Feixas Guillem, Montesano Adrián, Compañ Victoria, Salla Marta, Dada Gloria, Pucurull Olga, Trujillo Adriana, Paz Clara, Muñoz Dámaris, Gasol Miquel, Saúl Luis Ángel, Lana Fernando, Bros Ignasi, Ribeiro Eugenia, Winter David, Carrera-Fernández María Jesús, Guàrdia Joan
Department of Personality, Assessment and Psychological Treatments, University of Barcelona, Spain; Institute for Brain, Cognition and Behaviour, University of Barcelona, Spain.
Br J Clin Psychol. 2014 Nov;53(4):369-85. doi: 10.1111/bjc.12050. Epub 2014 Apr 16.
The notion of intrapsychic conflict has been present in psychopathology for more than a century within different theoretical orientations. However, internal conflicts have not received enough empirical attention, nor has their importance in depression been fully elaborated. This study is based on the notion of cognitive conflict, understood as implicative dilemma (ID), and on a new way of identifying these conflicts by means of the Repertory Grid Technique. Our aim was to explore the relevance of cognitive conflicts among depressive patients.
Comparison between persons with a diagnosis of major depressive disorder and community controls.
A total of 161 patients with major depression and 110 non-depressed participants were assessed for presence of IDs and level of symptom severity. The content of these cognitive conflicts was also analysed.
Repertory grid analysis indicated conflict (presence of ID/s) in a greater proportion of depressive patients than in controls. Taking only those grids with conflict, the average number of IDs per person was higher in the depression group. In addition, participants with cognitive conflicts displayed higher symptom severity. Within the clinical sample, patients with IDs presented lower levels of global functioning and a more frequent history of suicide attempts.
Cognitive conflicts were more prevalent in depressive patients and were associated with clinical severity. Conflict assessment at pre-therapy could aid in treatment planning to fit patient characteristics.
心理内部冲突的概念在精神病理学领域已存在一个多世纪，存在于不同的理论取向中。然而，内部冲突尚未得到足够的实证关注，其在抑郁症中的重要性也未得到充分阐述。本研究基于认知冲突的概念，即蕴含性两难困境（ID），以及一种通过 repertory grid 技术识别这些冲突的新方法。我们的目的是探讨抑郁症患者中认知冲突的相关性。
对诊断为重度抑郁症的患者与社区对照者进行比较。
对 161 名重度抑郁症患者和 110 名非抑郁症参与者进行评估，以确定是否存在蕴含性两难困境以及症状严重程度。还分析了这些认知冲突的内容。
repertory grid 分析表明，抑郁症患者中存在冲突（蕴含性两难困境）的比例高于对照组。仅考虑那些存在冲突的网格，抑郁症组中每人的平均蕴含性两难困境数量更高。此外，存在认知冲突的参与者症状严重程度更高。在临床样本中，存在蕴含性两难困境的患者整体功能水平较低，自杀未遂史更频繁。
认知冲突在抑郁症患者中更为普遍，且与临床严重程度相关。治疗前的冲突评估有助于根据患者特征制定治疗计划。
