Does culture moderate the relationships between rumination and symptoms of posttraumatic stress disorder and depression?

Haoxiang Li; Bryan Lee; Tamsyn Reyneke; Shamsul Haque; Siti Zainab Abdullah; Britney Kerr Wen Tan; Belinda Liddell; Laura Jobson

doi:10.1371/journal.pone.0278328

Abstract

Brooding rumination is positively associated with symptoms of both depression and posttraumatic stress disorder (PTSD). However, non-clinical cross-cultural research indicates that culture may influence these associations. This study aimed to examine the moderating effect of cultural group (Australian versus Malaysian) on the associations between brooding rumination and symptoms of depression and PTSD. European Australians (n = 109) and Malaysians of varying Asian heritages (n = 144) completed an online questionnaire containing the Hospital Anxiety and Depression Scale, PTSD checklist for DSM-5 and the Ruminative Response Scale-Short Form. First, Malaysian participants had higher brooding rumination than Australian participants. Second, higher levels of brooding rumination were positively associated with depression and PTSD symptom severity. Third, contrary to our expectations, cultural group did not moderate the relationships between brooding rumination and symptoms of depression and PTSD. If replicable, these results suggest that existing assessment and treatment approaches that target brooding rumination may apply to Malaysian individuals with depression and PTSD.

Citation: Li H, Lee B, Reyneke T, Haque S, Abdullah SZ, Tan BKW, et al. (2022) Does culture moderate the relationships between rumination and symptoms of posttraumatic stress disorder and depression? PLoS ONE 17(11): e0278328. https://doi.org/10.1371/journal.pone.0278328

Editor: Rogis Baker, Universiti Pertahanan Nasional Malaysia, MALAYSIA

Received: July 9, 2022; Accepted: November 15, 2022; Published: November 29, 2022

Copyright: © 2022 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data is available at https://osf.io/g6h8a/.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Brooding rumination, defined as repetitively dwelling on the causes, consequences and meaning of one’s negative emotions, is a transdiagnostic process associated with the etiology and maintenance of several psychiatric disorders [1]. Posttraumatic stress disorder (PTSD) and depression are two psychiatric disorders that have received considerable attention in terms of brooding rumination and symptom severity. Globally, depression and PTSD are pervasive debilitating mental health disorders, recognized in most societies and cultures, and associated with numerous adverse outcomes for affected individuals and society [2, 3]. Considering the prevalence and adverse consequences of PTSD and depression worldwide, it is important to investigate factors that may contribute to these disorders and identify how culture may influence such factors.

Research has consistently implicated brooding rumination in the onset and maintenance of depression. For instance, brooding rumination predicts the onset of depression, serves as a moderator between negative affect and depression symptoms, and mediates the relationship between several known vulnerabilities of depression and depression symptomatology [4–6]. The Response Styles Theory [7] posits that brooding rumination triggers and intensifies depression by a) prompting individuals to think negatively about their past, present and future, b) impeding effective problem-solving, c) inhibiting the use of goal-directed behaviour, and d) eroding social support.

Brooding rumination is also consistently associated with higher PTSD symptomatology. Two recent meta-analyses found moderate to strong associations between rumination and PTSD symptoms [8, 9]. Researchers propose that that repetitively dwelling on the negative outcomes of trauma can generate more negative trauma-related appraisals, thus increasing arousal and anxiety symptoms [10–12]. Consequently, this enhances the association between traumatic stimuli and fear and perpetuates PTSD symptoms through memory biases [10–12]. Brooding rumination can also impede PTSD treatment efforts [13].

Thus, there is considerable evidence demonstrating the relationship between brooding rumination and these two psychiatric conditions, which in turn informs current psychological treatments. However, this evidence base is almost entirely derived from Western samples. Consequently, the dominant paradigm that suggests rumination is universally associated with increased psychopathology, is a notion based largely on Western research and cultural values. This is a key limitation given that (1) globally, many individuals with depression and PTSD do not come from Western cultural backgrounds, and (2) accumulating research suggests that the relationship between brooding rumination and psychopathology may vary between different cultural groups. It is important to address this concerning limitation because clinical guidelines highlight the importance of cultural tailoring in clinical practice, yet there is little research to support these practices [2, 14], and treatment effects improve significantly when interventions are culturally-tailored [15]. Thus, it is crucial to explore how culture may moderate the relationship between brooding rumination and psychopathology to improve culturally-tailored treatment approaches.

Accumulating research indicates that brooding rumination is more common in Asian than Western individuals [16]. Despite this, brooding rumination has been found to be less associated with poor psychological outcomes, including anxiety, depression and life dissatisfaction, in Asian individuals compared to Western individuals [17, 18]. Two key cultural differences have been proposed to account for these findings. First, Asian collectivistic cultures tend to value negative emotions more favourably than Western, individualistic cultures [16, 19] and often encourage brooding rumination and self-criticism as a means of maintaining group harmony [20–22]. As such, Asian individuals may be less likely to get ‘stuck’ in their negative emotions, leaving more room for flexible and adaptive reflection [16]. Second, in Asian collectivistic cultures, when compared to Western individualistic cultures, there is an increased tendency to self-distance from emotional experiences and focus more on contextual factors [16]. Thus, thinking repetitively about the past may be less likely to increase distress in individuals from Asian cultures. While these studies indicate that cultural factors may influence the psychological outcomes of brooding rumination, little research has examined cultural differences in brooding rumination in clinical populations and of the very few studies that have, all have been conducted within Western countries [23].

Additionally, cross-cultural non-clinical research in this area is limited by its sampling of mostly American and Chinese populations. Australia and Malaysia are two heavily underrepresented populations. While Australia and America are both portrayed as individualistic societies [24], Australians have lower autonomy needs than Americans and may not be as individualistic as America [25]. Similarly, Malaysia is a multi-cultural society primarily populated by individuals of Malay, Chinese and Indian heritage [26]. Like China, Malaysia is considered to be collectivistic [26]. However, the presence of other cultural factors within Malaysian societies may influence their social emphasis on collectivism [27]. For instance, unlike Chinese cultures which base their collectivisms on Confucianism, Malaysians also obtain their emphasis on collectivism from the traditional cultures of Islam and the indigenous Malay [27]. Hence, it is crucial to explore the relationships between brooding rumination and psychological adjustment in varying Western individualistic and Asian collectivistic cultures.

