Phenomenological aspects of the cognitive rumination construct

Aspectos fenomenológicos relacionados ao construto de ruminação cognitiva

Leonardo Fernandez Meyer José Geraldo Vernet Taborda Fábio Antônio da Costa Ana Luiza Alfaya Galego Soares Kátia Mecler Alexandre Martins Valença About the authors

Abstracts

Objective:

To evaluate the importance of phenomenological aspects of the cognitive rumination (CR) construct in current empirical psychiatric research.

Method:

We searched SciELO, Scopus, ScienceDirect, MEDLINE, OneFile (GALE), SpringerLink, Cambridge Journals and Web of Science between February and March of 2014 for studies whose title and topic included the following keywords: cognitive rumination; rumination response scale; and self-reflection. The inclusion criteria were: empirical clinical study; CR as the main object of investigation; and study that included a conceptual definition of CR. The studies selected were published in English in biomedical journals in the last 10 years. Our phenomenological analysis was based on Karl Jaspers' General Psychopathology.

Results:

Most current empirical studies adopt phenomenological cognitive elements in conceptual definitions. However, these elements do not seem to be carefully examined and are indistinctly understood as objective empirical factors that may be measured, which may contribute to misunderstandings about CR, erroneous interpretations of results and problematic theoretical models.

Conclusion:

Empirical studies fail when evaluating phenomenological aspects of the cognitive elements of the CR construct. Psychopathology and phenomenology may help define the characteristics of CR elements and may contribute to their understanding and hierarchical organization as a construct. A review of the psychopathology principles established by Jasper may clarify some of these issues.

Psychopathology; phenomenology; cognitive rumination


Objetivo:

Verificar a importância de aspectos fenomenológicos relacionados ao construto de ruminação cognitiva (RC) nas pesquisas empíricas psiquiátricas atuais.

Método:

Foram pesquisadas as bases de dados SciELO, Scopus, ScienceDirect, MEDLINE, OneFile (GALE), SpringerLink, Cambridge Journals e Web of Science, entre fevereiro e março de 2014, buscando artigos cujo tópico ou título contivessem os seguintes termos-chave: ruminação cognitiva; escala de resposta ruminativa; e autorreflexão. Os critérios de inclusão foram: estudos clínicos empíricos; RC como principal objeto de pesquisa; e estudos que incluíssem uma definição conceitual de RC. Foram considerados apenas artigos em inglês publicados em periódicos biomédicos nos últimos 10 anos. Nossa análise fenomenológica se fundamentou na Psicopatologia Geral de Jaspers.

Resultados:

Os conceitos de RC atualmente encontrados nas pesquisas empíricas utilizam majoritariamente elementos fenomenológicos em suas definições. Entretanto, esses elementos cognitivos são indistintamente entendidos como elementos objetivos (empíricos), passíveis de mensuração, e não parecem ser cuidadosamente examinados. Este fato pode contribuir para uma compreensão enganosa sobre RC, além de favorecer a interpretação errônea de resultados e a elaboração de paradoxos teóricos problemáticos.

Conclusão:

As pesquisas empíricas atuais sobre RC falham ao avaliar os aspectos fenomenológicos inerentes ao construto de RC. A psicopatologia e o método fenomenológico podem ajudar a definir características relacionadas aos elementos da RC, bem como contribuir para a sua compreensão e organização hierárquica enquanto construto. Um retorno aos princípios da psicopatologia, nos moldes de Jaspers, poderia trazer esclarecimentos ao tema.

Psicopatologia; fenomenologia; ruminação cognitiva


Introduction

Cognitive rumination (CR) is generally defined as recurrent and repetitive thoughts about one's feelings and quests that intrude consciousness.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24.

2. Joormann J, Dkane M, Gotlib IH. Adaptive and maladaptative components of rumination? Diagnostic specificity and relation to depressive bias. Behav Ther. 2006;37:269-80.
- 33. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11. The associations of CR with psychiatric disease and psychopathological symptoms have been the focus of an increasing number of empirical studies.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24.

