit indices of the model support the psychometric properties of the Japanese translation. To examine the longitudinal associations of the Brooding score and the Reflection score for depression measured after 8 wk., multiple regression analyses were conducted with the Brooding score, the Reflection score, and the CES D score at Time 1 as independent variables and the CES D score at Time 2 and the IDDL score as dependent variables. Multiple regression analyses were also conducted with the total RRS score and CES D score at Time 1 as independent variables and CES D score at Time 2 and IDDL score as dependent variables. The CES D score at Time 1 was included in the model for the IDDL score because to examine longitudinal predictions of rumination measures for depression, baseline depression scores should be controlled. Moreover, to assess if the Brooding and Reflection subscale scores at follow-up were best predicted by their own initial subscale scores, multiple regression analyses were conducted with the Brooding score, Reflection score, and CES D score at Time 1 as independent variables and Brooding score and Reflection score at Time 2 as dependent variables.

9 574 A. HASEGAWA, ET AL. TABLE 2 D ESCRIPTIVE STATISTICS FOR EACH SCALE AT TIME 1 AND TIME 2 FOR THE TOTAL SAMPLE, BY SEX, WITH SEX DIFFERENCES FOR EACH SCALE Men Women Total Sample ( N = 378) Scale ( n = 163) ( n = 215) t M SD α Skew. Kurt. M SD M SD 1. Brooding, Time Brooding, Time * 3. Reflection, Time Reflection, Time RRS Total, Time RRS Total, Time CES D, Time CES D, Time IDDL * Note. CES D = Center for Epidemiologic Studies Depression Scale; RRS = Ruminative Responses Scale; IDDL = Inventory to Diagnose Depression, Lifetime Version; Skew. = skewness; Kurt. = kurtosis. * p <.05. R ESULTS Descriptive statistics for each scale are displayed in Table 2. There were significant sex differences for Brooding at Time 2 and for the IDDL. All of the analyses described below were repeated after controlling for sex, and similar results were observed. Therefore, the analyses are not described after controlling for sex, since sex was not a variable of interest. 6 Confirmatory Factor Analysis was conducted to confirm the factor structure of the Japanese RRS (i.e., Brooding and Reflection). In line with Treynor, et al. (2003) and other previous studies (e.g., Schoofs, et al., 2010 ; Hasegawa, 2013 ), the 12 depression-related items were removed and the 10 items that assessed Brooding and Reflection were subjected to factor analysis. Goodness-of fit indices for the model were examined using 6 Depressive rumination has been proposed as an explanation of the increased likelihood of depression in women than in men, and this notion has been supported by a number of studies (see Nolen-Hoeksema, et al., 2008 for review). However, a previous study conducted in Japan by Sakamoto, Kambara, and Takano (2001), using a different version of the RRS from that later revised by Treynor, et al. (2003), did not show significant sex differences in RRS scores. Also, re-analysis of the data by Hasegawa (2013) has indicated that there are no sex differences in the total scale and subscales scores of the Japanese RRS.

