HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 1

A Habit-Goal Framework of Depressive Rumination

Edward R Watkins

University of Exeter and University of Western Australia

Susan Nolen-Hoeksema

Yale University

Author Note

Edward R Watkins, Mood Disorders Centre, School of Psychology, University of Exeter,

and School of Psychology, University of Western Australia; Susan Nolen-Hoeksema, Department

of Psychology, Yale University.

Correspondence concerning this article should be addressed to Edward Watkins, Sir Henry

Wellcome Building for Mood Disorders Research, University of Exeter, EX4 4GG. E-

mail:e.r.watkins@exeter.ac.uk
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 2

Abstract

Rumination has been robustly implicated in the onset and maintenance of depression.

However, despite empirically well-supported theories of the consequences of trait rumination

(Response Styles Theory; Nolen-Hoeksema, 1991) and of the processes underlying state episodes of

goal-oriented repetitive thought (Control Theory; Martin & Tesser, 1989, 1996), the relationship

between these theories remains unresolved. Further, less theoretical and clinical attention has been

paid to the maintenance and treatment of trait depressive rumination. We propose that

conceptualizing rumination as a mental habit (Hertel, 2004) helps to address these issues.

Elaborating on this account, we propose a framework linking the Response Styles and Control

Theories via a theoretical approach to the relationship between habits and goals (Wood & Neal,

2007). In this model, with repetition in the same context, episodes of self-focused repetitive thought

triggered by goal discrepancies can become habitual, through a process of automatic association

between the behavioral response (i.e., repetitive thinking) and any context that occurs repeatedly

with performance of the behavior (e.g., physical location, mood), and where the repetitive thought

is contingent on the stimulus context. When the contingent response involves a passive focus on

negative content and abstract construal, the habit of depressive rumination is acquired. Such

habitual rumination is cued by context independent of goals, and resistant to change. This habit

framework has clear treatment implications and generates novel testable predictions.

Keywords: rumination, control theory, response styles, goal, habit, abstract

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 3

A Habit-Goal Framework of Depressive Rumination

Depressive rumination is the tendency to repetitively analyze oneself and one’s problems,

concerns, and feelings of distress and depressed mood (Nolen-Hoeksema, 1991; Watkins, 2008).

Prospective longitudinal and experimental studies have implicated depressive rumination in the

onset and maintenance of symptoms and diagnosis of major depression (Nolen-Hoeksema, 2000;

Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008; Watkins, 2008), as well as anxiety disorders,

eating disorders, and substance/alcohol abuse, leading to the hypothesis that it is a transdiagnostic

pathological process (Harvey, Watkins, Mansell, & Shafran, 2004; Ehring & Watkins, 2008; Nolen-

Hoeksema & Watkins, 2011).

The principal theory concerning depressive rumination is the Responses Styles Theory

(RST; Nolen-Hoeksema, 1991), which hypothesizes that depressive rumination is a stable,

enduring, and habitual trait-like tendency to engage in repetitive self-focus in response to depressed

mood (see Nolen-Hoeksema et al., 2008). RST argues that depressive rumination leads to

depression by enhancing negative mood-congruent thinking, impairing problem-solving, and

interfering with instrumental behavior, with these mechanisms confirmed in experimental studies

(Nolen-Hoeksema, 1991; Nolen-Hoeksema et al., 2008).

A distinct alternative view of rumination is provided by Control Theory accounts, which

define it as “a class of conscious thoughts that revolve around a common instrumental theme and

that recur in the absence of immediate environmental demands requiring the thoughts” (Martin &

Tesser, 1996, p.7). This account explains the conditions leading to state episodes of ruminative

thought. It hypothesizes that state rumination is initiated by and focused on a perceived discrepancy

between one’s goals and one’s current state and continues until the goal is either attained or

abandoned (Martin & Tesser, 1989, 1996). Unlike RST, this account encompasses both normal and

constructive versus abnormal and unconstructive forms of repetitive thought: goal-oriented

rumination can be helpful if focus on the unresolved goal facilitates progress, but unhelpful if it
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 4

only serves to increase salience of the discrepancy. Consistent findings confirm that unattained

personally important goals predict repetitive thought in real-world studies (see Watkins, 2008).

Watkins (2008) examined what processes determine whether repetitive thought has

unconstructive versus constructive consequences. During rumination, negative thought content,

negative context (e.g., negative mood), and abstract-evaluative thinking focused on the meaning and

implications of negative events (e.g., asking “Why?”) relative to concrete thinking focused on the

details, process, and context of negative events (e.g., asking “How?”), contribute to unconstructive

outcomes. In Control Theory, goals, events, and actions can be represented at different levels of

abstraction within a hierarchy ranging from abstract representations capturing their

decontextualized gist and characterizing why they occurred or are performed, down to concrete

representations of their contextual and situational details characterizing how they occurred or are to

be performed. Effective self-regulation requires flexible movement through the hierarchy to match

circumstances. Overly abstract processing of negative information was hypothesized and found to

be unhelpful because it increases the personal importance of events and exacerbates emotional

reactivity (Watkins, Moberly & Moulds, 2008) and impairs problem-solving by limiting the

availability of detailed alternative plans (Watkins & Moulds, 2005). This elaborated Control Theory

account (Watkins, 2008) provides a partial reconciliation between RST and Control Theory because

it identifies abstract-evaluative thinking focused on negative content as pathological, consistent with

the RST characterisation of depressive rumination as focusing on the causes and implications of

depressive mood.

Despite the successes of these theories, key questions such as “What are the developmental

antecedents of individual differences in rumination?” and “What makes it so difficult to break free

of rumination once it has begun?” remain unanswered (Nolen-Hoeksema et al., 2008, p. 418).

Moreover, the relationship between state episodes of goal-oriented repetitive thought and the trait

tendency towards depressive rumination is unresolved. Are they separate and distinct processes? Or
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 5

do some individuals transition from state episodes of goal-oriented rumination into more habitual

depressive rumination?

