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Fiorentino F, Lo Buglio G, Morelli M, Chirumbolo A, Di Giuseppe M, Lingiardi V, Tanzilli A. Defensive functioning in individuals with depressive disorders: A systematic review and meta-analysis. J Affect Disord 2024; 357:42-50. [PMID: 38663554 DOI: 10.1016/j.jad.2024.04.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND This systematic review and meta-analysis aimed to address the limited generalizability of studies on defense mechanisms in depression by comparing depressive individuals with non-clinical controls (aim a) and examining changes throughout psychological interventions (aim b) (PROSPERO CRD42023442620). METHODS We followed PRISMA 2020 guidelines, searching PubMed/Web of Science/(EBSCO)PsycINFO until 13/04/2023 for studies evaluating defense mechanisms with measures based on the hierarchical model in depressive patients versus non-clinical controls or throughout psychological intervention. We conducted random-effect meta-analyses for mature defenses/non-mature (neurotic/immature) defenses/overall defensive functioning (ODF), with standardized mean difference (SMD) as outcome measure metric. Meta-regression/sub-group/sensitivity analyses were conducted. Study quality was appraised using the Newcastle-Ottawa Scale (NOS), and certainty of evidence for aim b outcomes was evaluated using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). RESULTS 18 studies were included (mean NOS score = 5.56). Depressive patients used significantly more non-mature defenses than non-clinical controls (SMD = 0.74; k = 13). Non-clinical controls did not significantly differ in use of mature defenses compared to depressive patients (SMD = 0.33; k = 14). Significant moderators were publication year/NOS score/geographical distribution/mean age for non-mature defenses and NOS score/geographical distribution for mature defenses. Throughout psychological interventions, only ODF significantly increased (SMD = 0.55; k = 2) (GRADE = very low). LIMITATIONS Quality of many studies was medium/sub-optimal, and longitudinal studies were scarce. CONCLUSION Individuals with depressive disorders show a high use of non-mature defenses that could be assessed and targeted in psychological interventions, especially in younger patients.
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Affiliation(s)
- Flavia Fiorentino
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Gabriele Lo Buglio
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Mara Morelli
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | | | | | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
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Porto Tabeleão V, Coelho Scholl C, Pereira Kammer K, Bonati de Matos M, Puchalski Trettim J, Stark Stigger R, Jacondino Pires A, de Avila Quevedo L. Change in Defense Mechanisms During a Brief Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder. J Nerv Ment Dis 2024; 212:347-351. [PMID: 38810098 DOI: 10.1097/nmd.0000000000001770] [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: 05/31/2024]
Abstract
ABSTRACT Defense mechanisms (DMs) are strategies used by the individuals to protect the ego. Therefore, compulsive behaviors in obsessive-compulsive disorder (OCD) can be recognized as DMs. We analyzed how DMs changed in a brief cognitive behavioral therapy (CBT) for OCD. This was a quasi-experimental study with 92 OCD patients (aged 18-60 years). We used the Mini International Neuropsychiatric Interview to confirm OCD diagnosis, and we assessed the DMs with the Defense Style Questionnaire at three time points. Through a latent change score modeling, we found that the mature mechanism presented a constant change during the therapy. This mechanism increased in average 0.37 points at each measured moment of CBT, showing a linear trajectory. Neurotic and immature mechanisms showed no significant changes during therapy. The increased use of the mature mechanism can be an indicator of improvement in OCD treatment, showing that patients intensified their more adaptive responses to conflicts.
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Ma D, Cao J, Wei J, Jiang J. Immature defense mechanisms mediate the relationship between negative life events and depressive symptoms. Front Psychiatry 2024; 14:1341288. [PMID: 38274424 PMCID: PMC10808586 DOI: 10.3389/fpsyt.2023.1341288] [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: 11/20/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Objective This study aimed to analyze the patterns of life events (LEs) and defense mechanisms in outpatients with depression and investigate the mediating role of defense mechanisms in the association between LEs and depressive symptoms in a psychosomatic outpatient sample in China. Materials and methods All of 2,747 outpatients (aged 18-65) from psychosomatic department were investigated in this study. LEs, depressive symptoms, and defense mechanisms were assessed by the Life Events Scale (LES), Patient-Health-Questionnaire-9 (PHQ-9), and the Defense Style Questionnaire (DSQ), respectively. Results Based on the optimal cut-off point of PHQ-9, 1840 (67.0%) patients had a PHQ-9 score of 10 or higher (depression group), and 907 (33.0%) had a score below 10 (non-depression group). The scores of Negative Life Events (NLEs), immature and intermediate defense mechanisms in the depression group were significantly higher than those in the non-depression group, while the scores of mature defense mechanisms were the opposite (p < 0.001). NLEs was directly related to depressive symptoms (b = 0.010, p < 0.001), and significant indirect effect via immature defense mechanisms (b = 0.008, p < 0.001) was observed. Conclusion Immature defense mechanisms play an important mediating role in the relationship between NLEs and depressive symptoms. Helping patients improving defense mechanisms and dealing with NLEs may be of great help in the treatment of relevant patients.