10 BROODING, REFLECTION, AND DEPRESSION 575 the Comparative Fit Index (CFI), the Normed Fit Index (NFI), the Non- Normed Fit Index (NNFI), the Root Mean Square Error of Approximation (RMSEA), and the consistent version of Akaike's Information Criterion (CAIC). CFI, NFI, NNFI, and RMSEA values range from 0 to 1. CFI, NFI, and NNFI values above.90 represent a good model fit, whereas RMSEA values of less than.08 demonstrate an acceptable model fit. Parsimony was assessed using the CAIC, with smaller values representing a better fit. The resulting fit indices indicated that a two-factor model of the RRS showed a moderate fit to the data (CFI =.87, NFI =.84, NNFI =.83, RMSEA =.098, & CAIC = ). Moreover, the fit indices of the two-factor model were better than those for a unidimensional model in which the 10 items of Brooding and Reflection comprised one factor (CFI =.77, NFI =.75, NNFI =.71, RMSEA =.129, & CAIC = ). Correlations between each measure are displayed in Table 3. The correlation between Brooding and Reflection was.48 at Time 1 and.49 at Time 2. These coefficients were slightly higher than those obtained by Treynor, et al. (2003 ; r s =.37.42) and Schoofs, et al. (2010 ; r s =.33.42), but lower than that obtained by Pearson, et al. (2010 ; r =.72). The Brooding score was correlated with the CES D score assessed simultaneously at Times 1 and 2 ( r s =.50 and.46, respectively). The Reflection subscale score, compared to the Brooding score, was correlated weakly with the CES D score assessed simultaneously, at Times 1 and 2 ( r s =.30 and.29, respectively). Student t tests were conducted to examine statistically significant differences in correlations between Brooding and Reflection subscale scores with the CES D score at identical time points. Results indicated that the correlation between Brooding score and CES D score at Time 1 was significantly stronger than TABLE 3 C ORRELATIONS BETWEEN EACH MEASURE Brooding, Time 1 2. Brooding, Time Reflection, Time Reflection, Time RRS Total, Time RRS Total, Time CES D, Time CES D, Time IDDL Note. CES D = Center tor Epidemiologic Studies Depression Scale; RRS = Ruminative Responses Scale; IDDL = Inventory to Diagnose Depression, Lifetime Version. All correlations statistically significant at p <.001.

11 576 A. HASEGAWA, ET AL. that with Reflection subscale score at Time 1 ( t 375 = 4.39, p <.001). Also, the correlation between Brooding score and CES D score at Time 2 was significantly stronger than that with the Reflection score at Time 2 ( t 375 = 3.68, p <.001). These findings corroborated the results reported in previous studies ( Schoofs, et al., 2010 ; Hasegawa, 2013 ). Next, the longitudinal relationships between the RRS subscales at Time 1 and scores for depression assessed at Time 2 were examined. Brooding at Time 1 was positively correlated with CES D at Time 2 and IDDL ( r s =.39 and.45, respectively, p s <.001), and Reflection at Time 1 was positively correlated with both variables ( r s =.25 and.35, respectively, p s <.001). A multiple regression analysis was conducted with Brooding, Reflection, and CES D at Time 1 as independent variables and CES D at Time 2 as a dependent variable. Only CES D at Time 1 predicted CES D at Time 2, and Brooding and Reflection were not significant. The independent variables explained 46.5% of the variance of CES D scores at Time 2. A regression analysis was conducted with the RRS total score and CES D score at Time 1 as independent variables and CES D score at Time 2 as the dependent variable. This showed that both variables were significantly related to CES D scores at Time 2. The independent variables explained 46.8% of the variance in CES D scores at Time 2 (see Table 4 for the detailed results of two regression analyses). Next, a multiple regression analysis was conducted with Brooding, Reflection, and CES D at Time 1 as independent variables and IDDL as a dependent variable. All variables were significantly related to IDDL. The independent variables explained 36.2% of the variance in IDDL scores. A regression analysis was conducted with RRS Total score and CES D scores at Time 1 as independent variables and IDDL scores as a dependent variable. This showed that both variables were significantly related to IDDL scores. The independent variables explained 36.8% of the variance of IDDL scores (see Table 4 for the detailed results of two regression analyses). The test-retest correlations for Brooding, Reflection, and the total score of the RRS were.60,.58,.66, respectively (all p s <.001; see Table 3 ). To assess whether Brooding and Reflection are distinct constructs, we used the analyses described in Treynor, et al. (2003). A multiple regression analysis was run to examine whether Brooding and Reflection at Time 2 were each best predicted by their own scores at Time 1, even after controlling for the other RRS subscale and CES D scores at Time 1. Multiple regression analysis with Brooding at Time 2 as the dependent variable showed that Brooding and CES D scores at Time 1 were significantly related to Brooding at Time 2. The standardized beta of Reflection was not significant. Also, multiple regression analysis with Reflection at Time 2 as the dependent variable