A major but relatively unelaborated implication within RST is that depressive rumination is

a habitual cognitive response to negative mood (Nolen-Hoeksema et al., 2008). We propose that

more explicitly considering rumination as a mental habit (see Hertel, 2004) has value in generating

potential insights and testable hypotheses relevant to these issues. Habits are behaviors that are

performed frequently in stable contexts (Ji & Wood, 2007). In classical conditioning and learning

theory (e.g., Hull, 1943), habits are learned behavioral responses to situational cues that have

become established through a history of systematic repetition and reinforcement. A stimulus-

response (S-R) habit is learnt when a particular behavioral response is contingent on the stimulus

(Dickinson, 1985; Mackintosh, 1983; Rescorla & Wagner, 1972). For example, with overtraining or

training with interval schedules of reward contingency, animals learn to perform a response

habitually to set cues, even when the reward is devalued, for example, by making animals mildly ill

with a lithium chloride injection after consuming sucrose pellets (Dickinson, 1985).

Wood and Neal (2007, p. 843) defined habits as “learned dispositions to repeat past

responses. They are triggered by features of the context that have covaried frequently with past

performance, including performance locations, preceding actions in a sequence, and particular

people.” Habitual behavior typically involves some automaticity (Verplanken, 2006; Verplanken &

Orbell, 2003; Wood, Tam, & Guerrero Witt, 2005). A behavior can be conceptualized as automatic

on several distinct dimensions: lack of conscious awareness, not requiring extensive resources to be

performed (e.g., performed equally well under cognitive load versus not under load), lack of

control, and lack of conscious intent (Bargh, 1994). Verplanken, Friborg, Wang, Trafimov, and

Woolf (2007, p. 526) proposed that a habit is “a behavior that has a history of repetition, is

characterized by a lack of awareness and conscious intent, is mentally efficient, and is sometimes

difficult to control.”
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 6

As a response that occurs frequently, unintentionally, and repetitively to the same emotional

context (depressed mood), depressive rumination fulfils all of these conceptualizations of habit. Its

gold standard measure, the Response Styles Questionnaire (Nolen-Hoeksema & Morrow, 1991),

assesses the frequency of repeated ruminative behaviors in response to the stable internal context of

feeling sad, down, or depressed. Depressive ruminators report that rumination occurs without

conscious intent, and that they are unable to control it (Watkins & Baracaia, 2001). A self-reported

index of habitual negative thinking capturing frequency, lack of conscious awareness, lack of

conscious intent, mental efficiency, and difficulty in control, was positively correlated with both

trait and state rumination (Verplanken et al., 2007).

More explicitly, Hertel (2004) hypothesizes that rumination is a habit of thought, noting that

the initiation of an episode of rumination often occurs automatically, without conscious awareness

or effort. Hertel argues that impairments in cognitive control may enable the emergence of such

mental habits. Situations in which stimulus and task dimensions do not inherently constrain and

guide attention (e.g., tasks with lax external control) afford habitual rumination in patients with

depression (Hertel, 1998) whereas situations constrained to force participants to sustain attention on

particular task stimuli do not (Hertel & Rude, 1991). Outlining an argument further developed here,

Hertel (2004, p. 208) proposes that “the best antidote to maladaptive habits is a new set of habits”

formed through repeated practice at more controlled responses.

In this paper, we focus on analysing depressive rumination as a habit, consistent with Hertel

(2004), whilst adding Wood and Neal’s (2007) empirically-supported theoretical framework. We

propose that applying this habit-goal framework provides a means to understand the relationship

between trait depressive rumination (RST) and goal-oriented state repetitive thought (Control

Theory), helps to explain why rumination may be hard to change, and suggests novel therapeutic

implications and testable predictions.

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 7

A Habit-Goal Framework of Depressive Rumination

Wood and Neal (2007) argue that repeated performance of a behavior in a consistent context

can lead to the development of habitual responding via (1) associative learning and (2) instrumental

learning. They identify three interrelated principles that summarize the development and

performance of habits: (1) habits are cued by context; (2) habit context-response associations are

not mediated by goals; (3) since habits are acquired slowly with experience, they are inherently

conservative and tend to persist even in the face of antagonistic current goals or intentional

behavior. These principles reflect properties within conditioning models (Mackintosh, 1983;

Rescorla & Wagner, 1972), in which (1) habits are acquired when responses are contingent on

stimulus contexts; (2) S-R habit strength is not mediated by goals; (3) Because habits are acquired

slowly, they extinguish or counter-condition slowly. We propose that these principles provide a

useful framework to consider how the consequences of habits may play out in depressive

rumination, with implications for understanding and treating depressive rumination.

First Principle: Habits are Directly Cued by Context as a Result of Frequent Covariation of

the Behaviour with the Cueing Context.

Wood and Neal (2007, p. 844) propose that “habits typically are the residue of past goal

pursuit: they arise when people repeatedly use a particular behavioral means in particular contexts

to pursue their goals”. Such context cues become automatic triggers for the behavioral response,

such that the behavior is controlled by the presence or absence of the cue, rather than mediated by

an implicit or explicit goal. Thus, a goal-based response that occurs frequently and contingently to a

particular context could result in the development of a habitual response to that context, consistent

with classic stimulus-response (S-R) theories of learning (Mackintosh, 1983). Context includes

physical setting (e.g., bedroom), time of day, the people (e.g., alone), behaviors performed prior to,

and internal state (e.g., mood, fatigue, Ji & Wood, 2007), and any combination thereof, in which the

behavior typically occurs.

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 8

The formation of associative links between the habitual response and a potential cueing

context requires the repeated co-activation of the mental representations of both response and

context, as a consequence of contingent pairings between the response and the cueing context

across multiple episodes in the environment. The learning of a habit (S-R association) requires the

context and the response to occur close together in time (temporal contiguity), and for the potential

habitual response (e.g., rumination) to be contingent on the stimulus context. With repetition across

multiple episodes, incremental changes are hypothesized to occur in procedural memory, such that

the common features of response and context become learnt and encoded (Gupta & Cohen, 2002).

Importantly, multiple different behaviors occurring to a particular context will weaken any reliable

co-variation and contingency between any one particular habitual behavior and the contextual cue:

“the greater the numbers of behaviors linked to a given context, the lesser the capacity for the

context to cue any one behavior directly” (Wood & Neal, 2007, p.858).

Implications for Depressive Rumination

This habit-goal framework suggests that depressive rumination will become a habitual trait

if state episodes of ruminative thought are contingent on the context of negative mood, such that the

negative mood state becomes an automatic cue for ruminative thought. This account provides a

mechanism by which state episodes of repetitive thought initiated by goal-discrepancy (consistent

with Control Theory) can become habitual if such thinking is contingent on a co-occurring context

(negative affect) (consistent with RST). With respect to goal-discrepancy accounts of rumination

(Martin & Tesser, 1989, 1996; Watkins, 2008), the identification of an unresolved goal (or of

insufficient goal progress) can directly generate repetitive thought as a function of increased

priming and accessibility of goal-relevant information, and the perseverance of goal-related

thoughts (Brunstein & Gollwitzer, 1996; Goschke & Kuhl, 1993; Martin & Tesser, 1989; Zeigarnik,

1938).

Control theory accounts (Carver & Scheier, 1982) and goal models of emotion (Oatley &

Johnson-Laird, 1987) also predict that insufficient goal progress can generate negative affect (e.g.,
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 9

perceived loss of valued goal produces sadness). These dual effects of unresolved goals afford the

opportunity for sad mood (or other mood states) to co-occur with repetitive thought, making it a

potential mechanism for developing habitual repetitive thought. Building on Wood and Neal (2007),

this goal-habit framework suggests that habitual rumination can emerge as an unintended residue of

goal-oriented repetitive thought.

However, the repetitive thought produced by unresolved goals is not necessarily

pathological: as noted earlier, goal-oriented repetitive thought can be constructive (Watkins, 2008).

Thus, the habit of pathological depressive rumination would only develop under conditions where

the form of state repetitive thought contingent on a stable context (e.g., depressed mood) was

predominantly passive, negative, and abstract. If over time, an individual used a range of different

behaviors (e.g., distraction, abstract thought) in response to unresolved goals and associated

negative mood, there may be no distinct contingency between context and response, and no

particular habit would develop. Conversely, the repeated use of concrete action-oriented thinking in

the face of goal-discrepancy might buffer against the development of unhelpful rumination-as-a-

habit (Watkins, 2008), instead forming a helpful habit of problem-solving to sad mood. Thus, the

co-occurrence of episodes of goal-discrepancy rumination and negative mood is insufficient to

result in trait depressive rumination, explaining why many people can experience occasional

episodes of negative rumination without necessarily developing depressive-rumination-as-a-habit.

This habit-goal framework suggests hypotheses about the developmental antecedents of

individual differences in depressive rumination. The formation of habitual depressive rumination is

hypothesized to involve two background conditions: (1) Environments and situations that generate

repeated and frequent episodes of goal-discrepancy repetitive thought contiguous and contingent

with negative mood (and other contextual cues, e.g., behavior of others; locations), such as the

experience of having hard-to-abandon personally important goals chronically thwarted (e.g.,

chronic stress, abuse, or trauma); (2) A restricted repertoire of coping behaviors and/or reduced

flexibility in selecting behaviors within this repertoire, constraining individuals towards passive and
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 10

abstract responses, which increases the likelihood of unhelpful episodes of repetitive thought

becoming contingent to negative mood.

To date, these background conditions have tended to be studied in isolation. A novel

prediction from this framework is that the effect of one background condition on the formation of

rumination-as-a-habit will be moderated by the presence or absence of the other condition. Being in

an ongoing difficult situation will not necessarily lead to habitual depressive rumination: Ongoing

difficulties may lead to episodes of state rumination as a normal and often adaptive response to

unresolved goals but this will not result in habitual depressive rumination unless unhelpful episodes

of repetitive thought are contingent on the associated context (e.g., sad mood), which will be

facilitated by a reduced range of coping options. Conversely, having a tendency towards abstract

processing or passive responses will not necessarily lead to habitual depressive rumination, unless

there are ongoing unresolved goals that afford the opportunity for repeated episodes of repetitive

thought in a co-occurring context, leading to repetitive thought being contingent on negative mood.

Of course, some circumstances may simultaneously produce both conditions (e.g., neglect, abuse),

and are thus significant risk factors for habitual rumination.

Consistent with exposure to chronically unresolved goals acting as a setting condition, trait

depressive rumination is associated with history of sexual abuse, emotional abuse, and assault,

which reflect situations in which major personal goals of safety, affiliation, and sense-making tend

to be chronically unresolved (e.g., Conway, Mendelson, Giannopoulos, Csank, & Holm, 2004;

Spasojevic & Alloy, 2002). Further, ongoing chronic stress and reduced sense of mastery in women

predicted increases in trait rumination over time (Nolen-Hoeksema, Larson, & Grayson, 1999).

This account hypothesizes that developmental circumstances and socialization processes

that encourage limited and passive responding increase the likelihood of developing habitual

rumination. Such circumstances include overcontrolling parenting, reduced positive reinforcement,

and socialization into the stereotypically feminine gender role identity.

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 11

Operant conditioning approaches hypothesize that when active responses repeatedly fail to

receive sufficient positive reinforcement, the contingency learnt is that there is no value in being

active, leading to a reduced behavioral repertoire and increased passive responding (Ferster, 1973).

