What is anger rumination and how does it affect individuals with ASD?
Have you ever experienced challenging behavior like a meltdown, hostility, anger, or aggression when supporting a person with autism spectrum disorder (ASD)? Did the incident seem to come out of the blue? More than likely, there was a trigger that you didn’t notice or something that was building for a period of time. That “something” could be anger rumination.
What is anger rumination?
Anger rumination is a cognitive-emotional process referring to the tendency to dwell on frustrating experiences and recall past anger experiences (Sukhodolsky et al. 2001). More generally, rumination represents a maladaptive form of emotion processing that entails remaining focused on the stressor through repetitive and passive dwelling upon distress, past mistakes, regrets, and short-comings (Nolen-Hoeksema 1991; Nolen- Hoeksema et al. 2008). Rumination may inhibit the use of cognitive control strategies such as reappraisal (being able to assess something or someone again or in a different way) and problem solving, due to the prolongation of emotional distress.
Anger rumination can deplete self-regulatory resources, leading to reduced behavioral inhibition (Kashdan et al., 2009). Social anxiety could also lead to anger rumination, which in turn could lead to hostility or expressions of anger.
Anger rumination is also positively correlated with autism symptom severity. It is also associated with poorer functioning, including more depression symptoms and overall emotional and behavioral dysregultion. (Patel et al. 2017). Rumination may also be a factor in other forms of challenging behavior such as disruptive behaviors (irritability, anger and aggression).
Perseveration
Repetitive thoughts and dwelling on negative incidents can make a person become “stuck”. This fixation can also be called perseveration. Perseverative thoughts can happen because a person may be trying to manage stress, process information, shift attention, can’t stop thinking about certain things, or can’t control behaviors.
Perseveration may look like:
- worrying about something that might happen because it happened in the past
- having difficulty getting past being angry or scared
- continuing to ask the same question long after getting an answer to the question
- going over previous conversations or interactions in the mind (also known as looping thoughts)
- repeating an action over and over again (also known as repetitive or restrictive behaviors)
- repeatedly talking about something that happened a long time ago
- giving the same answer to a different set of questions, even if it makes no sense
Rumination and Mental Health Issues
Autism spectrum disorders often present with comorbidities, particularly mental health issues. Many mental health conditions can cause rumination, but rumination may also intensify the symptoms of some pre-existing conditions. In an article from Medical News Today, these examples of mental health issues and rumination were given.
Depression: A person with depression may ruminate on very negative or self-defeating thoughts. For example, they may obsess over a belief that they are unworthy, not good enough, or doomed to fail.
Anxiety: People with anxiety may ruminate on specific fears, such as the idea that something bad will happen to their family. Or they might ruminate more generally, continually scanning their mind for things that might go wrong.
Obsessive-compulsive disorder (OCD): People with OCD may feel overwhelmed by intrusive thoughts about things that could go wrong. To relieve these thoughts, they may engage in rituals, such as checking door locks, cleaning, or counting.
Phobias: People with phobias may ruminate on their fears, especially when they encounter the source of their phobia. For example, a person with a spider phobia may be unable to think about anything but their fear when in the same room as a spider.
Schizophrenia: People with schizophrenia may ruminate on unusual thoughts or fears, or they might feel distracted by intrusive voices and hallucinations. A 2014 study found that people with schizophrenia who ruminate on the condition’s associated social stigma might be more vulnerable to depression.
Rumination, Emotional Dysregulation, and Repetitive or Restrictive Behaviors (RRBs)
In a recent study, researchers looked at the association between rumination and RRBs contributing to overall emotional dysregulation in ASD. They found there may be common underlying deficits in cognitive control neural circuitry. Anger rumination may possibly be part of the core ASD symptoms, particularly RRBs (rigid thinking, insistence on sameness and perseveration). Difficulty in stopping perseverative thoughts may predispose children with ASD to engage in rumination. Impairments in emotional reactivity and cognitive control in combination with RRB’s may inhibit the use of adaptive emotional regulation strategies such as problem solving. These impairments may in turn predispose children with ASD to an increased risk for developing comorbid psychiatric disorders.
This becomes a cycle because deficits in cognitive control and using maladaptive strategies like rumination can prevent a person from using a more effective strategy like problem solving. Engaging in anger rumination or ruminative thoughts in general could be tied into deficits in emotional regulation in ASD. The correlation of anger rumination, emotional dysregulation and RRBs could make children with ASD more susceptible to a risk of disruptive behaviors.
What can help with ruminating thoughts?
Reduce Anxiety – There are many strategies to reduce anxiety so try using a variety of strategies to build your toolbox.
Exercise – Being physically active can reduce stress and increase feelings of well-being. Don’t know where to start? Have a look at our physical activity article.
