Cognitive conflicts in major depression: between desired change and personal coherence.

OBJECTIVES: 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. DESIGN: 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.

Stability and consistency of coping in adolescence: A longitudinal study.

This study analyzed stability and consistency of coping among adolescents. The objectives were twofold: a) to analyze temporal stability and cross-situational consistency of coping responses after a 17- month interval, taking into account gender, age and type of stressor. b) To analyze the relative weight of contextual versus dispositional factors in predicting future coping. A cohort of 341 adolescents (51% girls and 49% boys aged between 12 and 16) were assessed twice by means of the Coping Responses Inventory - Youth. The results indicated that the coping responses were quite stable over time at the group level, but with important within-subject differences. Girls showed slightly more stability than boys. Among the girls, Avoidance coping showed as much stability as consistency and Approach coping showed more stability than consistency. Among the boys, Avoidance coping showed more stability than consistency, and Approach coping showed both low stability and low consistency. Among the boys, the coping used at Time 1 barely predicted that used at Time 2; in contrast, among the girls, the type of coping used in the past, especially Avoidance coping, predicted the coping that would be used in the future.

Facing Interpersonal Violence: Identifying the Coping Profile of Poly-Victimized Resilient Adolescents.

Coping strategies are factors that mediate the relationship between interpersonal victimizations and psychological maladjustment. The objectives are as follows: (a) to establish the coping profile of adolescents according to the number of reported interpersonal victimizations; (b) to identify the most victimized adolescents (poly-victims), detecting those with psychological symptoms (nonresilient poly-victims) and those without psychological symptoms (resilient poly-victims), and then to examine any differences in coping strategies between the two groups; (c) to determine the accumulative effect of victimizations on mental health; and (d) to test the mediating role of both approach and avoidance coping between lifetime interpersonal victimizations and symptoms. Participants were 918 community Spanish adolescents (62.7% girls) aged between 14 and 18 years. Measures used were Youth Self-Report, Juvenile Victimization Questionnaire, and Adolescent Coping Orientation for Problem Experiences. The following results were reported: (a) The most victimized adolescents used to a greater degree avoidance coping strategies than nonvictimized adolescents. (b) Resilient poly-victimized adolescents were more likely to seek family support and tended to use more positive reappraisal than nonresilient poly-victimized adolescents. (c) A clear cumulative effect of victimizations on mental health was observed: 45% of the most victimized adolescents (poly-victims) reached clinical range on Youth Self-Report in front of 2% of nonvictimized adolescents. (d) Avoidance coping and more specifically Escaping and Venting feelings strategies played a mediating role between interpersonal victimizations and psychological symptoms. Approach coping had no mediating role, except for Positive reappraisal in girls. In conclusion, the possibility of identifying the coping profile of victimized adolescents may have clinical implications in terms of both prevention and intervention.

Psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory-Adult Form.

One of the goals of psychological assessment focuses on the adaptation of its instruments to different populations. The objective of this study is to establish the psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory-Adult Form (CRI-Adult, Moos, 1993). The following criteria were analyzed: a) descriptive statistics; b) internal consistency reliability (Cronbach's alpha, and intercorrelations between scales); c) test-retest reliability (4-week interval); d) dimensionality of CRI-Adult (exploratory factor analysis); e) construct validity (confirmatory factor analysis); f) convergent criterion validity (correlations between CRI-Adult and Coping Strategies Indicator, CSI, Amirkhan, 1990), and g) predictive criterion validity (correlations between CRI-Adult, and SCL-90-R, Derogatis, 1983). The results, obtained with 800 adults from Barcelona and surrounding area (334 men and 466 women, aged between 18 to 76 years) indicate that the Spanish version of CRI-Adult has satisfactory psychometric properties that allow using this test with guarantee.

Systemic couple therapy for dysthymia.

We examined the effect of Systemic Couple Therapy on a patient diagnosed with dysthymic disorder and her partner. Marge and Peter, a middle-aged married couple, showed significant and meaningful changes in their pattern of interaction over the course of the therapy and, by the end of it, Marge no longer met the diagnostic criteria for dysthymic disorder. Her scores on the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and Beck Depression Inventory, Second Edition (BDI-II) were in the clinical range before treatment and in the nonclinical one at the end of therapy. Although scores on Dyadic Adjustment Scale showed different patterns, both members reported significant improvement. The analysis of change in the alliance-related behaviors throughout the process concurred with change in couple's pattern of interaction. Treatment effects were maintained at 12-month follow-up. Highlights in the therapy process showed the importance of relational mechanisms of change, such as broadening the therapeutic focus into the couple's pattern of interaction, reducing expressed emotion and resentment, as well as increasing positive exchanges. The results of this evidence-based case study should prompt further investigation of couple therapy for dysthymia disorder. Randomized clinical trial design is needed to reach an evidence-based treatment status.