Thus, any environment characterized by reduced positive reinforcement is hypothesized to engender

the development of passive responding. Mothers who did not explicitly encourage their 5-7 year old

children to try different approaches and who told the child what to do, had children who become

more helpless, passive, and poorer at active problem-solving when faced with an upsetting and

frustrating situation (Nolen-Hoeksema, Mumme, Wolfson, & Guskin, 1995). Consistent with such

parenting being associated with habitual rumination, in a retrospective design Spasojević and Alloy

(2002) found that undergraduates who reported over-controlling parenting during their childhood

reported increased trait rumination, after controlling for levels of psychopathology. Further, in a

multi-wave prospective study, Gaté et al. (2012) found that laboratory observation of reduced

positive maternal behavior (indexed by frequency of happy, pleasant, or caring affect, and

approving, validating, affectionate, or humorous statements) when discussing and planning a

pleasant event with the child at age 12 prospectively predicted trait depressive rumination in the

child at age 15, but only in girls. Thus, fewer validating and caring responses from mothers to

daughters when jointly planning a pleasant event predicted later rumination. This gender effect is

consistent with the commonly found gender difference in the expression of rumination, with

rumination more frequent in girls and women than boys and men (Nolen-Hoeksema et al., 1999),

with this gender difference emerging in early adolescence (ages 12-13; Jose & Brown, 2008).

This gender difference in rumination may partially reflect developmental differences in the

socialization into gender role identities. The stereotypically feminine gender role identity

emphasises greater focus on emotions and passivity. Therefore, socialization into this gender role is

hypothesized to increase the likelihood of developing rumination-as-a-habit. Consistent with this, in

a prospective longitudinal study, Broderick and Korteland (2004) found that 9-12 year old school

children strongly identifying with the feminine role identity reported significantly more trait
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 12

rumination at follow-up, regardless of gender. Cox, Mezulis and Hyde (2010) found that greater

feminine gender role identity amongst children at age 11 and maternal encouragement of emotion

expression in response to the child completing a difficult math task each separately mediated the

relationship between child gender and the development of trait depressive rumination at age 15,

after controlling for trait rumination at age 11.

An abstract style of responding to difficulties is also implicated in impaired problem-solving

and reduced action orientation (Watkins, 2008). In healthy individuals, there appears to be

flexibility and contextual variability in the use of abstract versus concrete processing, with

individuals adopting abstract processing as a default mode, particularly when in positive mood, but

switching towards concrete processing in response to difficulties and sad mood (Beukeboom &

Semin, 2005; Watkins, 2011). This flexibility in regulating processing mode to different contexts is

hypothesized to be functional, with concrete processing aiding problem-solving, and thus adaptive

for difficult situations, whereas abstract processing aids longer-term planning, generalization, and

consistency and stability of behavior towards long-term goals across time and situations, and is thus

adaptive when things are going well. There are individual differences in the tendency and/or ability

to regulate processing mode to context, with depressed patients impaired at becoming more

concrete in response to sad mood relative to healthy controls (Watkins, 2011; Watkins, Moberly, &

Moulds, 2011). We hypothesize that these individual differences influence the formation of habitual

depressive rumination: Impaired regulation of processing mode reduces flexibility in responding

and increases the likelihood of episodes of repetitive thought being unhelpful, providing

circumstances for such thinking to become contingent on low mood.

Such dysregulation of processing mode could reflect deficits in cognitive control:

Individuals with deficits in executive/inhibitory control, either because of greater cognitive load or

reduced cognitive resources, may be impaired at effectively regulating processing in response to

situational demands (Watkins, 2011). Dysregulation of processing mode could also be the

consequence of past developmental learning and parenting style. Praising or criticising a child
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 13

generically (i.e., as a person, “You are a good boy”), rather than giving feedback on the specific

process and concrete behaviour (e.g., “You came up with a good solution”) can lead children to

think in abstract trait terms (for both positive and negative events), leading to helplessness in

response to later mistakes (Cimpian, Arce, Markman, & Dweck, 2007; Kamins & Dweak, 1999).

The hypothesized relationship between habitual depressive rumination and a restricted

coping repertoire is probably bi-directional. As well as a reduced range of coping strategies

increasing the chance of episodes of unhelpful repetitive thought becoming contingent on negative

mood, habitual rumination may also reduce flexibility in selecting coping strategies. Rumination

mediates the relationship between induced negative affect and working memory capacity (Curci,

Lanciano, Soleti, & Rimé, 2013) and causally reduces central executive functioning (Watkins &

Brown, 2002), which are implicated in flexible responding.

Second Principle: Habit Context-response Associations are not Mediated by Goals.

Wood and Neal (2007) suggest that the habitual response is then activated by the perception

of the cues in the context where the behavior has been repeatedly performed, such that the habit is

performed without mediation by a goal. Supporting this account, contexts but not goals

automatically trigger overt habit performance (Ji & Wood, 2007; Neal, Wood, Labrecque, & Lally,

2012). For strong habits, attitudes and intentions have limited predictive power on behavior,

whereas one index of habit strength (operationalized by combining frequency and stability of

behavior to the same context) predicts how much people repeat behaviour, even in the absence of an

explicit supporting goal (Ji & Wood, 2007; Neal et al., 2012; Ouellette & Wood, 1998).

Implications for Depressive Rumination

The goal-habit framework suggests that depressive rumination would be triggered by the

relevant cueing context (e.g. negative mood) in the absence of a personally important unresolved

goal or of an intention to think about the related concern. The habit being directly cued by context

means that depressive rumination can occur without direct intention and without effort. Once the

habit is formed, rumination can still occur even if the unresolved goals that originally triggered
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 14

episodes of state repetitive thought have been attained or abandoned. Moreover, negative mood

states induced by processes other than a perceived goal discrepancy, such as direct

physical/biological effects (e.g., effect of weather, pharmacological agent) or direct responses to

stimuli (e.g., empathic response to another’s distress, watching a sad movie) could then trigger

rumination, extending the range of situations cueing this response.

This principle could be tested by adapting the methodologies used by Ouellette and Wood

(1998) and Neal et al., (2012) in which habit strength, context, explicit goals, self-efficacy, attitudes

and beliefs are examined as prospective predictors of the repeated behavior (episodes of depressive

rumination). Habit strength is hypothesized to predict subsequent ruminative behavior, as assessed

by diary or experience sampling methods, over and above motivational and belief variables.

