8) Rumination and Metacognition - Anmol Guest Lec

The role of metacognitive beliefs regarding rumination in the depressive experience - for Test 3

why is Depression often referred to as a remitting,
recurring disorder?

50% of people remit within one year without treatment

• inter-episode remissions = an individual experiences periods between major depressive episodes where their symptoms significantly decrease or disappear entirely, allowing them to return to a normal or near-normal level of functionin- but then depressive episode can come back

• Most episodes of depression are characterized by periods of stasis punctuated by sudden changes (“sudden gains”, “spikes”) in depressive symptom

Sudden Gains and Depressive Spikes

• what causes sudden gains

• what happens after a gain

Depression typically shows:

• Long periods of stasis

• Sharp “sudden gains” or “spikes” (large, rapid changes)

Supporting studies:

• looked at depressed ppl before and after doing CBT sessions (2/wk), n=61

  • Defined a sudden gain as:

    • ≥ 7-point drop

    • ≥ 25% decrease from prior score

what causes gains

• Improvements in therapeutic alliance (we see gain between pregain session and after gain session)

• Cognitive change, specifically:

  • Insights into beliefs relevant to the depressive episode

Patients who experience sudden gains often show:

• Patients showing rapid early response + later spike → lower eventual depression symptoms

• The spike was associated with:

  • ↑ processing

  • ↑ insight

• Lack of spike was associated with:

  • Avoidance

• Implication: Cognitive work during gains leads to long-term improvement.

• depressive symptoms spike up as they relaize something, but then drops down to lower than before as the realization helps them

• patients with no gain = do not improve in symptoms

Hypothesized liner and circular model of spontaneous remission

• which one has more robust support

Key concepts:

• RCA (Root Cause Analysis) – identifying causal factors that could have prevented the problem

• PSA (Problem-Solving Analysis) – using causal understanding to design solutions

linear Hypothesized Model:

Depression → Root Cause Analysis → Problem-Solving Analysis → less depression (note spike in depression)

circular hypothesis model: MORE ROBUST SUPPORT

Reciprocal process → circular system.

Depression → (+) → RCA
RCA → (+) → PSA
PSA → (–) → Depression

• in the middel circle its overall positive bc Bivariate correlations (simple correlations) between:

  • Depression (DEP)

  • RCA

  • PSA
    → hover around 0 to 0.2

This occurs because:

• The circular model includes opposing effects that cancel out in simple correlations.

Modeling Spontaneous Remission - longitudial vs cross sectional data

Longitudinal:

• Captures dynamic changes → sudden gains, spikes

• Linear model works (variables not in equilibrium)

Cross-sectional:

• Represents a snapshot during a stable period

• Depression, RCA, and PSA are in temporal equilibrium
  → Use a circular model

does depression promote problem- solving

depression does not promote general problem solving

• it promotes problem solveing analysis - founded in a causal understanding of the problems.

Limitations for circular model of depression

Could the circular relationship go the other way?

Reverse model proposed:

• Depression inhibits PSA

• RCA increases depression

• PSA increases RCA (harder to justify)

Reason against reverse model:

• Evidence (e.g., Cyberball writing studies) shows:

  • RCA precedes PSA

  • RCA → upward counterfactual thoughts (a PSA component)

Thus RCA → PSA order more plausible.

Sequential Model of Rumination

FMR shifts the perspective of rumination from a simply repetitive thinking style to a breakdown in the natural, smooth progression of thoughts and experiences in conscious awareness.

metacognition

• def

• 2 types of metacognitive beliefs abotu rumination

• role in rumination and depressive experience

• Metacognition = higher-order thinking that monitors, controls, and regulates cognition.

• 2 types

  • Positive metacognitive beliefs about rumination (PMBR) = engage in rumination intentionally, for learning/problem-solving

    • “I need to ruminate to find answers.”

    • “Rumination helps me understand/control my depression.”

    • “Thinking about past mistakes helps prevent future ones.”

    • “Rumination means I care.”

  • Negative metacognitive beliefs about rumination (NMBR) = view rumination as uncontrollable, harmful, unproductive

    • “Rumination is uncontrollable.”

    • “Rumination makes me more depressed.”

    • “When I ruminate, I can’t do anything else.”

    • “Rumination is harmful.”

why did the conventional clinical model of depression believe both PMBR and NMBR worsen depressive symptoms?

• why is this wrong?

bc: 

• PMBR encourage rumination, which is clinically believed to be an “unhelpful” and “passive” cognition that worsens depression.

• NMBR are thought to cause “emotional disturbances” in response to the “negative consequences” of rumination itself.

class version of a metacognitive model of depression:

• Depressive rumination is necessary for problem-solving

• Problem-solving is adaptive

• Therefore:

  • PMBR = beneficial because they encourage productive rumination

  • NMBR = reduce rumination engagement → may slow remission

Integrated in the linear model:

Depression
→ RCA
→ PSA
→ reduction in depression
↑ PMBR facilitate this process
↓ NMBR may hinder it

• PMBR → positively linked to RCA and PSA pathways

• NMBR → expected negative effect on RCA was not significant
  → suggests more complexity

key takeaways

• Depression promotes RCA-based problem-solving through rumination

• This explains why depression looks unproductive clinically but may be productive long-term

• Sudden gains/spikes reflect insight and processing increases

• PMBR appear to support natural remission processes

• NMBR did not significantly disrupt RCA

• Circular model explains spontaneous remission

• Rumination plays a functional role in resolving depressive episodes

what is better - CBT or ACT?

• CBT → treats rumination as harmful; tries to suppress/interrupt

• ACT / Mindfulness-Based CBT → don’t suppress; encourage nonjudgmental observation

• Class model suggests:

  • Rumination is instrumental in recovery

  • It promotes causal understanding + problem-solving

  • PMBR may be beneficial

  • Therapy could help patients understand that:

    • Rumination is not always harmful

    • It may help resolve depressive episodes

    • Encouraging structured, reflective rumination might improve outcomes