METACOGNITION AND RUMINATIVE THOUGHT IN DEPRESSED INDIVIDUALS

Yıl 2024, Cilt: 33 Sayı: 1, 120 - 128, 01.04.2024

Mahmut Evli , Nuray Şimşek , Tülay Yılmaz Bingöl , Zehra Su Topbaş

https://doi.org/10.34108/eujhs.1382283

Öz

It is known that the repetitive and persistent ruminative thought style in depression is closely related to metacognition. In Türkiye, studies on this subject in depressed patients are relatively limited.This study aimed to examine the relationships between metacognitions and ruminative thought style in individuals diagnosed with depression.The data was collected between 01.05.2021 and 31.12.2022 from 210 depression patients who applied to psychiatric clinics of a state hospital in the Black Sea Region. Introductory Information Form, Ruminative Thought Style Scale and Metacognition-30 Scale were used to collect data. The Spearman correlation test was used to determine the correlations. Path analysis was used to test how metacognitions predicted ruminative thought in depressive individuals. It was determined that there was a statistically significant and moderately positive correlation between the mean scores of ruminative thought style and psychopathological metacognitive activity (r=0.477; p<0.01). In addition, according to the established path model, 36.5% of the variance changes in the ruminative t thought style are explained by this model. It was determined that the effect of psychopathological metacognitive activities on variance changes in ruminative thought was 60.7%. It is seen that there is a relationship between problematic metacognitions and ruminative thought. Studies in the literature support this result. This study, which determined that metacognition and sub-dimensions are related to rumination in individuals diagnosed with depression in a Turkish sample, will serve as a reference for therapy approaches to be applied to individuals with depressive symptoms.

Anahtar Kelimeler

Depression patient, metacognition, ruminative thought

DEPRESİF BİREYLERDE ÜSTBİLİŞLER VE RUMİNATİF DÜŞÜNME

Öz

Depresyonda tekrarlayıcı ve süreklilik arz eden ruminatif düşünce biçiminin üstbilişlerle yakından ilişkili olduğu bilinmektedir. Türkiye’de ise depresif hastalarda bu konuda yapılan çalışmalar oldukça sınırlıdır. Bu çalışmada depresyon tanısı almış bireylerde üstbilişler ve ruminatif düşünme biçimi arasındaki ilişkileri incelemek amaçlanmıştır.Veriler Karadeniz Bölgesi'nde yer alan bir devlet hastanesi psikiyatri kliniklerine başvuran 210 depresyon hastasından 01.05.2021-31.12.2022 tarihleri arasında toplanmıştır toplanmıştır.Verilerin toplanmasında Tanıtıcı Bilgi Formu, Ruminatif Düşünme Biçimi Ölçeği ve Üstbiliş-30 Ölçeği kullanılmıştır. Korelasyonları belirlemek amacıyla Spearman korelayon testi uygulanmıştır. Üst bilişlerin depresif bireylerde ruminatif düşünme biçimini ne ölçüde yordadığını test etmek amacıyla path analizi kullanılmıştır.Ruminatif düşünme biçimi ve psikopatolojik üst bilişsel faaliyet puan ortalamaları arasında pozitif yönde orta düzeyde istatistiksel olarak anlamlı bir ilişki olduğu belirlenmiştir (r=0.477; p<0.01). Ayrıca kurulan path modeline göre ruminatif düşünme biçimindeki varyans değişimlerinin %36.5’inin bu model tarafından açıklandığı ve ruminatif düşünme biçimindeki varyans değişimlerinde psikopatolojik üst bilişsel faaliyetlerin etkisinin %60.7 olduğu belirlenmiştir.Sorunlu üstbilişlerle ruminatif düşünce arasında ilişki olduğu görülmektedir. Bu bulgu literatürde yer alan çalışmalarla desteklenmektedir. Türkiye örnekleminde depresyon tanısı almış bireylerde üstbiliş ve alt boyutlarının ruminasyonla ilişkili olduğunu belirleyen bu çalışma, depresif semptomları olan bireylerde uygulanacak terapi yaklaşımları için bir referans görevi görecektir.