Motivated Cueing and Instrumental Learning

In addition to associative learning, Wood and Neal (2007, p. 846) propose that “habit

associations may also arise through a process in which the reward value of response outcomes (e.g.,

positive affect from eating popcorn) is conditioned onto context cues (e.g., movie theater) that have

historically accompanied the receipt of those rewards. This analysis builds on instrumental learning

theories in which habits develop as organisms learn context-response associations in order to obtain

rewarding events.” In this process of motivated cueing, given sufficient repetitions, the reward

associated with a response is conditioned on the contextual cue, such that the cue then motivates the

response by activating a desire or urge towards the response as an opportunity to acquire the

associated reward.

Because depressive rumination has such clear negative consequences, it is not obvious what

potential reward value or instrumental function it may have. Nonetheless, motivated cueing could

potentially cement the strength of the habit if robust reinforcing functions for rumination exist.

Rumination has been hypothesized to act as avoidance that is negatively reinforced by

reducing distress. Martell, Addis, and Jacobson (2001, p.121) proposed that “although rumination

may be experienced as aversive to the individual, it is possible that it is maintained by the avoidance
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 15

of even more aversive conditions.” Rumination may put off overt action and avoid the risk of actual

failure and humiliation, or serve to avoid unwanted personal characteristics (e.g., becoming selfish)

through constant vigilance and criticism of one’s performance. Nolen-Hoeksema et al., (2008)

hypothesized that rumination is reinforced by the reductions in distress that come from withdrawing

from aversive situations and from being relieved of responsibility for outcomes. Although trait

rumination is correlated with avoidance (e.g., Giorgio et al., 2010), this is not direct evidence that

rumination has an avoidant function.

Rumination may also have perceived positive reward value as a means to increase

understanding and insight into self, feelings, and problems and to make sense of difficulties

(Lyubomirsky & Nolen-Hoeksema, 1993; Watkins & Baracaia, 2001). Believing that rumination

increases understanding predicts the maintenance of trait rumination over 8 weeks prospectively

(Kingston, Watkins, & O’Mahen, in prep), whilst experimentally manipulating appraisals that

rumination is helpful versus unhelpful for understanding problems causally influenced state

rumination occurring to a subsequent failure task (Kingston, Watkins, & Nolen-Hoeksema, in prep).

However, there is no direct experimental evidence of whether depressive rumination has any

reinforcing qualities and whether they consolidate it as a habit. Testing this functional hypothesis is

challenging: Each individual may have his or her own idiosyncratic function(s) for rumination,

making it hard to detect the effects of manipulating rumination on functional outcomes within

standardised experimental conditions. Experimental studies also need to ensure that the function-

under-test is of value to the participant. For example, there is no point in testing for an avoidant

function unless the study design exposes the participant to a sufficiently negative experience that it

is meaningful and motivating for the participant to avoid. Kingston, Watkins and Nolen-Hoeksema

(submitted) exposed undergraduates to the challenging situation of believing they had to be

assertive to a friend or family member about a difficult issue, before randomising them to

ruminating about this situation versus thinking over the situation in a non-ruminative way, and

assessed various indices of avoidance as dependent variables. Consistent with Nolen-Hoeksema et

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 16

al., (2008) hypothesis, rumination increased justification for avoidance by reducing sense of

responsibility and increasing certainty that efforts would be fruitless, relative to the control

condition.

This design only tested whether manipulating rumination influences outcomes that enable

inference about function. A necessary further stage to test the functional hypothesis is to examine

whether such inferred functions increase the use of rumination. One potential next step is to test

whether individual differences in the effect of manipulated rumination on justification for avoidance

prospectively predicts trait rumination.

Third Principle: Because Habits are Acquired Slowly with Experience, They are Conservative

and Do Not Alter in Response to Current Goals or Infrequent Counter-Habitual Responses.

Wood and Neal (2007, p.844) argue that “habits arise from context-response learning that is

acquired slowly with experience. As a result, habit dispositions do not alter in response to people’s

current goals or occasional counter-habitual responses. Thus, habits possess conservative features

that constrain their relation with goals.” Hertel (2004, p.208) noted that “habits of thought are

difficult to oppose.” Habits are insensitive and resistant to changes in goals, outcomes, and

intentions, including the devaluing of outcomes (Dickinson, 1985).

Because control of a habitual behavior is outsourced directly to those contextual cues that

have been reliably paired with past enactment of the behavior, habits are enacted and performed

without reference to goals or outcomes. Because a habitual behavior is not especially sensitive to

either outcomes or goals, it continues to be performed even if it has unhelpful outcomes. Further,

because automatic cueing of behavior in response to contextual cues is likely to be more

immediately available and require less executive capacity than more deliberate and thoughtful

actions, it will tend to take precedence over intentional behaviors. Thus, when in conflict with

habits, goals have little impact on actual behaviour. Similarly, when goals are in concert with habits

and both dictate the same response, goals effectively become epiphenomena.

Implications for Depressive Rumination

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 17

This analysis suggests that once rumination becomes a habit, it will be hard to stop even if

new behavioral goals are adopted, even if it has negative consequences, or even if the rumination is

at odds with an individual’s attitudes and intentions. This is consistent with the phenomenological

quality reported by patients of “not being able to help” ruminating (Watkins & Baracaia, 2001).

Intentions to stop ruminating alone are unlikely to be successful and habitual rumination will be

resistant to change. The goal-habit framework thus provides a partial explanation of why patients

find it so difficult to break free of rumination once it has begun, even when they recognise it has

negative consequences.

Implications for the Treatment of Depressive Rumination

This framework offers a fresh approach to considering interventions for depressive

rumination when allied with the literature on successful habit change. It suggests, for the reasons

noted above, that interventions focused on changing individual’s beliefs, attitudes, and intentions

and providing new information are unlikely to be effective at changing habitual behaviors, as

empirically confirmed by Verplanken and Wood (2006) and Webb and Sheeran (2006). Changing

goals, persuasion, cognitive restructuring, or psycho-education is thus hypothesized to be less

effective at changing depressive rumination. Although trait rumination has not been frequently

examined in randomized controlled trials of psychological interventions, the few extant studies

suggest that rumination does not change significantly in response to cognitive behavioral therapy

(CBT) (Schmaling, Dimidjian, Katon, & Sullivan, 2006) or that elevated rumination predicts worse

outcomes to CBT (Jones, Siegle, & Thase, 2007). We hypothesize that the more rumination is a

strong (versus weak) habit, the harder it will be for patients to stop, and the less successful

information-based interventions will be (Webb & Sheeran, 2006).