This study aimed to investigate the moderating effect of cultural group on the association between brooding rumination and symptoms of PTSD and depression within an Asian collectivistic (Malaysia) and Western individualistic (Australia) cultural context. We hypothesized that there would be greater brooding rumination reported by the Malaysian group than the Australian group (Hypothesis 1). Second, brooding rumination would be positively associated with both depression and PTSD symptom severity (Hypothesis 2). Third, cultural group would moderate the associations between brooding rumination and both depression and PTSD symptoms, such that brooding rumination would be more strongly associated with symptom severity in the Australian group than Malaysian group (Hypothesis 3).

Method

Participants

Given the prevalence of depression and trauma-exposure in the general community, a general community sample provided a wide range of symptomatology allowing for the hypothesized relationships to be examined. Utilising G*Power [28], with a small-moderate effect size (f² = .14) [29], an alpha of .05 and power of .80, 101 participants (50 per cultural group) were found to be sufficient to power all hypotheses. Using convenience sampling, 253 participants (109 Australian, 144 Malaysian) were recruited from the general community. Eligibility criteria included being a) between 18 and 65 years of age, b) able to read and complete the questionnaire in English or Malay, and c) either residing in Australia and identifying as having European heritage or residing in Malaysia and identifying as having either Malay, Indian or Chinese heritage. Additionally, to be included in the PTSD analyses, participants had to have been exposed to a Criterion A trauma experience as indexed on the Life Events Checklist-5 [30] (Australian n = 107, Malaysian n = 121).

Measures

Hospital Anxiety and Depression Scale (HADS).

The depression subscale of the HADS (HADS-D) [31] was used to measure depression symptoms. The subscale contains seven items scored on 4-point Likert-type scales (0 = not at all to 3 = definitely). Individual item scores were summed (five items are reversed scored) to give a total depression score ranging from 0 to 21, with higher scores indicating greater depression symptom severity. This measure has demonstrated good validity and reliability, including in cross-cultural research [32]. In this study the HADS-D demonstrated acceptable internal consistency (Australia α = .78, Malaysia α = .80).

PTSD Checklist for DSM-5 (PCL-5) with Life Events Checklist for DSM-5 (LEC-5).

The PCL-5 with LEC-5 [30] assessed trauma exposure and PTSD symptom severity. The LEC-5 screens for exposure to traumatic events in a respondent’s lifetime. Participants identify their worst single traumatic event; the index trauma. The LEC-5 is not scored, but used to ensure trauma exposure (i.e., eligibility criteria) and categorise participants’ index traumas. The PCL-5 checklist is a 20-item self-report questionnaire that assesses PTSD symptom severity in relation to the respondent’s index trauma. Items are scored using 5-point Likert scales (0 = not at all to 4 = extremely). Scores are summed to yield a total score ranging from 0–80, with higher scores indicating greater PTSD symptom severity. The PCL-5 has demonstrated good psychometric properties, including in cross-cultural research [33]. In the present study, internal consistency was excellent (Australian α = .95; Malaysian α = .96).

Ruminative Response Scale-Short Form (RRS-SF).

Brooding rumination was measured using the brooding subscale of the RRS-SF (RRS-B) [34]. The five items were scored on 4-point Likert-type scales (1 = almost never to 4 = almost always). Item scores are summed and range from 5 to 20, with higher scores indicating greater levels of brooding rumination. The RRS-B has been shown to have good reliability and validity, including in cross-cultural research [35]. The RRS-B demonstrated good internal consistency in this study (Australian α = .79, Malaysian α = .84).

Conscientious Responders Scale (CRS).

The CRS was utilised to identify participants who answered questions hastily and inaccurately [36]. The five items were interspersed throughout the questionnaire. Each item directly instructs participants on how to answer and is scored as either correct (1) or incorrect (0). Scores ranged from 0–5, and participants who scored less than 3 on the CRS were excluded from data analyses, based on less than 3% of random responders achieving a score of 3 or above by chance alone [36, 37].

Procedure

Ethical approval was obtained from BLINDED. To ensure cultural appropriateness, the study was co-designed by Australian and Malaysian researchers. Following the gold standard approach [38], English measures were translated into Malay and then back-translated into English. The study was advertised on social media (Facebook and Gumtree). Interested respondents contacted the researchers via email and received a link to the online questionnaire (Qualtrics). Participants completed the PCL-5 with LEC-5, HADS-D, RRS-B and demographics. Participants were reimbursed with gift vouchers.

Statistical analyses

All statistical analyses were conducted using SPSS (version 27.0). As some variables did not meet assumptions for normality, bootstrapping was utilised for all analyses. Given significant group differences in age, education and religion, these variables were included as covariates. A subset of the sample (n = 228) was included in the PTSD analyses; to be included in the PTSD analyses participants had to have been exposed to a Criterion A trauma experience. To test Hypothesis 1, a one-way analysis of covariance was conducted comparing the Malaysian and Australian groups with brooding rumination as the dependent variable. To assess Hypothesis 2, Spearman’s correlation analysis examining the associations between brooding rumination, depression and PTSD symptoms were conducted in the overall sample, and for each separate group. To test Hypothesis 3, two moderation analyses (model 1) using PROCESS v3.5 [39] were conducted to determine whether cultural group moderated the associations between 1) brooding rumination and depression symptoms, and 2) brooding rumination and PTSD symptoms. Significance of results was indicated by 95% confidence intervals not including zero.

Results

Table 1 presents participant characteristics and shows significant group differences for age, education, religion and time since trauma.

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Table 1. Participant characteristics.

https://doi.org/10.1371/journal.pone.0278328.t001

Hypothesis 1

As shown in Table 1, Malaysian participants had significantly greater brooding rumination than Australian participants, F(1, 228) = 5.77, p = .02, .

Hypothesis 2

There was a statistically significant, moderate positive correlation between brooding rumination and depression, r_s(251) = .42, 95%CI [.29, .52], p < .001, and between PTSD and brooding rumination, rs(226) = .51, 95%CI [.40, .60], p < .001. When examining each cultural group separately, there was a statistically significant positive associations between brooding rumination and depression in the Malaysian, r_s(142) = .50, 95%CI [.36, .62], p < .001, and Australian groups, r_s(107) = .31, 95%CI [.10, .50], p = .001, and between brooding rumination and PTSD in the Australian, rs(105) = .43, 95%CI [.26, .57], p < .001 and Malaysian groups, rs(119) = .59, 95%CI [.45, .70], p < .001. The PTSD findings were similar when trauma type and time since trauma were included as covariates.

Hypothesis 3

Table 2 presents the results of the moderation analyses. There was no evidence that cultural group moderated the associations between brooding rumination and depression, F(1, 249) = 3.03, p = .08, R²Δ = .01, or brooding rumination and PTSD symptoms, F(1, 220) = 2.06, p = .15, R²Δ < .01. The PTSD findings were similar when trauma type and time since trauma were included as covariates.

