Defense mechanisms predict differential lifespan change in Self-control and Self-acceptance

The mediating role of body image concern in the relationship between immature defense mechanisms and postpartum depression in Iranian women

BACKGROUND

Postpartum depression leaves irredeemable impacts on a mother's mental health and her child. Little is known about the relationship between immature defense mechanisms and body image concerns or postpartum depression. The present study examines the mediating role of body image concerns in the relationship between immature defense mechanisms and postpartum depression.

MATERIALS AND METHODS

In a correlational study, 227 women were selected through a convenience sampling method from all women in the postpartum period in medical centers in 2021 in Tehran, Iran. The participants were asked to fill out the Edinburgh Postnatal Depression Scale (EPDS), the Defense Style Questionnaire-40 (DSQ-40) by Andrews et al., and the Body Image Concern Inventory (BICI). The collected data was analyzed using the IBM SPSS Amos 24 and SPSS 21 software.

RESULTS

There was a positive correlation between body image concern, immature defense mechanisms, and postpartum depression. Furthermore, body image concern was a mediator in the relationship between immature defense mechanisms and postpartum depression. The immature defense mechanisms had an indirect positive impact on depression due to the concerns over one's body image after giving birth (P > 0.05).

CONCLUSION

Immature defense mechanisms and body image concerns can increase the risk of postpartum depression. Therefore, providing mental health and psychiatric services to expecting mothers is an effective tool to decrease the activation of immature defense mechanisms, which would reduce their body image concerns and prevent them from falling into postpartum depression.

Psychological traits predict impaired awareness of deficits independently of neuropsychological factors in chronic traumatic brain injury

OBJECTIVES

To dissociate injury-related factors from psychological contributions to impaired awareness of deficits following traumatic brain injury (TBI); impaired awareness is theorized to partly reflect psychological factors (e.g., denial), but empirical evidence for this theory is scarce.

DESIGN

We examined how different factors predict awareness in patients undergoing rehabilitation (N = 43). Factors included (1) neurological (injury severity), (2) neuropsychological loss, (3) psychological (denial, projection, identification), and (4) personality (narcissism).

METHODS/MAIN MEASURES

The Patient Competency Rating Scale, comparing patient with clinician reports on different functional domains; the Thematic Apperception Test, an injury-independent measure of the propensity to mobilize specific defence mechanisms; and the Narcissism Personality Inventory.

RESULTS

Impaired awareness was not predicted by injury-related and neuropsychological scores but was significantly predicted by use of primitive defence mechanisms (denial and projection). Patients who underestimate their abilities also demonstrated high denial levels, but contrary to underestimators, this was positively related to depression and negatively to awareness.

CONCLUSIONS

Primitive defence mechanism use significantly contributes to impaired awareness independent of injury-related factors, particularly in domains associated with self-identity. Well-validated tests of defence mechanism mobilization are needed to support clinical interpretation of and intervention with impaired awareness. More research is needed to understand the psychology of hypersensitivity to deficits.

PRACTITIONER POINTS

This study provides an empirical demonstration of dissociable contributions of neurological and psychological factors to awareness of deficits in TBI. Trait proclivity to mobilize defence mechanisms in response to anxiety-provoking situations can be measured, and strongly predicts impaired awareness. Importantly, measures of psychological reactions were independent of responses to the neurological deficits themselves, discriminating between psychological and neurological contributions to impaired awareness. The importance of identifying psychological reactions to impaired awareness and hindering rehabilitation success is highlighted, and vital for clinicians to consider during the rehabilitation process. Psychological reactions to TBI can be identified using well-validated, quantitative measures of the use of psychological defences (e.g., Cramer's Thematic Apperception Test scoring system), and the authors suggest this is a critical step to properly characterize and manage awareness in patients during treatment. Although only TBI patients were examined, the results may inform impaired awareness that occur as a result of other disorders and illnesses. The patients in this study were in the chronic stages of the injury, and therefore, the results may not generalize to patients in more acute stages.