Instead, Wood and Neal (2007, p.860) propose that “interventions to maximize habit change

provide people with concrete tools for controlling habit cueing”. The current framework suggests

that habits can be broken by altering or avoiding exposure to the cues that trigger habit performance

(Verplanken & Wood, 2006). Removing contextual cues could occur as a consequence of deliberate
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 18

attempts to control cue exposure, which may require ongoing and sustained effortful control to

identify and avoid relevant cues, or from unplanned changes that occur naturally as a consequence

of life events, such as moving house or changing job. Wood, Tam, and Guerrero Witt (2005) found

that when the location or environment associated with a habitual behavior (e.g., TV watching)

changed when students transferred to a new university, the behavior became less habitual.

Hence, this framework suggests that one way to reduce depressive rumination is to alter or

reduce exposure to its triggering context. Where the cueing context for rumination involves a

particular location (e.g., bedroom), person, preceding behavior (e.g., sitting down for a coffee after

work) or environmental feature (e.g., sad music), environmental modification to remove or avoid

the triggering context is hypothesized to interrupt depressive rumination.

One context identified by Hertel (1998; 2004) is situations that lack external control over

attention and that therefore afford mind-wandering. Habitual rumination is more likely to occur

when the current activity or task does not externally constrain attentional focus. Habitual rumination

will be triggered during tasks that are open-ended, unstructured, and rely on self-control, and when

an individual has an “empty” unplanned period of time, such as lying in bed doing nothing.

Introducing more structure and constraints into activities may change the context to reduce the

triggering of habitual rumination.

A long-term reduction in rumination is possible if contextual cues can be permanently

removed or consistently avoided. However, this strategy is dependent on individuals being able to

accurately identify cues for habits, requiring a detailed functional and contextual analysis to

determine the triggering cues for rumination, although this may not always be successful.

Consistent with this hypothesis, an intervention incorporating functional analysis and stimulus

control (Rumination-focused CBT; Watkins et al., 2007, utilising behavioral activation principles,

Martell et al., 2001) successfully reduced depression and rumination (Watkins et al., 2011) in a

randomised controlled trial. However, this treatment had multiple components and the effectiveness

of stimulus control has not been tested as a separate intervention. This framework predicts that
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 19

stimulus control alone will reduce trait depressive rumination when there are identifiable

environmental cues tractable to modification.

However, when the cueing context is an internal state, such as a negative mood, as typical

for depressive rumination, it is less straightforward to permanently alter or avoid the context. This

framework predicts that reducing the negative mood would, at least temporarily, reduce the

enactment of the depressive rumination habit. This framework predicts that any intervention that

reduces negative mood, whether antidepressant medication, psychotherapy, distraction, or change in

circumstances, would reduce the expression of habitual rumination by removing one cue that

triggers the ruminative habit. Consistent with this, self-reported trait rumination reduces as acute

symptoms of depression diminish (Roberts, Gilboa & Gotlib, 1998).

However, a key implication of this framework is that removing the context does not change

the context-response association underlying the habit but only limits its expression. On any

subsequent return of the triggering context, such as another period of sad or depressed mood, the

ruminative habit would reoccur. This analysis therefore predicts that any interventions that improve

mood state will temporarily disrupt depressive rumination, but only interventions that directly

modify the context-response association will lead to long-standing reductions in depressive

rumination and associated depressive vulnerability. In sum, improvements in mood can temporarily

reduce rumination by removing a potential cue for the habit. However, because of their conservative

nature, habits are easily reactivated and do not change unless the S-R association itself is counter-

conditioned.

This account can partially explain the high rates of relapse and recurrence (50-80%) and the

limited sustained recovery (less than 1/3 at 1 year) obtained for even our best interventions for

depression (Hollon et al., 2002). We hypothesize that many interventions for depression improve

symptoms in the short-term through positive expectancy, remoralization, increased activation, and

therapist support, but because they do not directly target depressogenic habits like rumination, they

leave patients vulnerable to relapse. A novel testable prediction is that post-treatment measures
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 20

indexing habit strength for rumination (and alternative coping strategies) will better prospectively

predict sustained recovery for depression than post-treatment beliefs, expectancies, and symptoms.

One such measure is the Self-Report Habit Index, which measures the frequency and automaticity

of behaviour, has good reliability and validity predicting actual habitual behavior (Orbell &

Verplanken, 2010; Verplanken & Orbell, 2003; Verplanken et al., 2007), and is adaptable for

different behaviors.

This key implication suggests that directly targeting the automatic context-response

association will improve the efficacy and durability of interventions for rumination and depression.

Marteau, Holland, and Fletcher (2012) noted that most interventions aimed at changing health-

related behaviors target reflective processes rather than automatic habits, and that this may explain

the relative inefficacy of these interventions. We propose that this analysis is equally pertinent to

improving mental health, because automatic mental habits (e.g. rumination) are a central process

within psychopathology.

To be effective at modifying the context-response association and, thereby, reducing

habitual rumination, the unhelpful ruminative response to the cueing context needs to be replaced

with a more helpful response, with the patient in effect learning a new more adaptive habit. This

echoes Hertel (2004, p.209) recommendation towards “the training of new habits through practice

in control.” Changing these habits requires “counterconditioning or training to associate the

triggering cue with a response that is incompatible and thereby conflicts with the unwanted habit”

(Wood & Neal, 2007, p.859). Such an intervention involves repeated practice at utilizing an

alternative incompatible coping strategy (e.g., concrete thinking, relaxation) in response to the

identified triggering contextual cue (e.g., sad mood) to develop the new context-response

association. Critically, this habit analysis predicts that systematically counter-conditioning

alternative functional responses to the cueing context for rumination will improve prevention of

relapse and recurrence, whether as a distinct acute treatment or following successful acute treatment

of depression.
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 21

This analysis suggests that traditional CBT approaches such as thought challenging will not

necessarily be effective at changing habitual rumination. Successfully challenging a thought or

belief would not change the underlying S-R habit. However, thought challenging could potentially

be an effective intervention for rumination if repetitively trained as an alternative coping skill in

response to cues for rumination.

