Decision making and its correlates in recurrent depressive disorder

Decision-making (DM) is simply choosing among alternatives or defining one's course of action. A depressed individual does not perceive himself as a decision-maker as ruminations reinforce dysfunctional metacognitive beliefs and poor executive functioning. The aim was to study and compare the relationship among DM, metacognition, and executive functioning in those with recurrent depressive disorder (RDD) and in healthy controls (HCs).

A cross-sectional comparative group study design was used with a sample size of 40, with 20 participants in each group. The tools used were Mini International Neuropsychiatric Interview, General Health Questionnaire, Melbourne Decision Making Questionnaire, Metacognitive Questionnaire, Wisconsin Card Sorting Test, and Controlled Oral Word Association Test.

The RDD group had significantly higher scores on buck-passing (BP), procrastination (PR), hypervigilance, and dysfunctional metacognitive beliefs, and poor performance on executive functioning than HC. PR was inversely correlated with executive functioning and dysfunctional metacognitive beliefs in the RDD group, whereas in the HC group, BP was positively correlated with executive functioning and dysfunctional metacognitive beliefs.

DM has a significant relationship with executive functions and dysfunctional metacognitive beliefs; therefore, changes in any one variable contribute to changes in the other two. The altered attentional and executive control due to dysfunctional metacognitive beliefs leads to poor DM, resulting in psychosocial dysfunction. The underlying metacognitive beliefs and executive functioning play a crucial role in DM, the process determining psychosocial functioning.