SELF CONSTRUCTION, COGNITIVE CONFLICTS AND DIFFERENTIATION IN A SAMPLE OF WOMEN WITH BULIMIA NERVOSA Claudia  Montebruno ,...
OBJECTIVES <ul><li>General purpose: </li></ul><ul><li>To examine cognitive structure, understood as a construct system, in...
OBJECTIVES <ul><li>Specific goals: </li></ul><ul><li>To study self construction, assessed using the Repertory Grid Techniq...
OBJECTIVES <ul><li>To compare general symptoms (SCL-90-R) in a group of women with BN and in a non-clinical sample. </li><...
PERSONAL CONSTRUCT THEORY (Kelly, 1955; 2001) <ul><li>Constructivist Theory: </li></ul><ul><li>- Reality is only accessibl...
PERSONAL CONSTRUCTS <ul><li>Definition: distinctions that each individual constructs, in a unique way, from personal exper...
PERSONAL CONSTRUCT SYSTEMS <ul><li>Constructs are related in an interdependent, hierarchic, and complex meaning network. <...
REPERTORY GRID TECHNIQUE <ul><li>An instrument used to assess dimensions and structures of meaning. </li></ul><ul><li>- Se...
 
Measures of self construction <ul><li>Self-esteem: degree of association between “Self” and “Ideal Self”. </li></ul><ul><l...
Measures of cognitive structure <ul><li>Cognitive differentiation: number of dimensions used by an individual for the cons...
Cognitive Conflicts <ul><li>- A particular configuration of constructs leading to contradictory actions or dispositions (F...
Example of Implicative Dilemma <ul><li>Congruent Pole   Undesirable Pole </li></ul><ul><li>Responsible   Irresponsible </l...
Method <ul><li>Participants: </li></ul><ul><li>- Clinical sample: 32 women diagnosed of BN treated in ITA. </li></ul><ul><...
Method <ul><li>Instruments: </li></ul><ul><li>- Repertory Grid Technique </li></ul><ul><li>(Kelly, 1955; Feixas & Cornejo,...
Method <ul><li>- Administration of RGT </li></ul><ul><li>- Administration of SCL-90-R and BDI </li></ul><ul><li>- RECORD 4...
RESULTS
SCL- 90-R 0,009 0,59 0,98 GSI 0,050 0,63 0,93 Paranoid Ideation 0,007 0,34 0,70 Psychoticism 0,013 0,21 0,54 Phobic Anxiet...
REPERTORY GRID TECHNIQUE 0,000 22,91 30,72 Number of Constructs Sig. Bilateral Non-clinical (mean) Clinical (mean)
0,548 0,23 0,31 32 Clinical 0,20 0,34 32 Non-clinical Feelings of “nearness” “ Self”-“Others” Correlation 0,069 0,29 0,25 ...
COGNITIVE CONFLICTS:  Implicative dilemmas 0,180 1,77 59,4% 75% Triadic conflicts 0,001 18,22 18,8% 71,9% Implicative dile...
Implicative dilemmas:  Predictive power <ul><li>Criterion variable: sample (Clinical/NC) </li></ul><ul><li>Predicting vari...
* p <  0,01 (bilateral) 0,39 -0,42 “ Ideal-Others” Correlation -0,51* -0,50* “ Self- Others” Correlation 0,42 0,56* Nº Tre...
DISCUSSION <ul><li>Women with BN show higher number of constructs than non-clinical ones. Possible reasons: </li></ul><ul>...
DISCUSSION (cont.) <ul><li>Even though we do not find significant differences in the “adequacy perceived of others” betwee...
DISCUSSION (cont.) <ul><li>This finding could be coherent with the role of perfectionism and low self-esteem,  specific ch...
CONCLUSIONS <ul><li>Implicative dilemmas seem to have a role in BN. </li></ul><ul><li>Even though present treatments take ...
CONCLUSIONS (cont) <ul><li>A longer evolution of BN is associated with a higher presence of general and depressive symptom...
Conclusions (cont.) <ul><li>Women with BN show lower self-esteem (measured with RGT) than the non-clinical sample. </li></...
Conclusions (cont.) <ul><li>Personal construct theory is relevant in the comprehension of BN and offers instruments that c...