12 BROODING, REFLECTION, AND DEPRESSION 577 TABLE 4 R ESULTS OF MULTIPLE REGRESSION ANALYSES B SE β t p R 2 Adj R 2 F p Dependent variable: CES D, Time 2 Brooding, Time Reflection, Time CES D, Time < <.001 Dependent variable: CES D, Time 2 RRS Total, Time CES D, Time < <.001 Dependent variable: IDDL Brooding, Time <.001 Reflection, Time CES D, Time < <.001 Dependent variable: IDDL RRS Total, Time <.001 CES D, Time < <.001 Dependent variable: Brooding, Time 2 Brooding, Time <.001 Reflection, Time CES D, Time <.001 Dependent variable: Reflection, Time 2 Brooding, Time Reflection, Time <.001 CES D, Time <.001 Note. CES D = Center for Epidemiologic Studies Depression Scale; RRS = Ruminative Responses Scale; IDDL = Inventory to Diagnose Depression, Lifetime Version. showed that only Reflection at Time 1 was significantly related to Reflection at Time 2, and Brooding and CES D scores at Time 1 were not significantly related. This showed that Brooding and Reflection at Time 2 were each best predicted by their own subscale scores at Time 1, even after controlling for the other RRS subscale and CES D scores at Time 1 (see Table 4 for the detailed results of two regression analyses). D ISCUSSION The first purpose of the present study was to examine whether Brooding was associated positively with future depression scores, and whether Reflection was associated negatively with depression, as had been found in previous studies conducted in Western countries. A multiple regression analysis showed that Brooding at Time 1 was not significantly related to CES D scores at Time 2. However, the same regression analysis showed

13 578 A. HASEGAWA, ET AL. that Brooding at Time 1 was significantly related to IDDL scores. Therefore, the hypothesis that Brooding was related longitudinally to depression was supported by the analysis with IDDL as a dependent variable. Why did this inconsistency between predictions of CES D and IDDL scores occur? In the regression analysis with CES D at Time 2 as a dependent variable, the same scale score was entered as an independent variable. It could be argued that Brooding at Time 1 did not explain the residual variance of CES D scores at Time 2 after partialling out the influence of CES D at Time 1, because CES D scores at Time 1 were more strongly related to CES D scores at Time 2, than were IDDL scores assessed at Time 2. Since the correlation between CES D at Times 1 and 2 was slightly higher than that of CES D at Time 1 and IDDL ( r s =.67,.54, respectively), this explanation seems reasonable. To examine longitudinal predictions of rumination measures for depression, baseline depression should be controlled. Future study should re-examine the present findings with depression measures unified at Times 1 and 2. However, because correlation between Brooding at Time 1 and IDDL ( r =.45) was slightly higher than that between Brooding at Time 1 and CES D at Time 2 ( r =.39), it is possible that Brooding was associated more strongly with the construct assessed by IDDL. Therefore, there are two other possible explanations of the inconsistent longitudinal predictions of Brooding for CES D at Time 2 and IDDL. Firstly, the CES D at Time 2 assesses depressive symptoms at Time 2, while the IDDL assesses the severity of the worst episodes of depressive symptoms experienced in the period from Times 1 through 2. Theoretically, depressive rumination (especially the brooding component of rumination) increases the severity and duration of depression (see Nolen- Hoeksema, 1991 ). Some participants experienced their worst episodes of depressive symptoms in the follow-up period at Time 2, whereas others experienced the worst episodes in the days of the follow-up period other than Time 2. Therefore, it is plausible that the Brooding score was longitudinally related to the worst episode of depressive symptoms experienced in the period from Times 1 through 2 (assessed with the IDDL), but that the Brooding score was not related to depressive symptoms at Time 2 (assessed with the CES D). However, the seminal paper of Treynor, et al. (2003) and subsequent studies ( Pearson, et al., 2010 ; Schoofs, et al., 2010 ; Raes, et al., 2012, undergraduate sample) showed that Brooding was significantly related to future BDI or BDI-II scores, which assessed depressive symptoms at Time 2. Therefore, it is possible that Brooding is significantly related to depressive symptoms at follow-up times, as assessed with measures other than the CES D. The second possibility involves the constructs each of the depression scales assesses. The IDDL, BDI, and BDI-II are composed of items repre-

14 BROODING, REFLECTION, AND DEPRESSION 579 senting the symptom criteria for major depressive episodes. On the other hand, the items of the CES D do not cover all of the symptoms of major depression (e.g., suicidal ideation and attempts) and include four reversescored items. Positive emotions and cognitions that are assessed with the reverse-scored items have different functions than negative emotions and cognitions, which are the main symptoms of depression (e.g., Brown, Chorpita, & Barlow, 1998 ). Therefore, the CES D, which was developed for use with general populations, may assess depressive mood states, but not clinical depressive symptoms in the same way as more clinical instruments. Previous studies have demonstrated that Brooding was significantly related to future depression utilizing the BDI and