The Death rumination Questionnaire 13 (DRQ-13): Factor structure and psychometric properties in a sample of cancer patient population

International Journal of Medical Science
© 2017 by SSRG - IJMS Journal
Volume 4 Issue 3
Year of Publication : 2017
Authors : Minoo Sharbafshaaer, Rajeev Kumar, FRANZCP and Mohsen Kord
How to Cite?

Minoo Sharbafshaaer, Rajeev Kumar, FRANZCP and Mohsen Kord, "The Death rumination Questionnaire 13 (DRQ-13): Factor structure and psychometric properties in a sample of cancer patient population," SSRG International Journal of Medical Science, vol. 4,  no. 3, pp. Factor structure and psychometric properties in a sample of cancer patient population" SSRG International Journal of Medical Science 43 (20171-6, 2017. Crossref,


Background: Rumination can impair thinking and problem-solving, and can drive away critical social support. Rumination is an extended process with inflexible cognitive style and negative thinking. The aim of this study was to evaluate the factor structure and psychometric properties of the DRQ-13 in a sample of cancer patients in Iran using exploratory and confirmatory factor analytic procedures. Method: The DRQ-13 was used to measure the conscious derivatives of 3 death rumination styles - death_concentration, death_critical, and death_exhaust in a sample of 200 cancer patients. Result: Cronbach's coefficient alpha for death_concentration (ex = 0.71),death_critical (ex = 0.7) were deemed fair. the alpha of death_exhaust (ex = 0.66) was found to be low in terms of potential clinical significance. Conclusion: Our results were consistent with the previous research on the DRQ indicating that the psychometric features need to be improved before the wider use of the scale. Further, DRQ-13 is a suitable tool to assess cancer patients’ thinking and mood about death and that may be used for psychological interventions to improve the care of these patients.


rumination, death rumination, DRQ-13, exploratory and confirmatory analysis, death rumination questionnaire.


