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Shareh H, Yazdanian M. The effectiveness of dialectical behavior group therapy on stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students: A randomized clinical trial. Clin Child Psychol Psychiatry 2023:13591045231163068. [PMID: 36893401 DOI: 10.1177/13591045231163068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
INTRODUCTION This study aimed to evaluate the effectiveness of dialectical behavior group therapy (DBGT) regarding stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students. MATERIAL AND METHODS This was an experimental study with a pretest-posttest design and a control group. The statistical population included 133 mothers with intellectually disabled children divided into wait-list control and experimental groups. Then, DBGT was performed on the treatment subjects. Data collection tools included the Emotion Regulation Questionnaire, Beck Depression Inventory-II, Depression-Anxiety-Stress Scale, Clinical Global Improvement Scale, Client Satisfaction Questionnaire, and Working Alliance Inventory-Short Form. A p-value less than 0.05 was considered statistically significant. RESULTS A significant difference in depression, stress, and cognitive emotion regulation was observed between the intervention and control groups (p < 0.001). In the post-test, the adjusted mean of depression and stress in the intervention group showed a significant decrease compared to the control group mothers. Also, cognitive reappraisal, expressive suppression, and total cognitive emotion regulation scores increased following DBGT. Participants in DBGT had a good therapeutic relationship, were satisfied with the treatment, and showed notable improvements. CONCLUSION The results indicated that DBGT might affect stress, depression, and cognitive emotion regulation in mothers of intellectually disabled students.
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Affiliation(s)
- Hossein Shareh
- Department of Educational Science, Faculty of Letters & Humanities, Hakim Sabzevari University, Sabzevar, Iran
| | - Mina Yazdanian
- Department of Psychology, Faculty of Letters and Humanities, Islamic Azad University Shahrood Branch, Shahrood, Iran
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Tanzilli A, Cibelli A, Liotti M, Fiorentino F, Williams R, Lingiardi V. Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114290. [PMID: 36361183 PMCID: PMC9656964 DOI: 10.3390/ijerph192114290] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/10/2022] [Accepted: 10/27/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic has considerably influenced all domains of people's lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning. METHODS The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37, SD = 12.79) who completed an online survey, including an instrument assessing four response styles to the pandemic and lockdown(s), the Personality Inventory for DSM-5-Brief Form, the Defense Mechanisms Rating Scales-Self-Report-30, the Reflective Functioning Questionnaire, and the Epistemic Trust, Mistrust, Credulity Questionnaire. RESULTS Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology were predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others' mental states, and high epistemic credulity. CONCLUSIONS Recognizing and understanding dysfunctional psychological pathways associated with individuals' difficulties in dealing with the pandemic are crucial for developing tailored mental-health interventions and promoting best practices in healthcare services.
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Vlachopanou P, Karagiannopoulou E. Defense Styles, Academic Procrastination, Psychological Wellbeing, and Approaches to Learning: A Person-Oriented Approach. J Nerv Ment Dis 2022; 210:186-193. [PMID: 34608020 DOI: 10.1097/nmd.0000000000001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT This study investigates the relationships among defense styles, academic procrastination, psychological well-being, and approaches to learning. The questionnaires Defense Style Questionnaire-88, Procrastination Assessment Scale Questionnaire, Flourishing Scale, and HowULearn are used to measure the aforementioned variables, respectively. Social science students (N = 628) take part in the study. A hierarchical cluster analysis is used for clustering students into homogeneous groups. Three groups of students are identified: "psychologically stable and adaptive" (n = 285), "immature and unstable at risk" (n = 134), and "defensively dissonant" (n = 209) students. A decision tree model is used with the grade point average (GPA) score as an outcome variable to further examine interactions between the three clusters and the years of study on GPA. "Psychologically stable and adaptive" students report the highest GPA. Our findings bridge mental health variables with learning shedding light on our understanding of the use of defense styles when it comes to learning.
