Montesano Adrián, López-González María Angeles, Saúl Luis Angel, Feixas Guillem
Department of Personality, Assessment and Psychological Treatments, University of Barcelona, Barcelona, Spain.
Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, National Distance Education University, Madrid, Spain.
Neuropsychiatr Dis Treat. 2015 Dec 4;11:2997-3006. doi: 10.2147/NDT.S91861. eCollection 2015.
Recent research has highlighted the role of implicative dilemmas in a variety of clinical conditions. These dilemmas are a type of cognitive conflict, in which different aspects of the self are countered in such a way that a desired change in a personal dimension (eg, symptom improvement) may be hindered by the need of personal coherence in another dimension. The aim of this study was to summarize, using a meta-analytical approach, the evidence relating to the presence and the level of this conflict, as well as its relationship with well-being, in various clinical samples. A systematic review using multiple electronic databases found that out of 37 articles assessed for eligibility, nine fulfilled the inclusion criteria for meta-analysis. Random effects model was applied when computing mean effect sizes and testing for heterogeneity level. Statistically significant associations were observed between the clinical status and the presence of dilemmas, as well as level of conflict across several clinical conditions. Likewise, the level of conflict was associated with symptom severity. Results highlighted the clinical relevance and the transdiagnostic nature of implicative dilemmas.
近期研究突显了隐含性困境在多种临床状况中的作用。这些困境是一种认知冲突，其中自我的不同方面相互抵触，以至于个人某一维度上期望的改变（如症状改善）可能会因另一维度上个人连贯性的需求而受到阻碍。本研究的目的是采用荟萃分析方法，总结各种临床样本中与这种冲突的存在、程度及其与幸福感的关系相关的证据。使用多个电子数据库进行的系统评价发现，在评估 eligibility 的 37 篇文章中，有 9 篇符合荟萃分析的纳入标准。计算平均效应量和检验异质性水平时应用了随机效应模型。在临床状况与困境的存在以及几种临床状况下的冲突程度之间观察到了具有统计学意义的关联。同样，冲突程度与症状严重程度相关。结果突显了隐含性困境的临床相关性和跨诊断性质。
