From brooding to detachment: Rumination longitudinally predicts an increase in depersonalization and derealisation

Miriam Vannikov-Lugassi, Hadar Shalev, Nirit Soffer-Dudek

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objectives: Depersonalization–derealization (DEP-DER) is a dissociative experience which is related to psychopathology and distress. Yet, the aetiological factors leading to DEP-DER are not sufficiently clear. In this study, we suggest rumination as one possible antecedent. Thus, the goal of the study was to explore the longitudinal relationship between rumination and DEP-DER. Design: Longitudinal self-report study; mixed clinical and community sample. Methods: The study was conducted on 98 participants, 49 of them were diagnosed with depression, anxiety disorders, or obsessive–compulsive disorder, and the other 49 were healthy, matched community controls. The participants underwent a structured clinical interview and completed a battery of questionnaires. Then, the participants completed the same battery again once a month, for five additional assessment points (6 months in total). The data were analysed using multilevel linear modelling with time-lag analysis. Results: We found that levels of rumination and DEP-DER increased and decreased simultaneously, meaning that on assessments in which people reported that they tended to ruminate, they also reported higher levels of DEP-DER symptoms. In addition, we found support for a unidirectional association, consistent with our theoretical hypothesis. Specifically, rumination levels on a certain month longitudinally predicted a higher likeliness for reporting DEP-DER on the following month, even when controlling for the contemporaneous relationship. Conversely, DEP-DER symptoms did not longitudinally predict increased rumination. Conclusions: These findings suggest that rumination may be an antecedent of DEP-DER, but not vice versa. Possible mechanisms to explain this link are discussed. Practitioner points: Rumination and DEP-DER oscillate together over time; additionally, rumination predicts a longitudinal increase in DEP-DER. Clinicians noticing ruminative thought followed by decreased emotionality should distinguish between an authentic decrease of distress versus detachment. The findings provide one possible explanation for the frequency of DEP-DER symptoms in anxiety and depressive disorders. Poor sleep quality and emotion regulation difficulties should be explored as potential mediators explaining this link.

Original languageEnglish
Pages (from-to)321-338
Number of pages18
JournalPsychology and Psychotherapy: Theory, Research and Practice
Issue numberS2
StatePublished - 1 Apr 2021


  • depersonalization
  • derealisation
  • dissociation
  • emotion regulation
  • rumination
  • sleep

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health


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