Ruminations, cognitive inflexibility, and their relationship with suicidal ideation in depressive disorders: A neuropsychological approach

Depression is theorized to result from “cognitive constriction” and problem-solving deficits, making an individual vulnerable to suicidal thoughts and acts. The present study explored the relationships between metacognitive beliefs, ruminations, and executive functions in patients with depression with suicidal ideation and without suicidal ideation. Fifty patients of clinical depression (n = 25 depression with suicidal ideation, n = 25 depression without suicidal ideation) were recruited using purposive sampling. All participants completed the sociodemographic data sheet, Modified Scale for Suicidal Ideation, Metacognition Questionnaire 30, Ruminative Response Scale, Cognitive Flexibility Scale and Hamilton Rating Scale for Depression, and executive functions tests such as Wisconsin Card Sorting Test and Eriksen Flanker Test. Metacognition and rumination responses were significantly higher in patients with depression with suicidal ideation than in patients without suicidal ideation. In addition, cognitive flexibility is higher in patients with depression without suicidal ideation, and executive deficits were higher in depression with suicidal ideation than without suicidal ideation. The findings support the role of metacognitive beliefs, ruminations, and executive deficits in maintaining suicidal ideations in depression.