Dissonance, resistance and commitment: a pilot analysis of moderated mediation relationships.
BACKGROUND
Encouraging engagement is a challenge in forensic services. A model of behaviour change suggests that dissatisfaction with the self may express itself either as resistance to or commitment to engagement in treatment, and that this expression may be moderated by the individual's attributional style.


OBJECTIVE
It was hypothesised that there would be relationships between measures of dissonance, resistance to treatment and commitment to treatment, and that these relationships would be moderated by locus of control.


METHODS
Thirty-two patients from within a high secure dangerous and severe personality disorder service completed assessments measuring dissonance, locus of control, resistance and commitment. These measures were analysed for a moderated mediation using techniques outlined by Preacher et al. (2007).


RESULTS
There were significant indirect relationships between dissonance and both resistance and commitment. These relationships were moderated by locus of control. However, the specifics of the relationships were not as expected - both internal and external locus of control interfered with therapy, but in different ways.


CONCLUSIONS
A patient who experiences dissonance may translate this into either commitment to or resistance to treatment, depending on features of the patient such as attributional style.
The Paddock Centre, Broadmoor Hospital, Crowthorne, Berkshire, UK. simon.draycott@wlmht.nhs.uk
Simon
S
Draycott
D000328:Adult; D003073:Cognitive Dissonance; D006801:Humans; D007389:Internal-External Control; D010554:Personality Disorders / Q000523:psychology / Q000628:therapy*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales