Ruminating Thoughts Linked to Increased Depression Risk

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Many young people have depressive symptoms. Ruminative thinking, and even thinking about how much you ruminate, reinforces symptoms. But there is hope.

Once you have depressive symptoms, it’s easy to fall into a pattern of aggravating your ruminative thought disorder.

One of the key themes is what is called negative metacognitions , a phrase that needs some explanation.

"Metathoughts, or metacognitions, are the thoughts we think about the thoughts we think ," says Leif Edward Ottesen Kennair, professor in the Department of Psychology at the Norwegian University of Science and Technology (NTNU) and lead supervisor of the current study.

Psychologist and first author Helene Pedersen from Helse Bergen HF explains: "Having thoughts about our own thinking that we are more or less aware of is quite common."

Thoughts about our own thinking are not harmful in and of themselves. Positive thoughts about our own thinking can lead us to reflect on topics we want to reflect on more often, and perhaps even enjoy more. But that can backfire for some people.

The results of a new study on the topic have recently been published in BMC Psychiatry .

I’m a freak?

Negative metacognitions may, for example, think that depressive rumination is a sign that we are damaged, or we may think that our rumination is uncontrollable.

For some people, this ruminative thinking leads to thoughts that can be difficult to get out of. Those thoughts can quickly lead to getting caught up in a self-reinforcing negative pattern.

“It’s only a problem when we have a lot of those negative thoughts about our own thinking and we fall into an unfortunate thinking pattern that can be difficult to stop,” Pedersen says.

But Kennair offers encouragement. “We are not weak or damaged products, and learning that you can control rumination yourself can be done fairly quickly with metacognitive therapy.” So fortunately there are methods that can probably help. And you’re not alone either.

Girls are more vulnerable

Depressive symptoms and depression are common in young people. Girls have these symptoms more often than boys, and more often they also have a diagnosis of depression.

A new NTNU survey included nearly 1,200 people aged 16 to 20. Girls and women scored higher on all measures, including depressive symptoms. They also scored higher on both positive metacognitions, or thoughts that rumination is helpful, and negative metacognitions about their own thoughts. Girls and women ruminate more in general.

Here we find clear gender differences. But the reasons why some people get stuck in depressive thoughts are the same for both sexes.

“We found that the main reasons for persistent depressive symptoms are negative metathoughts and melancholia , and this applies to both sexes and regardless of age,” says Kennair.

Metacognitive therapy can help

Improving involves overcoming self-reinforcing patterns, thoughts, and actions.

“We believe that metacognitive therapy may also be an effective treatment for treating depressive symptoms in young people,” says Professor Kennair.

Pedersen says metacognitive therapy focuses on changing what keeps depressive illnesses going: depressive rumination and negative thoughts about our own thinking.

“Melancholic and negative metacognitions can be both triggers and maintenance factors of depressive symptoms. So it can be useful to focus on this to prevent depression,” says psychologist and co-author Ingrid Grønnæss.

“This therapy allows us to both help people who are already developing increasing depressive symptoms and prevent others from developing such symptoms,” he says.

Metacognitive therapy is a new form of treatment developed by Adrian Wells at the University of Manchester, where the main goal is to discontinue negative thought processes and change metacognitions about worry and rumination.

Conclusion and clinical implications

This first investigation of the invariance of the effect of rumination and metacognitions on depressive symptoms across sex and age group supports the metacognitive model of the maintenance of depressive symptoms. Adolescent females had higher levels of depressive symptoms, metacognition, and melancholia than adolescent males. There was support for a metacognitive model of depression in a community sample of nonclinical adolescents aged 16 to 20 years.

Consistent with previous research, melancholic and negative metacognitions were central components in the development and maintenance of depressive symptoms. Furthermore, there was no effect of age. The model did not vary between the groups of adolescents aged 16 to 20 years. Negative and brooding metacognitions are important targets for clinical interventions aimed at reducing depressive symptoms among adolescents.

The results could have clinical implications. Recent studies have shown support for the use of metacognitive therapy (MCT) in the treatment of depression in adults. Since rumination also appears to be closely related to depressive symptoms in adolescence, the current results indicate that MCT could be a beneficial therapeutic option for treating depression in these age groups.

Reference : Pedersen, H., Grønnæss, I., Bendixen, M. et al. Metacognitions and melancholy predict depressive symptoms in a sample of young people in society. BMC Psychiatry 22, 157 (2022). Published March 1, 2022. https://doi.org/10.1186/s12888-022-03779-5