2. Joormann J, Dkane M, Gotlib IH. Adaptive and maladaptative components of rumination? Diagnostic specificity and relation to depressive bias. Behav Ther. 2006;37:269-80.

3. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11.
- 44. Bagby RM, Rector NA, Bacchiochi JR, McBride C. The stability of the response styles questionnaire rumination scale in a sample of patients with major depression. Cognit Ther Res. 2004;28:527-38. Their findings have led to the development of psychometric scales, such as the Ruminative Response Scale (RRS). These instruments provide data for statistical analyses in studies about CR and for the exploration of possible correlations with specific psychiatric symptoms.55. Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. J Pers Soc Psychol. 1991;61:115-21. , 66. Moberly N, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314-23.

CR should be examined rigorously to limit and define it unambiguously as an object of scientific study. Current concepts adopt phenomenological descriptions of cognitive elements, more adequate for clinical investigations than for empirical study settings.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24. , 22. Joormann J, Dkane M, Gotlib IH. Adaptive and maladaptative components of rumination? Diagnostic specificity and relation to depressive bias. Behav Ther. 2006;37:269-80. , 66. Moberly N, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314-23.

7. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/ depressive symptoms. J Abnorm Psychol. 2000;109:504-11.

8. Armey MF, Fresco DM, Moore MT, Mennin DS, Turk CL, Heimberg RG, et al. Brooding and pondering: isolating the active ingredients of depressive rumination with exploratory factor analysis and structural equation modeling. Assessment. 2009;16:315-27.
- 99. Miranda R, Nolen-Hoeksema S. Brooding and reflection: rumination predicts suicidal ideation at 1-year follow-up in a community sample. Behav Res Ther. 2007;45:3088-95.

Karl Jaspers' efforts to study psychopathology played a major role in the development of diagnostic classifications and in clinical (psychic) examination techniques.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.
- 1515. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23. According to Jaspers, psychopathology is the science of abnormal conscious psychological phenomena, and phenomenology, the method to investigate these phenomena, which are experienced by the examinee and presented to the examiner through the examinee's narratives and behavior.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Psychic phenomena are presented to and understood by the examiner as cognitive performances. For teaching purposes, they are divided into objective performances, such as attention, formal logic, thought patterns, memory, speech disturbances and psychomotor function, and subjective performances, such as affect and mood, thought content, volition and self-awareness.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

15. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.
- 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. In this sense, they are ongoing aspects of empathy and intuition that allow patients and examiners to share common aspects of reality.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

15. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.
- 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26.

This study evaluated the extent to which the phenomenological aspects of the CR construct have been used in current empirical psychiatric studies. It also analyzed findings using the phenomenological approach developed by Jaspers.

Method

Figure 1 summarizes the steps of our literature review of studies about CR. We searched SciELO, Scopus, ScienceDirect, MEDLINE, OneFile (GALE), SpringerLink, Cambridge Journals and Web of Science between February and March of 2014 for studies whose title or topic had the following terms: ((cognitive rumination) AND (rumination response scale)) or ((cognitive rumination) AND (self-reflection)).

Figure 1
Flowchart of review of literature about cognitive rumination (CR)

Inclusion criteria were: original clinical studies; CR as their main object of investigation; clear conceptual definition of CR; written in English; and published in a biomedical journal in the last 10 years. Because of the pioneering nature of the studies about CR conducted by Nolen-Hoeksema et al., we selected their studies despite their publication date whenever all the other inclusion criteria were met. We excluded articles not in English, editor comments, letters, case reports and literature reviews about CR. We also excluded clinical empirical studies in which the main object of study was not CR or that did not provide a clear conceptual definition of CR.

