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Amaslidou A, Ierodiakonou-Benou I, Bakirtzis C, Nikolaidis I, Tatsi T, Grigoriadis N, Nimatoudis I. Multiple sclerosis and mental health related quality of life: The role of defense mechanisms, defense styles and family environment. AIMS Neurosci 2023; 10:354-375. [PMID: 38188008 PMCID: PMC10767059 DOI: 10.3934/neuroscience.2023027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Background Multiple sclerosis is a demyelinating chronic neurologic disease that can lead to disability and thus to deterioration of quality of life. Psychological parameters such as ego defense mechanisms, defense styles and family environment are important factors in the adaptation process, and as such they can play important roles in QoL. This study aims to assess the psychological factors as well as the clinical and demographic characteristics related to mental health quality of life (MHQoL). Methods This was an observational, cross-sectional study conducted in a sample of 90 people with MS in the years 2018-2020. All participants completed the following questionnaires: MSQoL-54, DSQ-88, LSI, FES-R, SOC, BDI-II, STAI. Disability was assessed using EDSS. Results In multiple linear regression, significant roles were played by depression (R2: 41.1%, p: 0.001) and, to a lesser extent, the event of a relapse (R2: 3.5%, p: 0.005), expressiveness (R2: 3.6%, p < 0.05) and image distortion style (R2: 4.5%, p: 0.032). After performing a hierarchical-stepwise analysis (excluding depression), the important factors were maladaptive defense style (R2: 23.7%, p: 0.002), the event of relapse (R2: 8.1%, p < 0.001), expressiveness (R2: 5.5%, p: 0.004) and self-sacrificing defense style (R2: 2.4%, p: 0.071). Conclusion Psychological factors play important roles in MHQoL of people with multiple sclerosis. Thus, neurologists should integrate in their practice an assessment by mental health specialists. Moreover, targeted psychotherapeutic interventions could be planned i to improve QoL.
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Affiliation(s)
- Anthi Amaslidou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioanna Ierodiakonou-Benou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Christos Bakirtzis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nikolaidis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Theano Tatsi
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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FALIOVA OLENA. The Role of Defence Mechanisms in Coping with Stress in PTSD Patients. SCIENTIFIC BULLETIN OF MUKACHEVO STATE UNIVERSITY SERIES “PEDAGOGY AND PSYCHOLOGY” 2022. [DOI: 10.52534/msu-pp.8(4).2022.18-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In the context of the war in Ukraine, the risk of post-traumatic stress disorders increases, which in critical cases cause the development of chronic mental illnesses and a decline in physiological functions. In connection with the emergence of a feeling of helplessness due to the inability to act effectively in a dangerous situation, various psychological defence mechanisms are formed to overcome intrapsychic conflicts. The purpose of this stud was to investigate the dominant mechanisms in individuals with post-traumatic stress disorder who had been in regions with different scenarios for the development of hostilities since the beginning of the war, using the PlutchikKellerman-Conte methodology. The information was collected from people of different age categories, types of employment, educational qualification levels, and gender who were in Kyiv, Kharkiv, and Lviv during the first two months of the full-scale war and periodically moved through the territory of Central and Western Ukraine. Cases of short-term residence abroad were also considered during the study. The results of the tension of psychological defence indicate that in individuals with post-traumatic stress disorder that stayed in different regions of Central and Western Ukraine since the beginning of the war, the projection mechanism dominated (75%), and the substitution mechanisms (12.5%) and denial mechanisms (12.5%) were equally distributed. The dominance of the projection may indicate the transfer of intrapsychic conflict to the outside. In this case, the external world is perceived by the individual as the main carrier of the threat from which they need to protect themselves. Instead, denial may indicate ignoring certain aspects of reality. Respondents who are prone to substitution use the approach of transferring repressed emotions, which can be expressed in the form of anger, fear, and hostility towards more accessible objects that are no less dangerous than those that led to frustrating experiences. It was determined that the total sample tension does not exceed 50%. This may indicate the ability of patients with post-traumatic stress disorder to resolve intrapsychic conflicts that have developed at the moment. The results of the study may be of practical interest to specialists investigating the identification and generation of methods for the prevention and treatment of post-traumatic stress disorder
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Hersoug AG, Wærsted M, Lau B. Defensive Functioning Moderates the Effects of Nondirective Meditation. Front Psychol 2021; 12:629784. [PMID: 33584485 PMCID: PMC7876444 DOI: 10.3389/fpsyg.2021.629784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/07/2021] [Indexed: 12/02/2022] Open
Abstract
We have recently found that nondirective meditation facilitates stress reduction. This supplementary study investigated whether defensive functioning would moderate these beneficial effects. We explored the occurrence of defense mechanisms and the impact of defensive functioning on the outcome of companies’ stress management programs regarding worries nervousness, mental distress, sleep problems, and muscle pain. The sample was a population of active, working professionals recruited from Norwegian companies (n = 105). The intervention group obtained significant benefits on all outcome measures, but there were no effects in the control group. We analyzed defensive functioning with the self-report questionnaire, Life Style Index, at four time points. The healthy adults who participated had a low level of defense scores at the outset. There was a significant reduction in the level of defenses in both groups over the study period, 6 months. Defensive functioning significantly moderated the change of the outcome measures from baseline to follow-up in the intervention group, but not in the control group.
