Presentazione Congresso Europeo Terapia Cognitivo Comportamentale, Helsinki, 2008 www.gabrielecaselli.it

1. Ruminationas a predictorofproblemdrinking Gabriele Caselli1,2, Chiara Bortolai3,Mauro Leoni1,4, Francesco Rovetto1, Marcantonio Spada5 1 Università degli studi di Parma, Parma, Italy 2 Studi Cognitivi, Scuola di Psicoterapia Cognitiva, Modena, Italy 3 Ospedale Privato Accreditato Villa Rosa, Modena, Italy 4 Fondazione Sospiro, Cremona, Italy 5Roehampton University, London, United Kingdom

2. Introduction Ruminationisa coping strategy for controlling negative affect that is characterisedby heightened self-focused attention involving persistent, recyclic, and depressive thinking(Lyubomirsky and Nolen-Hoeksema 1993) Ruminationisanimportantfactorin the vulnerability processes leading to the occurrence of, and relapse into, dysphoriaand major depressive disorder (Nolen-Hoeksema and Morrow 1991; Lyubomirskyand Nolen-Hoeksema 1993) The co-occurrence of alcohol use disorders and depressive symptoms has frequently been reported in problem drinking and psychiatric samples (Helzer and Pryzbeck1988; Petty 1992; Grant and Harford 1995)

3. Rumination and alcoholuse Rumination has been shown to increase the risk for depressive symptoms (Nolen-Hoeksema 1991) Alcohol use has been conceptualised as a cognitive self-regulatory strategy (Spada and Wells 2005; Spada et al. 2007) So... Ruminationmayincrease the risk of alcohol use as a means of attempting to control the ruminative process in itself (Nolen-Hoeksema et al. 2007) and its negative consequences like depressive symptoms

4. Aims (1) Examine the presence of rumination in individuals with problem-drinking relative to a community sample of social drinkers (2) Examine whether rumination would predict alcohol use independently of depression in a mixed clinical and community sample

5. Method Participants 36 patients (8 females) seeking treatment for problem drinking (47.4 years; SD=8.8; range=31-64) 37 social drinkers (9 females; 45.6 years; SD=10.0; range=28–60) Materials Depression (BDI), Rumination (RRS), Alcohol Use (QFS) Statistics Mann Whitney U-Tests, logistic regression analysis, hierarchical regression analysis

6. Results (1) Descriptive statistics and t tests Note: PD=Problem Drinkers CP=Community Participants ** = p < 0.001

7. Results (2) Logistic regression equation predicting problem drinking category membership The grouping variable was taken to be problem-drinking caseness Depression and rumination were entered as a block and were found to be significant predictors of problem drinking

8. Results (3) Hierarchical regression statistics

9. Discussion Problem drinkers and community participants were significantly different in rumination, depression and alcohol use Rumination and depression are significant predictors of category membership (with 75.3% of cases correctly classified) Rumination was found to account for a significant 4.0% (p< 0.05) of variance in problem drinking, in addition to the variance accounted for by depression Only rumination was found to be a significant predictor of alcohol use therefore mediating the relation between depression and alcohol use

10. Limitations Lackofneurological demonstration of ruminative tendencies to corroborate self-reported tendencies Social desirability, self-report biases, context effects and poor recall may have contributed to errors in self-report measurements The sample in this study was mainly male and was taken from one geographic region

11. Preliminaryconclusions General tendency to ruminate predicts category membership as a problem drinker and general alcohol use independently of depression These findings highlight a possible cognitive regulatory function of alcohol use aimed at controlling perseverative thinking patterns (such as rumination) The facilitation of skills that promote a direct change in rumination may be helpful in the treatment of depression in problem drinking

12. Whatnext… Employ longitudinal designs to assess the contribution of rumination to problem drinking (and relapse more specifically) using larger and more representative samples Investigate the nature of the focus of rumination to identify which typology of rumination contributes to problem-drinking behaviour Investigate the possible mechanisms linking rumination to problemdrinking, in particularwhether alcohol use does provide an escape from ruminative self-awareness Investigate whether duration of alcohol related problems has a mediating role on the tendency to ruminate