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Table 2. Summary of moderation analyses.

https://doi.org/10.1371/journal.pone.0278328.t002

Discussion

This study investigated the moderating effect of cultural group (Australia vs Malaysia) on the relationships between brooding rumination and symptoms of depression and PTSD. In support of Hypothesis 1, we found that Malaysian participants had higher levels of brooding rumination compared to Australian participants. In support of Hypothesis 2, brooding rumination was significantly associated with both greater depression and PTSD symptom severity. Inconsistent with Hypothesis 3, we did not find a significant moderating effect of cultural group on the relationship between brooding rumination and either depression or PTSD symptom severity.

Our finding that Malaysians reported higher levels of brooding rumination compared to Australians aligns with previous cross-cultural non-clinical research; members of collectivistic cultures (e.g., Malaysia) tend to brood more than members of individualistic cultures (e.g., Australia) [18, 29, 40]. In relation to Hypothesis 2, we found that brooding rumination was positively associated with both depression and PTSD symptom severity in both Australian and Malaysian groups, which also aligns with previous literature indicating that brooding rumination is associated with increased psychopathology [9, 41].

However, there was no evidence of a moderating effect of cultural group on the relationship between brooding rumination and either symptoms of PTSD or depression. This observation does not align with the expected cross-cultural differences theorized and observed in non-clinical research which indicates brooding rumination is less associated with psychopathology for Asian individuals than Western individuals [16–18]. Our results suggest that these cultural differences observed in the non-clinical literature may not extend to clinical populations. It is possible that at higher levels of psychopathology, the strong negative effect of brooding rumination may override the cultural differences found in healthy populations. Such a notion is consistent with existing literature which implicates high levels of brooding rumination as a transdiagnostic maintenance factor across many disorders [41], which may play a role regardless of cultural background [23]. Thus, when considering psychopathology, brooding rumination may be similarly maladaptive.

If such findings are robust and replicable across other cultures, existing clinical models, which implicate brooding rumination in the maintenance of depression and PTSD (e.g., [7, 11]), may be applicable cross-culturally. Additionally, as existing evidence-based treatments for depression and PTSD recommend brooding rumination as a key target [8, 42, 43], such a target may be suitable for Malaysian clients. However, future research is needed to further understand the content and form of brooding rumination in Malaysian clinical populations and the influence of culture on the role of brooding rumination in psychopathology.

The study had several limitations. First, we did not measure participants’ cultural views and beliefs, and instead utilised nationality (Australian or Malaysian) and cultural heritage as an indicator of cultural orientation. While this approach was consistent with previous cross-cultural research [29, 44], future research could also examine cultural values at the individual level [45]. Second, we did not utilise a clinical sample. Third, the cross-sectional study design does not allow for causal inferences to be made. Finally, there were significantly more females than males in our study. Females tend to ruminate more on their depressive symptoms [46, 47]. Consequently, the mean levels of brooding rumination and depression symptoms could have been inflated by the imbalanced gender ratios of participants in the study. Despite these limitations, we found Malaysians had higher levels of brooding rumination than Australians, and that brooding rumination was positively associated with PTSD and depression symptom severity in both cultural groups.

Acknowledgments

A special thanks to all the participants that entered the study.

