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Negative views of self or internal
conflicts as targets of
psychotherapy?
Dr. Guillem Feixas
gfeixas@ub.edu
Dr. Adrián Mon...
General Idea
 Negative views of self → vulnerability for
depression and other disorders.
Little is known about perceived...
Implicative dilemma
Polo Congruente Polo Indeseable
Polo Actual
Polo
Deseado
r >20
Constructo
Congruente
Constructo
Discre...
Clinical samples vs. controls
To which extent there are more clinical
participants presenting with at least one
Implicati...
Presence of Implicative Dilemmas
Depression (Feixas et al, 2014a & b); Dysthimia (Montesano et al, 2014); Bulimia (Feixas
...
Clinical samples vs. controls
To which extent there are more clinical
participants presenting with at least one
Implicati...
Depression (Feixas et al, 2014a & b); Dysthimia (Montesano et al, 2014); Bulimia (Feixas
et al, 2010); Anxiety (Melis et a...
Clinical samples
Is number of Implicative Dilemmas
related to symptom level?
Correlation of number of
Implicative Dilemmas
with symptom inventories
Depression (Feixas et al, 2014a & b); Dysthimia (Mo...
Depression Study
ii████
Demographic and baseline
characteristics of participants
Depression
(n = 161)
Control
(n = 110) Group difference
Sex (fema...
Implicative Dilemmas in Depression
161 patients with MDD (SCID-I)
compared with 110 community controls
68%
35%
χ2 = 28.73;...
Patterns in self-construing
(n = 161)
(n = 110)
Predicting Distress
– BDI-II: F(2,268) = 74.87; 36% (R2); p <.001
1. Self-ideal Discrepancy ( β= -.54; p = .001)
2. Number...
Predicting group allocation
X2 (2, N = 271) = 258.33; p <.001; 31.8% (Cox & Snell R square) - 43% (Nagelkerke R squared)
L...
Some Conclusions
 The presence of implicative dilemmas as
captured by repertory grids is quite common
(around 35%) in non...
Some Conclusions
Implicative dilemmas can be a new
individualized target for intervention in
depression and some other di...
Dilemma Focused Therapy for
Depression: A Manual
Guillem Feixas & Victoria Compañ
University of Barcelona
Thanks for your attention!
My e-mail address: gfeixas@ub.edu
MULTI-CENTER DILEMMA PROJECT:
www.usal.es/tcp
The GRIDCOR ...
Negative views of self or internal conflicts
Negative views of self or internal conflicts
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Negative views of self or internal conflicts

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Feixas, G. y Montesano, A. (2015, Marzo). Negative Views of Self or Internal Conflicts as Targets of Psychotherapy, In G. Feixas (Chair), Conflict in Meaning Systems: Perspectives and Implications for Mental Health and Psychotherapy del International Convention of Psychological Science, Amsterdam, Holanda.

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Negative views of self or internal conflicts

