title: Cognitive conflicts in major depression: between desired change and personal coherence.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Comparison between persons with a diagnosis of major depressive disorder and community controls.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Personality, Assessment and Psychological Treatments, University of Barcelona, Spain; Institute for Brain, Cognition and Behaviour, University of Barcelona, Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Feixas
authors.forename: Adrián
authors.initials: A
authors.lastname: Montesano
authors.forename: Victoria
authors.initials: V
authors.lastname: Compañ
authors.forename: Marta
authors.initials: M
authors.lastname: Salla
authors.forename: Gloria
authors.initials: G
authors.lastname: Dada
authors.forename: Olga
authors.initials: O
authors.lastname: Pucurull
authors.forename: Adriana
authors.initials: A
authors.lastname: Trujillo
authors.forename: Clara
authors.initials: C
authors.lastname: Paz
authors.forename: Dámaris
authors.initials: D
authors.lastname: Muñoz
authors.forename: Miquel
authors.initials: M
authors.lastname: Gasol
authors.forename: Luis Ángel
authors.initials: LÁ
authors.lastname: Saúl
authors.forename: Fernando
authors.initials: F
authors.lastname: Lana
authors.forename: Ignasi
authors.initials: I
authors.lastname: Bros
authors.forename: Eugenia
authors.initials: E
authors.lastname: Ribeiro
authors.forename: David
authors.initials: D
authors.lastname: Winter
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Carrera-Fernández
authors.forename: Joan
authors.initials: J
authors.lastname: Guàrdia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D060685:Sense of Coherence; D055815:Young Adult
keywords: Cognitive conflicts; Implicative dilemmas; Major depression; Repertory Grid Technique
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