Our analysis followed the phenomenological approach described by Jaspers.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

15. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.
- 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. We used both English and Portuguese translations of Allgemeine Psychopathologie to avoid misinterpretations of the original.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

We applied the cross-sectional phenomenological method, including its positive and negative perspectives. The positive perspective represents the conscious expressions of CR that uncover its ontic aspects, gathered through direct observation of psychic phenomena.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

15. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.
- 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. The negative perspective refers to delimitations of rumination in finite totalities, to its correlation with another psychic totality and to its organization in the context of the psychic whole.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

15. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.
- 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26.

According to Jaspers, phenomenological understanding may be static and genetic.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. , 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. Static understanding is restricted to present observation and objective description of the psychic phenomena as presented to and understood by the examiner's perception. Psychic phenomena may, therefore, be identified using three approaches: behavior observations, interviews and self-report.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Additional empirical elements include neurochemical and neuroanatomical factors, whenever observed.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

Genetic understanding, described in the second part of Jaspers' book, concerns the comprehension of motivation or causation that is associated with the sequence of psychic events. Our analysis of CR did not take into consideration the psychological (genetic) explanations and was limited to its static phenomenological elements.

Results

Our results are presented in two sections. First, we describe the phenomenological aspects of the main CR concepts used in current empirical studies. After that, we analyze the phenomenological aspects inherent to the CR construct, according to Jaspers' phenomenology.

We chose this presentation pattern because of the complexity of the theme and the impossibility of presenting results simultaneously. The results are discussed and interrelated below.

Rumination in current research and phenomenology

Our final sample had 19 studies about CR. Table 1 summarizes the main CR concepts used in the studies selected and their phenomenological aspects. All definitions were close to the original: persistent and recurring thoughts that unintentionally enter consciousness.55. Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. J Pers Soc Psychol. 1991;61:115-21. One author proposed a slightly different definition in the RRS: the process of thinking perseveringly about one's feelings and problems, and not the specific contents of thoughts.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24. Both definitions include characteristically phenomenological elements: persistent and recurring thoughts, process of thinking perseveringly, feelings and thought contents. They refer to transient cognitive states, such as thought, affect and volition.

Table 1
Main definitions of cognitive rumination and their phenomenological aspects

In another study, CR was defined as the style of thinking repetitively about negative emotions, focusing on symptoms of distress and worrying about meanings of distress.77. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/ depressive symptoms. J Abnorm Psychol. 2000;109:504-11. Here, CR was described identically and simultaneously as a pattern of response (default response) to depressive mood, as a predisposing factor to mental disorders and as a sign of phenomenological elements of specific clinical symptoms.

For the CR definitions used in psychometric scales, appropriate terms were carefully chosen to respond to the needs of empirical studies.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24.

2. Joormann J, Dkane M, Gotlib IH. Adaptive and maladaptative components of rumination? Diagnostic specificity and relation to depressive bias. Behav Ther. 2006;37:269-80.

3. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11.

4. Bagby RM, Rector NA, Bacchiochi JR, McBride C. The stability of the response styles questionnaire rumination scale in a sample of patients with major depression. Cognit Ther Res. 2004;28:527-38.

5. Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. J Pers Soc Psychol. 1991;61:115-21.

6. Moberly N, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314-23.

7. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/ depressive symptoms. J Abnorm Psychol. 2000;109:504-11.

8. Armey MF, Fresco DM, Moore MT, Mennin DS, Turk CL, Heimberg RG, et al. Brooding and pondering: isolating the active ingredients of depressive rumination with exploratory factor analysis and structural equation modeling. Assessment. 2009;16:315-27.
- 99. Miranda R, Nolen-Hoeksema S. Brooding and reflection: rumination predicts suicidal ideation at 1-year follow-up in a community sample. Behav Res Ther. 2007;45:3088-95. , 1717. Andersen SB, Moore RA, Venables L, Corr PJ. Electrophysiological correlates of anxious rumination. Int J Psychophysiol. 2009;71:159-69.

18. Brinker JK, Dozois DJ. Ruminative thought style and depressed mood. J Clin Psychol. 2009;65:1-19.

19. Hasegawa A, Koda M, Hattori Y, Kondo T, Kawaguchi J. Depressive rumination and past depression in Japanese university students: comparison of brooding and reflection. Psychol Rep. 2014;114:653-74.

