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Dissonance, resistance and commitment: a pilot analysis of moderated mediation relationships
1The Paddock Centre, Broadmoor Hospital, Crowthorne, Berkshire, UK. simon.draycott@wlmht.nhs.uk
Patient dissonance can lead to treatment resistance or commitment, influenced by attributional style and locus of control. Both internal and external locus of control negatively impacted therapy engagement.
Area of Science:
- Psychology
- Forensic Psychiatry
- Behavioral Science
Background:
- Engaging patients in forensic services presents a significant challenge.
- Behavioral change models indicate self-dissatisfaction can manifest as treatment resistance or commitment.
- Attributional style may moderate how self-dissatisfaction influences engagement.
Purpose of the Study:
- To investigate the relationship between dissonance, treatment resistance, and treatment commitment.
- To examine if locus of control moderates these relationships in a forensic setting.
Main Methods:
- Thirty-two patients in a high-secure personality disorder service were assessed.
- Measures included dissonance, locus of control, resistance, and commitment.
- Moderated mediation analysis was employed.
Main Results:
- Significant indirect relationships were found between dissonance and both resistance and commitment.
- Locus of control moderated these relationships.
- Both internal and external locus of control interfered with therapy, but in distinct ways.
Conclusions:
- Patient dissonance can result in either treatment commitment or resistance.
- Attributional style and locus of control are key patient factors influencing this outcome.
- Understanding these moderators is crucial for forensic treatment engagement.
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