Get Outside in Nature – There are a number of studies done on the benefits of nature . Walking in nature can reduce perseverative thoughts. My son goes on a hike once a week and we have seen improvement in his moods.
Distraction – While this may not work every time, providing a distraction can take a person’s mind off what it bothering them. For my daughter Julia, there are couple of cat videos that change her mood instantly. Talking about favorite topics and interests can stop ruminating thoughts.
Meditation or meditation techniques – Our son developed his own over the years to classical music. He spends an hour every Monday meditating in his room. He closes his eyes and breathes deeply. There are also books on mindfulness practice, but keep in mind that not every person with autism can do this successfully. For more ideas on mindfulness, have a look at this article which also has a great reference section.
Develop Interoceptive Awareness – Interoception is considered to be the eighth sense and tells us a lot about our internal state – are we hungry, tired, thirsty, hot, cold, or in pain. It is also tied into our emotions and self-regulation. Being able to understand how these emotions feel in the body and mind could also potentially help with rumination.
Future Study of Anger Rumination
Researchers feel that further study of this topic is needed to better understand the role of perseveration and ASD, and if these tendencies are associated with anxiety, disruptive behavior and depressive symptoms. Could perseveration be used in interventions to recall positive personal memories rather than negative ones? We also can’t discount the increased prevalence of trauma in children with ASD and the role that rumination may play in strengthening the association between trauma symptoms and anger. For example, how might the traumatic effects of bullying be related to anger rumination and core ASD symptoms? There may also be gender differences with anger rumination. So much to think about…
References
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I was officially diagnosed with Autism as a child but the diagnosis was withheld from me by my parents and doctors. I’m 60 and only learned about what happened 4 years ago. I now am on a combination of Keto, Paleo and Feingold diets, a Cortisol manager, Progesterone, Magnesium, DHEA, probiotics, and vitamins A, C, D, and B-complex, and am involved in swimming, Zumba, aerobics, Yoga, and Taekwondo. These, along with a strict prayer/meditation schedule, have helped me tremendously!
Left out of the comments for the most part is the concept of instigating, abuse, and bullying for sensitivitivites, deficiencies, or odd behavior. Neurotypicals typically want to take no responsibility for their possible role in setting someone off. They are the healthy sane ones out to caretake the sick crippled ones, in their heads sometimes. A lot of anger rumination and meltdowns is made much worse by complex PTSD from bullying or being forced into relatively intolerable situations. Why ignorant parents, teachers, etc. like to themselves is easy to see, it protects the ego and shifts responsibility. They tend to think tough love or lots of rules will solve the problem, never examining things from an ASD or child’s point of view. Despite having no training or even self-education on developmental disabilities, in my opinion the majority of caretakers still act as authoritarian know it alls and blame the kids.
I am so tired of finding article on how I am supposed to CHANGE my behavior. How about for once someone just love us the way we are instead of telling us to go make friends , get a hobby, see a therapist, take drugs …. How about for once we take the responsibility off of us , for just fn once, and just love us for how we are. I am done changing for people so I feel better , when going out and finding a hobby isn’t cutting it, it’s a bandaid. Just love us and stop trying g to give us what we can do. Love needs to step up!
I don’t allow myself to experience anger, because I’m scared of it. I don’t get angry at individual events, I seem to be angry that I actually exist. I have an internal dialogue, full of rage, that I turn off before my words leave my mouth.
My nephew has autism and just recently experienced the loss of his father tragically, since then he has been isolating and ruminating on a child-play fight he had with his cousin/best friend. He now avoids her at all costs, refuses to play with her, be around, have any engagement…the problem is mounting and he is increasingly digging in his heels and allowing it to grow. We’re doing all we can to give him tools to express himself and mend this bond, it’s a difficult road.
We have two things coming into play here – the experience and expression of grief and rumination. Please read my article on grieving – https://autismawarenesscentre.com/how-to-support-individuals-with-asd-through-grief-and-loss/ It suggests quite a few resources. You may need to use some techniques on how to park perseverative thoughts. I am giving a webinar on the topic through AIDE Canada on March 9th. https://aidecanada.ca/community/events/details/autismcalgary20230302 This webinar is free and will take place at 10 am MT. Anyone in the world can sign up. You may find it helpful. I also wrote a booklet for that organization on the topic – https://aidecanada.ca/docs/default-source/articleitems/understanding-and-alleviating-anger-rumination-and-perseveration-en.pdf
This is a very valuable article. I work with an individual with autism and they have aggressive episodes and behaviors towards people, including myself, that they attribute to their autism; however, some of these behaviors /actions are very hurtful. We are constantly steered towards providing empathy and understanding to our autistic colleague but are unsure how to cope with the hurtful/harmful behavior. Any advice or resources would be appreciated.