20. Johnson MK, Nolen-Hoeksema S, Mitchell KJ, Levin Y. Medial cortex activity, self-reflection and depression. Soc Cogn Affect Neurosci. 2009;4:313-27.

21. Kocovski NL, Rector NA. Predictors of post-event rumination related to social anxiety. Cogn Behav Ther. 2007;36:112-22.

22. Kuehner C, Hujjziger S, Liebsch K. Rumination, distraction and mindful self-focus: effects on mood, dysfunctional attitudes and cortisol stress response. Psychol Med. 2009;39:219-28.

23. McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behav Res Ther. 2011;49:186-93.

24. Schoofs H, Hermans D, Raes F. Brooding and reflection as subtypes of rumination: evidence from confirmatory factor analysis in nonclinical samples using the Dutch Ruminative Response Scale. J Psychopathol Behav Assess. 2010; 32: 609-17.

25. Thomsen DK, Tonnesvang J, Schnieber A, Olesen MH. Do people ruminate because they haven't digested their goals? The relations of ruminations and reflection to goal internalization and ambivalence. Motiv Emot. 2011;35:105-17.
- 2626. Trapnell PD, Campbell JD. Private self-consciousness and the five factor model of personality: distinguishing rumination from reflection. J Pers Soc Psychol. 1999;76:284-304. This approach reduces CR to an object of empirical investigation exclusively.

CR was also associated with other psychopathological constructs: maladaptive cognitive styles, dysfunctional attitudes, hopelessness, pessimism, self-criticism and depression.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24.

2. Joormann J, Dkane M, Gotlib IH. Adaptive and maladaptative components of rumination? Diagnostic specificity and relation to depressive bias. Behav Ther. 2006;37:269-80.
- 33. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11. Phenomenological dissimilarities between these constructs were not analyzed, and they were not classified hierarchically.33. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11.

4. Bagby RM, Rector NA, Bacchiochi JR, McBride C. The stability of the response styles questionnaire rumination scale in a sample of patients with major depression. Cognit Ther Res. 2004;28:527-38.

5. Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. J Pers Soc Psychol. 1991;61:115-21.

6. Moberly N, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314-23.
- 77. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/ depressive symptoms. J Abnorm Psychol. 2000;109:504-11. All were ontologically identical, equivalent and horizontally distributed, and there was no definition of hierarchical differences between them.11. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Rethinking rumination. Perspect Psychol Sci. 2008;3:400-24.

2. Joormann J, Dkane M, Gotlib IH. Adaptive and maladaptative components of rumination? Diagnostic specificity and relation to depressive bias. Behav Ther. 2006;37:269-80.

3. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11.

4. Bagby RM, Rector NA, Bacchiochi JR, McBride C. The stability of the response styles questionnaire rumination scale in a sample of patients with major depression. Cognit Ther Res. 2004;28:527-38.

5. Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. J Pers Soc Psychol. 1991;61:115-21.

6. Moberly N, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314-23.

7. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/ depressive symptoms. J Abnorm Psychol. 2000;109:504-11.

8. Armey MF, Fresco DM, Moore MT, Mennin DS, Turk CL, Heimberg RG, et al. Brooding and pondering: isolating the active ingredients of depressive rumination with exploratory factor analysis and structural equation modeling. Assessment. 2009;16:315-27.
- 99. Miranda R, Nolen-Hoeksema S. Brooding and reflection: rumination predicts suicidal ideation at 1-year follow-up in a community sample. Behav Res Ther. 2007;45:3088-95. These characteristics may have resulted in misconceptions that, in turn, led to theoretical disagreement, erroneous theoretical models and flawed interpretations of results.33. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005;39:1105-11.