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Affiliation(s)
| | - Jinya Cao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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da Silva Machado R, Vieira IS, Scaini C, Molina ML, Barbosa LP, da Silva GDG, Ores L, de Mattos Souza LD, Jansen K, da Silva RA. Ego-defense mechanisms and brief psychotherapies for the management of major depressive disorder in adults: A longitudinal and quasi-experimental study. J Affect Disord 2023; 330:291-299. [PMID: 36871912 DOI: 10.1016/j.jad.2023.02.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To evaluate the effect of psychotherapies on ego defense mechanisms and the reduction of depressive symptoms in a 12-month follow-up period. METHODS This longitudinal and quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. Two models of psychotherapy were used: Supportive Expressive Dynamic Psychotherapy (SEDP) and Cognitive Behavioral Therapy (CBT). Defense Style Questionnaire 40 was used to analyze defense mechanisms and the Beck Depression Inventory was used to measure the depressive symptoms. RESULTS The total sample comprised 195 patients (113 SEDP and 82 CBT), with the mean age was 35.63 (11.44) years. After adjustments, increased mature defenses was significantly associated with reduced depressive symptoms at all follow-up times (p < 0.001) and the decrease in immature defenses was significantly associated with the reduction of depressive symptoms at all follow-up times (p < 0.001). While neurotic defenses were not associated with a reduction in depressive symptoms at any time of follow-up (p > 0.05). CONCLUSION Both models of psychotherapy were effective in increasing mature defenses and decreasing immature ones, as well as decreasing depressive symptoms at all evaluation times. With this, it is understood that a greater understanding of these interactions will allow a more adequate diagnostic and prognostic evaluation and the design of useful strategies that adapt to the patient's reality.
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Affiliation(s)
- Rosiene da Silva Machado
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | - Igor Soares Vieira
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil; Centro Universitário Estácio de Sergipe, SE, Brazil
| | - Carolina Scaini
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | - Mariane Lopez Molina
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil; Faculdade Anhanguera do Rio Grande, RS, Brazil
| | - Luana Porto Barbosa
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | - Giovana Del Grande da Silva
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | | | - Luciano Dias de Mattos Souza
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | - Karen Jansen
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brazil.
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Peng B, Liao J, Li Y, Jia G, Yang J, Wu Z, Zhang J, Yang Y, Luo X, Wang Y, Zhang Y, Pan J. Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder. Front Psychol 2023; 14:989711. [PMID: 36777206 PMCID: PMC9909038 DOI: 10.3389/fpsyg.2023.989711] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is commonly seen in adolescents with depression and is a high-risk factor leading to suicide. The psychological mechanisms underlying depression with NSSI are still unclear. The purpose of this study was to explore the differences in personality traits, defensive styles, and borderline symptoms among first-episode youth patients with depression and self-injury compared with patients with depression without self-injury and healthy populations. Methods The current study recruited 188 participants, including 64 patients with depression and NSSI, 60 patients with depression without NSSI, and 64 healthy control subjects. Eysenck Personality Questionnaire, the Defense Style Questionnaire, the short version of the Borderline Symptom List, the Beck Depression Inventory, and the Ottawa Self-Injury Inventory were used to assess all participants. Results Patients with depression and NSSI showed more psychoticism than patients with depression without NSSI and healthy control subjects. Patients with depression and NSSI presented more intermediate defense styles than healthy control subjects. In the patients with depression and NSSI group, the frequency of self-injury in the last week was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. Further regression analysis showed that EPQ-psychoticism and depressive symptoms were independent risk factors for NSSI in patients with depression. Conclusion This study found that patients with depression and self-injury presented more neuroticism, introversion, EPQ-psychoticism, immature defenses, intermediate defenses, and borderline symptoms. Self-injury frequency was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. EPQ-Psychoticism and depressive symptoms are risk factors for predicting non-suicidal self-injury in patients with depression.
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Affiliation(s)
- Bo Peng
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China,Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China,Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Jiwu Liao
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Yang Li
- Teachers College, Columbia University, New York, NY, United States
| | - Guangbo Jia
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Jihui Yang
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Zhiwei Wu
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Jian Zhang
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Yingjia Yang
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Xinxin Luo
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Yao Wang
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China,Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Yingli Zhang
- Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China,Shenzhen Mental Health Center, Shenzhen, Guangdong, China,*Correspondence: Yingli Zhang, ✉
| | - Jiyang Pan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China,Jiyang Pan, ✉
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BİLGE Y, KARAMUSTAFALIOĞLU N, KANLISU N, ÖZDEMİR A. Examination of the Role of Defense Mechanisms and Attachment Styles in Personality Disorder Beliefs among Nonclinical and Clinical Samples. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1052998] [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
Attachment styles, defense mechanisms, and the underlying personality disorders’ personality beliefs are considered to be closely related to psychopathology. The aim of this study is to compare the scores of attachment styles, defense mechanisms, and personality beliefs variables in a non-clinical group and a clinical group diagnosed with depression, obsessive-compulsive, and anxiety disorder and to examine the relationships between these variables. A total of 178 participated in the study, 59 of which were in the clinical group and 119 in the nonclinical group. The Personality Belief Questionnaire-Short Form (PBQ-SF), The Defense Style Questionnaire-40 (DSQ-40), and Relationship Scales Questionnaire (RSQ) were applied to the participants. Avoidant, dependent, passive-aggressive, obsessive-compulsive (OC), antisocial, schizoid, paranoid, and borderline personality belief scores were found to be higher in the clinical group, while mature defense scores were significantly higher in the nonclinical group. On the other hand, there was no difference between the two groups in terms of attachment styles. According to multiple linear regression analysis results, attachment styles and defense mechanisms predicted personality disorder beliefs in the range of 19.5% to 33.5% for the clinical group and 22.7% to 46.9% for the nonclinical group. In conclusion, the findings suggest that attachment styles and defense mechanisms may contribute to the understanding of the etiological causes of personality disorders and may be helpful in the treatment of personality disorders.
