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In this article we present a system of 45 content categories for analyzing personal constructs elicited in the context of a repertory grid administration. These categories are divided into six basic areas: moral, emotional, relational, personal, intellectual/operational, and values/interests, as well as two possible supplemental areas: existential and concrete descriptors. We study the reliability of this classification system using a sample of 843 constructs extracted from the grids of 57 subjects and coded by two independent judges. The degree of consensus achieved is very satisfactory.

The Multi-Center Dilemma Project is a collaborative research endeavour aimed at determining the role of dilemmas -a kind of cognitive conflict, detected by using an adaptation of Kelly's Repertory Grid Technique-in a variety of clinical conditions. Implicative dilemmas appear in one third of the non-clinical group (n = 321) and in about half of the clinical group (n = 286), the latter having a proportion of dilemmas that doubles that of the non-clinical sample. Within the clinical group, we studied 87 subjects, after completing a psychotherapy process, and found that therapy helps to dissolve those dilemmas. We also studied, independently, a group of subjects diagnosed with social phobia (n = 13) and a group diagnosed with irritable bowel syndrome (n = 13) in comparison to non-clinical groups. In both health related problems, dilemmas seem to be quite relevant. Altogether, these studies, though preliminary (and with a small group size in some cases), yield a promising perspective to the unexplored area of the role of cognitive conflicts as an issue to consider when trying to understand some clinical conditions, as well as a focus to be dealt with in psychotherapy when dilemmas are identified. Keywords: cognitive conflict, repertory grid technique, personal construct theory, social phobia, irritable bowel syndromeEl Proyecto Multi-Céntrico Dilema aúna los esfuerzos de distintos centros de investigación con el propósito de determinar el papel de los dilemas personales en una amplia gama de problemas de salud. Estos dilemas, identificados mediante una adaptación de la Técnica de Rejilla de Kelly, aparecen en un tercio de un grupo de población normal (n = 321) y en la mitad del grupo clínico (n = 286). Comparando los sujetos que presentan dilemas, los del grupo clínico doblan a los del grupo normal en proporción de dilemas. También revisamos dos estudios independientes con un grupo de pacientes diagnosticados con fobia social (n = 13) y otro con síndrome del intestino irritable (n = 13), ambos en comparación con grupos de población normal. En los dos casos se encuentran diferencias que apuntan en la dirección de la relevancia de los dilemas. Tomando en conjunto los datos disponibles, todo parece augurar unas buenas perspectivas con respecto al papel relevante (auque hasta el momento no explorado) de los conflictos cognitivos a la hora de comprender algunos problemas clínicos. También sugieren el interés de incluir en su tratamiento el trabajo con dilemas, al menos para los sujetos que los presenten. Palabras clave: conflicto cognitivo, técnica de rejilla, teoría de los constructos personales, fobia social, síndrome del intestino irritable

The idea that internal conflicts play a significant role in mental health has been extensively addressed in various psychological traditions, including personal construct theory. In the context of the latter, several measures of conflict have been operationalized using the Repertory Grid Technique (RGT). All of them capture the notion that change, although desirable from the viewpoint of a given set of constructs, becomes undesirable from the perspective of other constructs. The goal of this study is to explore the presence of cognitive conflicts in a clinical sample (n = 284) and compare it to a control sample (n = 322). It is also meant to clarify which among the different types of conflict studied provides a greater clinical value and to investigate its relationship to symptom severity (SCL-90-R). Of the types of cognitive conflict studied, implicative dilemmas were the only ones to discriminate between clinical and nonclinical samples. These dilemmas were found in 34% of the nonclinical sample and in 53% of the clinical sample. Participants with implicative dilemmas showed higher symptom severity, and those from the clinical sample displayed a higher frequency of dilemmas than those from the nonclinical sample.

ObjectivesThe 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.DesignComparison between persons with a diagnosis of major depressive disorder and community controls.MethodsA 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.ResultsRepertory 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.ConclusionsCognitive 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.Practitioner points Internal conflicts have been postulated in clinical psychology for a long time but there is little evidence about its relevance due to the lack of methods to measure them. We developed a method for identifying conflicts using the Repertory Grid Technique. Depressive patients have higher presence and number of conflicts than controls. Conflicts (implicative dilemmas) can be a new target for intervention in depression. Cautions/Limitations A cross-sectional design precluded causal conclusions. The role of implicative dilemmas in the causation or maintenance of depression cannot be ascertained from this study.

ObjectiveThe objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.MethodSix hundred and forty-four adult participants were included in two samples: the clinical sample (n=192) from different mental health and primary care centers; and the nonclinical sample (n=452), which included a student and a community sample.ResultsThe questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment.ConclusionThe Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the questionnaire for monitoring the progress of Spanish-speaking psychotherapy clients.

When faced with a personal problem people typically give better advice to others than to themselves. A previous study showed how it is possible to enact internal dialogue in virtual reality (VR) through participants alternately occupying two different virtual bodies – one representing themselves and the other Sigmund Freud. They could maintain a self-conversation by explaining their problem to the virtual Freud and then from the embodied perspective of Freud see and hear the explanation by their virtual doppelganger, and then give some advice. Alternating between the two bodies they could maintain a self-dialogue, as if between two different people. Here we show that the process of alternating between their own and the Freud body is important for successful psychological outcomes. An experiment was carried out with 58 people, 29 in the body swapping Self-Conversation condition and 29 in a condition where they only spoke to a Scripted Freud character. The results showed that the Self-Conversation method results in a greater perception of change and help compared to the Scripted. We compare this method with the distancing paradigm where participants imagine resolving a problem from a first or third person perspective. We consider the method as a possible strategy for self-counselling.

This study used Kelly's (1955Kelly's ( /1991 Role Construct Repertory Grid (RepGrid) technique to assess cognitive features underlying depressive states. RepGrids from patients with depressive disorders (n = 105, including Major Depression, Dysthymia, and Adjustment Disorder with depressed or mixed symptoms) were compared with a non-clinical group (n = 305). The RepGrids of participants were analyzed using the computer program GRIDCOR (Feixas & Cornejo, 2002). Consistent with hypotheses, those with depressive disorders perceived themselves and others more negatively, perceived themselves as different from others, and generated fewer constructs to describe self and others in comparison to the non-clinical group. There were no differences in use of extreme ratings or in unidimensional construing (percent variance accounted for by the first factor in correspondence analysis) on the RepGrid. RepGrid techniques offer the potential to better understand the processes of construction of the self and others in persons with depressive disorders. Specific RepGrid profiles associated with depression-negativity, resentment, and isolation-may be helpful in further individuating treatment for depression.