Rumination: relationships with physical health.

Rumination is a form of perserverative cognition that focuses on negative content, generally past and present, and results in emotional distress. Initial studies of rumination emerged in the psychological literature, particularly with regard to studies examining specific facets of rumination (e.g., positive vs. negative rumination, brooding vs. self-reflection, relationships with catastrophic thinking, role of impaired disengagement, state vs. trait features) as well as the presence of rumination in various psychiatric syndromes (e.g., depression, alcohol misuse, generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, bulimia nervosa). Rumination studies are now emerging in the somatic literature, particularly in relationship to pain. In these studies, rumination appears to be associated with symptom magnification as well as poorer clinical outcomes. While still a nascent field, the assessment and treatment of rumination in primary care settings is beginning to unfold.