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Rumination Contributes to Depressive Symptoms in Sensitive Children

19th October 2021 - By Dr Francesca Lionetti

About the authors

Francesca Lionetti is a developmental psychologist and a researcher with expertise in parenting, attachment, socio-emotional development and environmental sensitivity.

She has contributed to the development and validation of sensitivity measures for infancy and childhood, and is involved in the longitudinal investigation of how sensitivity develops and interacts with the environment.


In a study following children from 3 to 12 years, we found that the combination of high sensitivity and permissive parenting increases the risk for the development of internalizing symptoms. Sensitive children who experience higher levels of early permissive parenting are more likely to develop ruminative coping strategies and consequently depressive symptoms.

The risk for depression in sensitive children

Depression and anxiety are common in youth and have increased over the last decade [1,2,3]. These psychological problems, also referred to as internalizing symptoms, tend to emerge in childhood and are relatively stable throughout life [4]. Hence, a better understanding of what contributes to the development of such problems is crucial.

Given the typical correlation between environmental sensitivity and negative affect or neuroticism [5], one group of children that might be at an increased risk for the development of internalizing symptoms, such as feeling sad or being withdrawn, are highly sensitive children.

However, the reasons that explain why and how heightened sensitivity increase the risk for the development of internalizing symptoms remain unexplored.

One key factor in the onset of internalizing symptoms, and particularly depression [7], is rumination, defined as the tendency to repeatedly reflect on the same negative thoughts [6]. Hence, rumination may be an important reason for the higher levels of internalizing problems in highly sensitive individuals.

Our hypothesis

The hypothesis that we investigated in our study [8] is that the tendency of highly sensitive children to process information more deeply can lead to negative cognitive patterns, such as rumination, but only if the environment children grew up in has not been able to promote the development of positive strategies for dealing with negative thoughts.

Study aim and methods

In a community sample of 196 families from the Stony Brook Temperament Study in the USA we investigated the interaction between parenting styles and sensitivity in the prediction of rumination and depression symptoms.

Informed by previous findings on the effect of parenting styles on internalizing symptoms [9], we hypothesized that sensitive children’s internalizing symptoms would be especially strongly predicted by permissive rather than other parenting styles.

This is because the tendency of sensitive children to process information more deeply, may result in difficulties controlling the processing of negative thoughts and feelings when they lack structure and positive disciplinary strategies as is the case in a permissive parenting style.

When children were 3 years old, mothers provided information on parenting, and children’s sensitivity was observed in a laboratory context and rated by trained psychologists. At 9 years, children provided information on ruminative coping strategies and at both 9 and 12 years on depressive symptoms.

Key findings

Children’s sensitivity interacted with permissive parenting in the prediction of rumination at age 9. Rumination, in turn, was associated with depressive symptoms at age 9 and, to a lesser extent, at age 12. No relevant interactions emerged for other parenting styles.

In other words, highly sensitive children were more likely to develop rumination in middle childhood when they experienced a permissive parenting style in early childhood and this rumination was then associated with depressive symptoms.

This suggests that rumination may be an important cognitive risk factor for the development of depressive symptoms in sensitive children.

What does this mean and what are the implications for parents and children?

Permissive parenting in early childhood seems to represent a specific risk factor for the development of depressive symptoms in highly sensitive children, due to heightened levels of rumination in middle childhood.

Sensitive children may be more at risk of developing depressive symptoms when exposed to permissive parenting because they are more likely to engage in ruminative coping strategies than less sensitive children.

The parenting of sensitive children who need more time when approaching new environments and process things more deeply seems to require parents who can provide emotional support as well as age-appropriate rule-enforcement, and who guide and support the child when confronted with new contexts and new developmental tasks, including the challenge of dealing with negative thoughts and emotions.


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  2. Collishaw, S. (2015). Annual research review: secular trends in child and adolescent mental health. Journal of Child Psychology and Psychiatry, 56(3), 370-393.
  3. Durbeej, N., Sörman, K., Selinus, E. N., Lundström, S., Lichtenstein, P., Hellner, C., & Halldner, L. (2019). Trends in childhood and adolescent internalizing symptoms: results from Swedish population based twin cohorts. BMC psychology, 7(1), 1-10.
  4. Ashford, J., Smit, F., Van Lier, P. A., Cuijpers, P., & Koot, H. M. (2008). Early risk indicators of internalizing problems in late childhood: a 9‐year longitudinal study. Journal of child Psychology and Psychiatry, 49(7), 774-780.
  5. Lionetti, F., Pastore, M., Moscardino, U., Nocentini, A., Pluess, K., & Pluess, M. (2019). Sensory processing sensitivity and its association with personality traits and affect: A meta-analysis. Journal of Research in Personality, 81, 138-152.
  6. Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of abnormal psychology, 100(4), 569.
  7. Verstraeten, K., Bijttebier, P., Vasey, M. W., & Raes, F. (2011). Specificity of worry and rumination in the development of anxiety and depressive symptoms in children. British Journal of Clinical Psychology, 50(4), 364-378.
  8. Lionetti, F., Klein, D. N., Pastore, M., Aron, E. N., Aron, A., & Pluess, M. (2021). The role of environmental sensitivity in the development of rumination and depressive symptoms in childhood: a longitudinal study. European Child & Adolescent Psychiatry, 1-11.
  9. Lionetti, F., Aron, E. N., Aron, A., Klein, D. N., & Pluess, M. (2019). Observer-rated environmental sensitivity moderates children’s response to parenting quality in early childhood. Developmental psychology, 55(11), 2389.