Metacognitive beliefs, maladaptive coping strategies, and depressive symptoms: A two-wave network study of the COVID-19 lockdown and reopening

Abstract

To address the increased levels of depressive symptoms during the COVID-19 and other pandemics, it is useful to identify the psychological processes that may explain the relationship between pandemic-related stressors and symptoms. In this study, both the combined network of metacognitions and maladaptive coping strategies—derived from the metacognitive therapy model—and the depressive symptoms were studied during the COVID-19 related lockdown and the partial reopening of the Norwegian society about 3 months later. In an online survey, 4936 participants responded at both these time points. They completed the Cognitive Attentional Syndrome-1 and the Patient Health Questionnaire-9. The combined process and symptom networks were estimated. The maladaptive coping strategies worry/rumination, avoidance, and thought suppression and the symptoms depressed mood and worthlessness showed both high strength centrality at the lockdown and, at least, moderate correlations between their change and overall symptom change from the lockdown to the reopening. None of the metacognitive beliefs attained these criteria. From the lockdown to the reopening, no change in strength centrality was observed. The network structure, however, was significantly different across the periods and several different connections (edge weights) between variables were revealed. For instance, low energy showed a stronger connection to anhedonia and a weaker connection to sleep problems during the reopening than during the lockdown. In conclusion, worry/rumination, avoidance, and thought suppression may maintain central depressive symptoms such as depressed mood and worthlessness during the COVID-19 pandemic. These propositions are actionable as they give access to well-established interventions.