4. Bagby RM, Rector NA, Bacchiochi JR, McBride C. The stability of the response styles questionnaire rumination scale in a sample of patients with major depression. Cognit Ther Res. 2004;28:527-38.

5. Nolen-Hoeksema S, Morrow J. A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. J Pers Soc Psychol. 1991;61:115-21.

6. Moberly N, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314-23.
- 77. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/ depressive symptoms. J Abnorm Psychol. 2000;109:504-11. , 1717. Andersen SB, Moore RA, Venables L, Corr PJ. Electrophysiological correlates of anxious rumination. Int J Psychophysiol. 2009;71:159-69. , 2020. Johnson MK, Nolen-Hoeksema S, Mitchell KJ, Levin Y. Medial cortex activity, self-reflection and depression. Soc Cogn Affect Neurosci. 2009;4:313-27. , 2121. Kocovski NL, Rector NA. Predictors of post-event rumination related to social anxiety. Cogn Behav Ther. 2007;36:112-22. , 2323. McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behav Res Ther. 2011;49:186-93.

24. Schoofs H, Hermans D, Raes F. Brooding and reflection as subtypes of rumination: evidence from confirmatory factor analysis in nonclinical samples using the Dutch Ruminative Response Scale. J Psychopathol Behav Assess. 2010; 32: 609-17.
- 2525. Thomsen DK, Tonnesvang J, Schnieber A, Olesen MH. Do people ruminate because they haven't digested their goals? The relations of ruminations and reflection to goal internalization and ambivalence. Motiv Emot. 2011;35:105-17.

The analysis of studies in our final sample suggested the existence of causal links between neurophysiological and neuroanatomical findings and CR.1717. Andersen SB, Moore RA, Venables L, Corr PJ. Electrophysiological correlates of anxious rumination. Int J Psychophysiol. 2009;71:159-69. , 2020. Johnson MK, Nolen-Hoeksema S, Mitchell KJ, Levin Y. Medial cortex activity, self-reflection and depression. Soc Cogn Affect Neurosci. 2009;4:313-27. , 2222. Kuehner C, Hujjziger S, Liebsch K. Rumination, distraction and mindful self-focus: effects on mood, dysfunctional attitudes and cortisol stress response. Psychol Med. 2009;39:219-28. These findings are based on the existence of hypothetical cerebral systems that may be responsible for activating and inhibiting specific types of human behaviors (response styles). Electroencephalographic findings showed hippocampus augmentation and neocortex activation during CR activity.1717. Andersen SB, Moore RA, Venables L, Corr PJ. Electrophysiological correlates of anxious rumination. Int J Psychophysiol. 2009;71:159-69.Functional magnetic resonance results showed hyperactivity in anterior medial cortex in patients with CR activity when compared to controls.2020. Johnson MK, Nolen-Hoeksema S, Mitchell KJ, Levin Y. Medial cortex activity, self-reflection and depression. Soc Cogn Affect Neurosci. 2009;4:313-27. Decreases of cortisol response levels were less frequently found among depressive patients.2222. Kuehner C, Hujjziger S, Liebsch K. Rumination, distraction and mindful self-focus: effects on mood, dysfunctional attitudes and cortisol stress response. Psychol Med. 2009;39:219-28.

Phenomenology contemplates and situates of all these empirical findings within psychopathology, as they are indispensable phenomenological elements and must be analyzed whenever found.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013. , 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. Misconceptions arise when they are interpreted as the full representation of their object of study (CR).1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. This may be explained by the nature of psychopathological objects, which rejects their reduction to exclusively objective or natural concepts, as further stated in the next section.

Our results also revealed hypothetical paradoxes between theoretical models of CR, such as the self-absorption paradox.2727. Joireman JA, Parrott L III, Hammersla J. Empathy and the self-absorption paradox: support for the distinction between self-rumination and self-reflection. Self Identity. 2002;1:53-65. In this case, CR and self-reflective activity are compared as similar mental processes, but outcomes are ambiguous. This issue will be elaborated further in the Discussion section.