References

1. Johnson DP, Rhee SH, Friedman NP, Corley RP, Munn-Chernoff MA, Hewitt JK, et al. A twin study examining rumination as a transdiagnostic correlate of psychopathology. Clinical Psychological Science [Internet]. 2016 Nov 1 [cited 2022 Jun 22];4(6):971–87. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=2ed20b76-ae50-3699-9a63-c4e6c9e7b96d pmid:28111610
- View Article
- PubMed/NCBI
- Google Scholar
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5^th ed. American Psychiatric Association Publishing; 2022.
3. World Health Organization. Depression fact sheet [Internet]. World Health Organization; 2020 [updated 13 Sep 21; cited 2022 Jun 22]. https://www.who.int/news-room/fact-sheets/detail/depression
4. Krause ED, Vélez CE, Woo R, Hoffmann B, Freres DR, Abenavoli RM, et al. Rumination, depression, and gender in early adolescence: A longitudinal study of a bidirectional model. J Early Adolesc [Internet]. 2018 [cited 2022 Jun 22];38(7):923–46. Available from: http://dx.doi.org/10.1177/0272431617704956
- View Article
- Google Scholar
5. Verstraeten K, Bijttebier P, Vasey MW, Raes F. Specificity of worry and rumination in the development of anxiety and depressive symptoms in children: Specificity of worry and rumination. Br J Clin Psychol [Internet]. 2011 [cited 2022 Jun 22];50(4):364–78. Available from: http://dx.doi.org/10.1348/014466510X532715
- View Article
- Google Scholar
6. Yoon KL, Maltby J, Joormann J. A pathway from neuroticism to depression: examining the role of emotion regulation. Anxiety Stress Coping [Internet]. 2013 [cited 2022 Jun 22];26(5):558–72. Available from: http://dx.doi.org/10.1080/10615806.2012.734810 pmid:23078141
- View Article
- PubMed/NCBI
- Google Scholar
7. Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol [Internet]. 1991 [cited 2022 Jun 22];100(4):569–82. Available from: http://dx.doi.org/10.1037/0021-843x.100.4.569 pmid:1757671
- View Article
- PubMed/NCBI
- Google Scholar
8. Moulds ML, Bisby MA, Wild J, Bryant RA. Rumination in posttraumatic stress disorder: A systematic review. Clin Psychol Rev [Internet]. 2020 [cited 2022 Jun 22];82(101910):101910. Available from: http://dx.doi.org/10.1016/j.cpr.2020.101910 pmid:32971312
- View Article
- PubMed/NCBI
- Google Scholar
9. Seligowski AV, Lee DJ, Bardeen JR, Orcutt HK. Emotion regulation and posttraumatic stress symptoms: a meta-analysis. Cogn Behav Ther [Internet]. 2015 [cited 2022 Jun 22];44(2):87–102. Available from: http://dx.doi.org/10.1080/16506073.2014.980753 pmid:25421727
- View Article
- PubMed/NCBI
- Google Scholar
10. Dalgleish T. Cognitive approaches to posttraumatic stress disorder: the evolution of multirepresentational theorizing. Psychological Bulletin [Internet]. 2004 Mar 1 [cited 2022 Jun 22];130(2):228–60. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=0313daff-2821-31f4-9559-03cbefcf392a pmid:14979771
- View Article
- PubMed/NCBI
- Google Scholar
11. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy [Internet]. 2000 Jan 1 [cited 2022 Jun 22];38(4):319–45. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=ec694699-ded7-3f36-8cc2-dc5f559a98eb pmid:10761279
- View Article
- PubMed/NCBI
- Google Scholar
12. Williams JMG, Barnhofer T, Crane C, Herman D, Raes F, Watkins E, et al. Autobiographical memory specificity and emotional disorder. Psychol Bull [Internet]. 2007 [cited 2022 Jun 22];133(1):122–48. Available from: http://dx.doi.org/10.1037/0033-2909.133.1.122 pmid:17201573
- View Article
- PubMed/NCBI
- Google Scholar
13. Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies / edited by Edna B. Foa… [and others] [Internet]. Guilford Press; 2009 [cited 2022 Jun 22]. https://discovery.ebsco.com/linkprocessor/plink?id=d01f4aab-768b-3ba1-aebc-0706acd571ba
14. Bernal G, Saez-Santiago E. Culturally centered psychosocial interventions. Journal of Community Psychology [Internet]. 2006 Mar 1 [cited 2022 Jun 22];34(2):121–32. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=7f38362f-23c1-31db-9729-726d81beefb9
- View Article
- Google Scholar
15. Huey SJ Jr., Tilley JL. Effects of mental health interventions with Asian Americans: a review and meta-analysis. Journal of Consulting & Clinical Psychology [Internet]. 2018 Nov 1 [cited 2022 Jun 22];86(11):915–30. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=3a648e28-ee28-3053-b35b-d1bb95d155cf pmid:30335424
- View Article
- PubMed/NCBI
- Google Scholar
16. De Vaus J, Hornsey MJ, Kuppens P, Bastian B. Exploring the East-West divide in prevalence of affective disorder: a case for cultural differences in coping with negative emotion. Personality and social psychology review [Internet]. 2018 Jan 1 [cited 2022 Jun 22];22(3):285–304. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=97416cea-df74-3bd0-a7dc-36f843e537f0 pmid:29034806
- View Article
- PubMed/NCBI
- Google Scholar
17. Bonanno GA, Papa A, Lalande K, Zhang N, Noll JG. Grief processing and deliberate grief avoidance: a prospective comparison of bereaved spouses and parents in the United States and the People’s Republic of China. Journal of Consulting & Clinical Psychology [Internet]. 2005 Feb 1 [cited 2022 Jun 22];73(1):86–98. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=9f3d6d2c-dfbc-3401-88bb-441818c9ff80 pmid:15709835
- View Article
- PubMed/NCBI
- Google Scholar
18. Chang EC, Tsai W, Sanna LJ. Examining the relations between rumination and adjustment: do ethnic differences exist between Asian and European Americans. Asian American Journal of Psychology [Internet]. 2010 Mar 1 [cited 2022 Jun 22];1(1):46–56. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=c2d5b2e7-3afb-3fdd-b9b4-1d89c62ffd08
- View Article
- Google Scholar
19. Zhang M, Cross SE. Emotions in memories of success and failure: a cultural perspective. Emotion [Internet]. 2011 [cited 2022 Jun 22];11(4):866–80. Available from: http://dx.doi.org/10.1037/a0024025 pmid:21707145
- View Article
- PubMed/NCBI
- Google Scholar
20. Fry PS, Grover SC. Cognitive appraisals of life stress and depression in the elderly: a cross-cultural comparison of Asians and Caucasians. International Journal of Psychology [Internet]. 1982 Dec 1 [cited 2022 Jun 22];17(4):437. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=b9934d22-055d-3c2c-b8e8-389544829b14
- View Article
- Google Scholar
21. Kitayama S, Markus HR, Matsumoto H, Norasakkunkit V. Individual and collective processes in the construction of the self: self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology [Internet]. 1997 Jan 1 [cited 2022 Jun 22];72(6):1245–67. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=55a084b1-cc3c-3b02-b10c-9716729822fb pmid:9177018
- View Article
- PubMed/NCBI
- Google Scholar
22. Nisbett RE, Peng K, Choi I, Norenzayan A. Culture and systems of thought: holistic versus analytic cognition. Psychol Rev [Internet]. 2001 [cited 2022 Jun 22];108(2):291–310. Available from: http://dx.doi.org/10.1037//0033-295x.108.2.291 pmid:11381831
- View Article
- PubMed/NCBI
- Google Scholar
23. Nagulendran A, Jobson L. Exploring cultural differences in the use of emotion regulation strategies in posttraumatic stress disorder. Eur J Psychotraumatol [Internet]. 2020 [cited 2022 Jun 22];11(1):1729033. Available from: http://dx.doi.org/10.1080/20008198.2020.1729033 pmid:32158518
- View Article
- PubMed/NCBI
- Google Scholar
