ArticlePloS one2018
Modeling and estimating the feedback mechanisms among depression, rumination, and stressors in adolescents.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- A System Dynamics Simulation Applied to Healthcare: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- The Young Adult Sleep model: an evolving causal loop diagram of mental health dynamics.BMC medicine · 2026Article
- The mediating roles of interpersonal sensitivity and rumination in the relationship between self-esteem and depression: a longitudinal study on Chinese psychiatric patients.BMC psychology · 2025Article
- Effects of physical activity on sleep quality among university students: chain mediation between rumination and depression levels.BMC psychiatry · 2025Article
- The influence of stress on mental health among Chinese college students: The moderating role of psychological suzhi.Heliyon · 2024Article
- Emotion Regulation Predicts Depressive Symptoms in Adolescents: A Prospective Study.Journal of youth and adolescence · 2024Article
- Simulation Models for Suicide Prevention: A Survey of the State-of-the-Art.Computers (Basel, Switzerland) · 2023Article
- Brooding and neuroticism are strongly interrelated manifestations of the phenome of depression.Frontiers in psychiatry · 2023Article
- Bidirectional associations between nightly sleep and daily happiness and negative mood in adolescents.Child development · 2022Article
- Tools for Supporting the MCH Workforce in Addressing Complex Challenges: A Scoping Review of System Dynamics Modeling in Maternal and Child Health.Maternal and child health journal · 2022Article
- Article
- Defining and Intervening on Cumulative Environmental Neurodevelopmental Risks: Introducing a Complex Systems Approach.Environmental health perspectives · 2021Article
- A complex systems approach to the study of change in psychotherapy.BMC medicine · 2020Article
- The network approach to psychopathology: a review of the literature 2008-2018 and an agenda for future research.Psychological medicine · 2020Review
- Dynamics of intervention adoption, implementation, and maintenance inside organizations: The case of an obesity prevention initiative.Social science & medicine (1982) · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
The systemic interactions among depressive symptoms, rumination, and stress are important to understanding depression but have not yet been quantified. In this article, we present a system dynamics simulation model of depression that captures the reciprocal relationships among stressors, rumination, and depression. Building on the response styles theory, this model formalizes three interdependent mechanisms: 1) Rumination contributes to 'keeping stressors alive'; 2) Rumination has a direct impact on depressive symptoms; and 3) Both 'stressors kept alive' and current depressive symptoms contribute to rumination. The strength of these mechanisms is estimated using data from 661 adolescents (353 girls and 308 boys) from two middle schools (grades 6-8). These estimates indicate that rumination contributes to depression by keeping stressors 'alive'-and the individual activated-even after the stressor has ended. This mechanism is stronger among girls than boys, increasing their vulnerability to a rumination reinforcing loop. Different profiles of depression emerge over time depending on initial levels of depressive symptoms, rumination, and stressors as well as the occurrence rate for stressors; levels of rumination and occurrence of stressors are stronger contributors to long-term depression. Our systems model is a steppingstone towards a more comprehensive understanding of depression in which reinforcing feedback mechanisms play a significant role. Future research is needed to expand this simulation model to incorporate other drivers of depression and provide a more holistic tool for studying depression.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.