Phenomenology and CR

Psychopathology is the science of the abnormal conscious manifestations of psychic life.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Its aim is not the absolute comprehension of human beings or their psyche, but the investigation of abnormal conscious psychic phenomena.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. One of its fundamental theoretical features is the analysis of psychic elements using different and complementary perspectives.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

Among these perspectives, we have the description of psychic phenomena, in the form of psychic examinations and self-narratives, as well as statistical analysis, case studies, genetic aspects, and neurochemical and neurobiological findings.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Each perspective has its own specificities, limitations and intercorrelations.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. The foundation of phenomenology, as a research method, is the atheoretical description of psychic phenomena as they are presented to the examiner.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. This method provides access to its object of investigation, abnormal conscious psychic phenomena, which may then be appropriately accessed and grasped as a psychopathological object to be further examined using complementary perspectives.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

Psychic capacities, or cognitive performances, may be distinguished only for teaching and analytical purposes.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. The psyche may be defined as a totality, or a whole, that has multiple and indistinguishable intercorrelations between its parts, the psychic elements. The context of reality, where psyche belongs and in which it participates, also determines and contributes to its change and signification along time. The psychic whole is not the sum or articulation of its parts; in fact, psychic elements, together with other elements that go beyond the scope of this study, compose an individual's transient whole.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

In phenomenology, statistical analyses of psychic phenomena may be appropriately applied. Any statistical analysis implies a previous theoretical hypothesis and some objective knowledge about the object under study, which is, in this case, psychic phenomena.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. The boundaries of statistics are its own limitations in measuring psychic phenomena as empirical elements and the impossibility of reaching causal associations based on statistic results only.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

Cognitive performances, such as memory and psychomotor functions, have characteristics that make them more suitable to the application of statistical methods than affect and thought.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. In CR, only the formal logic aspects of thought disturbances are objective, as their contents are subjective phenomena. When investigating subjective performances, statistical analysis may lead to miscomprehensions because of inappropriate identification or appropriation of cognitive performance subtypes.

Meaningful objective phenomena are sensitive phenomena and manifestations of psychic life.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Objective performances can be assessed directly by the examiner's sensory perception. CR objective performances correspond to: 1) formal logic thought disturbance - repetitive, perseveration; 2) concentration and vigilance disturbances - diminished concentration; lack of attention to secondary themes not related to the main subject; 3) psychomotor activity - agitation; 4) speech disturbances; and 5) memory disturbances - paramnesias.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011. , 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Except for the first item (formal logic thought disturbances), none of these elements are necessary for CR identification, and all can be signs of and randomly found in other clinical presentations, depending on the disorder and the moment when the examination is performed.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

The assessment of subjective performances must rely on empathy and intuition elements primarily.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.

15. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.
- 1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. Subjective and objective performances do not share the same characteristics; the former are exclusively expressed through "as if" descriptions that will only be understood if the examinee's psyche is interpreted.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. In CR, subjective performances correspond to: 1) thought content - monothematic, persevering, overvalued, delirious or delusional ideas; 2) affect or mood - sadness, pessimism, apprehension; and 3) volition - will inhibition.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013. These are similar to objective performances, when present. Thought content is the main subjective characteristic of the CR construct.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

The correct understanding of data obtained by means of clinical examinations must be analyzed according to the hierarchy inherent to the psychic whole, which is defined by psychopathology.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. The phenomenology of formal logic thought in CR is similar to that found in other psychopathological phenomena, and includes thought persevering, speech stereotypes and mussitation. In all, repetitive thoughts lead to dysfunction of other cognitive performances.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Speech disturbances may be present. The limited variability of themes associated with CR may be associated with experiences, affective and volitional states and intellectual capacity, as in other psychiatric disorders.1313. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.
- 1515. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23.

