New study suggests metacognitions about rumination play a prominent role in depression

Jennifer E. Engen

New research provides evidence that metacognition — or how people think about their thinking — is related to the development and maintenance of depressive symptoms in adolescents. The findings, published in BMC Psychiatry, indicate that metacognitive beliefs about rumination in particular are associated with depression.

“We have conducted treatment studies with metacognitive therapy, which seems to be efficient and long-lasting,” said Leif Edward Ottesen Kennair, a professor of psychology at the Norwegian University of Science and Technology. “For patients with depression, it seems that negative metacognitions and brooding explains their depressive symptoms, and that discontinuing brooding is an important treatment.”

“However, it might be even more helpful to prevent depression than to treat depression. The first step is to consider whether depressive symptoms are related to the same processes in a non-clinical population and whether young people have the same mental processes underlying depressive symptoms.”

The findings of the new study are based on responses from 1,198 Norwegian students (ages 16 to 20) who completed a web-based questionnaire.

Kennair and his colleagues found negative metacognitions about rumination strongly predicted brooding. In other words, participants who agreed with statements such as “Rumination about my problems is uncontrollable” and “People will reject me if I ruminate” had a greater tendency to compare their present situation to more desirable and unattainable standards. This type of brooding, in turn, predicted depressive symptoms.

Positive metacognitions about rumination (e.g. “Ruminating about the past helps me to prevent future mistakes and failures”) were also weakly associated with brooding.

“It is not helpful to ruminate,” Kennair told PsyPost. “It is also not helpful to believe that you cannot prevent yourself from ruminating/brooding. These are related to depressive symptoms. Treatment probably should focus on changing beliefs about rumination and helping patients stop ruminating.”

Previous research has found that women tend to experience more depressive symptoms than men, and the new findings shed light on this sex difference. Adolescent women reported both stronger positive metacognitions about rumination and stronger negative metacognitions about rumination. They also reported greater levels of brooding compared to their male counterparts.

However, the study only collected correlational data. “We cannot say anything about causality because this is a cross sectional study,” Kennair said.

But some of Kennair’s previous research has provided causal evidence that metacognitions about rumination play an important role in depression. A small randomized controlled trial, published in 2017, found significant improvements among patients who underwent metacognitive therapy for depression, which is focused on lessening the ruminative process.

The patients involved in the study were treated over a ten-week period. After six months, 80% of the participants had achieved full recovery from their depression diagnosis. A follow-up study suggested that the treatment had long-lasting benefits.

The new study, “Metacognitions and brooding predict depressive symptoms in a community adolescent sample“, was authored by Helene Pedersen, Ingrid Grønnæss, Mons Bendixen, Roger Hagen, and Leif Edward Ottesen Kennair.

New study suggests metacognitions about rumination play a prominent role in depression

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