  1. 1. Negative views of self or internal conflicts as targets of psychotherapy? Dr. Guillem Feixas gfeixas@ub.edu Dr. Adrián Montesano
  2. 2. General Idea  Negative views of self → vulnerability for depression and other disorders. Little is known about perceived positive self- attributes and their role in these disorders. Our research suggests that conflicting positive and negative self-perceptions are highly prevalent in depression and other disorders.
  3. 3. Implicative dilemma Polo Congruente Polo Indeseable Polo Actual Polo Deseado r >20 Constructo Congruente Constructo Discrepante r >20 Congruent Construct Discrepant Construct Congruent Pole Undesirable Pole Present Pole Desired Pole timid social modest arrogant SELF, IDEAL SELF SELF IDEAL SELF
  4. 4. Clinical samples vs. controls To which extent there are more clinical participants presenting with at least one Implicative Dilemma? Do clinical participants present with higher numbers of Implicative Dilemmas?
  5. 5. Presence of Implicative Dilemmas Depression (Feixas et al, 2014a & b); Dysthimia (Montesano et al, 2014); Bulimia (Feixas et al, 2010); Anxiety (Melis et al, 2011); Fibromyalgia (Compañ et al, 2011); Women victims of intimate partner violence (Soldevilla et al, 2014), IBS (Benasayag, et al, 2001).
  6. 6. Clinical samples vs. controls To which extent there are more clinical participants presenting with at least one Implicative Dilemma? Do clinical participants present with higher numbers of Implicative Dilemmas?
  7. 7. Depression (Feixas et al, 2014a & b); Dysthimia (Montesano et al, 2014); Bulimia (Feixas et al, 2010); Anxiety (Melis et al, 2011); Fibromyalgia (Compañ et al, 2011); Women victims of intimate partner violence (Soldevilla et al, 2014), IBS (Benasayag, et al, 2001). Medium mean effect size (d = 0.61; 95% CI: 0.49, 0.72). Number of Implicative Dilemmas
  8. 8. Clinical samples Is number of Implicative Dilemmas related to symptom level?
  9. 9. Correlation of number of Implicative Dilemmas with symptom inventories Depression (Feixas et al, 2014a & b); Dysthimia (Montesano et al, 2014); Bulimia (Feixas et al, 2010); Anxiety (Melis et al, 2011); Fibromyalgia (Compañ et al, 2011); Women victims of intimate partner violence (Soldevilla et al, 2014), IBS (Benasayag, et al, 2001).
  10. 10. Depression Study ii████
  11. 11. Demographic and baseline characteristics of participants Depression (n = 161) Control (n = 110) Group difference Sex (female: male) 126:35 79:31 2(1) = 1.14; p = .28 Age (M; SD) 47.13; 11.31 44.51; 4.39 t (269) = -1.675, p = .11 Marital Status Married/ living together (Fr; %) 93; 57.8 71; 64.5 2(1) = .99; p = .32 Single/ Divorced (Fr; %) 68; 42.2 39; 35.5 Years of education (M; SD) 12.31; 3.09 11.80; 2.71 t (269) = -1.40, p = .16 BDI-II (M; SD) 36.06; 9.81 5.28; 4.36 t (2636.8) = -35.06, p < .001
  12. 12. Implicative Dilemmas in Depression 161 patients with MDD (SCID-I) compared with 110 community controls 68% 35% χ2 = 28.73; p < .01; = .33 t = -5.79; p < .01
  13. 13. Patterns in self-construing (n = 161) (n = 110)
  14. 14. Predicting Distress – BDI-II: F(2,268) = 74.87; 36% (R2); p <.001 1. Self-ideal Discrepancy ( β= -.54; p = .001) 2. Number of Implicative Dilemmas ( β= .15; p = .003) – Global Assessment of Functioning (GAF): F(2,158) = 10.54, p <.001 1. Number of Implicative Dilemmas (β= .26; p = .001) 2. Self-ideal Discrepancy (β= 21; p = .004) Standard Multiple Regression
  15. 15. Predicting group allocation X2 (2, N = 271) = 258.33; p <.001; 31.8% (Cox & Snell R square) - 43% (Nagelkerke R squared) Logistic Regression
  16. 16. Some Conclusions  The presence of implicative dilemmas as captured by repertory grids is quite common (around 35%) in non-clinical samples.  Depressive (and many other) patients have more of these internal conflicts than controls.  A fully consistent pattern of self-negativity is very rare (1%) even in depression. INSTEAD, we found mixed and conflicting views of self.  Internal conflict deserves as much attention as it has been paid to self-negativity.
  17. 17. Some Conclusions Implicative dilemmas can be a new individualized target for intervention in depression and some other disorders Therapy should be aimed at conflict resolution so that desired changes in behavior and mood were compatible with the need of preserving coherence of identity
  18. 18. Dilemma Focused Therapy for Depression: A Manual Guillem Feixas & Victoria Compañ University of Barcelona
  19. 19. Thanks for your attention! My e-mail address: gfeixas@ub.edu MULTI-CENTER DILEMMA PROJECT: www.usal.es/tcp The GRIDCOR program for analyzing repertory grids (including a Manual): www.terapiacognitiva.net/record

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