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de Vlaming IH, Schellekens MPJ, van der Lee ML. Intensity of mental health treatment of cancer-related psychopathology: the predictive role of Early Maladaptive Schemas. Support Care Cancer 2023; 31:325. [PMID: 37154974 PMCID: PMC10167132 DOI: 10.1007/s00520-023-07764-w] [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: 01/12/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE With the limited availability of mental healthcare, it is of utmost importance to provide care that matches the needs of patients: short if possible, but also more intense when necessary. This study explored whether Early Maladaptive Schemas (EMSs) play a predictive role in the intensity of needed mental health treatment of cancer-related psychopathology. METHODS EMSs were assessed before mental health treatment in 256 patients who sought help at a specialized mental health care centre for those affected by cancer in the Netherlands. Data about treatment indication and intensity of mental health treatment were collected. Univariate and multivariate logistic regression analysis were used to assess the predictive value of the EMSs total score and specific domains on treatment indication and treatment intensity. RESULTS The presence of more severe EMSs predicted an indication for a more intense mental health treatment before start of the treatment, and actual more intense mental health treatment. The domain Impaired Autonomy and Performance appeared to be conceptually close to the domain Disconnection and Rejection, we left the latter out in our multivariate analysis and then found that Impaired Autonomy was the best predictor of intensity of mental health treatment. CONCLUSION Our findings imply that assessing EMSs could help to identify patients who will receive more treatment time.
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Affiliation(s)
- Irene H de Vlaming
- Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands
- Department of Medical Psychology, Alrijne Hospital, Leiden, The Netherlands
| | - Melanie P J Schellekens
- Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Marije L van der Lee
- Department of Scientific Research, Helen Dowling Institute, Bilthoven, The Netherlands.
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.
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AŞKAN T, ÇALIK VAR E, ÖZKAN B. Relationship Between Married Individuals' Relations with Their Family of Origin and Coping Styles with Stress. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1116904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study aims to determine the relationship between the family of origin relations and coping styles with stress in the married individuals. This research, which was conducted as a relational screening model was carried out with 150 married and at least high school graduates living in Ankara, selected with a purposeful sample. The data was obtained using the Information Form, Family of Origin Relations Inventory (FORI) and Styles of Coping Inventory (SCI). In married individuals,(n=150) the mean total score of SCI was 78.32±7.98; The mean total score of the FORI was found to be 26.51±4.50. There was no significant relationship between the total scores of FORI and SCI; It was determined that there is a positive correlation between the self-confident approach, helpless approach and submissive approach, which are the sub-dimensions of SCI, and the total score of the FORI. As a result, it was found that there was no relationship between family of origin relations and stress coping styles in married individuals, but as the relations with the family of origin relations improved, the use of self-confident approach, helpless approach and submissive approach increased among coping styles. For this reason, it is recommended to plan psychosocial interventions that will raise awareness about the relationship between their family of origin relations and their coping styles in order to enable married individuals to cope functionally.
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Affiliation(s)
| | - Esra ÇALIK VAR
- ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, SOSYAL HİZMET BÖLÜMÜ, SOSYAL HİZMET PR
| | - Birgül ÖZKAN
- ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ, HEMŞİRELİK BÖLÜMÜ
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Saab M, Hartmann M, Han X. Defense Mechanism Functioning in Patients With Breast Cancer: Using the Defense Mechanism Rating Scale. Front Psychol 2021; 12:666373. [PMID: 34456786 PMCID: PMC8385787 DOI: 10.3389/fpsyg.2021.666373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/05/2021] [Indexed: 02/04/2023] Open
Abstract
Background: Breast cancer (BC) is one of the highest incidence rates in Lebanon. Previous studies had focused scarcely on the unconscious protective shield of patients with BC or BC survivors against cancer, while only some studies had focused on the relationship between defense mechanisms (DMs) and high adaptation with the disease process and progress. Therefore, this study aimed to investigate the reaction of inpatients with BC toward the disease by measuring DMs in the Lebanon context. Methods: Seventy inpatients with BC were recruited randomly from six hospitals. Their DMs were measured using the Defense Mechanism Rating Scale. Moreover, the Relationship Anecdotes Paradigm (RAP) was used with three recent life vignettes of initial diagnosis, family, and daily life. The data were analyzed using repeated measure ANOVA, Wilcoxon rank-sum test, and Spearman's rank. Results: Patients with stage 2 BC used more high-adaptive defense levels than patients with stage 4 BC who used more minor image distorting defense levels. Moreover, patients with stage 2 BC used more self-observation and undoing, while patients with stage 4 BC used more devaluation. Conclusion: The severity of BC, the age of carriers, and the social status may lead to higher use of DMs, at the level of the individual defense and the hierarchal or the tripartite levels.
