Metacognitive judgements and abilities in patients with affective disorders

Barbara Drueke,Siegfried Gauggel,Lorenz Weise,Thomas Forkmann,Verena Mainz

doi:10.1007/s12144-022-02838-0

Barbara Drueke, Siegfried Gauggel + Show 3 more

Open Access

https://doi.org/10.1007/s12144-022-02838-0

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Abstract

ObjectivesCognitive and metacognitive deficits depict important factors in depression, but the relationship between these concepts remains to be elucidated. The present study investigated the difference between patients with depression and controls in metacognitive judgements regarding the domain of attention. Furthermore, the associations between different metacognitive abilities, depressiveness and confidence were investigated, as well as in how far the derived correlates would predict depression.MethodsThirty patients with a major depressive episode and 30 healthy participants were enrolled in the current study. Attention and executive functioning ability were assessed including metacognitive judgements of performance and confidence with regard to the test performance in the Stroop test. To examine further aspects related to (meta-)cognitive abilities, decentering skills, aspects of self-conscious attention, self-assessed intelligence and metacognitive beliefs, judgements and monitoring tendencies were assessed.ResultsAlbeit groups’ metacognitive judgements of performance did not differ, patients indicated to be significantly less confident in their judgements. Depressive patients showed less decentering abilities compared to healthy participants and there was a significant association between decentering and confidence ratings. Moreover, depressiveness was associated with dysfunctional self-consciousness and low cognitive confidence. Finally, lower decentering skills and higher dysfunctional self-attention were the best predictors for depressiveness.ConclusionsResults favor the assumption that patients’ metacognitive abilities regarding the domain of attention are not generally deficient. Rather, the lower confidence in their judgements and dysfunctional (meta-)cognitive abilities, like decentering, metacognitive beliefs and aspects of self-conscious attention and intelligence, seem to mirror the patients’ impairments.

Highlights

A large number of studies have shown that different cognitive functions can be impaired to varying degrees in depressive patients (Marvel & Paradiso, 2004; McClintock, Hussain, Greer, & Cullum, 2010; Vasic, Wolf, & Walter, 2007)
The present study focuses on two scales of rather classical intelligence areas namely selfestimated verbal (VI) and mathematical-logical intelligence (MLI) as these aspects relate best to the demands and performance in the subsequent tasks
In the study at hand, again, we focus on the two most relevant subscales with regard to our research questions: first, the “cognitive confidence” scale (CC) which contains items that refer to thoughts about the effectiveness of one's own cognitive abilities, especially memory and attention and, second, the “cognitive self-consciousness” scale (CSC) which is concerned with the extent to which individuals focus their attention on their own mental processes

Summary

Introduction

A large number of studies have shown that different cognitive functions can be impaired to varying degrees in depressive patients (Marvel & Paradiso, 2004; McClintock, Hussain, Greer, & Cullum, 2010; Vasic, Wolf, & Walter, 2007). 1996) or the more recent metacognitive model of depression (Wells, 2008), assumed both, cognitive processes like attention, and metacognition to be intermingled in pathology. The S-REF model integrates information processing research into Beck’s schema theory by proposing attention capacity and reduced cognitive flexibility as important factors in metacognition when regarding emotional disorders (Wells & Matthews, 1996). The metacognitive model of depression stresses, that depression is mainly being maintained by rumination, which again is maintained by dysfunctional metacognitions (Wells, 2008) Recent studies supported this model at least in parts (Kraft et al, 2017; Aldahadha, 2021). Kraft et al (2017) found dysfunctional metacognitive beliefs in a mixed clinical-, non-clinical population to be associated with decreased executive control, and, negative metacognitions were associated with reduced ability to shift between mental sets. In how far metacognition and the cognitive domain of attention, cognitive flexibility and executive functioning are empirically related has not yet been studied systematically

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