1,720,994 research outputs found
La valutazione dei meccanismi di difesa nel lavoro clinico: sviluppo di un Q-sort basato sulla DMRS
No full textL'utilizzo del Q-sort nella valutazione dei meccanismi di difesa: studio di validazione del DMRS-Q
No full textThe psychosocial impact of COVID-19 pandemic in Italy: A lesson for mental health prevention in the first severely hit European country
Full text linkItaly was the first European country severely hit by the COVID-19 pandemic. While the containment measures were relatively effective in the acute phase, the current postemergency phase addressing the long-term psychosocial consequences is the key challenge for our healthcare system, where the importance of mental health prevention is not sufficiently recognized
From Theory to Practice: The Need of Restyling Definitions and Assessment Methodologies of Coping and Defense Mechanisms
No full textThe empirical literature on defense and coping mechanisms has
taken a step forward in the last decades, although it remains quite
controversial in defining these constructs. Definitions, theoretical
frames, assessment methodologies, studied populations, as well
clinical implications are difficult to standardize whit regard to
defense mechanisms and coping. In their impressive effort to review
the literature, Silverman and Aafjes-van Doorn (2023) focus their
attention on the theoretical and clinical debate about relationships
and differences between coping and defense mechanisms and how
they change over time. They offer a comprehensive and critical
picture of the theoretical evolution of these two psychological
constructs, sustained by an in-deep analysis of both cross-sectional
and longitudinal research. While the firsts helped in capturing the
relationship between coping and defense mechanisms, the second
contributed to the dynamic understanding of how coping and
defense mechanisms interact together over time. In doing so, they
also raise several important questions about defining and measuring
these essential aspects of emotion regulation and suggested the need
to address future research to determine the directionality and temporality
of changes in coping and defense mechanisms.
In this commentary, we would like to further discuss these fundamental
questions and suggest potential ways to redefining and
remeasuring coping and defenses to succeed the controversies and
improve our understanding of both these constructs and their clinical
implications
Defenses and Attachment in Clinical Practice: What Came First?
No full textRichardson, Beath, and Boag (this issue) developed a questionnaire designed to measure
attachment-related defense mechanisms with considerable promise for research, practice, and training. Their robust design and the sophisticated psychometric techniques used to generate and validate the measure are notable. The goal of this commentary is to situate the measure in contemporary research on defenses, draw a distinction between defenses linked specifically to attachment and defenses more generally, and to stimulate a constructive dialogue with the Defense Mechanisms Rating Scales (DMRS; Di Giuseppe & Perry, 2021; Perry, 1990, 2014), a model and set of measures that has dominated defense mechanism research for half a century
Defense mechanisms and personality psychopatology in adolescence. A correlation study between DMRS and SWAP-200.
No full textCase report: Changes in defense mechanisms, personality functioning, and body mass index during psychotherapy with patients with anorexia nervosa
No full text: Eating disorders (EDs) are difficult to treat in psychotherapy due to their pervasive symptomatology and frequent and rapid relapses. Restrictive anorexia nervosa (AN) is the most challenging ED, often associated with severe physical and mental conditions. Perceived as an ego-syntonic syndrome that somehow protects the patient from a number of developmental tasks, treating AN requires extensive multidisciplinary long-term intervention. As with other emotion regulation strategies, defense mechanisms mediate an individual's reaction to internal or external stressors, including those related to ED conditions. Improving defensive functioning adaptiveness predicts psychotherapy outcomes and is an essential component of the therapeutic process. In this study, we qualitatively described changes in the use of defense mechanisms, personality functioning (PF), and body mass index (BMI) in two patients with severe AN in treatment with intense dynamic psychotherapy. Changes in personality functioning and defense mechanisms were periodically assessed every 6 months using clinician report measures such as the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Defense Mechanisms Rating Scales Q-sort (DMRS-Q), respectively. BMI was also monitored throughout the treatment. A qualitative description of the patient's defensive profile and the quantitative score on all ranges of defense mechanisms were used for studying changes in patients' use of defenses during the treatment and relationships between defenses and outcome indexes. Personality and defensive functioning improved after 1 year of intense dynamic psychotherapy, independently from BMI improvement. All outcome indexes dramatically decreased before a scheduled interruption of the treatment, underling that an integrated therapeutic approach is essential for improving and eventually orienting toward complete ED symptoms remission. Long-term dynamic psychotherapy fosters self-awareness of psychological distress and enhances more mature ways of coping. Monitoring changes in personality and defense mechanisms helps in understanding patients' reactions to stressful life events and in developing specific therapeutic interventions