24. Church A, Alvarez JM, Katigbak MS, Mastor KA, Cabrera HF, Tanaka-Matsumi J, et al. Self-concept consistency and short-term stability in eight cultures. Journal of Research in Personality [Internet]. 2012 Oct 1 [cited 2022 Jun 22];46(5):556–70. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=a352b519-abd6-39e4-b81a-7ada5637b058
- View Article
- Google Scholar
25. Church T, Katigbak MS, Locke KD, Zhang H, Shen J, de Jesus Vargas-Flores J, et al. Need satisfaction and well-being: testing self-determination theory in eight cultures. Journal of Cross Cultural Psychology [Internet]. 2013 Jan 1 [cited 2022 Jun 22];44(4):507–34. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=aca452c1-f5a1-3091-9346-70c5dcb19081
- View Article
- Google Scholar
26. Tan CB. Ethnic identities and national identities: some examples from Malaysia. Identities [Internet]. 2000 Jan 1 [cited 2022 Jun 22];6(4):441–80. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=e87f46ec-f61e-3bdd-97b8-ebad9ab73604
- View Article
- Google Scholar
27. Chang WC, Osman MMB, Tong EMW, Tan D. Self-construal and subjective well-being in two ethnic communities in Singapore. Psychology [Internet]. 2011 April 2 [cited 2022 Jun 22]; 2(2):63–70. Available from: https://www.scirp.org/journal/paperinformation.aspx?paperid=4426
- View Article
- Google Scholar
28. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods [Internet]. 2007 [cited 2022 Jun 22];39(2):175–91. Available from: http://dx.doi.org/10.3758/bf03193146 pmid:17695343
- View Article
- PubMed/NCBI
- Google Scholar
29. Grossmann I, Kross E. The impact of culture on adaptive versus maladaptive self-reflection. Psychological Science [Internet]. 2010 Aug 1 [cited 2022 Jun 22];21(8):1150–7. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=7cf79047-9384-3930-ad81-e32aad7d6af8 pmid:20624935
- View Article
- PubMed/NCBI
- Google Scholar
30. Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress [Internet]. 2015 [cited 2022 Jun 22];28(6):489–98. Available from: https://pubmed.ncbi.nlm.nih.gov/26606250/ pmid:26606250
- View Article
- PubMed/NCBI
- Google Scholar
31. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand [Internet]. 1983 [cited 2022 Jun 22];67(6):361–70. Available from: http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x pmid:6880820
- View Article
- PubMed/NCBI
- Google Scholar
32. Li Q, Lin Y, Hu C, Xu Y, Zhou H, Yang L, et al. The Chinese version of hospital anxiety and depression scale: psychometric properties in Chinese cancer patients and their family caregivers. European Journal of Oncology Nursing [Internet]. 2016 Dec 1 [cited 2022 Jun 22];25:16–23. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=fc3575aa-782e-32a2-9289-6809972b3e0e pmid:27865248
- View Article
- PubMed/NCBI
- Google Scholar
33. Sveen J, Bondjers K, Willebrand M. Psychometric properties of the PTSD Checklist for DSM-5: a pilot study. Eur J Psychotraumatol [Internet]. 2016 [cited 2022 Jun 22];7(1):30165. Available from: http://dx.doi.org/10.3402/ejpt.v7.30165 pmid:27098450
- View Article
- PubMed/NCBI
- Google Scholar
34. Treynor W, Gonzalez R, Nolen-Hoeksema S. Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research [Internet]. 2003 Jun 1 [cited 2022 Jun 22];27(3):247–59. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=97bcef6c-e224-35ee-b194-34d1898b1fa2
- View Article
- Google Scholar
35. Lee S, Kim W. Cross-cultural adaptation, reliability, and validity of the revised Korean version of Ruminative Response Scale. Psychiatry Investigation [Internet]. 2014 Jan 1 [cited 2022 Jun 22];11(1):59–64. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=c62f6c2e-3850-31f2-8e02-8ba03b29e07d pmid:24605125
- View Article
- PubMed/NCBI
- Google Scholar
36. Marjanovic Z, Struthers CW, Cribbie R, Greenglass ER. The Conscientious Responders Scale: a new tool for discriminating between conscientious and random responders. SAGE Open [Internet]. 2014 [cited 2022 Jun 22];4(3):215824401454596. Available from: http://dx.doi.org/10.1177/2158244014545964
- View Article
- Google Scholar
37. Marjanovic Z, Bajkov L, MacDonald J. The Conscientious Responders Scale helps researchers verify the integrity of personality questionnaire data. Psychol Rep [Internet]. 2019 [cited 2022 Jun 22];122(4):1529–49. Available from: http://dx.doi.org/10.1177/0033294118783917 pmid:29914343
- View Article
- PubMed/NCBI
- Google Scholar
38. Epstein J, Santo RM, Guillemin F. A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus. Journal of Clinical Epidemiology [Internet]. 2015 Apr 1 [cited 2022 Jun 22];68(4):435–41. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=8c2afddc-feb0-3b33-abd9-a568ed16508a pmid:25698408
- View Article
- PubMed/NCBI
- Google Scholar
39. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach / Andrew F. Hayes [Internet]. The Guilford Press; 2013 [cited 2022 Jun 22]. https://discovery.ebsco.com/linkprocessor/plink?id=553e185b-1b86-3781-a932-e5ae8f393391
40. Kwon H, Yoon KL, Joormann J, Kwon J-H. Cultural and gender differences in emotion regulation: relation to depression. Cognition & Emotion [Internet]. 2013 Aug 1 [cited 2022 Jun 22];27(5):769–82. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=4ff92515-9df7-3d5d-80ac-900903270aaa
- View Article
- Google Scholar
41. McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behav Res Ther [Internet]. 2011 [cited 2022 Jun 22];49(3):186–93. Available from: http://dx.doi.org/10.1016/j.brat.2010.12.006 pmid:21238951
- View Article
- PubMed/NCBI
- Google Scholar
42. Ahern E, Kinsella S, Semkovska M. Clinical efficacy and economic evaluation of online cognitive behavioral therapy for major depressive disorder: a systematic review and meta-analysis. Expert review of pharmacoeconomics & outcomes research [Internet]. 2018 Jan 1 [cited 2022 Jun 22];18(1):25–41. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=6cc03ebe-9add-35a7-b882-4b0b57195b0c pmid:29145746
- View Article
- PubMed/NCBI
- Google Scholar
43. Querstret D, Cropley M. Assessing treatments used to reduce rumination and/or worry: a systematic review. Clin Psychol Rev [Internet]. 2013 [cited 2022 Jun 22];33(8):996–1009. Available from: http://dx.doi.org/10.1016/j.cpr.2013.08.004 pmid:24036088
- View Article
- PubMed/NCBI
- Google Scholar
44. Mihailova S, Jobson L. The impact of depression and culture on responses to intrusive autobiographical memories: cognitive appraisals, cognitive avoidance, and brooding rumination. Br J Clin Psychol [Internet]. 2020 [cited 2022 Jun 22];59(1):66–79. Available from: http://dx.doi.org/10.1111/bjc.12232 pmid:31364774
- View Article
- PubMed/NCBI
- Google Scholar
45. Oyserman D, Coon HM, Kemmelmeier M. Rethinking individualism and collectivism: evaluation of theoretical assumptions and meta-analyses. Psychol Bull [Internet]. 2002 [cited 2022 Jun 22];128(1):3–72. Available from: http://dx.doi.org/10.1037/0033-2909.128.1.3 pmid:11843547
- View Article
- PubMed/NCBI
- Google Scholar
46. Nolen-Hoeksema S, Aldao A. Gender and age differences in emotion regulation strategies and their relationship to depressive symptoms. Pers Individ Dif [Internet]. 2011 [cited 2022 Jun 22];51(6):704–8. Available from: http://dx.doi.org/10.1016/j.paid.2011.06.012
- View Article
- Google Scholar
47. Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms. Psychol Bull [Internet]. 2017 [cited 2022 Jun 22];143(8):783–822. Available from: http://dx.doi.org/10.1037/bul0000102 pmid:28447828
- View Article
- PubMed/NCBI
- Google Scholar

