Examining the Metacognitive Model of Rumination and Depression: A Multi-method Approach.

Abstract

According to the WHO (2023) over 280 million individuals are estimated to suffer from depression, besides, it is considered one of the leading causes of disability worldwide (Kessler & Bromet, 2013), representing the second cause of global health burden (James et al., 2018). Likewise, it is considered highly prevalent, recurrent, and often a chronic disorder, as shown in the relapse and recurrence rates: less than one-third of patients recover at post-treatment, and relapse rates are estimated to be 50% after two years (Cuijpers, 2015); in addition, there is a substantial proportion of treatment-resistant patients (Beshai et al., 2011; Herrman et al., 2022). Efforts to research and examine this condition have been imperative, gaining extensive attention over time from psychological perspectives. Different psychological theories of depression have been identified, of which cognitive theories have been central. Cognitive structures are key to explaining this disorder and have been derived from two different models emphasizing different cognitive domains: the cognitive model and the metacognitive model. Cognitive theories of depression emphasize the importance of core beliefs and cognitions (Beck, 1967; Young et al., 2003), whereas the metacognitive theory of depression hypothesizes that beliefs, cognitions, or their content, are not the factors that causes emotional distress, but rather the metacognition, a separate level of higher-order cognition (Wells & Matthews, 1997; Wells, 2009, 2019). The aim of the present thesis is to deepen and expand the existing knowledge of the metacognitive approach and to extend its state-of-the-art regarding depressive symptomatology.