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Affiliation(s)
| | - Nesrin KARAMUSTAFALIOĞLU
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAKIRKÖY PROF.DR. MAZHAR OSMAN RUH SAĞLIĞI VE SİNİR HASTALIKLARI SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
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Loscalzo Y, Giannini M. Heavy Study Investment: An Analysis of the Defense Mechanisms Characterizing Studyholism and Study Engagement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159413. [PMID: 35954769 PMCID: PMC9368415 DOI: 10.3390/ijerph19159413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/14/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022]
Abstract
Defense mechanisms are unconscious processes that protect a person from excessive anxiety. They are part of everyday functioning, and mature defenses are associated with positive outcomes. However, the excessive use of defenses or the use of immature defenses is associated with psychopathology. The present study aims to analyze the defense mechanisms that characterize two types of heavy study investment: Studyholism and Study Engagement. We performed a path analysis, MANOVAs, and binary logistic regressions on 422 Italian college students (Mage = 22.56 ± 2.87; 63.5% females). Among the main findings, the strongest (and positive) predictor of Studyholism is regression (maladaptive defense), while for Study Engagement, it is task-orientation (adaptive defense). Hence, Studyholism might be defined as a new potential clinical condition. Additionally, a critical analysis of all the defense mechanisms predicting Studyholism supports the appropriateness of the OCD-related framework for conceptualizing Studyholism. Regarding Study Engagement, even if generally associated with a positive defense style, the finding that it is positively predicted by projection confirms previous studies suggesting that, for some students, it might constitute a coping strategy with paranoid symptoms (and social anxiety and anxiety). Hence, we recommend screening engaged students for social impairment and clinically relevant symptoms that might be hidden by hard studying.
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Beresford T, Teschke PU, Hipp D, Ronan PJ. Psychological Adaptive Mechanism Maturity, Age, and Depression Symptoms in Advanced-Stage Cancer Patients. Front Psychol 2021; 12:718476. [PMID: 34764906 PMCID: PMC8575870 DOI: 10.3389/fpsyg.2021.718476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Previously, we reported that the maturity of Psychological Adaptive Mechanism (PAM; alternatively, ego defense mechanism) endorsement, but not depression symptom severity, predicted 5-year survival rates in adult cancer patients and that study controlled for age as a significant variable. In this investigation, we hypothesized that greater PAM maturity would correlate significantly with age and with fewer depression symptoms in a larger sample. Methods: In this cross-section study, adult cancer outpatients (N=293) completed the Defense Style Questionnaire (DSQ), the Beck Depression Inventory (BDI), and provided additional clinical data. Spearman’s correlation and multiple regression modeling provided statistical tests of the study hypotheses. Results: Contrary to our hypothesis, DSQ PAM maturity endorsement did not correlate significantly with increasing age. Greater PAM maturity ratio on the DSQ (p<0.0001) and current antidepressant use (p<0.05), however, both provided inverse associations with total BDI symptom frequency (p<0.01). Age was inversely associated with BDI mood (p<0.0001) and somatic scores (p<0.04). Items that worsened BDI symptom frequency included self-reported mood-altering anti-cancer medications and any psychiatric history. Cancer stage, time since diagnosis, and chemotherapy treatment did not correlate with DSQ or BDI scores. Multiple regression analysis found that the correlated items accounted for 17.2% of the variance in mood symptoms and 4.9% in somatic symptoms. Specifically, adaptive maturity and age associated with fewer depression symptoms, while cancer medications affecting mood, and a previous psychiatric history each predicted higher frequency of depression scores. Conclusion: The results suggest that PAM maturity likely predicts fewer depression symptoms while younger age associates with more depression symptoms in this clinical sample. Centrally, acting cancer medications, such as glucocorticoids, and any history of psychiatric disorder correlated with increased depression symptom frequencies. In this cross-section study, antidepressant medications indicated higher frequencies of depressive symptoms, likely reflecting their use in persons previously diagnosed with depression. Further research should target factors that improve PAM maturity as a potential treatment target, especially in younger age groups.
