A Prospective Longitudinal Study of Repetitive Thought as a Vulnerability Factor for Depression in Patients with Coronary Heart Disease (CHD)

Abstract

Objective: Theoretical and empirical evidence suggests a relationship between Repetitive Thought (RT, e.g. rumination), and depression in patients with Coronary Heart Disease (CHD). To date, cross-sectional studies indicate that rumination is associated with depression in CHD, but additional prospective longitudinal research is required to determine if rumination predicts subsequent depression. This research therefore aimed to test the hypothesis that RT, specifically rumination, is a vulnerability factor for depression over time in a CHD population. It was predicted that RT at baseline would predict depression rates at three month follow-up after controlling for baseline depression and potential confounding factors. Methods: Inpatients and outpatients with a diagnosis of CHD completed self-report questionnaires at baseline (N = 101) and at three month follow-up (N = 85). The data was analysed using a hierarchical multiple regression. Results: Baseline rumination significantly predicted depression at the three month follow-up after controlling for baseline depression and potential confounding factors. Rumination accounted for 8.3% of the variance (p< .001). Subscales of brooding and reflection were also found to be individually predictive of follow-up depression explaining 4% of the variance (p< .005) and 7% of the variance (p< .001) respectively. Conclusion: Findings are consistent with previous prospective and cross-sectional research that indicates that rumination plays a unique role in the maintenance of depression in CHD patients and is an identifiable vulnerability factor.