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Richardson E, Beath A, Boag S. The Development of the Attachment Defenses Questionnaire (ADQ-50): A Preliminary Examination of Reliability, Validity, and Factor Structure. J Pers Assess 2024:1-15. [PMID: 38776445 DOI: 10.1080/00223891.2024.2353142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 04/28/2024] [Indexed: 05/25/2024]
Abstract
This paper marks the initial phase in the development of the Attachment Defenses Questionnaire (ADQ-50), a self-report tool crafted to assess defense mechanisms associated with attachment processes, catering to both clinical and research contexts. Anchored in the theoretical framework of attachment theory, the ADQ posits that an individual's internalized attachment style plays a influential role in predicting their defense mechanisms. The paper outlines the comprehensive development and refinement process of the ADQ-50. In Study 1 a preliminary 176-item version of the ADQ was examined. Data was collected online drawing from participants sourced from Prolific and undergraduate students (N = 1994). Study 2 further refined the ADQ, evaluating its initial convergent validity with a diverse participant pool (N = 726), including undergraduates, Prolific contributors, general practice medical patients, and individuals from social media. Exploratory factor analysis revealed a robust ten-factor structure, resulting in a 50-item scale aligning with theoretical expectations and demonstrating good psychometric properties. Findings, limitations, strengths and future research directions are discussed. We posit that the ADQ holds great potential to deepen our comprehension of defense mechanisms linked to attachment, with wide-ranging implications for clinical practices.
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Affiliation(s)
- Emma Richardson
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Alissa Beath
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Simon Boag
- School of Psychological Sciences, Macquarie University, Sydney, Australia
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2
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Abiola T, Yusuf AJ, Ibrahim MG, Fajimolu OO, Hayatudeen N, Ohaeri JU, Udofia O, Jidda MS. Mental Health Burden and Facilitators Among Frontline Healthcare Professionals in Nigeria Amid COVID-19 Pandemic: A Cross-sectional Study. Niger J Clin Pract 2024; 27:475-482. [PMID: 38679770 DOI: 10.4103/njcp.njcp_704_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/01/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, the frontline healthcare providers faced significant mental health stressors. Previous pandemics have revealed the need for psychosocial support and healthy coping mechanisms to mitigate mental health risks. AIM The study aimed to assess psychological impact and supportive mechanisms experienced by frontline healthcare workers treating COVID-19 patients in Kaduna State. METHODS This study involved 38 frontline healthcare providers mainly from Kaduna State Infectious Disease Treatment Center. Participants' mental health burden was captured through Hospital Anxiety and Depression Scale. Mental health facilitators were assessed through six tools: Ten-Item Values Inventory, healthy defense section of the Defense Style Questionnaire, Existential Anxiety Questionnaire, Brief Resilience Scale, Oslo Social Support Scale, and the Insomnia Severity Index. RESULTS The mean age of the study participants was 35.5 ± 6.6 years, with the majority being males (68.4%) and doctors (39.5%). More than a quarter of the participants showed appreciable symptoms of depression and anxiety. Psychosocial facilitators such as moral values, openness to change, self-transcendence, sublimation, anticipation, and humor scored above average for more than half of the participants. Most participants demonstrated moderate resilience and social support, with few experiencing sleep challenges. Comparisons of variables indicated "openness to change" was significantly higher among males, whereas symptoms of depression and anxiety were associated with higher levels of existential concerns and sleep challenges. CONCLUSION Our study finds that Nigerian frontline health workers experienced significant mental health challenges during the COVID-19 pandemic. It identified specific facilitators linked to gender and psychological burdens, informing the need for tailored support interventions.
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Affiliation(s)
- T Abiola
- Department of Medical Services, Federal Neuropsychiatric Hospital, Barnawa, Kaduna, Nigeria
| | - A J Yusuf
- Department of Medical Services, Federal Neuropsychiatric Hospital, Barnawa, Kaduna, Nigeria
| | - M G Ibrahim
- Department of Medical Services, Federal Neuropsychiatric Hospital, Barnawa, Kaduna, Nigeria
| | - O O Fajimolu
- Carleton Clinic, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Carlisle, Cumbria, United Kingdom
| | - N Hayatudeen
- Department of Medical Services, Federal Neuropsychiatric Hospital, Barnawa, Kaduna, Nigeria
| | - J U Ohaeri
- Department of Psychological Medicine, College of Medicine University of Nigeria, Ituku, Enugu, Nigeria
| | - O Udofia
- Department of Psychiatry, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - M S Jidda
- Department of Mental Health, University of Maiduguri, Maiduguri, Nigeria
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Amarante ICJ, Lippman SA, Sevelius JM, Saggese GSR, da Silva AAM, Veras MADSM. Anticipated Stigma and Social Barriers to Communication Between Transgender Women Newly Diagnosed with HIV and Health Care Providers: A Mediation Analysis. LGBT Health 2024; 11:229-238. [PMID: 37910864 PMCID: PMC11001954 DOI: 10.1089/lgbt.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
Purpose: We assessed whether anticipated stigma (i.e., fear of public mistreatment due to gender identity) impacts communication between transgender women (TGW) living with HIV and health care providers. Methods: This is a secondary analysis of baseline data from Trans Amigas, a study conducted in Brazil, 2018. The study population consisted of TGW living with HIV, older than 18 years, residing in the São Paulo metropolitan area. We used multivariable logistic regression (α = 0.05), mediation, and bootstrapping for the analysis. Results: One hundred and thirteen participants completed the study. Fear of public mistreatment had an adjusted odds ratio (aOR) of 7.42 (p = 0.003) for difficulty reporting new symptoms to providers. Concerning fear of public mistreatment, we found that unemployment had an aOR of 3.62 (p = 0.036); sex work, an aOR of 2.95 (p = 0.041); and issues related to name change in documents, an aOR of 2.71 (p = 0.033). For the indirect effect on difficulty reporting new symptoms, mediated by fear of public mistreatment, unemployment had an aOR of 1.52 (confidence interval [CI] = 0.88-2.24); sex work, an aOR of 1.48 (CI = 0.81-2.52); and name change issues, an aOR of 1.47 (CI = 0.96-2.43). Conclusions: Anticipated stigma was associated with communication difficulties between TGW living with HIV and providers. Our data suggest that structural factors associated with anticipated stigma could indirectly impact on difficulty reporting new symptoms. These findings indicate the importance of considering social contexts that intersect with individual experiences when analyzing communication barriers between providers and patients, and the need to strengthen social policies for TGW in Brazil. Clinical Trial Registration number: R34MH112177.