Not Your Same Old Story: New Rules for Thematic Apperceptive Techniques (TATs)

Stories told about pictures have been used for both research and clinical practice since the beginning of modern personality assessment. However, with the growing science-practice gap, these thematic apperceptive techniques (TATs) have been used differently in those 2 venues. Scientific validation is presumptively general, but clinical application is idiographic and situation-specific. A bridge is needed. The manualized human-scored narrative analysis systems discussed here are valuable scientist-practitioner tools, but they require a validation literature to support further research publication, maintain their role in clinical training, and justify clinicians' reimbursement by third-party payers. To facilitate wider understanding of manualized TAT methodologies, this article addresses long-standing criticisms of TAT reliability and proposes some strategic solutions to the measurement error problem for both researchers and clinicians, including analyzing person-situation interactions, purposeful situation sampling for within-storyteller comparisons, and uses of small samples. The new rules for TATs include conceptual and methodological standards that researchers should aim to meet and report, reviewers should apply to manuscripts, and clinical assessors can use to analyze their own data and justify third-party payment.

Defense mechanisms: 40 years of empirical research

This article reviews research on defense mechanisms carried out over the past 40 years with children, adolescents, adults, and psychiatric patients. Both experimental and observational studies are included.

Predictors of psychological well-being and stress among Jordanian menopausal women

PURPOSE

The aim of this study was to investigate purpose in life, self-acceptance, perceived stress levels, and menopausal symptoms among Jordanian women.

METHODS

A descriptive, correlational design with a convenience sample of 193 women aged 40-55 years was employed.

RESULTS

The average age at menopause for the current sample was 47.4 years, and menopausal status did not significantly affect purpose in life, self-acceptance, or perceived stress levels. Negative correlations were found between purpose in life and perceived stress, and between self-acceptance and perceived stress (r = -0.49; p = 0.01 and r = -0.58; p = 0.01, respectively). Menopausal symptoms were found to be a strong negative predictor of purpose in life, self-acceptance, and perceived stress levels. In addition, higher health rating was significantly associated with higher psychological well-being and lower perceived stress levels. Perimenopause was found to be a vulnerable stage for severe menopausal symptoms particularly psychological complaints. However, vasomotor symptoms and loss of sexual interest became more intense among postmenopausal women. Although women in the current study had low psychological well-being and high perceived stress, these were not affected by their menopausal status.

CONCLUSION

The study showed the importance of including both physical and psychological symptoms during encounters with health professionals, besides considering women's expectations about menopause to help ease their menopausal transition and improve their well-being.

Verbal expressive personality testing with older adults: 25+ years later

This review builds on those conducted over 25 years ago by Panek and Hayslip in examining the literature dealing with the use of verbal expressive techniques with older adults. Such findings based on the Rorschach Ink Blot Test, Holtzman Inkblot Technique, Hand Test, Sentence Completion methods, and the Thematic Apperception Test and kindred thematic apperceptive techniques are presented and evaluated regarding the evidence for age differences, differential diagnosis, extraneous individual differences in performance, and adequacy of normative data. Although available evidence appears to warrant the continued use of verbal expressive techniques with older adults, more adequately designed studies are necessary to fully support the potential of these assessment tools for decision making with this population: assisting in diagnosis, recommending the appropriateness of various living arrangements, facilitating supportive care choices, and aiding in treatment planning.

Depressive Symptoms, Self-Reported Physical Functioning, and Identity in Community-Dwelling Older Adults

OBJECTIVE: To examine the relationship between self-reported physical functioning and depressive symptoms by testing the mediation of identity processes in linking this relationship. METHODS: Sixty-eight older adults (mean age= 74.4) participated in this cross-sectional study. Participants completed measures of physical functioning (Physical Symptoms Checklist), depressive symptoms (CESD-20) and identity processes (IES-G). RESULTS: The relationship between physical functioning and depressive symptoms was partially mediated by sensitivity of older adults to feedback from experiences, the process known as identity accommodation (Whitbourne, Sneed, & Skultety, 2002). CONCLUSION: Not only are physical changes relevant to negative psychological outcomes in later adulthood, but it is the interpretation of these changes that seems to have particular relevance for aging individuals. Though preliminary based on cross-sectional data, the findings suggest that examining individual differences in sensitivity to aging stereotypes may help identify factors related to depressive symptoms in later adulthood. Future research is needed to disentangle these interrelated concepts.