In a recent study, metacognitive beliefs about worry and rumination were found to predict anxiety and depression, through their influence on perseverance behaviors. These findings were published in Behavioural and Cognitive Psychotherapy.
Anxiety and depression are two common psychological disorders that often co-occur. Some research has suggested that maladaptive perfectionism might be a shared aspect of the two disorders. Specifically, perseveration is an aspect of perfectionism which is defined as “the tendency to continue a particular behaviour or thought, even when it ceases to be effective or rewarding” and can include persistent negative thinking, such as rumination and worry.
Metacognitive beliefs — an individual’s understanding of their thought processes — can be either positive or negative. Either way, metacognitive thoughts can be maladaptive, since “repetitive efforts to avoid negative thoughts often counterintuitively increases perseverance behaviours.”
Lee Kannis-Dymand, a senior lecturer in clinical psychology at the University of the Sunshine Coast, and his colleagues conducted a study to explore the roles of metacognitive beliefs and perseverance behaviors in anxiety and depression.
“I have been drawn to importance of metacognitive processes, such as worry, rumination, and over-thinking and their impact within a range of conditions. I have been fascinated by the work of Adrian Wells in this area and this have motivated much of my research,” Kannis-Dymand told PsyPost.
A sample of 1,033 young adults between the ages of 18 and 30 completed a questionnaire that included the perseveration subscale of the Perfectionism, Persistence and Perseveration Questionnaire (PPPQ-22). Subjects were asked to rate statements like, ‘sometimes I find myself continuing to do something even when there is no point carrying on.’
Subjects also completed assessments of metacognitive beliefs. These included positive beliefs about worry, negative beliefs about the uncontrollability and harmfulness of worry, and beliefs about the need to control one’s thoughts. They also included positive beliefs about rumination, and negative beliefs about the uncontrollability and adverse consequences of rumination. All subjects were additionally assessed for symptoms of anxiety and depression.
Statistical analysis showed that all metacognitive beliefs indirectly influenced participants’ anxiety scores, through their influence on perseverance behaviors. In other words, beliefs about anxiety and rumination predicted perseverance, which then predicted anxiety.
“Our study provided evidence that people who view worry or rumination (dwelling) as a helpful strategy or see worry/rumination as uncontrollable are more likely contribute to anxiety and depression and be associated with unhelpful perfectionistic behaviours. Basically, we contributed to the current literature that over-thinking like worry and rumination are unhelpful coping strategies,” Kannis-Dymand explained.
Beliefs about worry were more strongly associated with anxiety than were beliefs about rumination. On the other hand, beliefs about rumination were more strongly related to depression than beliefs about worry. Moreover, “negative metacognitive beliefs about rumination indirectly influenced depression through its effect on perseverance.”
These results may offer insight into the comorbidity of anxiety and depression. As the authors suggest, “One explanation might be that the those with perfectionist traits who fail to adopt functional behaviours and thoughts to effectively subside their concerns about their self-image, and view these behaviours and worry as uncontrollable, may go on to develop depressive thoughts and concerns for their past actions, in the form of rumination, in order to protect themselves from damaging their self-image further.”
Overall, the findings suggest that perseverance behaviors may be a maladaptive component of perfectionism. “This is not to say we should not think things over and try and problem-solve issues or difficulties, but once this process becomes circular like worrying, then we need to detach from it. Further, we should try to ensure our worry or rumination is not being driven by perfectionism as this will only super-size it,” Kannis-Dymand said.
Kannis-Dymand has recently developed an app called Coping Coach that has some guidance for managing worry. The app is available on the Apple App store and Google Play.
The study, “Examining the roles of metacognitive beliefs and maladaptive aspects of perfectionism in depression and anxiety”, was authored by Lee Kannis-Dymand, Emily Hughes, Kate Mulgrew, Janet D. Carter, and Steven Love.