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Affiliation(s)
| | | | - Bjørn Lau
- Department of Psychology, University of Oslo, Oslo, Norway
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Sala MN, Testa S, Pons F, Molina P. Emotion Regulation and Defense Mechanisms. JOURNAL OF INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1027/1614-0001/a000151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study examined the relations between emotion regulation and defense mechanisms as assessed through self-report questionnaires. Participants were 314 undergraduate students at the University of Turin (Faculty of Agricultural Studies, School of Sport and Exercise Sciences and Faculty of Psychology). Correlational analysis identified several associations between emotion regulation strategies and defense mechanisms. A second-order factor model was tested in which each of the dimensions assessed by the defense mechanisms and emotion regulation instruments was assigned to either an adaptive or maladaptive latent dimension. The results suggested that the dimensions of adaptiveness and maladaptiveness may represent a key link between emotion regulation and defense mechanisms.
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Affiliation(s)
| | - Silvia Testa
- Psychology Department, Università di Torino, Italy
| | | | - Paola Molina
- Psychology Department, Università di Torino, Italy
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Sales PMG, Carvalho AF, McIntyre RS, Pavlidis N, Hyphantis TN. Psychosocial predictors of health outcomes in colorectal cancer: a comprehensive review. Cancer Treat Rev 2014; 40:800-9. [PMID: 24679516 DOI: 10.1016/j.ctrv.2014.03.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 02/28/2014] [Accepted: 03/03/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND A diagnosis of colorectal cancer (CRC) and its long-term treatment may lead to significant psychological distress and impaired health-related quality of life (HRQoL) for a significant proportion of patients. METHODS We searched the PubMed/MEDLINE electronic database for available literature on the associations between personality characteristics, depression, psychological distress and HRQoL in CRC. Additional references were identified through the citation tracking of the included articles. RESULTS Recent evidence indicates that Type-D (distressed) personality may predict distress among CRC patients. Additionally, other personality traits, such as specific ego defense mechanisms, influence the coping responses and HRQoL. Although the presence of a stoma has been linked to the development of depressive symptoms and impairment in HRQoL in CRC patients, more prospective studies are necessary to confirm these associations. Sense of coherence (SOC) has both a moderating and mediating effect on health (especially mental health and HRQoL), and preliminary data indicate that SOC may be an independent predictor of CRC survival. CONCLUSIONS The interplay between personality variables during the elaboration of "the impaired role" is complex, and the assessment of personality traits may be incorporated into a comprehensive psychosomatic evaluation of CRC patients. More well-designed prospective investigations are necessary to establish the contributory role of personality dimensions for the development of and protection from distress and impairment in the HRQoL of CRC patients, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population (for example, manual-based psychotherapies).
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Affiliation(s)
- Paulo M G Sales
- Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - André F Carvalho
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU) and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicholas Pavlidis
- Department of Medical Oncology, Medical School, University of Ioannina, Greece
| | - Thomas N Hyphantis
- Department of Psychiatry, Medical School, University of Ioannina, Greece.