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Affiliation(s)
- Thomas Beresford
- School of Medicine, University of Colorado, Aurora, CO, United States.,Rocky Mountain Regional VA Medical Center, VA Eastern Colorado Health Care System, Aurora, CO, United States
| | | | - Daniel Hipp
- Rocky Mountain Regional VA Medical Center, VA Eastern Colorado Health Care System, Aurora, CO, United States
| | - Patrick J Ronan
- Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States.,VA Medical Center-Sioux Falls, Sioux Falls, SD, United States
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Taurino A, Antonucci LA, Taurisano P, Laera D. Investigating defensive functioning and alexithymia in substance use disorder patients. BMC Psychiatry 2021; 21:337. [PMID: 34229633 PMCID: PMC8259003 DOI: 10.1186/s12888-021-03340-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance Use Disorder (SUD) causes a great deal of personal suffering for patients. Recent evidence highlights how defenses and emotion regulation may play a crucial part in the onset and development of this disorder. The aim of this study was to investigate potential differences in the defensive functioning between SUD patients and non-clinical controls. Secondly, we aimed at investigating the relationships between alexithymia and maladaptive/assimilation defenses. METHODS The authors assessed defensive functioning (Response Evaluation Measure-71, REM-71), personality (MMPI-II), and alexithymia (TAS-20) of 171 SUD patients (17% female; mean age = 36.5), compared to 155 controls. Authors performed a series of ANOVAs to investigate the defensive array in SUD patients compared to that of non-clinical controls. Student t test for indipendent samples was used to compare clinical characteristics between the SUD group and the controls. To investigate the role of single defenses in explaining alexithimia's subscores, stepwise multiple regression analysis were carried out on socio-demographic characteristics of participants (gender, age, and years of education), with REM-71 defenses as predictors. RESULTS SUD patients presented a more maladaptive/assimilation (Factor 1) defensive array (p < .001). Among SUD sub-groups, Alcohol Use Disorder patients showed more disfuncional defenses. Factor 1 defenses were related to a worse psychological functioning. In addition, alexyhimia (particularly DIF) was strongly related to Factor 1 defenses, expecially Projection (38% of variance explained, β = .270, p < .001). CONCLUSION The REM-71 and the TAS-20 might be useful screening instruments among SUD patients.
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Affiliation(s)
- Alessandro Taurino
- Department of Education, Psychology, Communication, University of Bari, Palazzo Chiaia-Napolitano, Via Scipione Crisanzio 42, 70122, Bari, Italy
| | - Linda A Antonucci
- Department of Education, Psychology, Communication, University of Bari, Palazzo Chiaia-Napolitano, Via Scipione Crisanzio 42, 70122, Bari, Italy
| | - Paolo Taurisano
- Section of Clinical Psychology and Neuropsychology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Domenico Laera
- Department of Education, Psychology, Communication, University of Bari, Palazzo Chiaia-Napolitano, Via Scipione Crisanzio 42, 70122, Bari, Italy.
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Kandaraki A, Vousoura E, Argyropoulos S, Ginieri-Coccossis M, Papadimitriou GN, Papageorgiou C, Zervas IM. Psychological Differences Between Greek Artists With and Without History of Major Psychopathology. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2021. [DOI: 10.1080/15401383.2020.1757005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anna Kandaraki
- Athens University Medical School, Eginition Hospital, Athens, Greece
| | - Eleni Vousoura
- Athens University Medical School, Eginition Hospital, Athens, Greece
| | | | | | | | | | - Iannis M. Zervas
- Athens University Medical School, Eginition Hospital, Athens, Greece
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Mostowik J, Mielimąka M, Rutkowski K, Ostrowski T. Time in the Mental Health Context: Neurotic Symptomatology, Defense Mechanisms and the Perception of Time Perspective Among Patients Diagnosed With Neurotic and Personality Disorders - A Clinical Study. Psychol Rep 2020; 125:232-255. [PMID: 33349168 DOI: 10.1177/0033294120978164] [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: 11/17/2022]
Abstract
AIM The main objective of the study is to explore relations between the time perspective, neurotic symptoms, anxiety, and defense mechanisms in the group of patients diagnosed with neurotic and personality disorders (ICD-10 groups: F4x, F60.x and F61) treated with group psychotherapy. The research is conducted on the theoretical basis of the Zimbardo and Boyd's Time Perspective Theory. METHODS The study included 49 patients treated in the day ward for the Treatment of Neurotic Disorders and Behavioral Syndromes at the University Hospital. The measurement of the TP was performed with the Zimbardo Time Perspective Inventory. Patients also completed the State-Trait Anxiety Inventory and the Defense Style Questionnaire 40. The diagnosis was done by licensed psychiatrists and supported with the measures: Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006. RESULTS Multiple regression analysis models showed that the four time perspectives (past negative, present fatalistic, present hedonistic, and future) are predicted in different variations by the level of anxiety state or trait and repertoire of used defense mechanisms (immature or mature). CONCLUSIONS Considering the established bilateral correlations, change in the time perspective may constitute an important factor in the reduction of neurotic symptoms, possibly through changes in the repertoire of utilized defense mechanisms. However, there is also possible that altering neurotic symptomatology would alter time perspective. The assessment of the time perspective in patients with neurotic and personality disorders may provide useful data for the diagnosis and the monitoring of psychotherapy effectiveness. Based on the results of this study conducting further research on the role of the changes in the time perspective in the course of psychotherapy is recommended and necessary to expand the understanding of the relations observed in this study.
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Affiliation(s)
- Joanna Mostowik
- Institute of Applied Psychology, Jagiellonian University, Krakow, Poland; Department of Psychotherapy, University Hospital in Krakow, Krakow, Poland
| | | | - Krzysztof Rutkowski
- Department of Psychotherapy, Jagiellonian University Medical College, Krakow, Poland
| | - Tadeusz Ostrowski
- Faculty of Psychology and Humanities, Andrzej Frycz-Modrzewski Cracow University, Krakow, Poland
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Prout TA, Zilcha-Mano S, Aafjes-van Doorn K, Békés V, Christman-Cohen I, Whistler K, Kui T, Di Giuseppe M. Identifying Predictors of Psychological Distress During COVID-19: A Machine Learning Approach. Front Psychol 2020; 11:586202. [PMID: 33240178 PMCID: PMC7682196 DOI: 10.3389/fpsyg.2020.586202] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/15/2020] [Indexed: 12/29/2022] Open
Abstract
Scientific understanding about the psychological impact of the COVID-19 global pandemic is in its nascent stage. Prior research suggests that demographic factors, such as gender and age, are associated with greater distress during a global health crisis. Less is known about how emotion regulation impacts levels of distress during a pandemic. The present study aimed to identify predictors of psychological distress during the COVID-19 pandemic. Participants (N = 2,787) provided demographics, history of adverse childhood experiences, current coping strategies (use of implicit and explicit emotion regulation), and current psychological distress. The overall prevalence of clinical levels of anxiety, depression, and post-traumatic stress was higher than the prevalence outside a pandemic and was higher than rates reported among healthcare workers and survivors of severe acute respiratory syndrome. Younger participants (<45 years), women, and non-binary individuals reported higher prevalence of symptoms across all measures of distress. A random forest machine learning algorithm was used to identify the strongest predictors of distress. Regression trees were developed to identify individuals at greater risk for anxiety, depression, and post-traumatic stress. Somatization and less reliance on adaptive defense mechanisms were associated with greater distress. These findings highlight the importance of assessing individuals' physical experiences of psychological distress and emotion regulation strategies to help mental health providers tailor assessments and treatment during a global health crisis.
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Affiliation(s)
- Tracy A. Prout
- School-Clinical Child Psychology Program, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | | | - Katie Aafjes-van Doorn
- Clinical Psychology Program, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Vera Békés
- Clinical Psychology Program, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Isabelle Christman-Cohen
- School-Clinical Child Psychology Program, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Kathryn Whistler
- School-Clinical Child Psychology Program, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Thomas Kui
- School-Clinical Child Psychology Program, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology and of Critical Care Medicine, University of Pisa, Pisa, Italy
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Pawlaczyk M, Siembida J, Balaj K, Rajewska-Rager A. The assessment of stress level, anxiety, depressive symptoms, and defense mechanisms among Polish and English medical students. Ann Gen Psychiatry 2020; 19:29. [PMID: 32391067 PMCID: PMC7196228 DOI: 10.1186/s12991-020-00274-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/26/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Medical education is proven to be associated with a high degree of psychological stress. Different coping strategies used by students have been investigated on their efficacy. So far, studies on medical students have been limited to a single population. AIM OF THE STUDY Our study aimed to identify differences in the prevalence of depressive symptoms, anxiety, stress levels, and defense mechanisms among two groups of medical students, the Polish and English-speaking divisions. MATERIALS AND METHODS The study included two groups of first-year medical students, the Polish and English-speaking divisions, comprising 305 participants (n = 204 Polish, n = 101 English, men = 127, women = 176). It was divided into two periods: the students received author questionnaires during an exam-free academic period and then completed the same questionnaires during an exam session. The survey contained questions pertaining to demographics and studying habits among participants and included the Defense Style Questionnaire and Depression Anxiety Stress Scales. Data were analyzed using STATISTICA version 12.0, and p ≤ 0.05 was considered significant. RESULTS Polish medical students presented with significantly increased overall stress levels (p = 0.007858) and depressive symptoms (p = 0.030420) compared to the English division students. Polish students also presented with more symptoms of stress, depression, and anxiety during the exam period compared to the exam-free period (p = 0.000625), which did not apply to the English-speaking students. The English division students reached higher scores in the mature defense mechanisms section than the Polish students (p = 0.000001). The use of mature defense mechanisms correlated negatively with the intensity of stress, anxiety, and depressive symptoms in both groups, while immature defense mechanisms promoted higher values of those variables (p = 0.000001). CONCLUSIONS Our study showed significant and multidirectional differences between medical students of the Polish and English divisions attending the same university. Such results could suggest that strategies aimed at reducing depressive symptoms among medical students ought to be adapted towards the needs of a specific population.
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Affiliation(s)
- M Pawlaczyk
- 1Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Siembida
- 2Psychiatry Students Scientific Group, Poznan University of Medical Sciences, Poznan, Poland
| | - K Balaj
- 2Psychiatry Students Scientific Group, Poznan University of Medical Sciences, Poznan, Poland
| | - A Rajewska-Rager
- 1Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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Investigating the Impact of Past Trauma and Defense Styles on Posttraumatic Stress Following Homicide and Psychiatric Co-morbidity. Psychiatr Q 2018; 89:439-449. [PMID: 29086239 DOI: 10.1007/s11126-017-9546-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To examine the prevalence of PTSD following homicide and investigate the relationship between PTSD from past traumas, defense styles and PTSD following homicide and psychiatric co-morbidity. 167 male homicide perpetrators participated in the study and completed the Posttraumatic Stress Diagnostic Scale, the General Health Questionnaire-28 and the Defense Styles Questionnaire. 45% met the criteria for PTSD following homicide and 55% for no-PTSD. With the number of times for imprisonment adjusted, regression analyses showed that immature defense style was associated with PTSD following homicide with the severity of PTSD from past traumas as a moderator. Neurotic and immature defense styles and PTSD from past trauma were significantly and independently associated with psychiatric co-morbidity. Homicide perpetrators could develop PTSD following homicide. The severity of PTSD from past traumas could affect PTSD following homicide and other psychological problems, and influence the effect of using immature defense against PTSD from homicide. Past trauma, immature and neurotic defense styles had a unique and specific pattern of influence on psychological symptoms, other than trauma symptoms.
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Boerner M, Joseph S, Murphy D. Reports of Post-Traumatic Growth and Well-Being: Moderating Effect of Defense Style. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.1521/jscp.2017.36.9.723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bartczak M, Bokus B. Semantic Distances in Depression: Relations Between ME and PAST, FUTURE, JOY, SADNESS, HAPPINESS. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2017; 46:345-366. [PMID: 27339227 PMCID: PMC5368207 DOI: 10.1007/s10936-016-9442-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Using the Semantic Distance Task, we investigated the semantic distances between ME and five metaphorically conceptualized notions: PAST, FUTURE, JOY, SADNESS, and HAPPINESS. Three Polish-speaking groups participated in the study: depressive subjects ([Formula: see text]), patients in remission ([Formula: see text]), and non-depressed individuals ([Formula: see text]). T-test and the Kruskal-Wallis nonparametric equivalent of ANOVA analyses showed that subjects in remission placed ME significantly farther away from PAST than non-depressed individuals and depressed patients. Data mining algorithms indicated the distances ME-SADNESS, ME-PAST, and ME-FUTURE as the three strongest predictors of group membership. We interpret the findings in the light of a contrast effect and defense mechanisms. We propose that intergroup differences are especially prominent in tasks requiring creation of semantic associative relations, that is, in the first stage of conceptual processing. We suggest treating the results as confirmation that Beck's theory of depression applies at the level of notion comprehension, proving that processing of key concepts in depression symptoms (particularly PAST) runs differently in all three groups under consideration.
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Affiliation(s)
- Marlena Bartczak
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
| | - Barbara Bokus
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland
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Abstract
Our study was intended to test whether there are any differences in the way defense mechanisms are used by patients suffering from pure anxiety and those with pure depressive disorders. The sample size was as follows: depressive disorders without psychotic symptoms 30, anxiety disorders 30, and the healthy control group 30. The assessment of defense mechanisms was made using the DSQ-40 questionnaire. Our findings show that "pure" anxiety disorders differ from "pure" depressive disorders only in the use of immature defense mechanisms. The group with depressive disorders was significantly more prone to use immature defense mechanisms than the group with anxiety disorders (p = 0.005), primarily projection (p = 0.001) and devaluation (p = 0.003). These defense mechanisms may therefore be used both to differentiate between anxiety and depressive disorders and also to determine which symptoms (anxiety or depressive disorders) are dominant at any given stage of treatment.
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Abstract
Our study examines whether defense styles and separate defenses in depressed adolescent outpatients predict adult personality disorders (PDs). We obtained data from consecutive adolescent outpatients who participated in the Adolescent Depression Study at baseline and at the 8-year follow-up (N = 140). Defense styles were divided into mature, neurotic, image-distorting, and immature and a secondary set of analyses were made with separate defenses as predictors of a PD diagnosis. Neurotic, image-distorting, and immature defense styles in adolescence were associated with adulthood PDs. Neurotic defense style associated with cluster B diagnosis and image-distorting defense style associated with cluster A diagnosis. Separate defenses of displacement, isolation, and reaction formation were independent predictors of adult PD diagnosis even after adjusting for PD diagnosis in adolescence. Defense styles and separate defenses predict later PDs and could be used in the focusing of treatment interventions for adolescents.
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Waqas A, Rehman A, Malik A, Muhammad U, Khan S, Mahmood N. Association of Ego Defense Mechanisms with Academic Performance, Anxiety and Depression in Medical Students: A Mixed Methods Study. Cureus 2015; 7:e337. [PMID: 26543695 PMCID: PMC4627837 DOI: 10.7759/cureus.337] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 09/30/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Ego defense mechanisms are unconscious psychological processes that help an individual to prevent anxiety when exposed to a stressful situation. These mechanisms are important in psychiatric practice to assess an individual's personality dynamics, psychopathologies, and modes of coping with stressful situations, and hence, to design appropriate individualized treatment. Our study delineates the relationship of ego defense mechanisms with anxiety, depression, and academic performance of Pakistani medical students. METHODS This cross-sectional study was done at CMH Lahore Medical College and Fatima Memorial Hospital Medical and Dental College, both in Lahore, Pakistan, from December 1, 2014 to January 15, 2015. Convenience sampling was used and only students who agreed to take part in this study were included. The questionnaire consisted of three sections: 1) Demographics, documenting demographic data and academic scores on participants' most recent exams; 2) Hospital Anxiety and Depression Scale (HADS); and 3) Defense Style Questionnaire-40 (DSQ-40). The data were analyzed with SPSS v. 20. Mean scores and frequencies were calculated for demographic variables and ego defense mechanisms. Bivariate correlations, one-way ANOVA, and multiple linear regression were used to identify associations between academic scores, demographics, ego defense mechanisms, anxiety, and depression. RESULTS A total of 409 medical students participated, of whom 286 (70%) were females and 123 (30%) were males. Mean percentage score on the most recent exams was 75.6% in medical students. Bivariate correlation revealed a direct association between mature and neurotic ego defense mechanisms and academic performance, and an indirect association between immature mechanisms and academic performance. One-way ANOVA showed that moderate levels of anxiety (P < .05) and low levels of depression (P < .05) were associated with higher academic performance. CONCLUSION There was a significant association between academic performance and ego defense mechanisms, anxiety, and depression levels in our sample of Pakistani medical students.
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Affiliation(s)
- Ahmed Waqas
- Final year MBBS Student, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
| | - Abdul Rehman
- Medical Student, Allama Iqbal Medical College, Lahore, Pakistan
| | - Aamenah Malik
- Department of Biochemistry, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
| | - Umer Muhammad
- Department of Psychiatry, Combined Military Hospital, Lahore, Pakistan
| | - Sarah Khan
- Department of Biochemistry, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
| | - Nadia Mahmood
- Department of Pathology, CMH Lahore Medical College and Institute of Dentistry, Shami Road, Lahore Cantt
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Abstract
Somatization is the experience and expression of psychological distress through bodily symptoms. Somatization can be conceptualized as an emotional state that has not been represented symbolically or as a defense against intolerable emotions and fantasies. Bodily concerns can also function as a means of seeking responsiveness from others. Alexithymia refers to a difficulty identifying and symbolizing emotional states that has been found to be associated with somatization. When functioning as a defense, a focus on the body can be used to avoid frightening or intolerable feelings and fantasies, or to ward off aggressive fantasies by viewing oneself as physically damaged. Systematic studies have demonstrated the presence of the defense of somatization in mood disorders, particularly anxiety and panic disorders. In treating anxiety disorders, the therapist helps the patient to determine the nature of emotions and fantasies that the patient is defending against, particularly fears and conflicts surrounding anger and separation.
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Immature psychological defense mechanisms are associated with women's greater desire for and actual engaging in masturbation. SEXUAL AND RELATIONSHIP THERAPY 2013. [DOI: 10.1080/14681994.2013.810810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Halim MA, Sabri F. Relationship Between Defense Mechanisms and Coping Styles Among Relapsing Addicts. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.sbspro.2013.07.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Brody S, Costa RM, Hess U. Sometimes a Bear is Just a Bear: No Evidence of Nonclinical Adult Toy Animal Ownership Indicating Emotion Dysregulation. JOURNAL OF ADULT DEVELOPMENT 2012. [DOI: 10.1007/s10804-012-9149-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Defense Mechanisms in Mania, Bipolar Depression and Unipolar Depression. PSYCHOLOGICAL STUDIES 2010. [DOI: 10.1007/s12646-010-0017-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Brody S, Houde S, Hess U. Greater Tactile Sensitivity and Less Use of Immature Psychological Defense Mechanisms Predict Women's Penile-Vaginal Intercourse Orgasm. J Sex Med 2010; 7:3057-65. [DOI: 10.1111/j.1743-6109.2010.01917.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Calati R, Oasi O, De Ronchi D, Serretti A. The use of the defence style questionnaire in major depressive and panic disorders: a comprehensive meta-analysis. Psychol Psychother 2010; 83:1-13. [PMID: 19671241 DOI: 10.1348/147608309x464206] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The issue of defence mechanisms is of great importance in clinical practice. The aim of this meta-analysis is to compare different defence styles (Mature, Neurotic, and Immature), assessed using the three-factor defence style questionnaire (DSQ), in major depressive disorder (MDD), and panic disorder (PD) in order to evaluate potential differences in defence profiles among these disorders. METHODS We assessed all publications listed in PubMed, PsycINFO, ISI, and Lilacs databases focusing on DSQ defence styles in MDD and PD. To be included studies had to be published in English, to include psychiatric patients, to provide defence style mean scores, and to employ the three-factor DSQ versions. Data were entered into the Cochrane Collaboration Review Manager Software and analysed by RevMan version 4.2. RESULTS MDD patients reported significantly lower scores in Mature style and both MDD and PD patients reported significantly higher scores in Neurotic and Immature styles. CONCLUSIONS A dissimilarity between depressive and anxious profiles emerged, since the former profile was characterized by low Mature and high Neurotic and Immature scores while the latter by high Neurotic and Immature scores only. These results could indicate the use of specific strategies in clinical and psychotherapeutic management of patients with these diagnoses. Nevertheless, present results should be considered with caution because of the high heterogeneity of the studies and some weaknesses in the psychometric properties of the DSQ.
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Affiliation(s)
- Raffaella Calati
- Institute of Psychiatry, University of Bologna, 40123 Bologna, Italy
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Brody S, Costa RM. Overestimation of heterosexually attributed AIDS deaths is associated with immature psychological defence mechanisms and clitoral masturbation during penile–vaginal intercourse. Int J STD AIDS 2009; 20:869-75. [PMID: 19948903 DOI: 10.1258/ijsa.2009.009435] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Research shows that (1) greater use of immature psychological defence mechanisms (associated with psychopathology) is associated with lesser orgasmic consistency from penile–vaginal intercourse (PVI), but greater frequency of other sexual behaviours and greater condom use for PVI, and (2) unlike the vectors of receptive anal intercourse and punctures, HIV acquisition during PVI is extremely unlikely in reasonably healthy persons. However, the relationship between overestimation of AIDS deaths due to ‘heterosexual transmission’ (often misunderstood as only PVI), sexual behaviour and mental health has been lacking. Two hundred and twenty-one Scottish women completed the Defense Style Questionnaire, reported past month frequencies of their various sexual activities, and estimated the total number of women who died from AIDS in Scotland nominally as a result of heterosexual transmission in the UK from a partner not known to be an injecting drug user, bisexual or infected through transfusion. The average respondent overestimated by 226,000%. Women providing lower estimates were less likely to use immature psychological defences, and had a lower frequency of orgasms from clitoral masturbation during PVI and from vibrator use. The results indicate that those who perceive ‘heterosexual transmission’ led to many AIDS deaths have poorer psychological functioning, and might be less able to appreciate PVI.
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Affiliation(s)
- S Brody
- Division of Psychology, School of Social Sciences, University of the West of Scotland, Paisley, UK
| | - R M Costa
- Division of Psychology, School of Social Sciences, University of the West of Scotland, Paisley, UK
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Abstract
We examined whether participants in depressed and anxious groups could be classified correctly using observer and self-report measures of defense mechanisms. A sample of 1182 university students completed the Personality Assessment Inventory and those scoring in the clinical range on either depression or anxiety indices were selected for participation. In total, 25 participants met criteria for the depressed group and 94 met criteria for the anxious group. Individual defense scores from the Defense-Q and the Defense Style Questionnaire were separately entered into 2 stepwise discriminant analyses. After cross-validation, the Defense-Q and Defense Style Questionnaire analyses classified participants with 75.0% and 71.3% accuracy, respectively. The results indicated that depression and anxiety groups can be significantly differentiated by defense use alone. Important differences in defensive functioning between these groups were confirmed and differences between observer and self-report measures of defenses mechanisms and current challenges in defense research were highlighted.
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Baldassin S, Alves TCDTF, de Andrade AG, Nogueira Martins LA. The characteristics of depressive symptoms in medical students during medical education and training: a cross-sectional study. BMC MEDICAL EDUCATION 2008; 8:60. [PMID: 19077227 PMCID: PMC2621219 DOI: 10.1186/1472-6920-8-60] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Accepted: 12/11/2008] [Indexed: 05/06/2023]
Abstract
BACKGROUND Medical education and training can contribute to the development of depressive symptoms that might lead to possible academic and professional consequences. We aimed to investigate the characteristics of depressive symptoms among 481 medical students (79.8% of the total who matriculated). METHODS The Beck Depression Inventory (BDI) and cluster analyses were used in order to better describe the characteristics of depressive symptoms. Medical education and training in Brazil is divided into basic (1st and 2nd years), intermediate (3rd and 4th years), and internship (5th and 6th years) periods. The study organized each item from the BDI into the following three clusters: affective, cognitive, and somatic. Statistical analyses were performed using analysis of variance (ANOVA) with post-hoc Tukey corrected for multiple comparisons. RESULTS There were 184 (38.2%) students with depressive symptoms (BDI > 9). The internship period resulted in the highest BDI scores in comparison to both the basic (p < .001) and intermediate (p < .001) periods. Affective, cognitive, and somatic clusters were significantly higher in the internship period. An exploratory analysis of possible risk factors showed that females (p = .020) not having a parent who practiced medicine (p = .016), and the internship period (p = .001) were factors for the development of depressive symptoms. CONCLUSION There is a high prevalence towards depressive symptoms among medical students, particularly females, in the internship level, mainly involving the somatic and affective clusters, and not having a parent who practiced medicine. The active assessment of these students in evaluating their depressive symptoms is important in order to prevent the development of co-morbidities and suicide risk.
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Affiliation(s)
- Sergio Baldassin
- Psychiatry and Medical Psychology Disciplines, ABC Regional Medical School, Santo André, Brazil
| | - Tânia Correa de Toledo Ferraz Alves
- Psychiatry and Medical Psychology Disciplines, ABC Regional Medical School, Santo André, Brazil
- Psychiatry Department of the Medical Faculty, University of São Paulo, São Paulo, Brazil
| | - Arthur Guerra de Andrade
- Psychiatry and Medical Psychology Disciplines, ABC Regional Medical School, Santo André, Brazil
- Psychiatry Department of the Medical Faculty, University of São Paulo, São Paulo, Brazil
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