Semiology indicates that repetitive thoughts, which may have different presentations, are found in cases of several psychiatry disorders.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013. Verbigeration, defined as the repetition of short sentences, embolalia, which is the repetition of short sentences lacking lexical meaning, and mussitation, the soundless repetition of sentences using lip movements only, are examples found in early stages of psychotic disorders.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Repetitive thoughts occur in severe dementia, when the cognitive repertoire is limited, and in psychoactive substance intoxication.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. A restricted repertoire is a common characteristic of obsessive-compulsive, developmental, mood and psychotic disorders.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

The analysis of phenomenological specificities reveals that CR shares its main characteristics with the psychiatric disorders listed in the paragraph above. The psychic whole has a variable presentation, which confirms the plasticity and the countless possible articulations of psychic phenomena.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. This finding disproves the idea that cognitive comprehension is the result of a prior combination of supposedly basic neuropsychiatric mechanisms.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

CR may be better defined as a psychopathological construct that refers to phenomenological elements understood in their context of presentation.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013. This characteristic is also present in other psychopathological constructs.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.

14. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013.
- 1515. Jaspers K. The phenomenological approach in psychopathology. Br J Psychiatry. 1968;114:1313-23. Psychopathological understanding demands the elaboration of ideal types to organize and shape all the meaningful psychic phenomena grasped.1111. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.

12. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

13. Fuchs T, Breyer T, Mundt C. Karl Jaspers's philosophy and psychopathology. New York: Springer Science; 2014.
- 1414. Stanghellini G, Fuchs T. One century of Karl Jaspers's general psychopathology. Oxford: Oxford University Press; 2013. These characteristics are useful for clinical and psychic examinations, for use in manuals of diagnostic classification and for empirical studies.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. , 2828. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Washington: American Psychiatric Publishing; 2013. , 2929. World Health Organization (WHO). International statistical classification of diseases and related health problems, 10th revision (ICD-10). Geneva: WHO; 2004.

Discussion

Current trends of research about CR prioritize suitable conceptual definitions that respond to the empirical need of natural sciences. They disregard, however, the psychopathological specificities of CR, which leads to miscomprehension and misconceptions about the object of study about CR.

The focus of this study is phenomenology and CR.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Phenomenology classifies and situates empirical psychic elements within the field of comprehension of the psychic totality, including statistical analysis.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Its appropriate application demands the identification of objective performances of the psychic phenomena under analysis, whenever available. The formulation of a theoretical model of psychopathology depends on the meaningful comprehension, or genetic understanding, that should be acquired from subjective phenomena and that cannot be statistically analyzed as objective phenomena.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997.

Phenomenology offers a safe methodological perspective to avoid these misconceptions. In the use of its positive perspective, the elements of psychic phenomena are uncovered through identification, description, experimentation and analysis of the participant's cognitive functions.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. The negative perspective carries the intrinsic limitations of phenomenology and ensures that knowledge will be reliable.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. It marks the borders and limits of the psychic phenomena under analysis for the identification and investigation of totalities.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. Current advances in neuroscience, such as topographic, encephalographic, neurochemical and statistical analyses, have produced new fundamental data, which should be analyzed in light of psychopathological foundations to assure that meaningful connections will be established.

Empirical studies about CR may benefit from phenomenological analysis. The positive perspective may identify objective psychic elements of CR by examining descriptions of the phenomena presented, considering their specificities and avoiding the indistinct naturalization of all its elements. The negative perspective may set limits to the CR construct and define its hierarchical position in psychopathology. This analysis defines an important task for neuroscience: to formulate appropriate scientific criteria to investigate the subjective performance of psychic phenomena, considering their nature and specificities.