BDI-II ( Treynor, et al., 2003 ; Pearson, et al., 2010 ; Schoofs, et al., 2010 ; Raes, et al., 2012, undergraduate sample). The present study also showed that Brooding was significantly related to IDDL scores, which represent the symptom criteria for major depression, similar to the BDI-II. Therefore, it is plausible that Brooding is associated with symptoms of clinical depression that are listed as the A criteria for major depressive episodes (DSM-IV TR; American Psychiatric Association, 2000 ). In line with this suggestion, Raes, et al. (2012) conducted a regression analysis, on the secondary school student sample using the Depression subscale score of the Depression Anxiety Stress Scale as the dependent variable, and found that Brooding was not significantly related to depression measured 3 mo. later. This could be because the DASS, similar to the CES D, does not cover all the symptoms of major depression (e.g., suicidal ideation and attempts, and indecisiveness) and may only assess depressive mood states. Examination of the possibility that Brooding is associated with symptoms of clinical depression is important to evaluate whether the Brooding scale of the Japanese RRS has similar psychometric properties as versions in other languages. Future research should utilize the BDI-II as a dependent variable in a longitudinal study to compare the psychometric properties of the Japanese Brooding scale and other language versions. In terms of Reflection, similar longitudinal predictions were found as for Brooding: Reflection did not predict CES D scores at Time 2 but predicted IDDL scores. Importantly, the association between Reflection and IDDL scores was positive, indicating that people with frequent Reflection also experience increased future depression. Treynor, et al. (2003) found that the standardized beta of Reflection for depression assessed at 1 yr. follow-up was negative, which is inconsistent with the present findings. Subsequent studies have shown that the standardized betas of Reflection for depression assessed after 3 to 6 mo. were negative, although not significant (range.06 to.01; Schoofs, et al., 2010 ; Raes, et al., 2012 ). It is possible that the inconsistent findings between the present study and

15 580 A. HASEGAWA, ET AL. previous studies are due to cultural differences between participants in this and previous studies. Treynor, et al. (2003) suggested that Reflection may eventually be adaptive in reducing negative affect, perhaps because it leads to effective problem solving (p. 257). In line with this suggestion, Marroquin, et al. (2010) showed that Reflection, in comparison to Brooding was significantly correlated with active coping, and weakly correlated with passive coping. The above possibility in combination with the findings of this study suggest that because Reflection leads to active social problem solving in Western populations, their thought patterns could be negatively related to depression, or have a non-significant relationship with depression. In the present study, Reflection was positively related to IDDL scores. This finding together with the above suggestions indicates the possibility that reflective thought patterns in Japanese people seldom lead to active social problem solving and may cause repetitive and negative cognitive processes. However, this possibility has never been investigated. We are currently conducting a study to investigate the relationships between depressive rumination and social problem solving in a Japanese sample. The results of this study may show whether or not Reflection in Japanese people leads to active problem solving. There are other possible explanations of the inconsistency, including the different measures of depression (BDI or IDDL), or simply a failure of replication. However, Reflection is associated with more suicidal ideation ( Miranda & Nolen- Hoeksema, 2007 ; Surrence, et al., 2009 ), indicating that Reflection has some maladaptive aspects. Therefore, it is necessary to re-examine the psychometric properties of Reflection from the Japanese RRS and other language versions in the future. In the present study, Brooding and Reflection showed similar longitudinal predictions for depression. Therefore, it is possible to argue that Brooding and Reflection subscales of the Japanese RRS were not distinct subcomponents. The correlations between Brooding and Reflection in the present study were slightly higher than those obtained in Treynor, et al. (2003) and Schoofs, et al. (2010). Also, CFA of the present data indicated that the two-factor model of the RRS showed a moderate fit to the data. However, the fit indices of the two-factor model were better than those of a unidimensional model, indicating that the 10 items assessing Brooding and Reflection consists of two subscales, rather than one factor. Moreover, the fit indices of the present study were similar to those of the same model obtained in Schoofs, et al. (2010 ; CFI =.87, NFI =.85, RMSEA =.14). 7 The correlations between Brooding and Reflection in the present study were lower than that obtained by Pearson, et al. (2010), indicating that the indepen- 7Schoofs, et al. (2010) indicated that the modified model, with error covariances between two pairs of items allowed, showed acceptable fit to the data (CFI =.96, NFI =.94, RMSEA =.08).