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Affiliation(s)
- Marwa Saab
- School of Psychology, Northeast Normal University, Changchun, China
| | - Matias Hartmann
- School of Psychology, Northeast Normal University, Changchun, China
| | - Xue Han
- School of Psychology, Northeast Normal University, Changchun, China
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Petralia A, Bisso E, Concas I, Maglitto A, Bucolo N, Alaimo S, Di Cataldo A, Signorelli MS, Pulvirenti A, Aguglia E. Psychopathological outcomes and defence mechanisms in clinically healed adults with a paediatric cancer history: an exploratory study. Gen Psychiatr 2021; 34:e100307. [PMID: 34308150 PMCID: PMC8256730 DOI: 10.1136/gpsych-2020-100307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 05/20/2021] [Indexed: 11/14/2022] Open
Abstract
Background The incidence of paediatric cancers has increased in recent years; however, with advances in the treatment of paediatric cancer, almost 80% of children and adolescents who receive a diagnosis of cancer become long-term survivors. Given the high stress levels associated with cancer, it becomes important to ascertain the risk and likelihood of psychiatric disorders in adult paediatric cancer survivors. Aims This study aims to investigate the relationship between defence styles and predisposition to psychiatric diseases in adults with a history of paediatric cancer. Methods We performed an explorative study on a sample of 66 clinically healed adults with a history of paediatric cancer (survivors) during follow-up visits at the University Hospital ‘Policlinico G Rodolico’ of Catania (Italy) and 98 healthy controls among medicine students. We administered the Defence Mechanism Inventory (DMI) to assess defence styles. The Symptom Checklist-90-Revised (SCL-90-R) and the Davidson Trauma Scale (DTS) were administered to assess psychopathological indices. We conducted comprehensive statistical analysis based on correlation analysis and mediation analysis to investigate the relationship between defence styles and psychopathological outcomes in survivors compared with controls. Results The survivors obtained statistically significant lower values in TAO, PRO and TAS defence styles and a higher value in REV. Both groups showed non-pathlogical mean scores in DTS and SCL-90-R (with an exception of the obsessive-compulsive subscale), with lower mean values among survivors. The results of mediation analysis showed that TAS had mediation effects on interpersonal sensitivity, anxiety, PSDI, GSI and avoidance, while TAO had mediation effects on DTS total score and intrusivity. Thus, for these psychopathological indices, the effect of the oncological pathology was indirect and mediated by TAO or TAS. Our analysis exlcluded mediation effects between the remaining variables and defence styles. Conclusion Integrating data from mediation and correlation analysis, we found how the decreasing of TAS utilization in survivors as the consequence of cancer history, has decreased interpersonal sensitivity, anxiety and GSI score in these subjects compared with controls. Similary, the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale. Unexpectedly, our analysis excluded relationships between cancer history, other defence styles and psycopathological scores as we initially assumed.
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Affiliation(s)
- Antonino Petralia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
| | - Emanuele Bisso
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
| | - Ilaria Concas
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
| | - Antonino Maglitto
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
| | - Nunzio Bucolo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
| | - Salvatore Alaimo
- Department of Mathematics and Computer Science, University of Catania, Catania, Italy
| | - Andrea Di Cataldo
- Department of Clinical and Experimental Medicine, Pediatric Hemato-Oncology Unit, University of Catania, School of Medicine, Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
| | - Alfredo Pulvirenti
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy.,Department of Mathematics and Computer Science, University of Catania, Catania, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, School of Medicine, Catania, Italy
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Di Giuseppe M, Gemignani A, Conversano C. Psychological Resources Against the Traumatic Experience of Covid-19. CLINICAL NEUROPSYCHIATRY 2020; 17:85-87. [PMID: 34908974 PMCID: PMC8629078 DOI: 10.36131/cn20200210] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/04/2020] [Indexed: 11/30/2022]
Abstract
Psychological resources, such as defense mechanism and mindfulness practice, can mediate the individual reaction to traumatic experiences as the ongoing COVID-19 pandemic outbreak. A novel self-reported measure based on the DMRS (DMRS-SR-30), has been developed with the aim of assessing potential adaptive defensive strategies against the traumatic experience of COVID-19. Preliminary validation of the DMRS-SR-30 showed good internal consistency in both overall defensive functioning and subscales. Combining adaptive defense mechanisms and mindfulness practice could prevent psychological distress due to the effect of COVID-19 losses and quarantining.
