Abstract
Rumination is defined as a type of perseverative cognition involving cyclical and selffocused
thoughts about an individual’s problems and concerns. Increasing research has
explored the role of rumination in adjustment after a cancer diagnosis. This multi-method
thesis aimed to extend the literature by exploring the association between different styles of
rumination and psychological and physical health in those diagnosed with cancer.
A systematic review and four empirical studies were conducted. The overarching
finding of the systematic review suggested that the style of rumination was important when
considering its association with distress after a cancer diagnosis. Study 1 and 2 extended this
finding to explore the different styles of rumination alongside negative and positive
psychological outcomes respectively. Results highlighted brooding to be associated with
depression and anxiety six months later, and intrusive rumination associated with anxiety.
Instrumental rumination was not associated with distress. Brooding was associated with
depression and anxiety through different mechanisms. For adaptive outcomes, post-traumatic
growth was associated with later instrumental rumination and was not associated with
brooding or intrusive rumination. Results from Study 3 showed brooding to also be
associated with self-rated health measures (somatisation and health-related quality of life) six
months later. Negative affect partially mediated the association between brooding and
somatisation. Finally, a qualitative exploration (Study 4) of the experience of rumination after
a cancer diagnosis found five main themes. Rumination stems from perceived discrepancy, is
multifaceted, involves positive and negative beliefs, is associated with various negative and
positive outcomes, and that rumination changes over time.
In summary, the results of this thesis provide novel evidence of the experience of
rumination and psychological and physical health in those diagnosed with cancer.
Rumination was associated with psychological and physical health measures, particularly
brooding which was associated with depression anxiety, and somatisation and poorer
health-related quality of life.