By the same logic, cognitive bias modification (CBM) approaches used to change negative

biases (Hertel & Mathews, 2011) are likely to have value in reducing habitual rumination. CBM

typically involves the repeated training of desired responses, incorporates programmed

contingencies between stimuli, responses, and desirable outcomes (e.g., faster task performance),

and is assumed to involve the same associative and instrumental learning processes as habit

formation and to work on processes that are often outside conscious awareness. Thus, Hertel and

Mathews (2011, p.528) argued that “in interpretation retraining, contingencies between ambiguous

situations and their pre-experimental resolutions are, in effect, counter-conditioned.” There is now

initial evidence supporting the assumption that CBM influences mental habits: Hertel, Holmes, and

Benbow (in press) used a variant of Jacoby’s (1996) process dissociation approach to confirm that

interpretation bias training changed automatic, habitual processes rather than controlled

recollection. Further, there is growing evidence that rumination is associated with biases in

disengaging attention from negative information (Koster, De Lissnyder, Derakshan, & De Raedt,

2010), abstract construal (Watkins, 2008) and negative interpretative bias (Mor, Hertel, Ngo,

Shachar, & Redak, in press). CBM approaches therefore seem particularly pertinent to changing

mental habits. The effects of CBM may perhaps be enhanced by training adaptive biases in response

to contextual cues for unwanted habits, with Hertel and Mathews (2011, p.529) arguing that

“training should incorporate situational cues that typically provoke the deployment of negative

biases in real life”.

Practice may need to be more extensive than typically employed in current psychological

interventions. Lally, Van Jaarsveld, Potts and Wardle (2010) examined the development of habits
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 22

for volunteers practising an eating, drinking, or exercise behavior daily in the same context. Self-

reported automaticity of the trained response increased with repetition in the consistent context but

took a median of 66 repetitions to reach a training plateau, with considerable individual variation.

Moreover, to ensure the required cueing context (e.g., mood state) is active prior to practising the

alternative response, treatment may require active attempts to engineer the cueing context in therapy

sessions, such as mood challenges or in imago exposure to cues. Such challenges provide an

opportunity to test whether the habitual response to the cue has changed. This framework suggests

that assessing the habitual nature of rumination and alternative coping strategies during therapy has

clinical value to determine whether a new habit has successfully been trained. Practice and training

would optimally continue until the new adaptive habit reaches a self-reported asymptote.

To our knowledge, there has only been one explicit attempt to test repeated training of an

alternative response to the contextual cues for rumination as an intervention. Building on the

evidence that concrete processing is an adaptive alternative to depressive rumination (Watkins,

2008), a proof-of-principle randomized controlled trial found that training dysphoric individuals to

be more concrete when faced with difficulties reduced depression, anxiety, and rumination relative

to a no-treatment control (Watkins, Baeyens, & Read, 2009). Concreteness training is a form of

CBM that involves repeated practice at focusing on the specific details, context, and sequence of

difficult events and asking “How the event happened?” During the training, concrete thinking is

explicitly used as a response to identified warning signs for rumination, and practiced repeatedly

with audio-recorded exercises.

In a Phase II randomized controlled trial, concreteness training was found to be superior to

treatment-as-usual in reducing rumination, worry, and depression in patients with major depression

recruited in primary care (Watkins et al., 2012). A control relaxation training condition, in which

patients practised progressive relaxation as an alternative response to cues for rumination, also

significantly reduced depression relative to treatment-as-usual and did not significantly differ from
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 23

concreteness training. These results suggest that repeated training in any functional alternative

response to rumination may be an effective intervention, consistent with the current habit analysis.

Relative to relaxation training, concreteness training significantly reduced trait rumination,

suggesting that interposing a cognitive alternative may be more effective at reducing habitual

rumination, perhaps because it facilitates adaptive repetitive thought in place of maladaptive

repetitive thought as an example of transfer-appropriate processing (see Hertel & Mathews, 2011

for full discussion). Moreover, consistent with the hypothesis that concreteness training works

through establishing an alternative habitual response to replace rumination, the benefits of

concreteness training were significantly stronger in those patients who reported that the practised

self-help response had become habitual (Watkins et al., 2012).

This habit analysis has implications for the generalizability and sustainability of clinical

improvement. Several theorists (Bouton, 2000; Hertel & Mathews, 2011; Wood & Neal, 2007) have

noted that new patterns of associative learning (i.e., new functional S-R associations) intended to

replace older patterns of associations are inherently unstable, enabling the original patterns of

learning to recur under certain circumstances. These recurrences occur because the original learning

that underpins the unwanted habit remains intact following counter-conditioning or extinction, with

new learning overlaid on the original learning. In these circumstances, a conditioned cue (e.g., sad

mood) is in the position of potentially signalling two available cue-response associations (e.g.,

rumination versus concrete thinking). Which association is predominant and which behavior it

evokes will be determined by the current occasion-setting context. If there are differences between

the setting contexts under which the original learning and subsequent counter-conditioning occur,

shifts back to the original setting context can renew the original relationship and original

contingencies. A key implication of considering rumination-as-habit is that despite conditioning of

new responses, the old habitual response can recur under particular circumstances, potentially

leading to relapse. Thus, even after successful counter-conditioning of a new habitual response to
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 24

sad mood, there may be a lapse back into rumination when the conditioned cue is encountered in a

different setting context.

