Cognitive conflicts and symptom severity in Dysthymia: “I'd rather be good than happy”

A. Montesano, Guillem Feixas, Luis-Angel Saul, M.I. Erazo-Caicedo, G. Dada, David Winter

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


A method for studying cognitive conflicts using the repertory grid technique
is presented. By means of this technique, implicative dilemmas
can be identified, cognitive structures in which a personal construct
for which change is wished for implies undesirable change on another
construct. We assessed the presence of dilemmas and the severity
of symptoms in 46 participants who met criteria for dysthymia and
compared then to a non-clinical group composed of 496 participants.
Finally, an analysis of the specific content of the personal constructs
forming such dilemmas was also performed. Implicative dilemmas
were found in almost 70% of the dysthymic participants in contrast to
39% of controls and in greater quantity. In addition, participants in
both groups with this type of conflict showed more depressive symptoms
and general distress than those without dilemmas. Furthermore,
a greater number of implicative dilemmas was associated with higher
levels of symptom severity. Finally, content analysis results showed that
implicative dilemmas are frequently composed of a constellation of
moral values and emotion, indicating that symptoms are often related
to moral aspects of the self and so change processes may be hindered.
Clinical implications of targeting implicative dilemmas in the
therapy context are discussed
Original languageEnglish
Pages (from-to)41-48
JournalSalud Mental
Issue number1
Publication statusPublished - 2014


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