Anahtar Kelimeler

Depresyon hastası, üstbiliş, ruminatif düşünme

Kaynakça

• Flavell JH. Metacognition and cognitive monitoring: A new area of cognitive developmental ınquiry. American Psychologist. 1979;34:906-911. doi:10. 1037/0003-066X.34.10.906
• Kuhn D. Metacognitive development. Current Directions in Psychological Science. 2000;9(5):178-181. doi:10.1111/1467-8721.00088
• Dasen PR. Culture and cognitive development. Journal of Cross-Cultural Psychology. 2022;53(7-8):789-816. doi:10.1177/00220221221092409
• Proust J, Fortier M. Metacognitive diversity across cultures: An introduction. Oxford University Press. 2018:4-11.
• Heyes C, Bang D, Shea N, Frith CD, Fleming SM. Knowing ourselves together: The cultural origins of metacognition. Trends in Cognitive Sciences. 2020;24(5):349-362. doi:10.1016/j.tics.2020.02.0 07
• Kuchling F, Fields C, Levin M. Metacognition as a consequence of competing evolutionary time scales. Entropy (Basel). 2022;24(5):601. doi:10.3390/e24050601
• Böke Ö, Pazvantoğlu O, Babadağı Z, et al. Metacognitions in panic disorder. Anatolian Journal of Psychiatry. 2015;16(1):1-6. doi:10.5455/apd.15 5782
• Yılmaz S, İzci F, Mermi O, Atmaca M. Metacognitive functions in patients who has obsessive compulsive disorder and major depressive disorder: A controlled study. Anatolian Journal of Psychiatry. 2016;17(6):451-458. doi:10.5455/apd.214063
• Faissner M, Kriston L, Moritz S, Jelinek L. Course and stability of cognitive and metacognitive beliefs in depression. Depression and Anxiety. 2018;35(12):1239-1246. doi:10.1002/da.22834
• Spada MM, Nikcević AV, Moneta GB, Wells A. Metacognition as a mediator of the relationship between emotion and smoking dependence. Addict Behav. 2007;32(10):2120-2129. doi:10.1016/j.add beh.2007.01.012
• Koç V. A review on depression and its treatment from metacognitive perspective. Journal of Clinical Psychol. 2017;1(1):34-43. doi:10.7816/kpd-01-01-04
• Wells A. Metacognitive therapy for anxiety and depression. New York, The Guilford Press. 2009:1-8.
• Wells A. Emotional disorders and metacognition: Innovative cognitive therapy. Wiley. 2000:23-26.
• Rippere V. What's the thing to do when you're feeling depressed?- A pilot study. Behavior Research and Ther. 1977;15(2):185-191. doi:10.10 16/0005-7967(77)90104-8
• Nolen-Hoeksema S. The other end of the continuum: The costs of rumination. Psychological Inqu. 1998;9(3):216-219. https://www.jstor.org/stable/ 1449557
• Leahy RL. A model of emotional schemas. Cognitive and Behavioral Prac. 2002;9(3):177-190. doi:10.10 16/S1077-7229(02)80048-7
• Papageorgiou C, Wells A. Metacognitive beliefs about rumination in recurrent major depression. Cognitive and Behavioral Pract. 2001;8(2):160-164. doi:10.1016/S1077-7229(01)80021-3
• Spada MM, Nikčević AV, Kolubinski DC, et al. Metacognitions, rumination, and worry in personality disorder. Journal of Affective Disord. 2021;293:117-123. doi.org/10.1016/ j.jad.2021.06.024.
• Özben İ, Şenormancı G, Demirci OO, Şenormancı Ö. Associations of dysfunctional attitudes, rumination and metacognitive beliefs about rumination with pharmacological treatment response in patients with first episode of major depression. International Journal of Psychiatry in Clinical Pract. 2023;27(1):51-58. doi:10.1080/13651501.2022. 2087529.
• Dragan M, Dragan W. Temperament and anxiety: The mediating role of metacognition. Journal of Psychopathology and Behavioral Assess. 2014;36(2):246-254. doi:10.1007/s10862-013-9392-z
• Gürbüz S, Şahin F. Research Methods in Social Sciences: Philosophy-Methods-Analysis. (Exploratory Factor Analysis and Reliability Analysis.). Ankara, Seçkin Publishing, 2018.
• Brinker JK, Dozois DJ. Ruminative thought style and depressed mood. Journal of Clinical Psychol. 2009;65(1):1-19. doi:10.1002/jclp.20542.
• Karatepe HT, Yavuz FK, Turkcan A. Validity and reliability of the Turkish version of the ruminative thought style questionnaire. Bulletin of Clinical Psychopharma. 2013;23(3):231-241. doi:10. 5455/bcp.20121130122311
• Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire: properties of the MCQ-30. Behaviour Research and Ther. 2004;42(4):385-396. doi:10.1016/S0005-7967(03)00147-5
• Tosun A, Irak M. Turkish adaptation of Metacognition Scale-30, its validity, reliability, and its relationship with anxiety and obsessive-compulsive symptoms. Turkish Journal of Psychi. 2008;19(1):67-80.
• Roelofs J, Papageorgiou C, Gerber RD, Huibers M, Peeters F, Arntz A. On the links between self-discrepancies, rumination, metacognitions, and symptoms of depression in undergraduates. Behavior Research and Ther. 2007;45(6):1295-1305. doi:10.1016/j. brat.2006.10.005
• PapageorgiouC, WellsA. An empirical test of a clinical metacognitive model of rumination and depression. Cognitive Therapy and Research. 2003;27(3):261-273. doi:10.1023/A:1023962332399
• Rafique Z. An exploration of the presence and content of metacognitive beliefs about depressive rumination in Pakistani women. The British Journal of Clinical Psycho. 2010;49(3):387-411. doi:10.1348/ 014466509X472020
• Pedersen H, Grønnæss I, Bendixen M, Hagen R, Kennair LEO. Metacognitions and brooding predict depressive symptoms in a community adolescent sample. BMC Psychi. 2022;22(1):157. doi:10.1186/s12888-022-03779-5
• Solem S, Hagen R, Hoksnes JJ, Hjemdal O. The metacognitive model of depression: An empirical test in a large Norwegian sample. Psychiatry Research, 2016;242:171-173. doi:10.1016/j.psychres.2016. 05.056
• Kovács LN, Takacs ZK, Tóth Z, Simon E, Schmelowszky Á, Kökönyei G. Rumination in major depressive and bipolar disorder - A meta-analysis. Journal of Affective Disor. 2020;276:1131-1141. doi:10.1016/j.jad.2020.07.131
• Li Y, Gu S, Wang Z, et al. Relationship between stressful life events and sleep quality: rumination as a mediator and resilience as a moderator. Frontiers in Psychi. 2019;10:348. doi.org/10.3389/fpsyt.2019.00348
• Renna ME, Rosie Shrout M, Madison AA, et al. Worry and rumination in breast cancer patients: perseveration worsens self-rated health. Journal of Behavioral Medi. 2021;44(2):253-259. doi.org/10. 1007/s10865-020-00192-9
• Watkins E, Teasdale JD. Rumination and over general memory in depression: effects of self-focus and analytic thinking. Journal of Abnormal Psycho. 2001;110(2):353-357. doi:10.1037/0021-843x.11 0.2.333
• van Vugt MK, van der Velde M, ESM-MERGE Investigators. How does rumination impact cognition? a first mechanistic model. Topics in Cognitive Sci. 2018;10(1):175-191. doi:10.1111/tops.12318
• Whitmer AJ, Gotlib IH. An attentional scope model of rumination. Psychological Bull. 2013;139(5):1036. doi:10.1037/a0030923
• Avard S, Garratt-Reed D. The role of inflated responsibility beliefs in predicting symptoms of generalized anxiety disorder and depression. Australian Journal of Psycho. 2021;73(2):157-166. doi:10.1080/00049530.2021.1882268
• Clark DA, Steer RA, Beck AT. Common and specific dimensions of self-reported anxiety and depression: implications for the cognitive and tripartite models. Journal of Abnormal Psycho. 1994;103(4):645-654. doi:10.1037/0021-843X.103.4.6 45
• Wells A. Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioral and Cognitive Psychothe. 1995;23(3):301-320. doi:10.1017/S13524 65800015897
• Evli M, Şimşek N. Mediating role of metacognitions in the relationship between cognitive avoidance and smoking addiction: a structural equation modeling. Cukurova Medical Jour. 2021;46(4);1640-1649. doi:10.17826/cumj.976394
• Ingeç Ö, Akyüz Z, Samancı A. Adaptation of Self-Critical Rumination Scale to Turkish and investigation of psychometric properties. Journal of Clinical Psycho. 2020;5(1). doi:10.5455/kpd.26024438m00 0035
• Yılmaz AE, Sungur M, Konkan R, Şenormancı Ö. Psychometric properties of rumination-related metacognition scales in clinical and non-clinical Turkish samples. Turkish Journal of Psychi. 2014;25:1-11.(6),451-458. doi:10.5080/u7879