A systematic review of the relationship between rigidity/flexibility and transdiagnostic cognitive and behavioral processes that maintain psychopathology

Abstract

An ever-growing number of transdiagnostic processes that maintain psychopathology across disorders have been identified. However, such processes are not consistently associated with psychological distress and symptoms. An understanding of what makes such processes pathological is required. One possibility is that individual differences in rigidity in the implementation of these processes determine the degree of psychopathology. The aim of this article is to examine the relationship between rigidity/flexibility and transdiagnostic maintenance processes. Initial searches were made for research examining relationships between 18 transdiagnostic processes and rigidity/flexibility. Relationships between rumination, perfectionism, impulsivity and compulsivity, and rigidity/flexibility were systemically reviewed; 50 studies met inclusion criteria. The majority of studies indicated that transdiagnostic cognitive and behavioral maintenance processes and rigidity were correlated, co-occurring, or predictive of each other. Findings are consistent with the hypothesis that it is inflexibility in the manner in which processes are employed that makes them pathologically problematic. However, further research is required to test and establish this.

The majority of professionally active women diagnosed with eating disorders may be at risk of work addiction: an overlooked comorbidity

“…Both show a strong relationship to rigid perfectionism, which is increasingly identified as a transdiagnostic process (Egan, Wade, & Shafran, 2011), as well as obsessive-compulsiveness, including anankastia/obsessive-compulsive personality disorder (OCPD). These are associated with a strong need for control (ICD-11 -World Health Organization, 2019; DSM-5 -American Psychiatric Association, 2013), as well as related to rigidity/flexibility, consistently with the assumption that inflexibility in the transdiagnostic processes is essential in making them problematic and pathological (Morris & Mansell, 2018). Similar family factors have been suggested as crucial for both disorders (e.g., enmeshment and criticism), and it was suggested that they generally might represent a way of coping with problems of identity and personal control (Polivy & Herman, 2002), specifically as a way to compensate for low self-esteem (see Andreassen, 2014;Atroszko, Demetrovics, & Griffiths, 2019;.…”

Communication Empowerment Framework: An integrative framework to support effective communication and interaction between carers and people living with dementia

“…The theory recognizes that since complete influence over events is rarely possible, the way to sustain adequate control, and thus avoid conflict and distress, is to recognize and adjust or abandon goals that cannot be achieved ( Brandtstädter, 2009 ; Morris, Mansell, & McEvoy, 2016 ; Powers, 1973 ). This change happens through a trial and error process termed reorganization ( Powers, 1973 ).…”

“…Training programmes need to provide techniques for responding to daily challenges that encourage the resolution of internal conflicts between higher-level goals, because this will increase the scope for control and thus promote resilience ( Alsawy et al., 2014 ; Dias et al., 2015 ; Harmell et al., 2011 ; Morris et al., 2016 ). As noted above, reorganizing and resolving higher-level conflicts is also likely to improve communication, because it reduces the likelihood of external conflict.…”

“…Carers benefit through the fulfilment of higher-level goals like creating joy and supporting the person living with dementia, commonly someone they have loved and known for a significant amount of time ( Butcher et al., 2001 ; Russell, 2001 ). Raising awareness of higher-level goals thus exposes not only self-oriented priorities but also other-oriented ones, enabling a creative approach to working with conflicting goals ( Morris et al., 2016 ).…”

Experiences of a transdiagnostic group, the Take Control Course, for clients with common mental health problems: A qualitative study

“…The two key elements here are a broad awareness of higher level goals (including goals that could potentially conflict) in conjunction with a mobility of awareness, so that an individual does not “get stuck” at higher level abstract goals but is able to implement higher level reorganization using lower level goals (Morris, Mansell, & McEvoy, ). Behaviourally, this might be demonstrated by the ability to disengage from patterns of responding that are no longer helpful in meeting an individual's important goals (Morris & Mansell, in press). Varied strands of evidence indicate that mindfulness can enable a broad and mobile awareness that allows access to conflicted goals and distressing experiences.…”