[ref1] 1. Johnson DP, Rhee SH, Friedman NP, Corley RP, Munn-Chernoff MA, Hewitt JK, et al. A twin study examining rumination as a transdiagnostic correlate of psychopathology. Clinical Psychological Science [Internet]. 2016 Nov 1 [cited 2022 Jun 22];4(6):971–87. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=2ed20b76-ae50-3699-9a63-c4e6c9e7b96d pmid:28111610
View Article
PubMed/NCBI
Google Scholar

[2] View Article

[3] PubMed/NCBI

[4] Google Scholar

[ref2] 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5^th ed. American Psychiatric Association Publishing; 2022.

[ref3] 3. World Health Organization. Depression fact sheet [Internet]. World Health Organization; 2020 [updated 13 Sep 21; cited 2022 Jun 22]. https://www.who.int/news-room/fact-sheets/detail/depression

[ref4] 4. Krause ED, Vélez CE, Woo R, Hoffmann B, Freres DR, Abenavoli RM, et al. Rumination, depression, and gender in early adolescence: A longitudinal study of a bidirectional model. J Early Adolesc [Internet]. 2018 [cited 2022 Jun 22];38(7):923–46. Available from: http://dx.doi.org/10.1177/0272431617704956
View Article
Google Scholar

[8] View Article

[9] Google Scholar

[ref5] 5. Verstraeten K, Bijttebier P, Vasey MW, Raes F. Specificity of worry and rumination in the development of anxiety and depressive symptoms in children: Specificity of worry and rumination. Br J Clin Psychol [Internet]. 2011 [cited 2022 Jun 22];50(4):364–78. Available from: http://dx.doi.org/10.1348/014466510X532715
View Article
Google Scholar

[11] View Article

[12] Google Scholar

[ref6] 6. Yoon KL, Maltby J, Joormann J. A pathway from neuroticism to depression: examining the role of emotion regulation. Anxiety Stress Coping [Internet]. 2013 [cited 2022 Jun 22];26(5):558–72. Available from: http://dx.doi.org/10.1080/10615806.2012.734810 pmid:23078141
View Article
PubMed/NCBI
Google Scholar

[14] View Article

[15] PubMed/NCBI

[16] Google Scholar

[ref7] 7. Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. J Abnorm Psychol [Internet]. 1991 [cited 2022 Jun 22];100(4):569–82. Available from: http://dx.doi.org/10.1037/0021-843x.100.4.569 pmid:1757671
View Article
PubMed/NCBI
Google Scholar

[18] View Article

[19] PubMed/NCBI

[20] Google Scholar

[ref8] 8. Moulds ML, Bisby MA, Wild J, Bryant RA. Rumination in posttraumatic stress disorder: A systematic review. Clin Psychol Rev [Internet]. 2020 [cited 2022 Jun 22];82(101910):101910. Available from: http://dx.doi.org/10.1016/j.cpr.2020.101910 pmid:32971312
View Article
PubMed/NCBI
Google Scholar

[22] View Article

[23] PubMed/NCBI

[24] Google Scholar

[ref9] 9. Seligowski AV, Lee DJ, Bardeen JR, Orcutt HK. Emotion regulation and posttraumatic stress symptoms: a meta-analysis. Cogn Behav Ther [Internet]. 2015 [cited 2022 Jun 22];44(2):87–102. Available from: http://dx.doi.org/10.1080/16506073.2014.980753 pmid:25421727
View Article
PubMed/NCBI
Google Scholar

[26] View Article

[27] PubMed/NCBI

[28] Google Scholar

[ref10] 10. Dalgleish T. Cognitive approaches to posttraumatic stress disorder: the evolution of multirepresentational theorizing. Psychological Bulletin [Internet]. 2004 Mar 1 [cited 2022 Jun 22];130(2):228–60. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=0313daff-2821-31f4-9559-03cbefcf392a pmid:14979771
View Article
PubMed/NCBI
Google Scholar

[30] View Article

[31] PubMed/NCBI

[32] Google Scholar

[ref11] 11. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy [Internet]. 2000 Jan 1 [cited 2022 Jun 22];38(4):319–45. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=ec694699-ded7-3f36-8cc2-dc5f559a98eb pmid:10761279
View Article
PubMed/NCBI
Google Scholar

[34] View Article

[35] PubMed/NCBI

[36] Google Scholar

[ref12] 12. Williams JMG, Barnhofer T, Crane C, Herman D, Raes F, Watkins E, et al. Autobiographical memory specificity and emotional disorder. Psychol Bull [Internet]. 2007 [cited 2022 Jun 22];133(1):122–48. Available from: http://dx.doi.org/10.1037/0033-2909.133.1.122 pmid:17201573
View Article
PubMed/NCBI
Google Scholar

[38] View Article

[39] PubMed/NCBI

[40] Google Scholar

[ref13] 13. Effective treatments for PTSD: practice guidelines from the International Society for Traumatic Stress Studies / edited by Edna B. Foa… [and others] [Internet]. Guilford Press; 2009 [cited 2022 Jun 22]. https://discovery.ebsco.com/linkprocessor/plink?id=d01f4aab-768b-3ba1-aebc-0706acd571ba

[ref14] 14. Bernal G, Saez-Santiago E. Culturally centered psychosocial interventions. Journal of Community Psychology [Internet]. 2006 Mar 1 [cited 2022 Jun 22];34(2):121–32. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=7f38362f-23c1-31db-9729-726d81beefb9
View Article
Google Scholar

[43] View Article

[44] Google Scholar

[ref15] 15. Huey SJ Jr., Tilley JL. Effects of mental health interventions with Asian Americans: a review and meta-analysis. Journal of Consulting & Clinical Psychology [Internet]. 2018 Nov 1 [cited 2022 Jun 22];86(11):915–30. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=3a648e28-ee28-3053-b35b-d1bb95d155cf pmid:30335424
View Article
PubMed/NCBI
Google Scholar

[46] View Article

[47] PubMed/NCBI

[48] Google Scholar

[ref16] 16. De Vaus J, Hornsey MJ, Kuppens P, Bastian B. Exploring the East-West divide in prevalence of affective disorder: a case for cultural differences in coping with negative emotion. Personality and social psychology review [Internet]. 2018 Jan 1 [cited 2022 Jun 22];22(3):285–304. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=97416cea-df74-3bd0-a7dc-36f843e537f0 pmid:29034806
View Article
PubMed/NCBI
Google Scholar