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Affiliation(s)
- Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
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Di Giuseppe M, Ciacchini R, Micheloni T, Bertolucci I, Marchi L, Conversano C. Defense mechanisms in cancer patients: a systematic review. J Psychosom Res 2018; 115:76-86. [PMID: 30470322 DOI: 10.1016/j.jpsychores.2018.10.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/26/2018] [Accepted: 10/27/2018] [Indexed: 10/28/2022]
Abstract
The importance of defense mechanisms in cancer progression and adaptation have been largely observed. However, few studies referred to the generally accepted hierarchical organization of defenses and used validated measurements for defensive assessment. In this systematic review, we investigated the whole hierarchy of defense mechanisms and how they associate with various psychological aspects in cancer patients. A literature search was conducted using electronic databases. Among 1570 records published from 1990 to date, only 15 articles met inclusion criteria. Findings related to cancer patients' defensive functioning and its relations with other physical and psychological variables were extracted. A general consistency emerges on the role of defense mechanisms in cancer progression and recovery. Following the hierarchical organization of defenses, higher physical and emotional functioning emerged as being associated with High-adaptive defenses, while Mental Inhibition defenses, in particular repression, promote psychosomatic symptoms, passive decisional preferences and worse physical and emotional health. Disavowal defenses foster lower anxiety and higher emotional functioning by denying anxiety about death. Image distortion defenses, including both Minor and Major image-distorting defenses, were more frequent in cancer patients than in control groups and finally, Action defenses predicted sleep disturbance and lower survival probability. The early detection of maladaptive defensive functioning may foster appropriate psychotherapeutic intervention and prevent worsening of the illness. Further investigations are required to replicate these findings and highlight associations between defense mechanisms and various aspects of mental functioning in cancer patients.
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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.
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Tommaso Micheloni
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Ilaria Bertolucci
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Laura Marchi
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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Lee SS, Rim HD, Won SH, Woo J. Avoidant Insecure Attachment as a Predictive Factor for Psychological Distress in Patients with Early Breast Cancer: A Preliminary 1-Year Follow-Up Study. Psychiatry Investig 2018; 15:805-810. [PMID: 30086610 PMCID: PMC6111221 DOI: 10.30773/pi.2018.06.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/07/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To identify attachment insecurity as an associative factor with unresolved psychological distress 1 year after surgery in the early breast cancer (BC) population. METHODS One-hundred fourteen participants completed the Hospital Anxiety and Depression Scale (HADS) and the Experiences in Close Relationship (ECR-M36) questionnaire within 1 week (baseline) and at 1-year post-surgery (follow-up). Participants were categorized into the distress and the non-distress groups based on a HADS-total score cut-off of 15. Logistic regression analysis revealed predictive factors of distress at follow-up. RESULTS At baseline, 53 (46.5%) participants were found to be in the distress group. The degree of distress decreased over 1 year (p= 0.003); however, 43 (37.7%) showed significant remaining distress at follow-up. Baseline scores of the ECR-M36 avoidance [odds ratio (OR)=1.045, 95% confidence interval (CI)=1.002-1.090] and HADS-total (OR=1.138, 95% CI=1.043-1.241) were predictors of distress at follow-up. CONCLUSION A substantial proportion of early BC patients suffer distress even one-year after surgery. Avoidant attachment appeared to be an influential factor on distress in early BC patients. Moreover, the finding that initial distress level could predict one at 1-year postoperation warrant a screening and management of distress along with BC treatment.
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Affiliation(s)
- Sang-Shin Lee
- Department of Psychiatry, Kosin University College of Medicine, Busan, Republic of Korea
| | - Hyo-Deog Rim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jungmin Woo
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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