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Di Giuseppe M, Prout TA, Ammar L, Kui T, Conversano C. Assessing children's defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:590. [PMID: 35047431 PMCID: PMC8715263 DOI: 10.4081/ripppo.2021.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022]
Abstract
Defense mechanisms are unconscious and automatic psychological processes that serve to protect the individual from painful emotions and thoughts. There is ample evidence from the adult psychotherapy and mental health literature suggesting the salience of defenses in the maintenance and amelioration of psychological distress. Although several tools for the assessment of children's defenses exist, most rely on projective and self-report tools, and none are based on the empirically derived hierarchy of defenses. This paper outlines the development of the defense mechanisms rating scale Q-sort for children (DMRS-Q-C), a 60-item, observer-rated tool for coding the use of defenses in child psychotherapy sessions. Modifications to the Defense Mechanisms Rating Scale Q-Sort for adults to create a developmentally relevant measure and the process by which expert child psychotherapists collaborated to develop the DMRS-Q-C are discussed. A clinical vignette describing the child's defensive functioning as assessed by the innovative DMRS-Q-C method is also reported. Finally, we provide an overview of forthcoming research evaluating the validity of the DMRS-Q-C.
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Affiliation(s)
- Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Tracy A. Prout
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Lauren Ammar
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Thomas Kui
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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de Roten Y, Djillali S, Crettaz von Roten F, Despland JN, Ambresin G. Defense Mechanisms and Treatment Response in Depressed Inpatients. Front Psychol 2021; 12:633939. [PMID: 33815219 PMCID: PMC8012720 DOI: 10.3389/fpsyg.2021.633939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/22/2021] [Indexed: 12/13/2022] Open
Abstract
The study investigated the extent to which defensive functioning and defense mechanisms predict clinically meaningful symptomatic improvement within brief psychodynamic psychotherapy for recurrent and chronic depression in an inpatient setting. Treatment response was defined as a reduction in symptom severity of 46% or higher from the baseline score on the Montgomery-Asberg Depression Rating Scale (MADRS). A subsample of 41 patients (19 responders and 22 non-responders) from an RCT was included. For each case, two sessions (the second and the penultimate) of brief inpatient psychodynamic psychotherapy (a manualized 12-session therapy program developed in Lausanne) were transcribed and then coded using the Defense Mechanism Rating Scales (DMRS) and the Psychotic Defense Mechanism Rating Scales (P-DMRS), an additional scale developed to study psychotic defenses. Results showed that defensive functioning and mature and immature defense changed during psychotherapy and predicted treatment response. Patient's defenses observed throughout therapy also predicted treatment response at 12-month follow-up. The addition of psychotic defenses allows a better prediction of the treatment response. Overall, these results are in line with previous research and provide further validation of defensive functioning as a predictor of outcomes and a mechanism of change in psychotherapy.
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Affiliation(s)
- Yves de Roten
- Institute of Psychotherapy, Department of Psychiatry, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Slimane Djillali
- Institute of Psychotherapy, Department of Psychiatry, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | | | - Jean-Nicolas Despland
- Institute of Psychotherapy, Department of Psychiatry, University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Gilles Ambresin
- Institute of Psychotherapy, Department of Psychiatry, University Hospital Center and University of Lausanne, Lausanne, Switzerland
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Babl A, Grosse Holtforth M, Perry JC, Schneider N, Dommann E, Heer S, Stähli A, Aeschbacher N, Eggel M, Eggenberg J, Sonntag M, Berger T, Caspar F. Comparison and change of defense mechanisms over the course of psychotherapy in patients with depression or anxiety disorder: Evidence from a randomized controlled trial. J Affect Disord 2019; 252:212-220. [PMID: 30986736 DOI: 10.1016/j.jad.2019.04.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/26/2019] [Accepted: 04/07/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Defense mechanisms play an important role in the development and maintenance of both health and psychopathology. Research is still in the early stages of investigating the specific relationships among diagnostic groups and defense mechanisms along with their response to different treatment types. METHODS For the present study a total of 47 outpatients diagnosed with depression or anxiety disorders were randomized to receive 25±3 sessions of cognitive-behavioral therapy with integrated elements of either emotion-focused therapy (CBT + EFT) or treatment components based on self-regulation theory (CBT + SR). An observer-rated method, the Defense Mechanism Rating Scale (DMRS) was used to code transcripts of the 1st, 8th, 16th and 24th session to assess change in defensive functioning. RESULTS Over the course of therapy, overall defensive functioning (ODF) as well as adaptive defenses increased significantly, whereas maladaptive and neurotic defenses did not change. At the beginning of treatment, the proportion of adaptive defenses and ODF was significantly higher in patients diagnosed with anxiety disorders than in patients with depressive disorders. However, depressed patients exhibited greater improvement in their defensive functioning over the course of therapy. CONCLUSIONS Results support the view of defense mechanisms as a useful transdiagnostic and transtheoretical concept and supports the notion that change of defense mechanisms may be a relevant mechanism of change in psychotherapy.