16 BROODING, REFLECTION, AND DEPRESSION 581 dence of RRS subscales was no more problematic in the Japanese translation than in other language versions of the RRS. In addition, the present study showed that Brooding and Reflection at 8 wk. were best predicted by the prior score of each subscale, even after controlling for the other RRS subscale score and baseline depression level. This is consistent with the formulation of Treynor, et al. (2003) that Brooding and Reflection are distinct components. More studies are needed to examine the factor structure and discrimination of the two subscales of the Japanese RRS. The present study showed that the RRS Total score was significantly related to depression, assessed with the CES D and IDDL at follow-up. The reason for the discrepancy between the significant longitudinal association of the total RRS score for CES D and the non-significant association of Brooding score could be due to the different number of items in the two scales. Cronbach's alpha of the RRS total scale at Time 1 (.91) was higher than that of Brooding at Time 1 (.77). It is plausible that the lower internal consistency of the Brooding weakened its longitudinal association with depression. It could be assumed that because the total RRS scale has 12 depression-related items, these items simply reflect the severity of depressive symptoms, rather than ruminative tendencies. However, since the longitudinal association of the RRS Total scale was examined after controlling for baseline depression scores, the significant longitudinal association of the RRS could not be simply the result of depression-related items of the RRS. Moreover, it has been reported that people with major depression in remission scored higher on the RRS Total scale than those who had never been depressed ( Joormann, et al., 2006 ; Beevers, et al., 2007 ), indicating that the RRS Total scale score was not contaminated by depressive symptoms at the same time point. Therefore, it is concluded that the Japanese version of the total RRS scale is a valid instrument for assessing vulnerability to depression and for research and clinical purposes. The second purpose of the present study was to examine the testretest reliability of the Japanese RRS with a relatively large sample. The test-retest correlations of both subscales were in the moderate range, and similar to the values obtained in previous studies conducted in Japan and Western countries (see Table 1 ). These results are consistent with the general idea that response styles, as assessed with the Brooding and Reflection subscales, represent relatively trait-like characteristics. In addition, these findings indicate that the reliability of the Japanese Brooding and Reflection subscales, is similar to the other language versions. Overall, the present study showed that the Brooding and Reflection subscales of the Japanese RRS at Time 1 were not significantly related to CES D scores at Time 2, but were associated positively with IDDL scores. These longitudinal predictions using each subscale were not completely consistent

17 582 A. HASEGAWA, ET AL. with findings from other language versions of the RRS. The inconsistencies might be due to different depression measures utilized as dependent variables, or cultural differences. Second, CFA with the present data indicated that the two-factor model of the Japanese RRS showed a moderate fit to the data. More information about the factor structure of the Japanese RRS is necessary. Thirdly, at least the total scale of the Japanese RRS can be utilized to assess vulnerability for depression. Fourthly, the subscales of the Japanese RRS have similar test-retest reliability as found with other language versions. Finally, consistent with Treynor, et al. (2003), Brooding and Reflection at the follow-up test were best predicted by their own prior scores, indicating that Brooding and Reflection are distinct components. The RRS has been utilized in a number of basic scientific studies and clinical outcome studies. The comparability of the psychometric properties of the scales is important for the use of these scales in research on depression in Japan. The present findings indicate that most aspects of the Japanese RRS are similar to other language versions, while some aspects may be different. This must be considered when the Japanese RRS is utilized and results are interpreted. Also, these consistencies and inconsistencies need to be replicated. There are some limitations in the present study. The correlations between depression measures (especially CES D) assessed at Times 1 and 2 were rather high, which might have made the longitudinal association of rumination measures for depression weaker. For practical reasons, an 8-wk. interval between the baseline and follow-up assessments was adopted, but this short interval might have lead to increased correlations between scores on depression measures assessed at Times 1 and 2. It is suggested that future studies should adopt a longer interval between the two assessments. Participants were university students rather than a clinical population. Information about psychometric properties of the Japanese RRS and the longitudinal associations of its subscales for depression in the clinical sample would be valuable for the clinical practice. It is possible that in clinical populations, Brooding would be related positively to the CES D score assessed after an interval of 8 wk. and Reflection would be related negatively to the future CES D score, although this is speculative, because only a few studies (e.g., Arditte & Joormann, 2011 ) have examined the longitudinal relationships between the RRS subscales and depression. 8 Future studies should re-examine the relationships among Brooding, Reflection, and depression in clinical samples. The data were self-report measures to assess mood status, so future studies should re- 8 Arditte and Joormann (2011) examined the longitudinal predictions of Brooding and Reflection after controlling for other emotional regulation strategies. Because direct comparison between the present study and Arditte and Joormann (2011) is impossible, we have not described the findings in detail.