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Affiliation(s)
- Isabella Chypriades Junqueira Amarante
- Department of Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, São Paulo, Brazil
- Núcleo de Pesquisa em Direitos Humanos e Saúde da População LGBT+ (NUDHES), São Paulo, São Paulo, Brazil
| | - Sheri A Lippman
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jae M. Sevelius
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Gustavo Santa Roza Saggese
- Núcleo de Pesquisa em Direitos Humanos e Saúde da População LGBT+ (NUDHES), São Paulo, São Paulo, Brazil
| | | | - Maria Amélia de Sousa Mascena Veras
- Department of Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, São Paulo, Brazil
- Núcleo de Pesquisa em Direitos Humanos e Saúde da População LGBT+ (NUDHES), São Paulo, São Paulo, Brazil
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Lishner Freud E, Berant E. Holocaust communication, attachment orientation and distress among descendants of female holocaust survivors. FAMILY PROCESS 2023; 62:1655-1670. [PMID: 36582137 DOI: 10.1111/famp.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
The multiple studies that have examined the transgenerational transmission of Holocaust trauma from survivors to their descendants have yielded inconsistent results. These can be attributed to differences in assessment tools and to individual differences between survivors, such as their specific experiences during the Holocaust. This study examined the differences between daughters and granddaughters of female Holocaust survivors (HS) of concentration camps (CCS) versus survivors of other circumstances (ghettos, concealment, etc.; OCCS) in terms of communication about their mothers' or grandmothers' Holocaust trauma (Holocaust communication), their attachment orientations, and their psychological distress. The sample was composed of 79 dyads of daughters of HS and their own daughters, divided into two groups according to the survivors' Holocaust experiences (CCS-47 dyads; OCCS-32 dyads). The findings indicated that daughters of CCS reported a higher number of conversations about the Holocaust with their mothers, perceived their mothers as more distant during Holocaust communication, and reported more guilt feelings than daughters of OCCS. Holocaust communication between daughters and granddaughters was characterized by shorter conversations, and granddaughters perceived their mothers as sadder in the CCS group than in the OCCS group. No difference between groups was found in Holocaust communication between survivors and their granddaughters. No difference was found between groups in their psychological distress. The granddaughters of CCS scored higher on attachment anxiety than the other group. Most of the significant differences between groups were linked to subtle differences in the characteristics of communication and in the inter-personal sphere.
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Affiliation(s)
- Eve Lishner Freud
- Department of Psychology, Ramat Gan and Baruch Ivcher School of Psychology, Interdisciplinary Center, Bar Ilan University, Herzliya, Israel
| | - Ety Berant
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel
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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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Finch EF, Hooley JM. Functional fantasies: the regulatory role of grandiose fantasizing in pathological narcissism. Front Psychiatry 2023; 14:1274545. [PMID: 37920536 PMCID: PMC10618345 DOI: 10.3389/fpsyt.2023.1274545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Pathological narcissism is characterized by maladaptive efforts to maintain a bolstered but fragile sense of self. Clinical theory suggests that grandiose fantasizing may be one form of this self-regulation. However, no empirical research has directly assessed the regulatory function of grandiose fantasizing in narcissism. Here, we examine (1) whether people scoring higher in narcissism choose to engage in grandiose fantasizing to regulate themselves when they are feeling down and (2) whether grandiose fantasizing is a more efficacious self-esteem and affect regulator for people scoring higher in narcissism than it is for those scoring lower in narcissism. Methods Adult participants (N = 189) completed a self-report measure of narcissism and were randomized to either a negative mood induction or filler task condition. Then, participants wrote about a future event to make themselves feel better, choosing between a positive affect word or a grandiose word to guide their writing. Throughout the study, participants reported their state positive and negative affect and self-esteem. A secondary sample (N = 128) of adult participants rated the future event writing of the original participants. Results Supporting the validity of the study design, grandiose future events significantly differed from positive future events (e.g., they were rated by independent raters as less plausible, more ambitious, more active, and occurring further in the future). Participants scoring higher in narcissism and participants who experienced larger increases in negative affect were more likely to choose to engage in grandiose fantasizing. Grandiose fantasizing was more effective at decreasing negative affect among participants scoring higher in narcissism than those scoring lower in narcissism, whereas positive future thinking was equally effective at decreasing negative affect across levels of narcissism. Discussion This study demonstrates that people scoring higher in narcissism are more likely to choose to engage in grandiose fantasizing to make themselves feel better. It further demonstrates that grandiose fantasizing is a more efficacious affect regulator for those scoring higher in narcissism.
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Affiliation(s)
- Ellen F. Finch
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Buchborn T, Kettner HS, Kärtner L, Meinhardt MW. The ego in psychedelic drug action - ego defenses, ego boundaries, and the therapeutic role of regression. Front Neurosci 2023; 17:1232459. [PMID: 37869510 PMCID: PMC10587586 DOI: 10.3389/fnins.2023.1232459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/18/2023] [Indexed: 10/24/2023] Open
Abstract
The ego is one of the most central psychological constructs in psychedelic research and a key factor in psychotherapy, including psychedelic-assisted forms of psychotherapy. Despite its centrality, the ego-construct remains ambiguous in the psychedelic literature. Therefore, we here review the theoretical background of the ego-construct with focus on its psychodynamic conceptualization. We discuss major functions of the ego including ego boundaries, defenses, and synthesis, and evaluate the role of the ego in psychedelic drug action. According to the psycholytic paradigm, psychedelics are capable of inducing regressed states of the ego that are less protected by the ego's usual defensive apparatus. In such states, core early life conflicts may emerge that have led to maladaptive ego patterns. We use the psychodynamic term character in this paper as a potential site of change and rearrangement; character being the chronic and habitual patterns the ego utilizes to adapt to the everyday challenges of life, including a preferred set of defenses. We argue that in order for psychedelic-assisted therapy to successfully induce lasting changes to the ego's habitual patterns, it must psycholytically permeate the characterological core of the habits. The primary working principle of psycholytic therapy therefore is not the state of transient ego regression alone, but rather the regressively favored emotional integration of those early life events that have shaped the foundation, development, and/or rigidification of a person's character - including his or her defense apparatus. Aiming for increased flexibility of habitual ego patterns, the psycholytic approach is generally compatible with other forms of psychedelic-assisted therapy, such as third wave cognitive behavioral approaches.
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Affiliation(s)
- Tobias Buchborn
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Hannes S. Kettner
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Laura Kärtner
- Centre for Psychedelic Research, Department of Medicine, Imperial College London, London, United Kingdom
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Marcus W. Meinhardt
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
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Allahvirdie Rezaieh S, Ghorbani N, Farahani H. Mediating role of splitting in relation to attachment styles and shopping addiction. Front Psychol 2023; 14:1249591. [PMID: 37854143 PMCID: PMC10581345 DOI: 10.3389/fpsyg.2023.1249591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Shopping can provide a sense of satisfaction and pleasure; however, if a person's excessive involvement in this behavior starts to negatively impact other aspects of their life, similar to other addictive behaviors like excessive internet use, gaming, and gambling, it may be classified as pathological. Given the lack of agreement regarding the classification of excessive shopping tendencies as a separate mental health condition or addictive behavior, taking a socio-emotional approach to explore the psychological factors that precede this behavior, may offer a better comprehension of it. Methods The purpose of this study was to examine the relationship between attachment styles and excessive shopping behavior, as well as to investigate the potential mediating effect of defense mechanisms like splitting on this relationship. Using convenience sampling, a group of 457 stock market employees (116 female, 341 male) between the ages of 24 and 60 were recruited. The researchers utilized a set of validated psychological questionnaires to assess the employees attachment styles, shopping addiction, and splitting tendencies. Results The results obtained from both the mediation model and path analysis suggest that attachment styles do not have a direct relationship with shopping addiction. Nonetheless, the study supports the impact of insecure anxious and avoidan attachment styles on splitting. Furthermore, the findings confirm that splitting has a mediating effect on the relationship between attachment styles and splitting. Discussion The present study enhanced our comprehension of the subconscious mechanisms underlying shopping tendencies. Specifically, the findings suggest that excessive tendencies towards shopping can be considered a maladaptive response resulting from insecure attachment styles and the unconscious utilization of the splitting defense mechanism.
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Affiliation(s)
| | - Nima Ghorbani
- Department of Clinical Psychology, University of Tehran, Tehran, Iran
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Furnham A, Cuppello S. Maladaptive (dark-side) and adaptive (bright-side) personality traits and defense styles. Acta Psychol (Amst) 2023; 239:104002. [PMID: 37573741 DOI: 10.1016/j.actpsy.2023.104002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023] Open
Abstract
This study explores the relationship between bright- and dark-side personality traits and four major styles of defense mechanisms (DMs) as this relationship remains unexplored and important in understanding the DMs. In all, 435 adult working participants (241 men; 194 women; Mean age 46.06 yrs) mainly in middle management jobs, completed a 78-item, six-trait measure of bright-side personality (HPTI: High Potential Type Indicator), a 25-item five-trait measure of the dark-side personality (PID-5;BF: DSM-5-Brief Form) and 88-item, four-styles measure of defense mechanisms (Defense Style Questionnaire). The aim was to examine demographic (sex, age, education), ideological and personality trait correlates of the DMs. It was hypothesized that the dark-side traits, particularly Detachment would be most strongly related to the DMs. Thereafter, a hierarchical linear regression was performed with each DM factor as criterion and predictors being demography, ideology, self-esteem as well as bright- and dark-side personality traits. Detachment was associated with all DMs, particularly Maladaptive (r = 0.68) and Image Distorting Style (r = 0.38) while Conscientiousness was associated with none. One implication concerns the assessment of DMs by standard tests. Limitations are acknowledged and include method invariance and sample homogeneity.
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Affiliation(s)
- Adrian Furnham
- Department of Leadership and Organisational Behaviour, Norwegian Business School (BI), Nydalveien, Olso, Norway.
| | - Stephen Cuppello
- Department of Psychology, City University London, London, United Kingdom of Great Britain and Northern Ireland
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Pilyugina E, Suleymanov R. Cinematherapy as a method of correction of a personality psychological defense at a young age. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04330-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Bashir A, Batool E, Bhatia T, Shoib S, Mir NA, Bashir U, Singh R, McDonald M, Hawk ME, Deshpande S. Community practices as coping mechanisms for mental health in Kashmir. SOCIAL WORK IN MENTAL HEALTH 2022; 21:406-421. [PMID: 37551352 PMCID: PMC10406466 DOI: 10.1080/15332985.2022.2159779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
With a steady rise in mental health issues such as depression, anxiety, and post-traumatic stress disorder (PTSD) in Kashmir, the need to address mental health in this region becomes important. This paper reports on traditional and current community mental health coping mechanisms among residents in Kashmir. Six focus group discussions (FGD) were facilitated with key informants. Data were analyzed via a thematic analytic approach. Community coping mechanisms reported include social spaces and shared chore spaces, cultural practices, shrines and religious places, faithealers. These findings demonstrate community strengths that can leverage to build additional coping strategies and resilience among people.
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Affiliation(s)
- Aadil Bashir
- Department of Social Work, University of Kashmir, Srinagar, India
| | - Essar Batool
- Department of Social Work, University of Kashmir, Srinagar, India
| | - Triptish Bhatia
- Centre of Excellence in Mental Health, ABVIMS-Dr.R.M.L. RML Hospital New Delhi, India
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | | | - Unjum Bashir
- Islamic University of Science and Technology, India
| | | | | | - Mary E. Hawk
- University of Pittsburgh Graduate School of Public Health, USA
| | - Smita Deshpande
- Centre of Excellence in Mental Health, ABVIMS-Dr.R.M.L. RML Hospital New Delhi, India
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Changes in the psychological defense mechanism and clinical features of patients with OCD - A four-year follow-up study. J Affect Disord 2022; 317:131-135. [PMID: 35987303 DOI: 10.1016/j.jad.2022.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The present study aims to (1) follow up with 4-year changes in the efficacy outcome, defense style questionnaire (DSQ) score, and clinical features of patients with obsessive-compulsive disorder (OCD) and (2) analyze the relationship between different levels of efficacy and changes in the patients' psychological defense mechanisms. METHODS The following data collection and 4-year follow-up were completed for 153 patients with OCD: (1) the treatment process, efficacy outcome, course of disease, and clinical features of OCD were collected using a self-made general information questionnaire and (2) the control method was used to analyze the changes in clinical symptoms (Yale-Brown obsessive compulsive scale [YBOCS], Hamilton anxiety score [HAMA], and Hamilton depression scale [HAMD]) in patients with OCD. Moreover, the changes in the psychological defense mechanism (measured by DSQ) and the relation between the prognosis and DSQ score were investigated. RESULTS (1) The HAMA score (8.7 ± 4.8 points), HAMD score (12.0 ± 6.6 points) and YBOCS score (16.4 ± 8.4 points) were significantly lower during the follow-up than at the time of enrollment (p < 0.01). In the two DSQ evaluations, there were no significant differences in the factors, with the exception of a significant decrease in the use of "reaction formation" (t = 2.533, p = 0.015). The changes of mature defense factors in the significant efficacy group significantly increased (p < 0.01). Which was mainly manifested in the significant increase in the score of "sublimation" item, and the difference was extremely significant (t = -3.093, p = 0.006). CONCLUSION An abnormal psychological defense mechanism plays an important role in OCD, and the use of a mature defense mechanism is significantly related to the treatment efficacy.
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Default defenses: the character defenses of attachment-anxiety and attachment-avoidance. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03919-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Contemporary attachment researchers claim that attachment-anxiety is associated with a hyperactivating defense strategy while attachment-avoidance is associated with a deactivating defense strategy. However, to date, no study has comprehensively examined the basic patterns of specific defense expression in the two dimensions of attachment insecurity (anxiety/avoidance). To address this research gap, the current study aimed to assess the character defenses associated with attachment-avoidance and attachment-anxiety, incorporating a broad spectrum of psychological defenses. The main objective was to understand what differentiates attachment-avoidance and attachment-anxiety in defensive functioning. In this study of online questionnaire design (N = 250), university undergraduates aged between 17 to 65 completed the Experiences in Close Relationship Scale (ECR) and the Defense Style Questionnaire (DSQ-60). The results show that the two dimensions of insecure attachment exhibit different defensive patterns. Regarding the main findings, attachment-avoidance uniquely predicted defensive isolation, and attachment-anxiety uniquely predicted the defenses splitting, projective identification, anticipation, acting out, passive-aggression, reaction formation, and undoing. Overall, the results indicate that attachment-anxiety is a significant predictor of global defensive functioning, over and above that of attachment-avoidance. One implication of this study is that the two-dimensional model of adult attachment may offer a promising framework for organizing psychological defenses. We discuss the significance of this concerning the future of the empirical study of psychological defenses. The discussion also considers the clinical application and relevance to attachment-based psychotherapy.
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Binder PE. Facing the uncertainties of being a person: On the role of existential vulnerability in personal identity. PHILOSOPHICAL PSYCHOLOGY 2022. [DOI: 10.1080/09515089.2022.2129002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Per-Einar Binder
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
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Abdus-salam RA, Balogun RO, Lawal TV, Lawal OO, Lawal RO, Abdulmalik JO, Morhason-Bello IO. Assessment of anxiety and depression, and coping mechanisms during COVID-19 lockdown among pregnant women. Heliyon 2022; 8:e10902. [PMID: 36210864 PMCID: PMC9528070 DOI: 10.1016/j.heliyon.2022.e10902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/15/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Background COVID-19 lockdown was associated with disruption of daily life, economy, essential health services including maternal health service, and psychological reflexes such as panic, sleep disorders, fear, anxiety, and depression. Aim To assess the perception of pregnant women on the COVID-19 pandemic lockdown and the prevalence of common mental health disorders (CMHD) among pregnant women. Methods A cross-sectional study was conducted among 380 pregnant women at the University College Hospital (UCH) Ibadan; participants were enrolled using a simple random sampling technique. Data was collected using pretested interviewer-administered questionnaire. Information obtained - sociodemographic and obstetric characteristics, perception and reaction to the COVID-19 pandemic and lockdown, effect on ANC, coping mechanisms, and presence of CMHD (anxiety and depression) were measured using Hospital Anxiety and Depression Scale (HADS). Data were analysed using STATA 16.0 Software. Descriptive and bivariate statistics were performed. The level of significance was p-value < 0.05. Results The mean age was 32 ± 4.78 years, most respondents were <35 years (75%), married (97.1%), had a higher education (89%) and multiparous (70%). About 43.9% were worried that COVID-19 would affect pregnancy care, 42.9% reported it affected care and 81.6% were not worried it would affect the delivery care. Among respondents, 96.6% were able to cope with the effects of the pandemic and 96.8% enjoyed good social support. Respondents did not have CMHD (88.16%), 7.9% had CMHD (4.74% had depression and 3.16% had anxiety) and 3.95% had co-morbid depression and anxiety. On multinomial regression analysis, relative to anxiety or depression only, respondents with combined depression and anxiety had higher odds of having no delivery plan and thought COVID-19 may affect their delivery. Conclusion Only a few women reported anxiety and depression symptoms during the lockdown and those with anxiety or combined symptoms of anxiety and depression had no birth plan and believed that COVID-19 would affect their delivery.
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Affiliation(s)
- Rukiyat Adeola Abdus-salam
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Oyo State, Nigeria
- Corresponding author.
| | | | - Temitayo Victor Lawal
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Olatunji Okikiola Lawal
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Oyo State, Nigeria
| | | | - Jibril Omuya Abdulmalik
- Department of Psychiatry, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Oyo State, Nigeria
| | - Imran Oludare Morhason-Bello
- Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Oyo State, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Teo DCL, Wuan EKM, Lee DSF, Tay ATS, Cheng SET. Psychodynamic Psychiatry in Singapore. Psychodyn Psychiatry 2022; 50:453-460. [PMID: 36047792 DOI: 10.1521/pdps.2022.50.3.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors provide an overview of the history of psychiatric services and training in Singapore, and the more recent introduction of psychodynamic psychotherapy training for psychiatric residents. They describe the current state of psychodynamic psychiatry services in the public healthcare system, including efforts at fostering psychodynamic thinking in nonpsychiatric community partners via community mental health integrated care programs and activities such as Balint Groups. They discuss current challenges in psychodynamic practice, such as the impact of language and culture on the Singaporean individual's receptiveness to psychodynamic psychotherapy, as well as systemic challenges in funding and expanding psychodynamic services. They highlight future directions, including challenges and opportunities for the local psychodynamic community in Singapore.
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Affiliation(s)
- David Choon Liang Teo
- Consultant Psychiatrist at the Department of Psychological Medicine, Changi General Hospital. He is Clinical Assistant Professor at Duke-NUS Medical School, and Clinical Senior Lecturer at Yong Loo Lin School of Medicine, National University of Singapore. Dr. Teo serves in the International Advisory Board of Psychodynamic Psychiatry.
| | - Eugene Kin Mun Wuan
- Consultant Psychiatrist, Department of Psychological Medicine, Changi General Hospital. He is Clinical Assistant Professor at Duke-NUS Medical School, and Clinical Senior Lecturer at Yong Loo Lin School of Medicine, National University of Singapore
| | - Dawn Sue-Fern Lee
- Consultant Psychiatrist, Institute of Mental Health. She is Clinical Teacher at Lee Kong Chian School of Medicine and Clinical Lecturer, Yong Loo Lin School of Medicine
| | - Andre Teck Sng Tay
- Senior Consultant Psychiatrist at the Department of Psychological Medicine, Changi General Hospital. He is Adjunct Assistant Professor, Duke-NUS Medical School and Clinical Senior Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore
| | - Samuel Eng Teck Cheng
- Senior Consultant Psychiatrist, Department of Psychological Medicine, Changi General Hospital. He is Clinical Assistant Professor at Duke-NUS Medical School and Clinical Senior Lecturer at Yong Loo Lin School of Medicine, National University of Singapore
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Porcerelli JH, Richardson LA, Smith JD, Huth-Bocks AC. Changes in Defense Mechanisms in Mothers From Pregnancy to 2 Years Postpregnancy. J Nerv Ment Dis 2022; 210:686-691. [PMID: 35344978 DOI: 10.1097/nmd.0000000000001519] [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 The objective of this study was to assess changes in maternal defensive functioning from the third trimester of pregnancy to 2 years postpregnancy. A community sample of at-risk mothers ( N = 84; non-White [61%], unmarried [67%], high school or less education [72%], and income less than $20,000 [50%]) were recruited for this longitudinal study. Mothers responded to a semistructured interview during pregnancy and at 2 years postpregnancy about the parent-infant relationship; interview transcripts were coded using the Defense Mechanism Rating Scale (DMRS). Results indicated a significant increase in both total defense mechanisms used and the relative percentage of immature defense mechanisms used over time. A significant decrease in the relative percentage of healthy/adaptive defenses was noted. When all seven levels of defenses of the DMRS were assessed, it was an increase in minor image-distorting defenses, mechanisms that supported vulnerable self-esteem, that accounted for most of the change in immature defenses. Stability coefficients of defense mechanisms were reported, with large effect sizes, for overall defensive functioning, and mature and immature defenses over a 2-year period. These findings lend support to the importance of assessing defense mechanisms to better understand stressful life transitions in mothers.
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Affiliation(s)
- John H Porcerelli
- Department of Psychology, University of Detroit Mercy, Detroit, Michigan
| | - Laura A Richardson
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts
| | | | - Alissa C Huth-Bocks
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital & Case Western Reserve University, Cleveland, Ohio
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18
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Altwaijri N, Abualait T, Aljumaan M, Albaradie R, Arain Z, Bashir S. Defense mechanism responses to COVID-19. PeerJ 2022; 10:e12811. [PMID: 35186458 PMCID: PMC8842651 DOI: 10.7717/peerj.12811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/28/2021] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic has had a wide range of negative physical and mental impacts. This review begins with a theoretical explanation of the psychological defense mechanisms used to deal with the pandemic. It then discusses different categories of defense mechanisms and their roles in managing the impacts of psychological distress. The aim of this review is to highlight the various psychological defense mechanisms individuals use to deal with the pandemic and to discuss how adjustment mechanisms can protect individuals from internal and external threats by shielding the integrity of the ego (the mind) and helping individuals maintain their self-schema.
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Affiliation(s)
| | - Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Aljumaan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Raidah Albaradie
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Zahid Arain
- Liver Transplant Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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19
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Oduntan A, Oyebode O, Beltran AH, Fowles J, Steeves D, Orji R. I Let Depression and Anxiety Drown Me: Identifying Factors Associated with Resilience Based on Journaling using Machine Learning and Thematic Analysis. IEEE J Biomed Health Inform 2022; 26:3397-3408. [PMID: 35139031 DOI: 10.1109/jbhi.2022.3149862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the years, there has been a global increase in the use of technology to deliver interventions for health and wellness, such as improving peoples mental health and resilience. An example of such technology is the Q-Life app which aims to improve peoples resilience to stress and adverse life events through various coping mechanisms, including journaling. Using a combination of sentiment and thematic analysis, this paper presents the results of analyzing 6023 journal entries from 755 users. We uncover both positive and negative factors that are associated with resilience. First, we apply two lexicon-based and eight machine learning (ML) techniques to classify journal entries into positive or negative sentiment polarity, and then compare the performance of these classifiers to determine the best performing classifier overall. Our results show that Support Vector Machine (SVM) is the best classifier overall, outperforming other ML classifiers and lexicon-based classifiers with a high F1-score of 89.7%. Second, we conduct thematic analysis of negative and positive journal entries to identify themes representing factors associated with resilience either negatively or positively, and to determine various coping mechanisms. Our findings reveal 14 negative themes such as stress, worry, loneliness, lack of motivation, sickness, relationship issues, as well as depression and anxiety. Also, 13 positive themes emerged including self-efficacy, gratitude, socialization, progression, relaxation, and physical activity. Seven (7) coping mechanisms are also identified including time management, quality sleep, and mindfulness. Finally, we reflect on our findings and suggest technological interventions that address the negative factors to promote resilience.
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20
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Grabowski JE, Porcerelli JH, Richardson L, Lowe K, Eshelman L, Huth-Bocks A. Defense mechanisms and childhood abuse potential in pregnant mothers. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02203-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Karaarslan C, Eldogan D, Yigit I. Associations between early maladaptive schema domains of parents and their adult children: The role of defence styles. Clin Psychol Psychother 2021; 28:1043-1054. [PMID: 33624909 DOI: 10.1002/cpp.2579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/15/2022]
Abstract
Although existing research recognized the associations between early maladaptive schemas (EMSs) of parents and their adult children, the mechanisms that underpin these associations were not fully understood. Therefore, the purpose of the current study was to explore the role of defence styles (DSs) on the associations between two EMS domains (Disconnection/Rejection and Impaired Autonomy) of parents and their adult children. Two hundred and fifteen families (i.e., mother, father, and their adult children) participated in the study. Both parents and their adult children were asked to complete Young Schema Questionnaire-Short Form (YSQ-SF) and Defence Style Questionnaire (DSQ) to assess their EMS domains and DSs. According to the results of the current study, there were significant associations between Disconnection/Rejection and Impaired Autonomy EMS domains of parents and their adult children, and these associations were mediated by only immature DS of parents and their adult children in a serial mediation model. These results contributed to our understanding of the associations between EMS domains of parents and their adult children through immature DSs. Moreover, our findings highlighted the importance of synthesizing the concepts of different theories to enhance our understanding of mental representations in families.
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Affiliation(s)
- Cemre Karaarslan
- Department of Psychology, Faculty of Science and Letters, Başkent University, Ankara, Turkey
| | - Dilay Eldogan
- Kavaklıdere Psychological Counseling Center, Ankara, Turkey
| | - Ibrahim Yigit
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Ankara Medipol University, Ankara, Turkey
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22
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Schanz CG, Equit M, Schäfer SK, Käfer M, Mattheus HK, Michael T. Development and Psychometric Properties of the Test of Passive Aggression. Front Psychol 2021; 12:579183. [PMID: 33981263 PMCID: PMC8107391 DOI: 10.3389/fpsyg.2021.579183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 03/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: To date, most research on aggression in mental disorders focused on active-aggressive behavior and found self-directed and other-directed active aggression to be a symptom and risk-factor of psychopathology. On the other hand, passive-aggressive behavior has been investigated less frequently and only in research on psychodynamic defense mechanisms, personality disorders, and dysfunctional self-control processes. This small number of studies primarily reflects a lack of a reliable and valid clinical assessment of passive-aggressive behavior. To address this gap, we developed the Test of Passive Aggression (TPA), a 24-item self-rating scale for the assessment of self-directed and other-directed passive-aggressive behavior. Method: Study 1 examined the internal consistency and factorial validity of the TPA in an inpatient sample (N = 307). Study 2 investigated the retest-reliability, internal consistency, and construct validity (active aggression, personality traits, impulsivity) of the TPA in a student sample (N = 180). Results: In line with our hypothesis, Exploratory Structural Equation Modeling revealed an acceptable to good fit of a bi-factorial structure of the TPA (Chi-square-df-ratio = 1.98; RMSR = 0.05, fit.off = 0.96). Both TPA scales showed good to excellent internal consistency (α = 0.83-0.90) and 4-week retest-reliability (r tt = 0.86). Correlations with well-established aggression scales, measures of personality, and impulsivity support discriminant and convergent validity of the TPA. Conclusions: The TPA is a reliable and valid instrument for the assessment of self-directed and other-directed passive-aggressive behavior.
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Affiliation(s)
- Christian G. Schanz
- Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Monika Equit
- Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Sarah K. Schäfer
- Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | | | - Hannah K. Mattheus
- Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Tanja Michael
- Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
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23
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Weber R, Ehrenthal JC, Brock-Midding E, Halbach S, Würstlein R, Kowalski C, Ernstmann N. Defense Mechanisms and Repressive Coping Among Male Breast Cancer Patients. Front Psychiatry 2021; 12:718076. [PMID: 34955906 PMCID: PMC8703166 DOI: 10.3389/fpsyt.2021.718076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: The concept of defense mechanisms has undergone extensive revision and expansion since Freud first described these processes. Initially formulated as an unconscious repression of unpleasant memories, with further development focusing on the role of defense mechanisms in the regulation of internal conflicts, the concept shifted and evolved to incorporate the adaptation to external demands, including intrapsychic and interpersonal handling of burden of illness. In addition to defense mechanisms, coping provides another perspective on human adjustment to difficult life events. While there is substantial research on both coping and defense mechanisms in various psychiatric and somatic diseases, including cancer, little is known about defensive regulation, coping, and their interaction in male breast cancer patients. Methods: The present study is part of the N-Male project conducted between 2016 and 2018 in Germany (Male breast cancer: patients' needs in prevention, diagnosis, treatment, rehabilitation, and follow-up care). Semi-standardized interviews with 27 male breast cancer patients were analyzed with regard to defense mechanisms. In addition, fear of progression and repressive coping was assessed by self-report. Results: There was considerable variety in levels of defensive functioning as well as repressive coping in our sample. We found no difference in overall levels of defensive functioning between men with vs. without repressive coping. However, patients with repressive coping demonstrated a decopupled association between fear of progression and defensive functioning as compared to patients without repressive coping. Discussion: The study provides the first evidence of disease processing in male breast cancer patients Knowledge of patients' defense patterns and repressive coping seems promising for better planning targeted intervention strategies.
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Affiliation(s)
- Rainer Weber
- Department of Psychosomatic and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Johannes C Ehrenthal
- Department of Psychology, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Evamarie Brock-Midding
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology (CIO Bonn), Bonn, Germany
| | - Sarah Halbach
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology (CIO Bonn), Bonn, Germany
| | - Rachel Würstlein
- Breast Center, Department of Gynecology and Obstetrics (Comprehensive Cancer Center Munich), University Hospital of Munich (Ludwig Maximilian University), Munich, Germany
| | | | - Nicole Ernstmann
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology (CIO Bonn), Bonn, Germany
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24
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Palmieri A, Kleinbub JR, Pagnini F, Sorarù G, Cipolletta S. Empathy-based supportive treatment in amyotrophic lateral sclerosis: A pragmatic study. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2021; 63:202-216. [PMID: 33617426 DOI: 10.1080/00029157.2020.1797623] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Scarce literature has been dedicated to the psychological treatment of amyotrophic lateral sclerosis (ALS). However, there have been some encouraging findings, such as in hypnosis-based studies, which revealed patient improvements in anxiety, depression and quality of life (QoL). We replicated such a design of a pragmatic study on empathy-based supportive counseling treatment in four weekly domiciliary sessions. Twenty-one people with ALS (pALS) consecutively attending the Motor Neuron Disease Center of Padova University were recruited to the study; in total, 21 pALS who did not undergo any kind of psychological treatment served as the control group. In the treatment group, depression, anxiety and QoL (measured respectively with the HADS-D, HADS-A and ALSSQOL-R) were assessed at pre- and post-treatment levels and at 3- and 6-month follow-ups. Statistical mixed-model regression analyses revealed that in the treated group, perceived conditions of anxiety, depression and QoL were significantly stable compared to worsening in the control patients. Interestingly, there were improvements in the QoL domains "Interaction", "Emotion" and "Physical" at the 6-month follow-up. Overall, even if not directly comparable, our current results on support-based counseling, though interesting, seem not to reach the efficacy of a hypnosis-based study in which the observed dimensions were significantly improved with respect to the baseline. The implications of our results from a psychodynamic perspective are highlighted.
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Affiliation(s)
| | | | - Francesco Pagnini
- Catholic University Sacro Cuore, Milano, Italy
- Harvard University, Cambridge, MA, USA
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25
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Alenazi TH, BinDhim NF, Alenazi MH, Tamim H, Almagrabi RS, Aljohani SM, H Basyouni M, Almubark RA, Althumiri NA, Alqahtani SA. Prevalence and predictors of anxiety among healthcare workers in Saudi Arabia during the COVID-19 pandemic. J Infect Public Health 2020; 13:1645-1651. [PMID: 33032969 PMCID: PMC7535800 DOI: 10.1016/j.jiph.2020.09.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/31/2020] [Accepted: 09/06/2020] [Indexed: 11/19/2022] Open
Abstract
Background During pandemics, healthcare workers (HCWs) may be prone to higher levels of anxiety than those of the general population. This study aimed to explore the anxiety levels among HCWs in Saudi Arabia during the COVID-19 pandemic and the predictors of increased anxiety levels. Method HCW participants in this cross-section study were solicited by email from the database of registered practitioners of the Saudi Commission for Health Specialties between 15 May and 18 May 2020. Sociodemographic characteristics, work-related factors, and organization-related factors were collected. Results Four thousand nine hundred and twenty HCWs (3.4%) responded. Reported levels of anxiety were low anxiety (31.5%; n = 1552), medium (36.1%; n = 1778), and high (32.3%; n = 1590). Participants reporting high anxiety levels were more likely to be unmarried (OR = 1.32, 95% CI: 1.14–1.52); nurses (OR = 1.54, 95% 1.24–1.91); workers in radiology (OR = 1.52, 95% CI: 1.01–2.28); or respiratory therapists (OR = 2.28, 95% CI: 1.14–4.54). Social factors associated with high anxiety levels were: living with a person who is elderly (p = 0.01), has a chronic disease (p < 0.0001), has immune deficiency (p < 0.0001), or has a respiratory disease (p-value <0.0001). Organization-related factors associated with a high level of anxiety were: working in an organization that hosts COVID-19 patients and working with such patients (p-value <0.0001). Conclusion Self-reported medium and high levels of anxiety were present in 68.5% of HCWs in the COVID-19 pandemic. This highlights the urgent need to identify high-risk individuals to offer psychological support and provide up to date information on the pandemic. These data should help policymakers drive initiatives forward to protect and prepare HCWs psychological wellbeing.
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Affiliation(s)
- Thamer H Alenazi
- Ministry of National Guard Health-Affairs, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Nasser F BinDhim
- Sharik Association for Health Research, Riyadh, Saudi Arabia; College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia; Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Meteb H Alenazi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Reem S Almagrabi
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Sameera M Aljohani
- Ministry of National Guard Health-Affairs, Riyadh, Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | | | | - Saleh A Alqahtani
- Liver Transplantation Unit, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Division of Gastroenterology and Hepatology, John Hopkins University, Baltimore, USA
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Ramsewak S, Putteeraj M, Somanah J. Exploring substance use disorders and relapse in Mauritian male addicts. Heliyon 2020; 6:e04731. [PMID: 32904255 PMCID: PMC7452487 DOI: 10.1016/j.heliyon.2020.e04731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/03/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background Substance Use Disorder (SUD) places a heavy burden on societal and health systems given its association with high mortality and morbidity rates worldwide, including Mauritius. Illicit substances act as a positive reinforcement and stimulate addiction through its pleasure-seeking attributes. Aim This study focused on identifying the risk factors leading to SUD among Mauritian male addicts as well as examining the potency of those factors in SUD development. The study also aimed at determining the prevalence of relapse and its causation. Research setting A cross-sectional study was conducted over a period of six months using a sample of 180 male addicts registered in a public hospital. A questionnaire investigating dimensions such as risk factors, self-esteem and peer pressure was administered. Findings A high percentage of relapse was noted amongst users within the first year of abstinence. Majority of respondents originated from nuclear or single parents’ family and were deprived of adequate social supports given their marital status. 57.5% of participants had a positive family history of SUD. Cannabis was the most commonly abused substance and 76.2% of the addicts were introduced to drugs through curiosity. Transposing the results against the Gateway Drug Theory showed a constant progression from soft to hard drugs for male addicts, a trend which was consistent with literature. Lastly, a theoretical model was developed based on the strong statistical association found between impulsivity and reduced thought processes prior to relapse; data revealing increased impulsivity which is a common trait in antisocial personality disorder and borderline personality disorder as being largely responsible for relapse. Conclusion The study was successful in bringing out the most common risk factors of SUDs which are linked to low socioeconomic status. The inability of addicts to progress with their rehabilitation given the alarming 92% of relapse was related to social pressure as prime deterrent to successful remission. Programmes involving relapse prevention must implemented in the first year of abstinence to facilitate rehabilitation.