[50] View Article

[51] PubMed/NCBI

[52] Google Scholar

[ref17] 17. Bonanno GA, Papa A, Lalande K, Zhang N, Noll JG. Grief processing and deliberate grief avoidance: a prospective comparison of bereaved spouses and parents in the United States and the People’s Republic of China. Journal of Consulting & Clinical Psychology [Internet]. 2005 Feb 1 [cited 2022 Jun 22];73(1):86–98. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=9f3d6d2c-dfbc-3401-88bb-441818c9ff80 pmid:15709835
View Article
PubMed/NCBI
Google Scholar

[54] View Article

[55] PubMed/NCBI

[56] Google Scholar

[ref18] 18. Chang EC, Tsai W, Sanna LJ. Examining the relations between rumination and adjustment: do ethnic differences exist between Asian and European Americans. Asian American Journal of Psychology [Internet]. 2010 Mar 1 [cited 2022 Jun 22];1(1):46–56. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=c2d5b2e7-3afb-3fdd-b9b4-1d89c62ffd08
View Article
Google Scholar

[58] View Article

[59] Google Scholar

[ref19] 19. Zhang M, Cross SE. Emotions in memories of success and failure: a cultural perspective. Emotion [Internet]. 2011 [cited 2022 Jun 22];11(4):866–80. Available from: http://dx.doi.org/10.1037/a0024025 pmid:21707145
View Article
PubMed/NCBI
Google Scholar

[61] View Article

[62] PubMed/NCBI

[63] Google Scholar

[ref20] 20. Fry PS, Grover SC. Cognitive appraisals of life stress and depression in the elderly: a cross-cultural comparison of Asians and Caucasians. International Journal of Psychology [Internet]. 1982 Dec 1 [cited 2022 Jun 22];17(4):437. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=b9934d22-055d-3c2c-b8e8-389544829b14
View Article
Google Scholar

[65] View Article

[66] Google Scholar

[ref21] 21. Kitayama S, Markus HR, Matsumoto H, Norasakkunkit V. Individual and collective processes in the construction of the self: self-enhancement in the United States and self-criticism in Japan. Journal of Personality and Social Psychology [Internet]. 1997 Jan 1 [cited 2022 Jun 22];72(6):1245–67. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=55a084b1-cc3c-3b02-b10c-9716729822fb pmid:9177018
View Article
PubMed/NCBI
Google Scholar

[68] View Article

[69] PubMed/NCBI

[70] Google Scholar

[ref22] 22. Nisbett RE, Peng K, Choi I, Norenzayan A. Culture and systems of thought: holistic versus analytic cognition. Psychol Rev [Internet]. 2001 [cited 2022 Jun 22];108(2):291–310. Available from: http://dx.doi.org/10.1037//0033-295x.108.2.291 pmid:11381831
View Article
PubMed/NCBI
Google Scholar

[72] View Article

[73] PubMed/NCBI

[74] Google Scholar

[ref23] 23. Nagulendran A, Jobson L. Exploring cultural differences in the use of emotion regulation strategies in posttraumatic stress disorder. Eur J Psychotraumatol [Internet]. 2020 [cited 2022 Jun 22];11(1):1729033. Available from: http://dx.doi.org/10.1080/20008198.2020.1729033 pmid:32158518
View Article
PubMed/NCBI
Google Scholar

[76] View Article

[77] PubMed/NCBI

[78] Google Scholar

[ref24] 24. Church A, Alvarez JM, Katigbak MS, Mastor KA, Cabrera HF, Tanaka-Matsumi J, et al. Self-concept consistency and short-term stability in eight cultures. Journal of Research in Personality [Internet]. 2012 Oct 1 [cited 2022 Jun 22];46(5):556–70. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=a352b519-abd6-39e4-b81a-7ada5637b058
View Article
Google Scholar

[80] View Article

[81] Google Scholar

[ref25] 25. Church T, Katigbak MS, Locke KD, Zhang H, Shen J, de Jesus Vargas-Flores J, et al. Need satisfaction and well-being: testing self-determination theory in eight cultures. Journal of Cross Cultural Psychology [Internet]. 2013 Jan 1 [cited 2022 Jun 22];44(4):507–34. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=aca452c1-f5a1-3091-9346-70c5dcb19081
View Article
Google Scholar

[83] View Article

[84] Google Scholar

[ref26] 26. Tan CB. Ethnic identities and national identities: some examples from Malaysia. Identities [Internet]. 2000 Jan 1 [cited 2022 Jun 22];6(4):441–80. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=e87f46ec-f61e-3bdd-97b8-ebad9ab73604
View Article
Google Scholar

[86] View Article

[87] Google Scholar

[ref27] 27. Chang WC, Osman MMB, Tong EMW, Tan D. Self-construal and subjective well-being in two ethnic communities in Singapore. Psychology [Internet]. 2011 April 2 [cited 2022 Jun 22]; 2(2):63–70. Available from: https://www.scirp.org/journal/paperinformation.aspx?paperid=4426
View Article
Google Scholar

[89] View Article

[90] Google Scholar

[ref28] 28. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods [Internet]. 2007 [cited 2022 Jun 22];39(2):175–91. Available from: http://dx.doi.org/10.3758/bf03193146 pmid:17695343
View Article
PubMed/NCBI
Google Scholar

[92] View Article

[93] PubMed/NCBI

[94] Google Scholar

[ref29] 29. Grossmann I, Kross E. The impact of culture on adaptive versus maladaptive self-reflection. Psychological Science [Internet]. 2010 Aug 1 [cited 2022 Jun 22];21(8):1150–7. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=7cf79047-9384-3930-ad81-e32aad7d6af8 pmid:20624935
View Article
PubMed/NCBI
Google Scholar

[96] View Article

[97] PubMed/NCBI

[98] Google Scholar

[ref30] 30. Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress [Internet]. 2015 [cited 2022 Jun 22];28(6):489–98. Available from: https://pubmed.ncbi.nlm.nih.gov/26606250/ pmid:26606250
View Article
PubMed/NCBI
Google Scholar

[100] View Article

[101] PubMed/NCBI

[102] Google Scholar

[ref31] 31. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand [Internet]. 1983 [cited 2022 Jun 22];67(6):361–70. Available from: http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x pmid:6880820
View Article
PubMed/NCBI
Google Scholar

[104] View Article

[105] PubMed/NCBI

[106] Google Scholar

[ref32] 32. Li Q, Lin Y, Hu C, Xu Y, Zhou H, Yang L, et al. The Chinese version of hospital anxiety and depression scale: psychometric properties in Chinese cancer patients and their family caregivers. European Journal of Oncology Nursing [Internet]. 2016 Dec 1 [cited 2022 Jun 22];25:16–23. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=fc3575aa-782e-32a2-9289-6809972b3e0e pmid:27865248
View Article
PubMed/NCBI
Google Scholar

