Assessing the efficacy of metacognitive training on depressive symptoms, dysfunctional attitudes and metacognition in elderly individuals diagnosed with depression

Introduction: Depression is a serious mental health problem that significantly reduces the quality of life among older adults and is often associated with dysfunctional attitudes and negative aging perceptions. Therefore, it is crucial to develop new intervention programs aimed at reducing depressive symptoms and improving related cognitive processes. Aim: The study aim was to evaluate the effects of the Metacognitive Training-Silver program on depressive symptoms, dysfunctional attitudes, metacognition, and aging perceptions in elderly individuals diagnosed with depression. Method: This randomized controlled experimental study employed a pretest-post test design with follow-up measurements. A total of 50 individuals aged 60 and older diagnosed with depression (intervention group: 24, control group: 26) participated in this randomized controlled experimental study. Data were collected using the Beck Depression Inventory, Dysfunctional Attitude Scale, Metacognition Questionnaire, and Attitudes to Aging Questionnaire. The intervention group participated in an 8-week Metacognitive Training-Silver program, and both groups completed the questionnaires at baseline, post-intervention, and at the third-month follow-up. Data were analyzed using Pearson Chi-Square test, independent samples t-test, Mann-Whitney U test, and Non-Parametric Repeated Measures Variance Analysis. Results: The mean age of participants was 67.50 ± 5.28 years in the intervention group and 68.88 ± 5.04 years in the control group, with both groups demonstrating similar sociodemographic and clinical characteristics. Compared to the control group, the intervention group showed statistically significant improvements in depressive symptoms (post-intervention p<0.001, third-month follow-up p<0.001), dysfunctional attitudes (post-intervention p=0.002, third-month follow-up p<0.001), metacognition levels (post-intervention p<0.001, third-month follow-up p<0.001), and aging perceptions (post-intervention p<0.001, third-month follow-up p<0.001). Conclusion: The findings of this study demonstrate that the MCT-Silver program is effective in reducing depressive symptoms, transforming dysfunctional thought patterns, enhancing metacognitive functioning, and promoting positive aging perceptions among older adults diagnosed with depression. In this context, it is recommended to strengthen professional training and establish continuing education programs for nurses to effectively implement metacognitive interventions, particularly for managing depression in older age.