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Affiliation(s)
- Shalina Ramsewak
- Psychiatry Department, Dr A.G. Jeetoo Hospital, Port-Louis, Mauritius
| | - Manish Putteeraj
- School of Health Sciences, La Tour Koeing, Point aux Sables, 11108, University of Technology, Mauritius
- Corresponding author.
| | - Jhoti Somanah
- School of Health Sciences, La Tour Koeing, Point aux Sables, 11108, University of Technology, Mauritius
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Matos J, Amorim M, Silva S, Nogueira C, Alves E. Prematurity-related knowledge among mothers and fathers of very preterm infants. J Clin Nurs 2020; 29:2886-2896. [PMID: 32497394 DOI: 10.1111/jocn.15361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/06/2020] [Accepted: 05/09/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Empowering parents as health promoters may contribute to decrease the costs associated with prematurity. In Portugal, 8% and 1% of the births occurring in 2018 were preterm and very preterm, respectively. This study aimed to assess prematurity-related knowledge with regard to its prevalence, causes and consequences, according to sociodemographic, obstetric and offspring's characteristics, among mothers and fathers of very preterm infants. METHODS Between May and July 2017, mothers and fathers of very preterm infants were invited to participate through the Portuguese association of parents for support to the premature baby, with 196 parents being included. Knowledge on prematurity (prevalence, causes and consequences) was collected through a structured online questionnaire. Reporting of this research follows STROBE guidelines for cross-sectional studies. RESULTS Parents estimated a median prevalence of preterm and of very preterm delivery in Portugal of 15% and 8%, respectively. However, approximately 20% did not provide an estimate. More than 90% of the participants acknowledged placental complications, hypertensive disorders of pregnancy, multiple pregnancy and intrauterine growth restriction as causes of preterm delivery, whereas only 24.2% identified low socioeconomic status. Cardiac complications and respiratory morbidity were recognised as the main consequences of prematurity by more than 80% of the parents. Overall, parents with a higher socioeconomic status tended to provide correct responses more frequently than those with a low socioeconomic status. CONCLUSIONS The results revealed the existence of knowledge gaps regarding the prevalence, causes and consequences of premature delivery. Understanding the main facilitators and barriers to the achievement of prematurity-related knowledge may contribute for the global improvement of preventing this condition. RELEVANCE TO CLINICAL PRACTICE It is crucial to include the improvement of parents' knowledge about prematurity as a complementary dimension during the provision of medical care, with nurses playing a key role as main sources of information.
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Affiliation(s)
- Joana Matos
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Mariana Amorim
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Susana Silva
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Conceição Nogueira
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences of the University of Porto, Porto, Portugal
| | - Elisabete Alves
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Tohme P, Grey I, Abi-Habib R. The Mental States Task (MST): Correlates and New Perspectives on Mentalizing in a Lebanese Student Sample. J Pers Assess 2020; 103:498-508. [PMID: 32496883 DOI: 10.1080/00223891.2020.1769114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Mentalizing is defined as one's capacity to think in terms of mental states underlying one's own and others' behaviors. It has been posited to develop within the context of a secure attachment relationship and has been linked to a myriad of psychological adjustment variables. Given the scarcity of research on mentalizing in Lebanon, this study aimed to investigate mentalizing in a sample of 293 Lebanese undergraduate students using a novel tool, the Mental State Task (MST). Higher mentalizing scores were found to be positively correlated with self-esteem, neurotic defenses, authenticity and adaptive emotion regulation strategies, as well as negatively correlated with psychological symptomatology. This study also provided descriptions of the six mental states measured by the MST continuum based on their correlations with related constructs. Findings diverge with the literature in relation to the association between defense styles and MST scores, which were posited to reflect cultural specificities of this sample.
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Affiliation(s)
- Pia Tohme
- Department of Social Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Ian Grey
- Department of Social Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Rudy Abi-Habib
- Department of Social Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
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29
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Gaddini A, Riefolo G. "I-ness" and the dissociative process. Working with defensive and creative dissociations in the analytic process. Am J Psychoanal 2020; 80:53-68. [PMID: 32111962 DOI: 10.1057/s11231-020-09240-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We suggest that the analytic dialogue develops as a continuous movement that we call "Dissociative Process", and that this process is the continuous oscillation between defensive positions (repression) and creative positions. Dissociation, as a defense, is a Freudian theoretical stance, while Dissociation, as a possibility for new and creative solutions, is a theory emanating from Janet and was adopted, especially, by relational and inter-subjective psychoanalysis. Through a clinical vignette we suggest how the attitude of an analyst, who is attentive to the Dissociative Process, will respect the Defensive Dissociations of the patient. But, at the same time, the analyst will be particularly careful to support potential solutions, never made real before, that emerge as new associative aggregates (Janet's Reaggrégation psychique) deriving from the dissociation of the frustrating or traumatic experience, which we propose calling "Creative Dissociations". The dissociative solutions (defensive and creative) are not sequential but simultaneous.
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Vogel M, Frenzel L, Riediger C, Haase M, Frommer J, Lohmann CH, Illiger S. The Pain Paradox of Borderline Personality and Total Knee Arthroplasty (TKA): Recruiting Borderline Personality Organization to Predict the One-Year Postoperative Outcome. J Pain Res 2020; 13:49-55. [PMID: 32021394 PMCID: PMC6959492 DOI: 10.2147/jpr.s226433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/24/2019] [Indexed: 11/23/2022] Open
Abstract
Background TKA is a common treatment for arthropathies of the knee; however, its results are compromised by psychosocial equivalents of pain: prior research suggests persistent pain and dysfunction after TKA not only to be linked to psychological symptoms such as depression or anxiety but also to psychodynamic determinants of borderline personality, namely borderline personality organization. Osteoarthritis (OA) and Rheumatoid arthritis (RA), the main indications for TKA, are themselves linked to personality factors and disorders, e.g. borderline. The present study investigates the influence of borderline personality organization (BPO) on the outcomes of TKA one year postoperatively. Methods We studied 144 patients scheduled for primary TKA before and after the operation using the IPO-16 and the WOMAC for the assessment of knee pain and function. Results Non-parametric correlations were found between primitive defenses and knee-pain, not function. Linear regression showed prediction of knee pain and knee function by the preoperative WOMAC scores (p<0.01), whereas there was additional prediction of knee-pain by gender (p=0.03) and primitive defenses (p=0.04). Discussion The results suggest a psychodynamic mechanism of maladaptation after TKA apparently representing the bodily manifestations of fundamental psychic defenses.