When it comes to harmful or hurtful behavior, you will have to change the lens in which you interpret those behaviors and try to understand the reason behind them as they are an expression of feelings. Here is an article on how to reframe behaviors – https://autismawarenesscentre.com/addressing-challenging-behavior-and-asd-going-beyond-what-we-see/ You will have to go deeper to find out the reasons for these behaviors as no person does this sort of thing without a reason. It’s not just because they are autistic. Perhaps they don’t feel they can trust the people around them. Maybe their day is not predictable enough. Maybe they are frustrated due to a lack of autonomy. Maybe transitions happen with no set plan in place. You will have to figure out through observation with none of your own emotions attached to it what the reason is because there is some piece missing here. I just don’t know what it is reading a few sentences.
Thank you for this article. I found it helpful and reassuring. My adult son is high-functioning autistic and the teenage years were a struggle. I have always accepted him as he is and tried to ignore the more difficult behaviour. Things seemed to improve as he matured, but recently he has had a huge ‘meltdown’ when he said some very cruel and hurtful things and virtually blamed me for making his childhood horrible.
As a parent who has always tried to do the best I could, I have been brought very low by his comments. It is exactly as you describe- he selectively recalls episodes that were unhappy for him and looks at these in the most negative way possible. He is unable to recall any positive things at all.
I’ve told him that he is loved and that I’ll be there for him no matter what, but it is very difficult to have to listen to a character assassination and feel helpless to try to point out the truth. He just won’t hear it. I’m hoping that time and a little space may help, but lines have been crossed this time and it is impossible to unhear the cruel and false accusations. Rebuilding trust is going to be difficult.
I am sorry to hear this is happening to you. Anger rumination is very complex and is tied into different emotions and experiences. I am giving a webinar on the topic through AIDE Canada on March 9th. https://aidecanada.ca/community/events/details/autismcalgary20230302 This webinar is free and will take place at 5 pm UK time. Anyone in the world can sign up. You may find it helpful. I also wrote a booklet for that organization on the topic – https://aidecanada.ca/docs/default-source/articleitems/understanding-and-alleviating-anger-rumination-and-perseveration-en.pdf The webinar will highlight the information in the booklet.
I am struggling with this now. I even wake up in the middle of the night going over events and circumstances over and over again, looking for answers that don’t make sense to me.
This is such a great article and describes my 23 yo son exactly. We have been struggling for what seems like years with trying to help him with this. Do you have any recommendations or examples of what to look for in community groups and outreach programs for young ASD adults? He struggles with depression, the anger issues, and has a lot of trouble connecting with others and making friends. He does see a therapist, but I am wondering if someone that specializes is ASD would be more beneficial to him?
Lynda, I am glad you found the article helpful. I have written a booklet about this topic for AIDE Canada. It just hasn’t been published yet but will be soon. I will also be offering a webinar through them in March on this topic.
Can you let me know where you are located so that I can try and direct you to local resources?
If the therapist understands autistic neurology and things like perseveration and rumination, then they may be helpful. Does your son have a good relationship with his therapist? That is important to build the trust. Don’t move him if there is a good relationship and trust between them. This can take months to build again if you switch therapists.
I have difficulty with this. I was writing a couple examples for this comment, and next thing I knew I had several paragraphs of me complaining about the things that cause me problems. Most of which was saying the same thing over and over again. And it wasn’t on purpose. I only realized I’d done it after I couldnt recall what my original point was.
My husband has Asperger’s. He has always been a negative person, often angry with others. But with age (he is now 60) he has become extremely agressive towards me, both verbally and occasionally physically. Lately, he has been under much pressure at work having struggled to keep up with his colleagues. He appears to suffer anger rumination and he clearly exhibits “poorer functioning, including more depression symptoms and overall emotional and behavioral dysregultion”. He has bad relationships with his colleagues, he has no friends, no relationship with his only brother, and he treats me as the worst enemy. I had to seek psychological support to sustain the pressure. My counsellor thinks that I am unsafe at home and that I should leave my husband. As traumatised and scared of my husband I am, I still hope that reduced stress at work or retirement may change my husband’s disruptive behaviour.
These are all wonderful suggestions. Unfortunately my husband won’t accept his Aspergers diagnosis. He’s extremely stubborn and becoming more and more aggressive with me, both verbally and physically. I’m thinking of taking a break from the marriage for a few weeks to give him his space. Maureen, do you think leaving for awhile would make him more violent and aggressive? I’m not sure how to handle the situation all by myself. Thank you!
Thank you for the article! I have a 22 year old low functioning very aggressive son. We are in the Phoenix area. Do you have any recommendations for therapists/clinics? Thank you!
Hi Tina, try contacting a different lawyer. There must be “pro-Bono” lawyers in your area that will help. Write them emails about your situation but leave out the racist part about Muslims because that will not help you and is irrelevant. Try to make the email “matter of fact” .
