Metacognitive awareness and prevention of relapse in depression: Empirical evidence.
John D. Teasdale, Richard G. Moore, Hazel Hayhurst, Marie Pope, Susan P. Williams, Zindel V. Segal
Journal of Consulting and Clinical Psychology January 1, 2002 DOI: 10.1037//0022-006x.70.2.275 (opens in new tab) via OpenAlex
Summary
AI-generated from the abstractMetacognitive awareness—experiencing negative thoughts and feelings as passing mental events rather than as reflections of the self—may protect against depression relapse. In a vulnerable group of residually depressed patients, reduced accessibility of this metacognitive set was linked to greater relapse risk. Cognitive therapy (CT) and mindfulness-based cognitive therapy (MBCT) both reduced relapse by increasing metacognitive awareness, not by altering belief in thought content. CT increased accessibility of metacognitive sets in residually depressed patients, and MBCT did so in recovered depressed patients. These therapies may work by changing how people relate to their thoughts.
Study at a glance
| Characteristics | Observational cohort with intervention components Peer reviewed |
|---|---|
| Population | Residually depressed patients and nondepressed controls; recovered depressed patients |
| Intervention | Cognitive therapy |
| Topics | Meditation |
| Keywords | Metacognition Mindfulness-based cognitive therapy Clinical psychology Depression economics Feeling |
| Citations | 966 |
| Key finding | Cognitive therapy and mindfulness-based cognitive therapy reduce depressive relapse by increasing metacognitive awareness, not by changing belief in thought content. |
Abstract
Metacognitive awareness is a cognitive set in which negative thoughts/feelings are experienced as mental events, rather than as the self. The authors hypothesized that (a) reduced metacognitive awareness would be associated with vulnerability to depression and (b) cognitive therapy (CT) and mindfulness-based CT (MBCT) would reduce depressive relapse by increasing metacognitive awareness. They found (a) accessibility of metacognitive sets to depressive cues was less in a vulnerable group (residually depressed patients) than in nondepressed controls; (b) accessibility of metacognitive sets predicted relapse in residually depressed patients; (c) where CT reduced relapse in residually depressed patients, it increased accessibility of metacognitive sets; and (d) where MBCT reduced relapse in recovered depressed patients, it increased accessibility of metacognitive sets. CT and MBCT may reduce relapse by changing relationships to negative thoughts rather than by changing belief in thought content.