A Prospective Test of the Metacognitive Model of Depression in Previously Depressed Individuals

  • Brage KraftEmail author
  • Rune Jonassen
  • Vidar Ulset
  • Tore Stiles
  • Nils Inge Landrø
Original Article


Metacognitive theory proposes that depression is caused by excessive rumination, which is in turn maintained by maladaptive positive and negative beliefs about rumination (“metacognitions”) and reduced executive control. Moreover, the metacognitive model asserts that metacognitions are maintained by prolonged depression symptoms. However, no studies have tested the metacognitive model of depression prospectively in a clinical population. Currently remitted adults with recurrent depressive disorder (N = 105) reported depression symptoms at five time points over a 12-month period. Based on this data, we used latent growth modelling to estimate depression levels and symptom trajectories. Positive metacognitions were associated with rumination, while negative metacognitions and rumination predicted higher depression levels, but not symptom recurrence. Moreover, depression levels and symptom recurrence predicted positive and negative metacognitions, as well as rumination. There was no association between metacognitions and reduced executive control. The present study lends partial support for the metacognitive model, but raises questions of the relevance of metacognitions as a proximal vulnerability marker for symptom recurrence.


Metacognitions Metacognitive beliefs Depression Executive control 



We want to thank the following research assistants: Inger Marie Andreassen, Adrian Dahl Askelund, Dani Beck, Sandra Aakjær Bruun, Jenny Tveit Kojan, Nils Eivind Holth Landrø, Elise Solbu Kleven and Julie Wasmuth. Further, we thank Kari Agnes Myhre and Senior Consultant, Research leader; MD, Phd Erlend Bøen at Diakonhjemmet Hospital, Division of Psychiatry, for help and support during the recruiting period. We also thank our external recruitment sites, Unicare, Coperiosenteret AS, Torgny Syrstad, MD, Synergi Helse AS and Lovisenberg Hospital.


This work was supported by grants from the Research Council of Norway, Norges Forskningsråd (NO) project number 247372 (NIL) and The South East Norway Health Authority Research Funding, Helse Sør-Øst RHF project number 2015052 (NIL). The Department of Psychology, University of Oslo has also supported the project.

Compliance with Ethical Standards

Conflict of interest

Nils Inge Landrø has received consultancy fees and travel expenses from Lundbeck. Brage Kraft, Rune Jonassen, Vidar Ulset and Tore Stiles declare that they have no conflict of interest.

Ethical Approval

All procedures in the present study were in accordance with the ethical standards of the national research committee in Norway and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual subjects participating in the study.

Research Involving Animal Rights

This article does not contain any studies with animals performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Neuroscience Research Group, Department of PsychologyUniversity of OsloOsloNorway
  2. 2.Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway
  3. 3.Department of PsychologyNorwegian University of Science and TechnologyTrondheimNorway
  4. 4.Division of PsychiatryDiakonhjemmet HospitalOsloNorway

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