I also suggest reaching out to other disability services because even if someone can’t help —they can point you in the right direction.
My husband definitely has Aspergers and I’ve been trying to find ways to help him because he suffers from really badly anxiety, depression, gets stressed easily, and has anger outbursts. I’ve been doing Interoception (asking questions to figure out the real issue) and I never knows there was a term for it. I still have a difficult time trying to get him “unstuck” when he is being obsessive over negative topics. He was abused growing up and now he has a lot of severe trauma. The rumination is very difficult for me to handle and he says that repeating things calms him down but it stresses me out SO badly and it’s hard for me to help him calm down when he is winding me up! I don’t like to dwell on negativity because that’ll make me stress, so I don’t know how to help him without my stress going up.
Sarah, have a look at some of the Low Arousal Approaches which should help – https://autismawarenesscentre.com/what-is-the-low-arousal-approach-and-how-can-it-benefit-my-family/ You also mentioned trauma – this is a great simple guide to understanding trauma and how you can help – https://autismawarenesscentre.com/what-is-trauma-a-simple-guide/
Sometimes our reaction to situations can make them worse. You may need to walk away and take small breaks when the rumination starts. Your husband will need to work on developing calming strategies for himself. You two may be in a pattern right now which is making the situation worse than it needs to be.
I live in Colorado and cannabis has been the most effective treatment I have had (45 Asperger’s)
My AF ASD 8 y.o. to a Tee! I Google searched how to help him and it lead me to this article. The obsessive negative thoughts are unbearable. He recognizes it’s not common trait in others, socially unacceptable and hates himself for it.Are antidepressants appropriate for rumination, particularly for children? I’m in Western Michigan.
Vanessa, I would really recommend contacting your doctor or a child psychologist to ask this question as I am not qualified to answer it. In don’t know much about antidepressants or their use in the pediatric community.
This is a very valuable read. Can anybody recommend a good therapist or private clinic? My son is 22 and needs help. His father had bipolar disorder. He died when my son was 15 so there is loss and grief on top of everything else.
Ruth, you would need to let us know where you are located in order to make any recommendations. I also have a good article on grieving and loss – https://autismawarenesscentre.com/how-to-support-individuals-with-asd-through-grief-and-loss/
This describes my 8 year old HFA daughter. I finally realized that she was perseverating on negative thoughts and my google search has led to this article. She has a great therapist and it has helped a lot but she still struggles with this in school bc the teachers do not know how to respond to her negative self talk.
It is exhausting but there is a light at the end of the tunnel. I just hope we get there soon.
CJ, my daughter is almost 22 and we are still dealing with rumination. This is part of being autistic. It’s about learning how to manage it. My daughter rehashes situations that happened back in Grade 7. I find regular exercise and body breaks throughout the day help with this. It’s long periods of sitting at the internet that seem to get this going for my daughter. I try to show her that she is in control and we figure out ways to “conquer” these feelings.
Thanks for the article, it describes my son and grandson. I wish we had some type of help for them. It is ripping this family apart..😢
Please have a look at the Low Arousal Approach. It really helps and makes a difference. We are a low arousal household with my two young adults with autism. https://autismawarenesscentre.com/what-is-the-low-arousal-approach-and-how-can-it-benefit-my-family/
Incredibly helpful. I’m a 46 yr old female recently diagnosed with high functioning ASD. This sudden rush of things “clicking” has been exhilarating and it deflated my depression balloon, so to speak. I always made sense to myself but never understood why I didn’t make sense to others. Now I know!! This article was very helpful and resonated with me.
Colleen, I am so glad that you found this article helpful.
Tina you sound like you need someone to talk to. You speak with a very paranoid tone. I would hope you seek out a therapist and discuss your thoughts with them so they can guide you in the right direction
Extremely insightful. I really appreciated this information very, very much! Thank you!
Dear Ida,
I am glad you found this article helpful. Thank you for taking the time to write.
Thank you for your articles. I’m autistic adult at age 54 and female. I’ve been autistic all my life and lost my only advocate about 5 years ago. No lawyers.no medical doctors. I have a church lady who took out a life insurance policy on me. She has stopped all medical services
No one will listen to me. I’ve tried to fight her in court. I’ve repeatedly .repeatedly. sent her legal papers .to stop her. But she manages to keep doing this. I’m homeless .I’m living in a shelter surrounded by mean muslims. I’m a jew-European mixed. No one wants to help me.shes stolen my trust fund. My disability payments. My food stamps. My cash assistance. I cant get rid of her. No one will help me.
Tina, I am not sure where you are located but I would suggest approaching your local autism society who may be able to give you some direction and help you advocate for yourself. Is the other lady you speak of considered your legal guardian?