Stability and consistency of coping in adolescence: a longitudinal study / La estabilidad y consistencia del afrontamiento en la adolescencia: un estudio longitudinal

This study analyzed stability and consistency of coping among adolescents. The objectives were twofold: a) to analyze temporal stability and cross-situational consistency of coping responses after a 17- month interval, taking into account gender, age and type of stressor. b) To analyze the relative weight of contextual versus dispositional factors in predicting future coping. A cohort of 341 adolescents (51% girls and 49% boys aged between 12 and 16) were assessed twice by means of the Coping Responses Inventory - Youth. The results indicated that the coping responses were quite stable over time at the group level, but with important within-subject differences. Girls showed slightly more stability than boys. Among the girls, Avoidance coping showed as much stability as consistency and Approach coping showed more stability than consistency. Among the boys, Avoidance coping showed more stability than consistency, and Approach coping showed both low stability and low consistency. Among the boys, the coping used at Time 1 barely predicted that used at Time 2; in contrast, among the girls, the type of coping used in the past, especially Avoidance coping, predicted the coping that would be used in the future(AU)

Este estudio analiza la estabilidad y consistencia del afrontamiento en la adolescencia. Sus objetivos son: a) analizar la estabilidad temporal y la consistencia situacional del afrontamiento tras un período de 17 meses, teniendo en cuenta el sexo, la edad y el tipo de estresor. b) Analizar el peso relativo de factores disposicionales vs contextuales en la predicción del afrontamiento futuro. Una cohorte de 341 adolescentes (51% chicas y 49% chicos) con edades comprendidas entre los 12 y los 16 años fueron evaluados dos veces mediante el Coping Responses Inventory - Youth. Los resultados indicaron una buena estabilidad temporal a nivel de grupo, pero con importantes variaciones intra-individuales. Las chicas mostraron una estabilidad ligera mayor que los chicos. En ellas el afrontamiento de tipo evitativo demostró tanta estabilidad como consistencia y el de aproximación más estabilidad que consistencia. Entre los chicos el afrontamiento de evitación denotó más estabilidad que consistencia y el de aproximación baja estabilidad y baja consistencia. En las chicas las respuestas de afrontamiento usadas en el pasado, especialmente las de evitación, tienen poder predictivo sobre las que usarán en el futuro. En los chicos esta capacidad predictiva es inferior(AU)

Psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory - Adult Form / Propiedades psicométricas y estructura dimensional de la versión española del Inventario de Respuestas de Afrontamiento - Versión Adultos

One of the goals of psychological assessment focuses on the adaptation of its instruments to different populations. The objective of this study is to establish the psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory- Adult Form (CRI-Adult, Moos, 1993). The following criteria were analyzed: a) descriptive statistics; b) internal consistency reliability (Cronbach’s alpha, and intercorrelations between scales); c) test-retest reliability (4-week interval); d) dimensionality of CRI-Adult (exploratory factor analysis); e) construct validity (confirmatory factor analysis); f) convergent criterion validity (correlations between CRI-Adult and Coping Strategies Indicator, CSI, Amirkhan, 1990), and g) predictive criterion validity (correlations between CRI-Adult, and SCL-90-R, Derogatis, 1983). The results, obtained with 800 adults from Barcelona and surrounding area (334 men and 466 women, aged between 18 to 76 years) indicate that the Spanish version of CRI-Adult has satisfactory psychometric properties that allow using this test with guarantee

Uno de los campos de aplicación de la evaluación psicológica se concreta en la adaptación de sus instrumentos de medida a diversas poblaciones. El objetivo de este estudio se centra en establecer las propiedades psicométricas y la dimensionalidad de la versión española del Coping Responses Inventory - Adult Form (CRI-Adult, Moos, 1993). Se han analizado los siguientes criterios: a) estadísticos descriptivos; b) consistencia interna (alfa de Cronbach y correlaciones entre escalas); c) fiabilidad test-retest (intervalo de 4 semanas); d) dimensionalidad del CRI-Adult (análisis factorial exploratorio); e) validez de constructo (análisis factorial confirmatorio); f) validez convergente (correlaciones entre CRI-Adult y Coping Strategies Indicator, CSI, Amirkhan, 1990); y g) validez predictiva (correlaciones entre CRI-A y SCL-90-R, Derogatis, 1983). Los resultados, obtenidos con una población de 800 sujetos adultos de Barcelona y área metropolitana (334 hombres y 466 mujeres de edades entre 18 y 76), indican que la versión española del CRI-Adult denota unas adecuadas propiedades psicométricas que permiten utilizar este test con garantías de bondad