Moreover, because the original unwanted habit typically results from a large number of

learning trials in which the triggering cue and the habitual response were paired over many different

settings and situations, more setting contexts will be associated with the original unwanted habit

than the replacement habit, which may be constrained to fewer contexts (e.g., the therapeutic

setting). One way to counter these renewal effects is to promote the retrieval of the new learning

(i.e., the new habit) through explicit retrieval cues and reminders throughout and after the training

(e.g., flashcards, texts from therapist, Hertel & Mathews, 2011). Another approach is to increase the

generalization of the counter-conditioning by conducting the training across different and varied

contexts (e.g., using multiple variants of the cueing context; pairing sad mood with new response in

different settings: at home, at the office, when alone, with other people; see Hertel & Mathews,

2011 for further detail).

In addition, the performance of unwanted habits becomes more likely when individuals are

under cognitive load, distracted, preoccupied, or stressed (Botvinick & Blysma, 2005; Schwabe &

Wolf, 2011). We hypothesize that the habitual ruminative response is more likely to be triggered

under circumstances of stress, pressure, or fatigue. The ruminative response is thus likely to be

hardest to stop at those times when individuals most need to stop it.

The habit literature suggests a further way to control habitual rumination is by “inhibiting

the performance of the habitually cued response once it has been activated” (Wood & Neal, 2007, p.

854). Quinn, Pascoe, Wood, and Neal (2010) provided evidence from episode-sampling studies that

vigilant monitoring (thinking “don’t do it”; watching for slipups) was the best strategy at self-

control of strong habits in daily life, relative to do nothing, stimulus control, and distraction.

However, inhibition of habitual behaviors requires the availability of sufficient levels of effortful

self-control: on days when students had a sustained load on self-control, they were more likely to

fail at overriding habitual behaviors but not non-habitual behaviors (Neal & Wood, 2007).
HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 25

Moreover, self-control is a finite resource that is depleted following effortful attempts to inhibit or

control thoughts, feelings, and actions (Muraven & Baumeister, 2000). It is likely to be reduced in

patients with depression (Joormann, 2010). This raises questions over the long-term sustainability

of effortful inhibition of strong habits in daily life. Inhibition of habitual responses may most

usefully contribute to long-term change by interrupting a habitual response to enable a new pattern

of responding to be counter-conditioned.

Focusing on self-control and inhibition in habits is particularly relevant to habitual

rumination because difficulties in turning attention away from negative stimuli are characteristic of

rumination. It remains unresolved to what extent these difficulties reflect difficulties in disengaging

attention from negative material (Koster, De Lissnyder, Derakshan, & De Raedt, 2010) and/or

difficulties in inhibiting no-longer-relevant material (Joormann, 2006, 2010). Consistent with the

former, habitual rumination is correlated with selective attentional bias towards sad faces

(Joormann, 2004; Joormann, Dkane, & Gotlib, 2006) and negative words (Donaldson, Lam, &

Mathews, 2007), although the causal direction of this relationship is not yet determined. Consistent

with the latter, habitual rumination is correlated with poor performance on inhibition-related tasks

including negative affective priming (e.g., Joormann, 2006) and suppression-induced forgetting

(Hertel & Gerstle, 2003), and with difficulties in removing now-irrelevant information from

working memory (Joormann & Gotlib, 2008; Joormann, Levens & Gotlib, 2011).

Interventions that strengthen inhibitory control or effortful self-control may thus have

potential to reduce the expression of habitual rumination. There is preliminary evidence that it may

be possible to improve working memory capacity through repeated training on cognitive tasks (e.g.,

Jaeggi, Buschkeuhl, Jonides, & Perrig, 2008), and that repeated practice can strengthen self-

regulatory control (Muraven & Baumeister, 2000). If robust and replicable, such cognitive training

has potential to improve self-control of habitual rumination as part of a treatment intervention,

particularly if combined with counter-conditioning of alternative responses.

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 26

We note that this habit analysis is not necessarily unique to rumination. Because the

theoretical framework is based on generic concepts of conditioning and habit formation, the

principles articulated could be applied to other behaviors and emotional regulation strategies.

Nevertheless, our focus in this paper was to consider the value of applying this approach to habitual

rumination, and to reconcile state episodes of repetitive thought engendered by goal discrepancy with trait

habitual tendency towards rumination. We further note that rumination may be harder to break than

other habits such as those involving overt behavioural routines. First, rumination tends to be

triggered by internal states, which makes it harder to successfully use stimulus/environmental

control. Second, changing habits requires a concerted and deliberate attempt at self-control in the

form of generating an alternative non-habitual response. However, habitual rumination reduces an

individuals’ ability to exert such self-control because of its impact on executive control and working

memory (e.g., Curci et al., 2013; Watkins & Brown, 2002). Thus, unlike many habits, by dint of

occupying mental resources, rumination may be harder to change, indicating the importance of

training ruminators into new habits, for example, by CBM.

Conclusion

We have articulated a habit-goal framework of depressive rumination that elaborates on

conceptualizations of depressive rumination as a mental habit (Hertel, 2004) and recent work

considering the relationship between goals and habits (Wood & Neal, 2007). This approach links

RST and Control Theory by explicating the mechanisms and conditions by which state episodes of

goal-discrepancy repetitive thought could develop into habitual depressive rumination. Further, this

habit account generates new insights and testable predictions concerning the developmental

antecedents of individual differences in rumination. The habitual nature of depressive rumination

provides a partial account of why it can be so difficult to break free of rumination. Understanding

the possible conditions and mechanisms that influence habit formation and habit change provides a

new perspective on how to optimise psychological interventions for depressive rumination.

HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 27

This manuscript reflects an ongoing collaboration between the authors, with an original draft

complete when Susan Nolen-Hoeksema tragically passed away. It is hoped that in some small part,

this final manuscript pays tribute to Susan, her wisdom and thoroughness, her friendship, and her

work, by elaborating on her seminal conceptualization of rumination and showing new insights and

value. Susan was first in research, first in teaching and first in the hearts of her peers and students; as a

collaborator, she made ideas flow in a way that was exciting and exhilarating: she will be greatly missed.
 HABIT FRAMEWORK OF DEPRESSIVE RUMINATION 28

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