Defense mechanisms in cancer patients: a systematic review
No full textThe importance of defense mechanisms in cancer progression and adaptation have been largely observed. However, few studies referred to the generally accepted hierarchical organization of defenses and used validated measurements for defensive assessment. In this systematic review, we investigated the whole hierarchy of defense mechanisms and how they associate with various psychological aspects in cancer patients. A literature search was conducted using electronic databases. Among 1570 records published from 1990 to date, only 15 articles met inclusion criteria. Findings related to cancer patients' defensive functioning and its relations with other physical and psychological variables were extracted. A general consistency emerges on the role of defense mechanisms in cancer progression and recovery. Following the hierarchical organization of defenses, higher physical and emotional functioning emerged as being associated with High-adaptive defenses, while Mental Inhibition defenses, in particular repression, promote psychosomatic symptoms, passive decisional preferences and worse physical and emotional health. Disavowal defenses foster lower anxiety and higher emotional functioning by denying anxiety about death. Image distortion defenses, including both Minor and Major image-distorting defenses, were more frequent in cancer patients than in control groups and finally, Action defenses predicted sleep disturbance and lower survival probability. The early detection of maladaptive defensive functioning may foster appropriate psychotherapeutic intervention and prevent worsening of the illness. Further investigations are required to replicate these findings and highlight associations between defense mechanisms and various aspects of mental functioning in cancer patients
Studio osservazionale trasversale dei livelli di mindfulness e maturità dei meccanismi di difesa nell’ambito della patologia psichiatrica
No full textÈ ormai riconosciuto come la psicopatologia si incardini nella disregolazione dei sistemi cognitivi e affettivi le
cui funzioni attraversano le categorie standard della diagnosi psichiatrica. Mentre l’aspetto di regolazione
emotiva e cognitiva è ampiamente studiato, i livelli di mindfulness e i meccanismi di difesa sono variabili
ancora poco comprese in questo ambito; in particolare, non è noto come questi tratti si confrontino tra i diversi
gruppi diagnostici. Allo scopo di indagare i livelli di tratto e di stato di mindfulness e il funzionamento dei
meccanismi di difesa in un campione trasversale di individui afferenti presso l’U.O. II di Psichiatria dell’Azienda
Ospedaliero-Universitaria Pisana (AOUP), sono stati somministrati dei reattivi psicologici (MAAS; FFMQ-15;
DMRS-SR-30) ed un questionario sociodemografico al campione di pazienti nel periodo compreso tra ottobre
2022 e gennaio 2023 (N=57). Sui dati sono state applicate analisi descrittive e di correlazione (SPSS 20.0;
Rstudio). Dalle analisi descrittive emerge un campione con età media di 35 anni ca. (M: 35,21; ds:14,63),
prevalentemente costituito da femmine (57,9%), con un livello di istruzione medio-alto e per la maggior parte
con impiego (87,79%). Le diagnosi più frequenti del campione sono state: Disturbo Bipolare di tipo I (40,35%),
Disturbi di personalità (14,04%) e Disturbo Depressivo Maggiore (10,53%). I risultati delle analisi correlazionali
mostrano come i livelli di mindfulness (MAAS) correlino in modo moderato e negativo con il funzionamento
globale dei meccanismi di difesa (r= -0,451; p < 0,01). Inoltre, i livelli di mindfulness (FFMQ) sono associati
positivamente all’utilizzo dei meccanismi di difesa maturi (r=0,514; p < 0,01) e al funzionamento difensivo
globale (r= 0,458; p < 0,01). In particolare, la componente del “Non Giudizio” (FFMQ) risulterebbe
positivamente correlata con le difese mature (r=0,529; p <0,01) e negativamente con le strategie di difesa
immature (r=-0,532; p <0,01).Questo studio presenta dei limiti tra cui l’utilizzo di soli strumenti self-report,
l’autodichiarazione da parte dei pazienti rispetto alla propria diagnosi ed eventuale farmacoterapia associata,
la scarsa numerosità del campione e la mancanza di un campione di controllo. Ciononostante, questo studio
risulta essere il primo ad indagare sia il funzionamento dei meccanismi di difesa che le abilità di mindfulness
in un campione di pazienti che soffrono di una malattia mentale; la ricerca in tale ambito permetterebbe una
maggiore comprensione dei livelli di consapevolezza e gestione dei conflitti interiori note per favorire il
benessere e il miglioramento dei sintomi psicopatologici
A preliminary study on validity and reliabily of the Defense Mechanisms Rating Scales Q-sort version (DMRS Q-sort)
No full textThis contribution focuses on the need to provide clinicians with a reliable and valid measure for detecting
patient defense mechanisms “inside psychotherapy.” To avoid the limitations of existing methods,
we designed a Q-sort based on the theoretical definitions and criteria of the Defense Mechanisms
Rating Scales (DMRS-Q), but one that does not require transcripts of clinical interviews or sessions
and may be applied without specific training on defenses. The DMRS-Q is sensitive to changes in
psychotherapy and its scores correlate significantly with various aspects of mental functioning, making
it potentially available for the psychotherapy process and outcome research as well
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