Ruminative thinking mediates the effects of exposure to adverse life events on psychotic-like experiences
Authors: Fazio Leonardo , Raio Alessandra , Banaschewski Tobias , Bokde Arun L. W. , Desrivières Sylvane , Flor Herta , Garavan Hugh , Gowland Penny , Grigis Antoine , Heinz Andreas , Martinot Jean-Luc , Paillère Martinot Marie-Laure , Artiges Eric , Nees Frauke , Papadopoulos Orfanos Dimitri , Paus Tomáš , Poustka Luise , Smolka Michael N. , Hohmann Sarah , Holz Nathalie , Vaidya Nilakshi , Walter Henrik , Whelan Robert , Schumann Gunter , Bertolino Alessandro , Pergola Giulio , Antonucci Linda A. ,   The IMAGEN Consortium
Published: November 2024

Introduction:

A growing literature has shown that exposure to adverse life events during childhood or adolescence is associated with the presence of psychotic-like experiences (PLEs), which is in turn associated with the risk of psychotic outcomes. Ruminative thinking, i.e., the tendency to dwell on particular issues or ideas, may affect the perceived aversiveness and ability to cope with adverse life events. However, the role that rumination plays in the relationship between adverse life events and the presence of PLEs remains unclear. The purpose of this study is to assess the association between adverse life events and PLEs in a longitudinal sample of young adults and adolescents, and to investigate whether this relationship is mediated by ruminative thinking.

Methods

We used a longitudinal naturalistic sample of 706 volunteers assessed at ages 18 and 22 years, within the Imagen consortium. Lifetime occurrence of adverse life events (i.e., events perceived as strongly negative by participants) was investigated using the Life Events Questionnaire. The Community Assessment of Psychic Experience (CAPE-42) served to assess the presence of PLEs, while ruminative thinking was investigated through the Ruminative Response Scale.

Results

Results showed that both frequency of PLEs and their persistence over time were associated with greater adverse life events exposure (r = 0.32, p &lt; 0.001 and F1 = 9.8; p &lt; 0.001, respectively) and greater ruminative response (r = 0.66, p &lt; 0.001 and F1 = 94.9; p &lt; 0.001, respectively). Mediation analyses showed that relationship between adverse life events and PLEs frequency was partially mediated by rumination (direct effect Z: 5.4, p &lt; 0.001; indirect effect Z: 6.9, p &lt; 0.001; total effect Z: 5.9, p &lt; 0.001). Considering changes between the two assessment timepoints, relationship between PLEs variation between 18 and 22 years and adverse life events occurred during the same period was partially mediated by changes in rumination (direct effect Z: 2.8, p &lt; 0.005; indirect effect Z: 4.3, p &lt; 0.001; total effect Z: 4.3; p &lt; 0.001).

Discussion

Overall, our findings confirm that the presence of adverse life events may increase the risk of experiencing PLEs in healthy individuals and suggest that dysfunctional coping strategies, such as ruminative thinking, may be related to psychosis proneness. Results do not disentangle whether individuals with greater risk for psychosis tend to ruminate more or whether rumination exacerbates psychosis risk.