Turk Psikiyatri Derg. 2022 Summer;33(2):82-89. doi: 10.5080/u26082.
The aim of this study was to test the metacognitive model of depression in individuals diagnosed with major depressive disorder (MDD) and to investigate the relative contributions of cognitions and metacognitions about rumination to the explanation of depressive symptoms.
The participants of the study consisted of 180 MDD patients not meeting the diagnostic criteria for other psychiatric disorders. The obtained data were analyzed through structural equation modelling (SEM) and hierarchical regression analyses.
SEM results showed that positive beliefs about rumination increased the rumination level, and the higher levels of rumination significantly predicted the increase in depressive symptoms partly through the mediating effect of negative metacognitive beliefs about rumination regarding interpersonal and social consequences. However, negative metacognitive beliefs about the uncontrollability and danger of rumination were not found to be associated with symptoms of depression in the participants of this study. The power of dysfunctional attitudes for predicting depression was lost when hierarchical regression analysis was carried out by controlling the metacognitions about negative interpersonal and social consequences of rumination.
The results are consistent with the metacognitive model of depression, which was originally developed for better understanding of MDD, and point to the usefulness of considering positive and negative metacognitions about rumination in the processes of clinical evaluation and intervention for MDD.
本研究旨在检验抑郁的元认知模型在被诊断为重度抑郁症(MDD)的个体中的适用性,并探讨对反刍的认知和元认知与抑郁症状解释的相对贡献。
研究对象包括 180 名未符合其他精神障碍诊断标准的 MDD 患者。通过结构方程建模(SEM)和分层回归分析对所获得的数据进行分析。
SEM 结果表明,对反刍的积极信念会增加反刍水平,而较高的反刍水平则会通过对人际和社会后果的负性元认知信念对反刍的中介作用,部分地预测抑郁症状的增加。然而,在本研究参与者中,对反刍的不可控性和危险性的负性元认知信念与抑郁症状并无关联。在对反刍的负性人际和社会后果的元认知进行控制的分层回归分析中,功能失调态度对抑郁的预测力丧失。
这些结果与最初为更好地理解 MDD 而开发的抑郁的元认知模型一致,并指出在 MDD 的临床评估和干预过程中考虑对反刍的正性和负性元认知是有用的。