Perseverate or decenter? Differential effects of metacognition on the relationship between parasympathetic inflexibility and symptoms of depression in a multi-wave study.

Depression often is characterized by inflexible autonomic and metacognitive processes that interfere with effective self-regulation. However, few studies have integrated these factors to improve the prediction of which individuals are at greatest risk for depression. Among 134 undergraduates, we evaluated whether parasympathetic inflexibility (a lack of reduction in respiratory sinus arrhythmia) in response to a sadness induction involving loss would prospectively predict symptoms of depression across four waves of follow-up over twelve weeks. Furthermore, we evaluated whether metacognitive components of perseverative cognition (PC) and decentering (identified by a principal component analysis) would moderate this relationship in opposite directions. Multilevel modeling demonstrated that the relationship between parasympathetic inflexibility and prospective symptoms of depression was exacerbated by PC, but attenuated by decentering. Furthermore, individuals with parasympathetic inflexibility, PC, and low decentering were at greatest risk for symptoms of depression across follow-up. These results support the utility of integrating autonomic and metacognitive risk factors to identify individuals at risk for depression.