Do sex differences in rumination explain sex differences in depression?

Abstract

It is generally accepted that women tend to ruminate more than men do and these thought patterns are often associated with depressive symptoms (Nolen-Hoeksema et al., ). Based on these findings, we considered whether the relationship between rumination and depression is stronger in women than in men and if so, whether this might explain the higher prevalence of major depressive disorder (MDD) in women and finally, whether the association can be disrupted through a mind/body intervention. Adult men and women, most of whom were clinically depressed, participated in an intervention known as MAP Training, which combines "mental" training with silent meditation and "physical" training with aerobic exercise (Shors et al., ). After eight weeks of training, both men and women reported significantly fewer symptoms of depression and fewer ruminative thoughts (Alderman et al., ). Statistical correlations between depressive symptoms and ruminative thoughts were strong and significant (rho > 0.50; p < 0.05) for both men and women before and after MAP Training. However, only in women did depressive symptoms relate to "reflective" ruminations, which involve analyses of past events, feelings, and behaviors. This is also the only relationship that dissipated after the intervention. In general, these analyses suggest that the strength of the relationship between depressive symptoms and rumination does not necessarily explain sex differences in depression; but because the relationship is strong, targeting rumination through intervention can reduce the incidence of MDD, which is more prevalent among women. © 2016 Wiley Periodicals, Inc.

Sex differences and the neurobiology of affective disorders

“…Recent studies do suggest an association between depressive rumination and functional connectivity between the DMN and the subgenual prefrontal cortex (sgPFC) [157]. Since studies also suggest that women experience a greater amount of rumination during depression than men [279], one could imagine that a sex difference specifically in DMN functional connectivity with the sgPFC may be detected. Alternatively, if confirmed, the presence of sex differences in DMN network activity in asymptomatic men and women, and the absence of comparable differences in depression, could inform our understanding of depressive illness.…”

“…Women have greater sensitivity to others, increased self-awareness, and increased capacity to manage new situations [339]. Women ruminate more than men [279], which may load on susceptibility to depression. As with the "orchid/dandelion dichotomy" [340,341], whereby the environmentally sensitive child will do worse under environmentally stressful and better under nurturing conditions than the environmentally insensitive child, so the "increased sensitivity" of women to socio-affective stimuli may allow for greater emotional flexibility (under good conditions) but greater stress-related adverse consequences under unfavorable conditions.…”

Sex differences in antidepressant efficacy

“…Rumination, chronic negative circumstances or strain, and a low sense of mastery have each been found to be more common in women [23]. These individual components contribute to greater depressive symptoms in women, and depressive symptoms feed into greater rumination and less mastery over time, setting the stage for positive feedback and recurrence in women in particular [24].…”

Depression in chronic ketamine users: Sex differences and neural bases

“…Increased sgACC connectivity with the dmPFC may be related to depression symptoms such as self-reproach and guilty rumination (Davey et al, 2012), in relation to the role of the dmPFC in autobiographical recall and self-referential analyses (Bado et al, 2014). Importantly, guilty rumination figured more prominently in women than in men with depression (Nolen-Hoeksema, 2012; Shors et al, 2017). A study combining fMRI and magnetic resonance spectroscopy revealed a significant negative correlation between GABA concentration in the dmPFC and BOLD signals in sgACC during exposure to sad face in contrast to control images (Stan et al, 2014).…”