[1] Probing the depression-rumination cycle: American Psychological Association. (2017, January 30).Retrieved from
[2] Broderick. P. C. (2005). Mindfulness and coping with dysphoric mood: contrasts with rumination and distraction. Cognitive Therapy and Research, 29(5), 501-510. Doi:10.1007/s10608-005-3888-0.
[3] Davis. R. N., & Nolen-Hoeksema. S. (2000). Cognitive inflexibility among ruminators and nonruminators. Cognitive Therapy and Research, 24(6), 699-711. Doi: 10.1023/A:1005591412406.
[4] Erdur-Baker. Ö., & Bugay. A. (2010). The short version of ruminative response scale: reliability, validity and its relation to psychological symptoms. Procedia - Social and Behavioral Sciences, 5, 2178–2181. Doi:10.1016/j.sbspro.2010.07.433.
[5] Floyd, F. J., & Widaman, K. F. (1995).Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7(3),286-299.Doi: 10.1037/1040-3590.7.3.286.
[6] Gavric D, Moscovitch, D. A., Rowa K, McCabe, R. E. (2017). Post-event processing in social anxiety disorder: Examining the mediating roles of positive metacognitive beliefs and perceptions of performance. Behav Res Ther, 4(91): 1-12. Doi: 10.1016/j.brat.2017.01.002.
[7] Kasch. K. L., Klein. D. N., & Lara. M. E. (2001). Construct validation study of the Response Styles Questionnaire Rumination scale in participants with a recent-onset major depressive episode. Psychological Assessment, 13(3), 375-383. Doi: 10.1037/1040-3590.13.3.375
[8] Kuehner. C., Huffziger. S., & Liebsch. K. (2009). Rumination, distraction and mindful self-focus: effects on mood, dysfunctional attitudes and cortisol stress response. Psychol Med, 39(2), 219-28. Doi: 10.1017/S0033291708003553.
[9] Lee S., & Kim W. (2014). Cross-Cultural Adaptation, Reliability, and Validity of the Revised Korean Version of Ruminative Response Scale. Psychiatry Investig, 11(1), 59-64. Doi: 10.4306/pi.2014.11.1.59.
[10] McEvoy. P. M., Mahoney. A. E., & Moulds. M. L. (2010). Are worry, rumination, and post-event processing one and the same?: Development of the repetitive thinking questionnaire. J Anxiety Disord, 24(5), 509-19. Doi: 10.1016/j.janxdis.2010.03.008.
[11] Mellings. T. M. B., & Alden. L. E. (2000).Cognitive processes in social anxiety: the effects of self-focus, rumination and anticipatory processing. Behaviour Research and Therapy, 38(3), 243–257. Doi: 10.1016/S0005-7967(99)00040-6.
[12] Michl. L. C., McLaughlin. K. A., Shepherd. K., Nolen-Hoeksema. S. (2006). Rumination as a mechanism linking stressful life events to symptoms of depression and anxiety: longitudinal evidence in early adolescents and adults. J Abnorm Psychol, 122(2), 339-52. Doi: 10.1037/a0031994.
[13] Nolen-Hoeksema. S., Wisco. B. E., & Lyubomirsky. S. (2008). Rethinking rumination. Perspect Psychol Sci, 3(5), 400-24. Doi: 10.1111/j.1745-6924.2008.00088.x.
[14] Roberts. J. E., Gilboa. E., & Gotlib. I. H. (1998). Ruminative response style and vulnerability to episodes of dysphoria: gender, neuroticism, and episode duration. Cognitive Therapy and Research, 22(4), 401-423. Doi: 10.1016/j.sbspro.2010.07.433.
[15] Roelofs. J., Muris. P., Huibers. M., Peeters. F., & Arntz. A. (2006). On the measurement of rumination: A psychometric evaluation of the ruminative response scale and the rumination on sadness scale in undergraduates. J Behav Ther Exp Psychiatry, 37(4), 299-313. Doi:10.1016/j.jbtep.2006.03.002.
[16] Roger. D., Scremin. L., Borril. J., & Forbes. A. (2011). Rumination, inhibition and stress: the construction of a new scale for assessing emotional style. Current psychology, 30(3), 234-244. Doi: 10.1007/s12144-011-9117-y.
[17] Ruscio. A. M., Gentes. E. L., Jones. J. D., Hallion. L. S., Coleman. E. S., & Swendsen. J. (2014). Rumination predicts heightened responding to stressful life events in major depressive disorder and generalized anxiety disorder. J Abnorm Psychol, 124(1), 17-26. Doi: 10.1037/abn0000025.
[18] Selby. E. A., Kranzler. A., Panza. E., & Fehling. K. B. (2014). Bidirectional-compounding effects of rumination and negative emotion in predicting impulsive behavior: implications for emotional cascades. J Pers. Doi: 10.1111/jopy.12147.
[19] Smart. L. M., Peters. J. R., & Baer. R. A. (2015). Development and Validation of a Measure of Self-Critical Rumination. Assessment. Doi: 10.1177/1073191115573300
[20] Soo. H., Sherman. K. A., & Kangas. M. (2014). Assessing rumination in response to illness: the development and validation of the Multidimensional Rumination in Illness Scale (MRIS). Journal of Behavioral Medicine, 37(4), 793-805. Doi: 10.1007/s10865-013-9531-8.
[21] Takano. K., & Tanno. Y. (2004). Self-rumination, self-reflection, and depression: Self-rumination counteracts the adaptive effect of self-reflection. Behaviour Research and Therapy, 47(3), 260–264. Doi: 10.1016/j.brat.2008.12.008.
[22] Teasdale. J. D., & Green. H. A. C. (2004). Ruminative self-focus and autobiographical memory. Personality and Individual Differences, 36(8), 1933–1943. Doi: 10.1016/j.paid.2003.08.022.
[23] Treynor. W., Gonzalez. R., & Nolen-Hoeksema. S. (2003). Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research, 27(3), 247-259. Doi: 10.1023/A:1023910315561.
[24] Watkins. E. d., & Baracaia. S. (2000). Why do people ruminate in dysphoric moods?. Personality and Individual Differences, 30(5), 723–734. Doi: 10.1016/S0191-8869(00)00053-2.