18 BROODING, REFLECTION, AND DEPRESSION 583 examine the relationships using observer-rated scales, such as the Hamilton Rating Scale for Depression. REFERENCES A MERICAN PSYCHIATRIC ASSOCIATION. (2000) Diagnostic and statistical manual of mental disorders. (4th ed., text rev.) Washington, DC : Author. ARDITTE, K. A., & JOORMANN, J. (2011) Emotion regulation in depression: reflection predicts recovery from a major depressive episode. Cognitive Therapy and Research, 35, B ECK, A. T., S TEER, R. A., & BROWN, G. K. (1996) Manual for the Beck Depression Inventory II. San Antonio, TX : The Psychological Corporation. B ECK, A. T., W ARD, C. H., MENDELSON, M., M OCK, J., & ERBAUGH, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, B EEVERS, C. G., ROHDE, P., S TICE, E., & NOLEN-HOEKSEMA, S. (2007) Recovery from major depressive disorder among female adolescents: a prospective test of the scar hypothesis. Journal of Consulting and Clinical Psychology, 75, B ROWN, T. A., C HORPITA, B. F., & BARLOW, D. H. (1998) Structural relationships among dimensions of the DSM IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107, B UTLER, L. D., & NOLEN-HOEKSEMA, S. (1994) Gender differences in responses to depressed mood in a college sample. Sex Roles: A Journal of Research, 30, DEBEER, E., HERMANS, D., & RAES, F. (2009) Associations between components of rumination and autobiographical memory specificity as measured by a Minimal Instructions Autobiographical Memory Test. Memory, 17, D ONALDSON, C., & LAM, D. (2004) Rumination, mood and social problem-solving in major depression. Psychological Medicine, 34, HARRIS, P. W., PEPPER, C. M., & MAACK, D. J. (2008) The relationship between maladaptive perfectionism and depressive symptoms: the mediating role of rumination. Personality and Individual Differences, 44, H ASEGAWA, A. (2013) Translation and initial validation of the Japanese version of the Ruminative Responses Scale. Psychological Reports, 112, J OORMANN, J., D KANE, M., & GOTLIB, I. H. (2006) Adaptive and maladaptive components of rumination: diagnostic specificity and relation to depressive biases. Behavior Therapy, 37, L AVENDER, A., & WATKINS, E. (2004) Rumination and future thinking in depression. British Journal of Clinical Psychology, 43, LOVIBOND, P. F., & LOVIBOND, S. H. (1995) The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, L YUBOMIRSKY, S., C ALDWELL, N. D., & NOLEN-HOEKSEMA, S. (1998) Effects of ruminative and distracting responses to depressed mood on retrieval of autobiographical memories. Journal of Personality and Social Psychology, 75, LYUBOMIRSKY, S., & NOLEN-HOEKSEMA, S. (1995) Effects of self-focused rumination on negative thinking and interpersonal problem solving. Journal of Personality and Social Psychology, 69,