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Poster presentado en congreso internacional de Trastornos de la conducta alimentaria

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  • R = 0,40 Aqui hace falta explicar que se saca de la rejilla que se explica a continación
  • Poster presentado en congreso internacional de Trastornos de la conducta alimentaria

    1. 1. SELF CONSTRUCTION, COGNITIVE CONFLICTS AND DIFFERENTIATION IN A SAMPLE OF WOMEN WITH BULIMIA NERVOSA Claudia Montebruno , Guillem Feixas & Montse del Castillo. Universidad de Barcelona Instituto de Trastornos Alimentarios (ITA)
    2. 2. OBJECTIVES <ul><li>General purpose: </li></ul><ul><li>To examine cognitive structure, understood as a construct system, in a group of women with diagnose of Bulimia Nervosa (BN) </li></ul>
    3. 3. OBJECTIVES <ul><li>Specific goals: </li></ul><ul><li>To study self construction, assessed using the Repertory Grid Technique (RGT), in a group of women diagnosed of Bulimia Nervosa (BN), comparing it to a matched non-clinical sample. </li></ul><ul><li>To compare cognitive conflicts (implicative dilemmas) in a sample of women with BN and in a non-clinical sample. </li></ul>
    4. 4. OBJECTIVES <ul><li>To compare general symptoms (SCL-90-R) in a group of women with BN and in a non-clinical sample. </li></ul><ul><li>To examine, within the clinical sample, the possible relationships between the following variables: years of evolution of BN, number of previous treatments, time currently in treatment, symptoms (SCL-90-R and BDI) and repertory grid indexes. </li></ul>
    5. 5. PERSONAL CONSTRUCT THEORY (Kelly, 1955; 2001) <ul><li>Constructivist Theory: </li></ul><ul><li>- Reality is only accessible through construction of dimensions for its interpretation. </li></ul><ul><li>Human being as a scientist who constructs informal theories to anticipate, organize and interpret his or her experiences. </li></ul>
    6. 6. PERSONAL CONSTRUCTS <ul><li>Definition: distinctions that each individual constructs, in a unique way, from personal experience. </li></ul><ul><li>They can be represented by bipolar dimensions, for example: </li></ul><ul><li>“ secure - insecure” </li></ul>
    7. 7. PERSONAL CONSTRUCT SYSTEMS <ul><li>Constructs are related in an interdependent, hierarchic, and complex meaning network. </li></ul><ul><li>- Higher level constructs can be a part of the core of the system, the person's identity. </li></ul>
    8. 8. REPERTORY GRID TECHNIQUE <ul><li>An instrument used to assess dimensions and structures of meaning. </li></ul><ul><li>- Self construction measures. </li></ul><ul><li>- Cognitive structure measures. </li></ul><ul><li>- Cognitive conflicts. </li></ul>
    9. 10. Measures of self construction <ul><li>Self-esteem: degree of association between “Self” and “Ideal Self”. </li></ul><ul><li>Perceived social isolation: lack of association between “Self” and “Others”. </li></ul><ul><li>Adequacy perceived in others: relationship between “Ideal Self” and “Others”. </li></ul>
    10. 11. Measures of cognitive structure <ul><li>Cognitive differentiation: number of dimensions used by an individual for the construction of interpersonal experience. </li></ul><ul><li>Measures: </li></ul><ul><li>- Percentage of Variance explained by the first factor (PVF1) </li></ul><ul><li>- Total construct Intensity </li></ul>
    11. 12. Cognitive Conflicts <ul><li>- A particular configuration of constructs leading to contradictory actions or dispositions (Feixas & Saúl, 2004): </li></ul><ul><li>- Implicative Dilemmas : cognitive structure where the undesirable pole of a construct is associated to positive aspects of the person’s identity. </li></ul>
    12. 13. Example of Implicative Dilemma <ul><li>Congruent Pole Undesirable Pole </li></ul><ul><li>Responsible Irresponsible </li></ul><ul><li>r = 0,40 </li></ul><ul><li>Current Pole Desirable Pole </li></ul><ul><li>Insecure Secure </li></ul>
    13. 14. Method <ul><li>Participants: </li></ul><ul><li>- Clinical sample: 32 women diagnosed of BN treated in ITA. </li></ul><ul><li> mean age = 24,22; sd = 5,66 </li></ul><ul><li>- Non-clinical sample: 32 women drawn from a pool of 331 female voluntaries, and matched by age to the clinical sample. </li></ul><ul><li> mean age = 24,56; sd = 5,82 </li></ul>
    14. 15. Method <ul><li>Instruments: </li></ul><ul><li>- Repertory Grid Technique </li></ul><ul><li>(Kelly, 1955; Feixas & Cornejo, 1996) </li></ul><ul><li>- SCL-90-R (Derogatis, 1977; 1994) </li></ul><ul><li>- BDI (Beck, 1978) </li></ul>
    15. 16. Method <ul><li>- Administration of RGT </li></ul><ul><li>- Administration of SCL-90-R and BDI </li></ul><ul><li>- RECORD 4.0 program data analysis (English version GRIDCOR 4.0 :, Feixas & Cornejo, 2002) </li></ul>
    16. 17. RESULTS
