Is rumination after bereavement linked with loss avoidance? Evidence from eye-tracking

Rumination has been identified as a risk factor in adjustment to bereavement. It is associated with and predicts development and persistence of psychopathology after loss. However, the function of rumination in bereavement remains unclear. In the past, researchers often assumed rumination to be a maladaptive confrontation process. However, others have suggested that chronic rumination may serve to avoid painful aspects of the loss, thereby contributing to complicated grief.To examine if rumination is linked with avoidance of the loss, an eye-tracking study was conducted with 54 bereaved individuals (27 high and 27 low ruminators). On 24 trials, participants looked for 10 seconds at a picture of the deceased and a picture of a stranger, randomly combined with negative, neutral or loss-related words. High ruminators were expected to show initial vigilance followed by subsequent disengagement for loss stimuli (i.e., pictures of the deceased combined with a loss word) in the first 1500ms of presentation time. Additionally, high ruminators were expected to avoid these loss stimuli and to show attentional preference for non-loss-related negative stimuli on longer exposure durations (1500-10000ms). Contrary to expectations, there was no evidence for an effect of rumination on initial vigilance and subsequent avoidance of loss stimuli in the first 1500ms of presentation time. However, on longer exposure durations (1500-10000ms) high ruminators showed shorter gaze durations for loss stimuli, and longer gaze durations for negative (and neutral) non-loss-related stimuli, even when controlling for symptom levels of depression and complicated grief. Effects of rumination on average fixation times for specific stimuli mirrored these findings. This suggests that rumination and loss avoidance are closely associated. A potential clinical implication is that rumination and grief complications after bereavement may be reduced through the use of exposure and acceptance-based therapeutic techniques.Overall analyses were conducted with p < .05 (two-sided), follow-up analyses (i.e., group comparisons) were conducted with p < .05 (one-sided).