Self-focused rumination links stressful events to depressive and anxiety symptoms in older adults with depressive symptoms: path and network analyses

Self-focused rumination, defined as an excessive attentional focus on one's depressive symptoms and their causes, meanings, and consequences, is well-established for its contribution to the onset and maintenance of depressive and anxiety symptoms. However, it remains unclear how this cognitive style can be manifested in older adults and how it might bridge the influences of different stressful life events (SLEs), namely dependent SLEs (partially attributable to one's behaviours) and independent SLEs (entirely beyond personal control), with the two symptom dimensions. Data were from 1868 community-dwelling older adults (mean age = 73.4; 83.1% female) as part of a territory-wide stepped-care intervention in Hong Kong for those with mild-to-moderately severe depressive symptoms (Patient Health Questionnaire-9 = 5-19). We investigated whether self-focused rumination would link dependent and independent SLEs to depressive and anxiety symptoms using both path and network analyses. In the path model, both SLE types were associated with self-focused rumination. Dependent SLEs were directly associated only with depressive symptoms, while independent SLEs were directly associated only with anxiety symptoms. Self-focused rumination linked SLEs to both symptom dimensions. With all symptoms accounted for in the network model, self-focused rumination also presented as the most central bridge symptom between the two SLEs and depressive and anxiety symptoms. Our study provided novel evidence to suggest the potential for targeting this cognitive response style in future interventions to reduce depressive and anxiety symptoms in older adults, particularly amid ongoing stressors.