A starting point for this investigation may be the foundations of psychopathology hermeneutics.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. , 3030. Spiegelberg H. Phenomenology in psychology and psychiatry. Evanston: Northwestern University Press; 1972. This analysis may enable the formulation of appropriate theoretical models using appropriate concepts, which would result in the definition of the objects of empirical research. The self-absorption paradox is an example of misunderstanding of identical cognitive processes, supposedly present in both CR and in self-reflective mental activity.2626. Trapnell PD, Campbell JD. Private self-consciousness and the five factor model of personality: distinguishing rumination from reflection. J Pers Soc Psychol. 1999;76:284-304. , 2727. Joireman JA, Parrott L III, Hammersla J. Empathy and the self-absorption paradox: support for the distinction between self-rumination and self-reflection. Self Identity. 2002;1:53-65. The distinction is usually made by analyzing outcomes, which are classified as favorable in self-reflective activity and unfavorable in CR.2626. Trapnell PD, Campbell JD. Private self-consciousness and the five factor model of personality: distinguishing rumination from reflection. J Pers Soc Psychol. 1999;76:284-304. , 2727. Joireman JA, Parrott L III, Hammersla J. Empathy and the self-absorption paradox: support for the distinction between self-rumination and self-reflection. Self Identity. 2002;1:53-65.

This issue does not apply when the psychopathological approach is adopted.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. As mentioned above, the shared characteristic of CR and self-reflective activity is formal logic thought disturbance, seen in repetitive behaviors and perseveration. The perspective of polarities, as described by Jaspers, may be useful to understand an array of psychic phenomena, as it affects, for example, mood, in the case of polarity between sadness and happiness, and memory, in the case of polarity between amnesia and normal memory.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. In this sense, CR and self-reflectivity may be understood as a continuum, that shares the same type of basic cognitive process, that is, formal logic thought disturbance, but that holds differences in other cognitive elements distinctly associated with each other.

As psychopathology studies abnormal conscious psychological phenomena, it may only explore CR, and not self-reflective activity. The latter is a natural human existential activity, better addressed by philosophy.1010. Jaspers K. Allgemeine psychopathologie. 8th ed. New York: Springer Science; 2011.

11. Jaspers K. Psicopatologia geral. 8th ed. Rio de Janeiro: Atheneu; 2005.
- 1212. Jaspers K. General psychopathology. Baltimore: John Hopkins University Press; 1997. The characteristics of both phenomena may be compared, but never without seriously considering the specificities of each one.

Limitations

Jaspers' definition of phenomenology represents one type of phenomenological method to access psychic phenomena. Other phenomenologists may suggest different and complementary methodological approaches and knowledge perspectives of psychic phenomena.3030. Spiegelberg H. Phenomenology in psychology and psychiatry. Evanston: Northwestern University Press; 1972. , 3131. Spiegelberg H. Phenomenological movement, a historical introduction. Netherland: Kluwer Academic Publisher; 1994.

We have only searched for and analyzed empirical clinical studies about CR. Reviews and case reports may offer a more detailed analysis. As only the studies in English were included, some current scientific data about CR may have been missed.

Conclusion

Phenomenology may contribute to the analysis of CR and improve conceptual definitions and the identification of cognitive elements of CR to be applied in empirical research. It may also benefit empirical psychiatric and psychopathological studies, including those that investigate CR. It may establish more adequate and accurate conceptual definitions to be used in the identification of psychic phenomena and of theoretical and methodological issues associated with them.1616. Kumazaki T. The theoretical root of Karl Jaspers' General Psychopathology. Part 1: Reconsidering the influence of phenomenological and hermeneutics. Hist Psychiatry. 2013;24:212-26. Further studies about psychopathology and phenomenology should focus on the review of classical methods and theoretical models used in current psychiatric and psychological research.3232. Thome J. Centenary of Karl Jaspers' general psychopathology: implications for molecular psychiatry. J Mol Psychiatry. 2014;2:3.

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  • Financial support: none.

Publication Dates

  • Publication in this collection
    Jan-Mar 2015

History

  • Received
    20 June 2014
  • Accepted
    06 Nov 2014
Associação de Psiquiatria do Rio Grande do Sul Av. Ipiranga, 5311/202, 90610-001 Porto Alegre RS/ Brasil, Tel./Fax: (55 51) 3024 4846 - Porto Alegre - RS - Brazil
E-mail: trends@aprs.org.br