DARRT - Distract or accept to release ruminative thoughts

Rumination, defined as repetitive, negative, self-referential thinking about the past, is a common symptom of anxiety and depressive disorders (Nolen-Hoeksema et al., 2008). Rumination has been consistently linked to neural abnormalities, such as increased activity in the brain’s default mode network (DMN), a network associated with self-referential and internally directed thought (Mısır et al., 2023; Zhou et al., 2020). Also, rumination has been proposed to be accompanied by maladaptive meta-cognition, including dysfunctional beliefs about the efficacy of rumination, and impairment in meta-control, i.e., the ability to regulate one’s own cognitive processes (Nayda & Takarangi, 2021). Mindfulness training has been proposed to reduce rumination by enhancing meta-cognitive processes, e.g., the ability to regulate negative thoughts (Jankowski & Holas, 2014; Mao, Li, Wo, Luo, & Hu, 2023; Ruimi et al., 2023). Here we hypothesize that mindfulness may help release ruminative thoughts by decreasing DMN activity, and that mindfulness is more effective in facilitating this release than a set of control interventions that also involve distraction to varying degrees but lack meta-cognitive elements. This hypothesis is grounded in prior work demonstrating that mindfulness can enhance meta-cognitive abilities, which enable people to divert attention away from rumination when this is adaptive (Hitchcock & Frank, 2024; Jankowski & Holas, 2014; Ruimi et al., 2023), thus teaching them a sustainable emotion-regulation strategy (Wells & Papageorgiou, 2004). Conversely, distraction alone might instead only transiently decrease rumination without contributing to strategy development. Once distraction is over, thoughts are still held in memory and can recapture attention (Singer & Dobson, 2007). In this within-subject study, we aim to support our hypothesis by integrating an experimental mindfulness intervention with functional magnetic resonance imaging (MRI) and subjective reports of ruminative thoughts. We will examine a non-clinical sample with elevated scores on the Rumination Response Scale (RRS), comparable to the scores of a clinical sample. Participants will undergo functional MRI while applying mindful acceptance and distraction strategies immediately after inducing ruminative, self-referential thoughts. This enables us to assess how each intervention modulates ruminative brain states, using both neural measures (i.e., comparing correlation between ruminative brain states before and after each intervention) and subjective ratings of rumination before and after each intervention. We expect mindful acceptance to yield a greater reduction in the strength of neural readouts of the ruminative thoughts compared to distraction, reflecting its efficiency to disengage from rumination. Finally, this research project will pave the way to uncover the differential neural mechanisms of mindfulness and distraction on rumination , which may ultimately help develop effective treatment methods.