    17. 18. SCL- 90-R 0,009 0,59 0,98 GSI 0,050 0,63 0,93 Paranoid Ideation 0,007 0,34 0,70 Psychoticism 0,013 0,21 0,54 Phobic Anxiety 0,008 0,66 1,35 Depression 0,018 0,71 1,22 Interpersonal Sensitivity 0,032 0,75 1,20 Obsessive- Compulsive SIG. (bilateral) MEANS (non-clinical sample) MEANS (clinical sample) SCL- 90-R SCALES
    18. 19. REPERTORY GRID TECHNIQUE 0,000 22,91 30,72 Number of Constructs Sig. Bilateral Non-clinical (mean) Clinical (mean)
    19. 20. 0,548 0,23 0,31 32 Clinical 0,20 0,34 32 Non-clinical Feelings of “nearness” “ Self”-“Others” Correlation 0,069 0,29 0,25 32 Clinical 0,23 0,37 32 Non-clinical Adequacy perceived in others (Correlation “ideal” - ”Others”) 0,000 0,24 0,41 32 Clinical 0,15 0,19 32 Non-clinical Self-esteem (“Self”- “ ideal” Distance) 0,000 0,35 0,13 32 Clinical 0,29 0,48 32 Non-clinical Self-esteem (“Self” - “ideal” Correlation) 0,024 9,28 35,46 32 Clinical 8,18 40,53 32 Non-clinical Cognitive Differentiation (PVF1) 0,018 0,5 0,16 32 Clinical 0,06 0,20 32 Non-clinical Cognitive Differentiation (Construct’s Intensity) Sig. bilateral Standard Deviation Mean N SAMPLE
    20. 21. COGNITIVE CONFLICTS: Implicative dilemmas 0,180 1,77 59,4% 75% Triadic conflicts 0,001 18,22 18,8% 71,9% Implicative dilemmas 0,083 3 65,3% 84,4% Dilemmatic constructs Sig. Bilateral Chi - square Non-clinical Clinical
    21. 22. Implicative dilemmas: Predictive power <ul><li>Criterion variable: sample (Clinical/NC) </li></ul><ul><li>Predicting variables: presence of implicative dilemmas, number of constructs, and the interaction between them. </li></ul><ul><li>Presence of implicative dilemmas: </li></ul><ul><li>76.6% of cases correctly classified. </li></ul><ul><li>R 2 (Nagelkerke) = 0,35 </li></ul>
    22. 23. * p < 0,01 (bilateral) 0,39 -0,42 “ Ideal-Others” Correlation -0,51* -0,50* “ Self- Others” Correlation 0,42 0,56* Nº Treatments 0,61* 0,78* Years of ED 0,82* 0,37 0,43 -0,46 0,64* GSI 0,44 0,55* Psychoticism 0,40* Paranoid Ideation 0,51* 0,44 0,52* Phobic Anxiety 0,52* -0,49* 0,65* Anxiety 0,40 -0,47 0,62* Depression -0,41 Interpersonal Sensitivity 0,38 0,47 Obsessive-Compulsive 0,40 Somatization Days at the centre BDI Age Dist. “ Self-ideal” Number of treatments “ Self-Other” Correlation Years of ED PEARSON p < 0,05 CORRELATION
    23. 24. DISCUSSION <ul><li>Women with BN show higher number of constructs than non-clinical ones. Possible reasons: </li></ul><ul><li>Administration of the grid. </li></ul><ul><li>Situation: clinical centre. </li></ul><ul><li>Saturation point (in terms of construct elicitation) could be placed farther away in women with BN than in control sample. </li></ul>
    24. 25. DISCUSSION (cont.) <ul><li>Even though we do not find significant differences in the “adequacy perceived of others” between the two samples, women with BN do show a tendency to see others more distant from their ideal self than those in the control sample. </li></ul><ul><li>Women with BN see themselves far away from their ideal self, but they also see others quite different from it. </li></ul>
    25. 26. DISCUSSION (cont.) <ul><li>This finding could be coherent with the role of perfectionism and low self-esteem, specific characteristics found in BN (Sassaroli, 2005) </li></ul><ul><li>Women with BN show a higher </li></ul><ul><li>percentage of implicative dilemmas than the non-clinical sample </li></ul>
    26. 27. CONCLUSIONS <ul><li>Implicative dilemmas seem to have a role in BN. </li></ul><ul><li>Even though present treatments take into account some aspects of self construction, until now none has considered working with implicative dilemmas. </li></ul>
    27. 28. CONCLUSIONS (cont) <ul><li>A longer evolution of BN is associated with a higher presence of general and depressive symptoms, and with less feelings of nearness to others. </li></ul><ul><li>Age is associated with a higher presence of obsessive and psychotic symptoms. </li></ul><ul><li>General symptoms are more frequent in women with BN than in non-clinical controls. </li></ul>
    28. 29. Conclusions (cont.) <ul><li>Women with BN show lower self-esteem (measured with RGT) than the non-clinical sample. </li></ul><ul><li>Both, implicative dilemmas and measures of self construction, seem to be remarkable and relevant aspects in the study of BN. </li></ul>
    29. 30. Conclusions (cont.) <ul><li>Personal construct theory is relevant in the comprehension of BN and offers instruments that contribute to the understanding of this disorder. </li></ul><ul><li>A Personal Construct approach to the treatment of BN including working with dilemmas, increasing self-esteem and examining the construction of others might result in relevant improvements. </li></ul>
    30. 31. Thanks

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