[108] View Article

[109] PubMed/NCBI

[110] Google Scholar

[ref33] 33. Sveen J, Bondjers K, Willebrand M. Psychometric properties of the PTSD Checklist for DSM-5: a pilot study. Eur J Psychotraumatol [Internet]. 2016 [cited 2022 Jun 22];7(1):30165. Available from: http://dx.doi.org/10.3402/ejpt.v7.30165 pmid:27098450
View Article
PubMed/NCBI
Google Scholar

[112] View Article

[113] PubMed/NCBI

[114] Google Scholar

[ref34] 34. Treynor W, Gonzalez R, Nolen-Hoeksema S. Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research [Internet]. 2003 Jun 1 [cited 2022 Jun 22];27(3):247–59. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=97bcef6c-e224-35ee-b194-34d1898b1fa2
View Article
Google Scholar

[116] View Article

[117] Google Scholar

[ref35] 35. Lee S, Kim W. Cross-cultural adaptation, reliability, and validity of the revised Korean version of Ruminative Response Scale. Psychiatry Investigation [Internet]. 2014 Jan 1 [cited 2022 Jun 22];11(1):59–64. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=c62f6c2e-3850-31f2-8e02-8ba03b29e07d pmid:24605125
View Article
PubMed/NCBI
Google Scholar

[119] View Article

[120] PubMed/NCBI

[121] Google Scholar

[ref36] 36. Marjanovic Z, Struthers CW, Cribbie R, Greenglass ER. The Conscientious Responders Scale: a new tool for discriminating between conscientious and random responders. SAGE Open [Internet]. 2014 [cited 2022 Jun 22];4(3):215824401454596. Available from: http://dx.doi.org/10.1177/2158244014545964
View Article
Google Scholar

[123] View Article

[124] Google Scholar

[ref37] 37. Marjanovic Z, Bajkov L, MacDonald J. The Conscientious Responders Scale helps researchers verify the integrity of personality questionnaire data. Psychol Rep [Internet]. 2019 [cited 2022 Jun 22];122(4):1529–49. Available from: http://dx.doi.org/10.1177/0033294118783917 pmid:29914343
View Article
PubMed/NCBI
Google Scholar

[126] View Article

[127] PubMed/NCBI

[128] Google Scholar

[ref38] 38. Epstein J, Santo RM, Guillemin F. A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus. Journal of Clinical Epidemiology [Internet]. 2015 Apr 1 [cited 2022 Jun 22];68(4):435–41. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=8c2afddc-feb0-3b33-abd9-a568ed16508a pmid:25698408
View Article
PubMed/NCBI
Google Scholar

[130] View Article

[131] PubMed/NCBI

[132] Google Scholar

[ref39] 39. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach / Andrew F. Hayes [Internet]. The Guilford Press; 2013 [cited 2022 Jun 22]. https://discovery.ebsco.com/linkprocessor/plink?id=553e185b-1b86-3781-a932-e5ae8f393391

[ref40] 40. Kwon H, Yoon KL, Joormann J, Kwon J-H. Cultural and gender differences in emotion regulation: relation to depression. Cognition & Emotion [Internet]. 2013 Aug 1 [cited 2022 Jun 22];27(5):769–82. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=4ff92515-9df7-3d5d-80ac-900903270aaa
View Article
Google Scholar

[135] View Article

[136] Google Scholar

[ref41] 41. McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behav Res Ther [Internet]. 2011 [cited 2022 Jun 22];49(3):186–93. Available from: http://dx.doi.org/10.1016/j.brat.2010.12.006 pmid:21238951
View Article
PubMed/NCBI
Google Scholar

[138] View Article

[139] PubMed/NCBI

[140] Google Scholar

[ref42] 42. Ahern E, Kinsella S, Semkovska M. Clinical efficacy and economic evaluation of online cognitive behavioral therapy for major depressive disorder: a systematic review and meta-analysis. Expert review of pharmacoeconomics & outcomes research [Internet]. 2018 Jan 1 [cited 2022 Jun 22];18(1):25–41. Available from: https://discovery.ebsco.com/linkprocessor/plink?id=6cc03ebe-9add-35a7-b882-4b0b57195b0c pmid:29145746
View Article
PubMed/NCBI
Google Scholar

[142] View Article

[143] PubMed/NCBI

[144] Google Scholar

[ref43] 43. Querstret D, Cropley M. Assessing treatments used to reduce rumination and/or worry: a systematic review. Clin Psychol Rev [Internet]. 2013 [cited 2022 Jun 22];33(8):996–1009. Available from: http://dx.doi.org/10.1016/j.cpr.2013.08.004 pmid:24036088
View Article
PubMed/NCBI
Google Scholar

[146] View Article

[147] PubMed/NCBI

[148] Google Scholar

[ref44] 44. Mihailova S, Jobson L. The impact of depression and culture on responses to intrusive autobiographical memories: cognitive appraisals, cognitive avoidance, and brooding rumination. Br J Clin Psychol [Internet]. 2020 [cited 2022 Jun 22];59(1):66–79. Available from: http://dx.doi.org/10.1111/bjc.12232 pmid:31364774
View Article
PubMed/NCBI
Google Scholar

[150] View Article

[151] PubMed/NCBI

[152] Google Scholar

[ref45] 45. Oyserman D, Coon HM, Kemmelmeier M. Rethinking individualism and collectivism: evaluation of theoretical assumptions and meta-analyses. Psychol Bull [Internet]. 2002 [cited 2022 Jun 22];128(1):3–72. Available from: http://dx.doi.org/10.1037/0033-2909.128.1.3 pmid:11843547
View Article
PubMed/NCBI
Google Scholar

[154] View Article

[155] PubMed/NCBI

[156] Google Scholar

[ref46] 46. Nolen-Hoeksema S, Aldao A. Gender and age differences in emotion regulation strategies and their relationship to depressive symptoms. Pers Individ Dif [Internet]. 2011 [cited 2022 Jun 22];51(6):704–8. Available from: http://dx.doi.org/10.1016/j.paid.2011.06.012
View Article
Google Scholar

[158] View Article

[159] Google Scholar

[ref47] 47. Salk RH, Hyde JS, Abramson LY. Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms. Psychol Bull [Internet]. 2017 [cited 2022 Jun 22];143(8):783–822. Available from: http://dx.doi.org/10.1037/bul0000102 pmid:28447828
View Article
PubMed/NCBI
Google Scholar

[161] View Article

[162] PubMed/NCBI

[163] Google Scholar

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