Dysfunctional Attitudes Versus Metacognitive Beliefs as Within-Person Predictors of Depressive Symptoms Over Time

Understanding within-person variation between theorized mechanisms of disorder and depressive symptoms can help identify targets for interventions. Cognitive models of depression hypothesize dysfunctional attitudes as underlying vulnerability factors, while the metacognitive model places emphasis on dysfunctional metacognitive beliefs. However, no previous study has tested the relative importance of change in dysfunctional attitudes and metacognitive beliefs as predictors of change in depressive symptoms within individuals. In a sample of 1,418 individuals measured at four time-points separated by 5-week intervals, a multilevel model approach was used to test the relative importance of change in dysfunctional attitudes and metacognitive beliefs as predictors of change in depressive symptoms. Change in dysfunctional attitudes and metacognitive beliefs predicted change in depressive symptoms over time. However, change in metacognitive beliefs and in particular negative metacognitive beliefs and judgements of cognitive confidence were significantly stronger predictors of change in depressive symptoms compared to dysfunctional attitudes. Furthermore, change in metacognitive beliefs predicted change in dysfunctional attitudes beyond change in depressive symptoms. These results suggest that metacognitive beliefs rather than dysfunctional attitudes might be more important for depressive symptoms over time within persons and that metacognitive change may also influence dysfunctional attitudes over time. Metacognitive beliefs are therefore a promising target for treatment and prevention aiming to reduce depressive symptoms, but replication of our results in clinical samples is warranted before more clear conclusions can be drawn.