Investigation of the relationship between depression, rumination, metacognitive beliefs and cognitive fusion
Kerr, Eleonore Sian
Background It has been found that both depressed patients and patients who have recovered from depression report more rumination and hold more meta-cognitive beliefs about the benefits of rumination than never-depressed controls. Furthermore, it is suggested that a ruminative cognitive style predicts the onset, length and severity of depressive episodes. Within an ACT (Acceptance and Commitment Therapy) perspective on depression, it is suggested that rumination in depression is a verbal reason-giving behaviour used to „solve‟ the problem of depressed mood. However, it is proposed that an individual‟s fusion with these verbal reasons (i.e. cognitive fusion) perpetuates rumination and impedes the adoption of more functional behaviours. The aim of this study is to investigate the relationships between depression, rumination, cognitive fusion and positive beliefs about rumination. Method A between-groups design was used comparing currently depressed adults (n = 26), recovered depressed adults (n = 21) and never depressed adults (n = 27) on a battery of self-report measures for depressive symptomatology, rumination, positive beliefs about rumination and cognitive fusion. Data were analysed using ANOVAs, post hoc comparisons, and path analysis: an extension of multiple regression. Results Significant differences were found in rumination and cognitive fusion between all three groups, with higher levels of rumination and cognitive fusion found in both the currently depressed and recovered depressed groups compared to never depressed controls. Significant differences in positive beliefs about rumination were found only between the currently depressed group and the never depressed group. Results also indicated that depression severity was best predicted by rumination and cognitive fusion rather than positive beliefs about rumination. Furthermore, the relationships between the variables of cognitive fusion and rumination (β = 0.76, p < .001), and cognitive fusion and depression (β = 0.66, p < .001), were stronger than the relationships between any of the other variables included in this study. Discussion Overall, the findings support the suggestion that cognitive fusion be considered in the conceptualisation of ruminative processes and depression. The results suggest that in individuals who have recovered from depression and are no longer clinically depressed, a difference in cognitive processes such as rumination and cognitive fusion remains. This may indicate that cognitive fusion is not secondary to depression and does appear to be implicated in the ruminative process.