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Personality traits, defense mechanisms and hostility features associated with somatic symptom severity in both health and disease. J Psychosom Res 2013; 75:362-9. [PMID: 24119944 DOI: 10.1016/j.jpsychores.2013.08.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 08/20/2013] [Accepted: 08/24/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Somatic symptoms are widespread in clinical practice. The association of somatic symptom severity with impaired health status holds both when symptoms are medically unexplained and when they are medically explained. The role of personality dimensions in the formation of somatic symptoms in patients with established, chronic diseases when compared to healthy participants had not been investigated prior to this study. METHODS In samples of 411 healthy subjects and 810 participants with any of 9 established, chronic medical conditions, we measured psychological distress (SCL-90-R), personality traits (Zuckerman-Kuhlman Personality Questionnaire), defensive profiles (Defense Style Questionnaire), individual defenses (Life Style Index) and hostility features (Hostility and Direction of Hostility Questionnaire). Hierarchical multivariate models were used to assess the independent associations between personality dimensions and somatic symptom severity in both samples. The SCL-90-R somatization scale served as the outcome variable. RESULTS In both samples, older age, less education, higher neuroticism, adoption of the displacement defense and depressive symptoms were independently and positively associated with somatic symptom severity. Higher somatic symptom severity was also associated with more "introverted" features (i.e., the self-sacrificing defensive style and self-criticism) among participants with established, chronic medical conditions. CONCLUSIONS These data suggest that similar personality traits and defense mechanisms are associated with somatic symptom severity in health and disease, indicating that somatic symptoms are not simply consequences of having a medical condition. The specific associations of the self-sacrificing defensive profile and self-criticism with somatic symptom severity in the patient sample may have important clinical implications.
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Hyphantis T, Almyroudi A, Paika V, Degner LF, Carvalho AF, Pavlidis N. Anxiety, depression and defense mechanisms associated with treatment decisional preferences and quality of life in non-metastatic breast cancer: a 1-year prospective study. Psychooncology 2013; 22:2470-7. [PMID: 23712915 DOI: 10.1002/pon.3308] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 04/12/2013] [Accepted: 04/24/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Thomas Hyphantis
- Department of Psychiatry, Medical School; University of Ioannina; Greece
| | | | - Vassiliki Paika
- Department of Psychiatry, Medical School; University of Ioannina; Greece
| | | | - André F. Carvalho
- Department of Clinical Medicine, Faculty of Medicine; Federal University of Ceará; Fortaleza CE Brazil
| | - Nicholas Pavlidis
- Department of Medical Oncology, Medical School; University of Ioannina; Ioannina Greece
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Hyphantis T, Papadimitriou I, Petrakis D, Fountzilas G, Repana D, Assimakopoulos K, Carvalho AF, Pavlidis N. Psychiatric manifestations, personality traits and health-related quality of life in cancer of unknown primary site. Psychooncology 2013; 22:2009-15. [PMID: 23359412 DOI: 10.1002/pon.3244] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Revised: 12/15/2012] [Accepted: 12/17/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Psychiatric manifestations and personality traits are known to influence cancer patients. We aimed to assess psychological distress symptoms, psychosocial factors and health-related quality of life (HRQoL) in cancer of unknown primary site (CUP) and to test whether these parameters differ between CUP and Metastatic (MKPC) or Non-Metastatic Known Primary Cancers (N-MKPC) after controlling for demographics and clinical variables. METHODS In this cross-sectional study, we recruited 50 CUP, 264 N-MKPC and 52 MKPC participants. We assessed depressive symptoms (Center for Epidemiologic Studies-Depression [CES-D]), psychological distress symptoms (Symptom Distress Checklist-90 Revised), sense of coherence (SOC), ego defense mechanisms (Life Style Index) and HRQoL (World Health Organization Quality of Life Instrument, Short Form). RESULTS The prevalence of clinically significant depressive symptoms (CES-D ≥ 23) was 40.0% in CUP, 28.8% in MKPC and 23.5% N-MKPC (p=0.037). Multivariate logistic regression analysis showed that N-MKPC patients were 5 times less likely (p=0.028) and MKPC patients 3.3 times less likely (p=0.05) to be assessed with probable depression compared with CUP patients after controlling for the major demographic and clinical variables studied. CUP patients presented also higher levels of somatization, anxiety and depressive symptoms; they also had more impaired Physical (p=0.005), Mental (p=0.041) and Social Relations (p=0.044) HRQoL, along with lower scores on SOC and intellectualization defense and higher scores on repression defense, compared with MKPC and N-MKPC patients. CONCLUSIONS These findings suggest that psychiatric manifestations are frequent in CUP, and the patients' resources to cope with the burden of their illness are limited. Attention to CUP patients' psychological distress and coping resources and capacities may enable oncologists to identify and manage modifiable aspects of HRQoL.
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Affiliation(s)
- Thomas Hyphantis
- Department of Psychiatry, Medical School, University of Ioannina, Greece.
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