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Affiliation(s)
- Anna Babl
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland.
| | - Martin Grosse Holtforth
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland; University Hospital Insel, Bern, Switzerland
| | | | - Noemi Schneider
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Eliane Dommann
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Sara Heer
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Annabarbara Stähli
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Nadine Aeschbacher
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Michaela Eggel
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Jelena Eggenberg
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Meret Sonntag
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
| | - Franz Caspar
- Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012 Bern, Switzerland
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Starrs CJ, Perry JC. Coping Action Patterns as Mechanisms of Change Across Psychotherapies: Three Case Examples of Personality Disorders With Recurrent Major Depression. J Pers Disord 2018; 32:58-74. [PMID: 29388894 DOI: 10.1521/pedi.2018.32.supp.58] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Maladaptive coping has been shown to be related to increased symptoms of distress and lower levels of well-being, whereas the use of adaptive coping has been shown to diminish distress and improve functioning. This suggests that change in coping may constitute a significant mechanism of change in psychotherapy. Utilizing a novel observer-rating method for assessing coping, the current report examined changes in overall coping functioning (OCF) in three participants with diverse personality disorders who were undergoing two different types of psychotherapy (cognitive-behavioral therapy and dynamic therapy) for recurrent major depression. Results showed that overall coping functioning improved in two cases and remained stable in a third. Preliminary findings, based on a detailed examination of changes in specific coping patterns, suggest that improvement may differ according to severity of personality pathology. As hypothesized, coping improved in both types of psychotherapy. Thus, overall results suggest that coping may constitute an important general mechanism of change.
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Affiliation(s)
| | - J Christopher Perry
- Department of Psychiatry, McGill University at the Jewish General Hospital, Institute of Community and Family Psychiatry, Montréal, Québec, Canada
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Jyrä K, Knekt P, Lindfors O. The impact of psychotherapy treatments of different length and type on health behaviour during a five-year follow-up. Psychother Res 2016; 27:397-409. [PMID: 26829646 DOI: 10.1080/10503307.2015.1112928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the influence of psychotherapy treatments of different lengths, number of sessions, and type on health behaviour. METHOD A total of 367 patients were monitored for their health behaviour (alcohol consumption, body mass index), serum cholesterol (total and HDL), smoking and exercise) for five years from the start of the therapy. The effectiveness of solution-focused therapy, short-term psychodynamic psychotherapy, and long-term psychodynamic psychotherapy (LPP) was examined in a randomized clinical trial, while the LPP group and the non-randomized psychoanalysis (PA) group were compared in a naturalistic design. RESULTS During the follow-up, an improvement was seen with regard to alcohol consumption, serum HDL cholesterol, and smoking in the LPP and PA groups. No notable differences in health behaviour between the two groups were found, however. During the last two years of the follow-up, changes towards higher alcohol consumption and higher total serum cholesterol levels were observed in the short-term therapy groups. CONCLUSIONS The impact of PA and LPP on health behaviour did not differ, whereas the changes were less health promoting in short-term psychotherapy. Large-scale studies are needed to confirm these findings.
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Affiliation(s)
- Kaisa Jyrä
- a National Institute for Health and Welfare , Helsinki , Finland
| | - Paul Knekt
- a National Institute for Health and Welfare , Helsinki , Finland
| | - Olavi Lindfors
- a National Institute for Health and Welfare , Helsinki , Finland
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Maricutoiu LP, Crasovan DI. Coping and defence mechanisms: What are we assessing? INTERNATIONAL JOURNAL OF PSYCHOLOGY 2014; 51:83-92. [PMID: 25418688 DOI: 10.1002/ijop.12113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 10/17/2014] [Accepted: 10/24/2014] [Indexed: 11/10/2022]
Abstract
The present research study addresses the disparity between theoretical considerations and empirical evidence regarding the relationships between coping strategies and defence mechanisms. Self-reported measures of coping and defences were administered to a Romanian adult sample (N = 542; 74.53% female, mean age = 31.28). Using structural equation modelling, models that assumed independence between coping and defences were compared with models that assumed the existence of relationships between the two concepts. Findings identified strong relationships between coping and defences, indicating large common variance between the two concepts. Furthermore, results suggested that coping and defences can be classified into two independent types of adaptation processes. Results of this research study suggested that coping and defences are facets of common adaptation processes.
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Affiliation(s)
| | - Danut I Crasovan
- Post-Graduate Research Center COMMSCIE, West University of Timisoara, Romania
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