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Affiliation(s)
- Matthias Vogel
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
| | - Lydia Frenzel
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
| | - Christian Riediger
- Universitätsklinik für Orthopädie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
| | - Matthias Haase
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
| | - Jörg Frommer
- Universitätsklinik für Psychosomatische Medizin und Psychotherapie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
| | - Christoph H Lohmann
- Universitätsklinik für Orthopädie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
| | - Sebastian Illiger
- Universitätsklinik für Orthopädie der Otto-von-Guericke-Universität Magdeburg, Magdeburg 39120, Germany
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31
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The Mediating Role of Implicit and Explicit Emotion Regulation in the Relationship Between Academic Emotions and Approaches to Learning: Do Defense Styles Matter? J Nerv Ment Dis 2019; 207:683-692. [PMID: 31356408 DOI: 10.1097/nmd.0000000000001027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The present study belongs to a new strand of research in learning in higher education focusing on emotions and emotion regulation, including defense mechanisms. The purpose of the study was to investigate the mediating role of implicit and explicit emotion regulation in the relationship between academic emotions and approaches to learning. Participants were composed of 226 undergraduates (40 males and 186 females studying in a social science department). They completed the following questionnaires: Emotion Regulation Questionnaire, Student Experience of Emotions Inventory, Defense Style Questionnaire, and Approaches to Learning and Studying Inventory. Both the moderating (interaction) and the mediational (indirect) effects were examined using the PROCESS program. Results failed to indicate the moderating role of emotion regulation in the association between academic emotions and approaches to learning. Instead, results revealed the dominant mediating role of emotion regulation and particularly the role of immature defense style in the relationship between negative emotions and approaches to learning. Moreover, reappraisal and suppression seemed to act as mediators in the relationship between positive and negative emotions with deep and surface approaches, respectively. The results of the study are discussed in the context of the recent literature. Implications for higher-education institutions regarding the role of unconscious cognitive processes are also discussed.
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Javanbakht A. A Theory of Everything: Overlapping Neurobiological Mechanisms of Psychotherapies of Fear and Anxiety Related Disorders. Front Behav Neurosci 2019; 12:328. [PMID: 30670956 PMCID: PMC6331393 DOI: 10.3389/fnbeh.2018.00328] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/12/2018] [Indexed: 11/13/2022] Open
Abstract
Similarities within the phenomenology, neurobiology, psychotherapeutic, and pharmacological treatments of distinctly categorized anxiety and fear related disorders suggest the involvement of common neurobiological mechanisms in their formation. This theory of integration is the focus of the Research Domain Criteria (RDoC) approach initiated by the NIH. The current article explores potential facets of overlap among mainstream methods of psychotherapy for anxiety, fear, and trauma related disorders. These overlaps include associative learning of safety, cognitive reappraisal and emotion regulation, therapist as a social safety cue, and contextualization. Temporal contextualization and placing memories in their time and place will be suggested as a potentially important, and less explored aspect of psychotherapy.
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Affiliation(s)
- Arash Javanbakht
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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Abstract
Anger and low self-esteem characterize borderline individuals, yet little is known about their role and impact in the presence or absence of self-injury behavior. The present study aimed to investigate the impact of anger and self-esteem in borderline patients and whether these variables distinguish these patients with and without self-injury. Patients were recruited from a psychiatric service and were evaluated for self-esteem and anger. Additionally, impulsivity and symptoms were assessed. Two groups were compared, one with self-injurious behavior (n = 18) and another one without it (n = 23). Those who injure themselves seem to have a lower self-esteem (p < 0.001), yet the strengthening of self-esteem seems to have different outcomes, according to the presence or absence of self-injury. Anger and self-esteem seem to influence the severity of diagnosis, but only in patients who self-injure. Anger and self-esteem may influence borderline patients differently according to the presence or absence of self-injury.
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Iwanicka K, Gerhant A, Olajossy M. Psychopathological symptoms, defense mechanisms and time perspectives among subjects with alcohol dependence (AD) presenting different patterns of coping with stress. PeerJ 2017; 5:e3576. [PMID: 28791198 PMCID: PMC5546178 DOI: 10.7717/peerj.3576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/23/2017] [Indexed: 12/22/2022] Open
Abstract
Background The problem of coping with stress is an important one in the context of development and persistence of alcohol dependence. In the literature to date very little attention has been paid to coping patterns construed as a configuration of specific coping styles, particularly as regards the functioning of addicted individuals. The aim of the study was to verify whether individuals with alcohol dependence characterized by different coping patterns differ with respect to the severity of psychopathological symptoms, defense mechanisms and time perspectives. Methods Participants were given a battery of psychological tests—Coping Inventory for Stresfull Situations (CISS), Defense Style Questionnaire (DSQ 40), Syndrom Checklist (SCL-90) and Short Zimbardo Time Perspective Inventory (SZPTI-PL). The sample comprised 112 individuals with alcohol dependence, aged 20 to 63 years old, the average age was 37.86; 78 percent were men. There were identified three sub-groups of individuals characterized by a distinctive patterns of coping with stress —“emotional-avoidant”, “task oriented” and a “mixed one”. Results Individuals with the predominant emotional-avoidant coping pattern are characterized by significantly higher severity of psychopathological symptoms, less mature defense mechanisms and past time perspectives. Subjects reliant on task-oriented coping pattern were characterized by the highest level of adaptation and the most constructive way of functioning in the face of difficulties. Conclusion It is worth regarding the examination of patterns of coping as an indispensable element of collecting medical history from alcohol dependent individuals.
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Affiliation(s)
| | - Aneta Gerhant
- Department of Psychiatry, Medical Academy in Lublin, Lublin, Poland
| | - Marcin Olajossy
- Department of Psychiatry, Medical Academy in Lublin, Lublin, Poland
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Liu H, Li X, Han B, Liu X. Effects of cognitive bias modification on social anxiety: A meta-analysis. PLoS One 2017; 12:e0175107. [PMID: 28384301 PMCID: PMC5383070 DOI: 10.1371/journal.pone.0175107] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 03/21/2017] [Indexed: 12/14/2022] Open
Abstract
Background Cognitive bias modification (CBM), a set of techniques for modifying bias in information processing—is considered a novel intervention for social anxiety disorder (SAD), which has drawn considerable interest from researchers. However, the effects of CBM on SAD are not consistent. Some studies have demonstrated significant positive effects compared to control groups, while others have found no such effects. Aims We conducted a meta-analysis aimed at quantitatively assessing the effects of CBM on SAD at post-test. Method Through a systematic literature search by two independent raters, 34 articles (36 randomized studies) including 2,550 participants were identified. A multilevel modeling approach was employed to assess the effects of CBM on SAD, and to explore the potentially crucial procedures and sample characteristics that enhance the effectiveness of benign training. Results In general, there were small but significant effects of CBM on the primary symptoms of SAD (g = 0.17), cognitive bias (CB) toward threat (g = 0.32), and reactivity in stressful situations (g = 0.25), but non-significant effects on secondary symptoms. However, the interpretation modification program was more effective than was attentional bias modification in reducing SAD primary symptoms and negative CB. Laboratory training procedures produced larger primary symptom reductions compared to Internet-based training, whereas the percentage of contingency and feedback about training performance boosted cognitive effects only. Finally, the following groups were more likely to benefit from CBM: younger participants (primary symptoms and cognitive effects), women (primary symptom effects), and samples with stronger CB (stressor effects). The quality of the randomized controlled trials was less than desirable, as there was some indication of publication bias in our study. Conclusions Current findings broadly supported cognitive theories of SAD that consider a bidirectional or mutually reinforcing relationship between symptoms and CBs. However, the small therapeutic effect observed here indicates that it is necessary to develop more reliable and efficient CBM interventions that are specific to SAD.
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Affiliation(s)
- Haining Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Psychology Department of Chengde Medical University, Chengde, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xianwen Li
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Buxin Han
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- * E-mail:
| | - Xiaoqian Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
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