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Rachele M, Giovanna MM, Alessia R, Isabella M, Michela DT, Massimo P. The Weight of Words: An analysis of Autobiographical Narratives and Psychopathological Measures in Anorexia Nervosa. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2025; 54:32. [PMID: 40338385 PMCID: PMC12062048 DOI: 10.1007/s10936-025-10150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/14/2025] [Indexed: 05/09/2025]
Abstract
This study aims to explore the relationship between linguistic features of the Referential Process (RP) applied to autobiographical narratives, personality dimensions, and affect regulation capabilities in a group of women diagnosed with restrictive anorexia nervosa (AN). The study included 40 female participants hospitalized with AN during an acute phase, with a mean age of 19.50 (SD = 3.8). Participants completed several assessments, including the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), the Eating Disorder Inventory (EDI-3), the 20-item Toronto Alexithymia Scale (TAS-20), the Emotion Regulation Questionnaire (ERQ), and the Relationship Anecdotes Paradigm Interview (RAP). The RAP interviews were audio-recorded and transcribed for the application of RP Linguistic Measures. The results of the correlation analysis revealed several significant associations among linguistic measures, EDI-3 scale scores, affect regulation measures, and personality dimensions. The linguistic measures indicating higher rationality, abstraction, and cognitive word usage, were associated with higher psychopathological severity in AN. Alexithymia showed significant correlations with the Affect words, supporting the perspective of MCT concerning dissociation of emotional schemas. These findings confirm the relationship between linguistic measures and the severity of the disease. Therefore, autobiographical narratives can be considered not only as diagnostic indicators, but also as variables to verify the efficacy of treatments in patients with AN.
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Affiliation(s)
- Mariani Rachele
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University, Rome, Italy.
| | - Massari Maria Giovanna
- Department of Human Sciences and Promotion of Quality of Life, San Raffaele Telematic University, Rome, Italy
| | - Renzi Alessia
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University, Rome, Italy
| | - Marini Isabella
- Dipartimento di Neuroscienze e Salute Mentale, AOU Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Di Trani Michela
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University, Rome, Italy
| | - Pasquini Massimo
- Department of Human Neurosciences, Sapienza University , Rome, Italy
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2
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Silvestro O, Vicario CM, Costa L, Sparacino G, Lund-Jacobsen T, Spatola CAM, Merlo EM, Viola A, Giorgianni CM, Catalano A, Fries W, Lo Coco G, Martino G. Defense mechanisms and inflammatory bowel diseases: a narrative review. RESEARCH IN PSYCHOTHERAPY (MILANO) 2025. [PMID: 40178111 DOI: 10.4081/ripppo.2025.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Accepted: 03/26/2025] [Indexed: 04/05/2025]
Abstract
Growing evidence highlights the crucial role of defense mechanisms in the context of chronic diseases. However, few studies have evaluated the impact of these implicit emotion regulation strategies on the adaptation processes related to inflammatory bowel diseases (IBD). This narrative review aimed to explore the role of defense mechanisms in patients with IBD and clarify their association with related psychological and physical symptoms. A literature search was conducted using PubMed and PsycINFO databases to select studies considering defense mechanisms in patients with IBD. Inclusion criteria were English language articles, diagnosis of Crohn's disease or ulcerative colitis, and use of validated assessment instruments specifically related to defense mechanisms. Six studies, including a total of 664 patients, were deemed eligible. Immature defense mechanisms were commonly detected in IBD patients, with significant effects on psychological and physical health. Significant associations were found between defense mechanisms, perceived health-related quality of life (HR-QoL), and psychological distress. Findings suggested that immature defense mechanisms may negatively impact the management of disease, leading to lower perceived HR-QoL, decreased treatment adherence, and increased risk of psychopathological symptoms. Considering these findings, we suggest that an integrated clinical evaluation, including an in-depth investigation of defense mechanisms, may promote more effective psychological treatments and improve psychological well-being in patients suffering from IBD.
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Affiliation(s)
- Orlando Silvestro
- Department of Health Sciences, University Magna Graecia of Catanzaro
| | - Carmelo M Vicario
- Department of Cognitive Science, Psychology, Education and Cultural Studies, University of Messina
| | - Ludovico Costa
- Course Degree in Clinical and Health Psychology in the Life Cycle, University of Messina
| | | | - Trine Lund-Jacobsen
- Department of Endocrinology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | | | - Emanuele M Merlo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina
| | - Anna Viola
- Department of Clinical and Experimental Medicine, University of Messina
| | - Concetto M Giorgianni
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina
| | - Walter Fries
- Department of Clinical and Experimental Medicine, University of Messina
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina
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Ma D, Wang Y, Wei J, Cao J. Progress in understanding personality functioning in light of the DSM-5 and ICD-11. Asian J Psychiatr 2024; 102:104259. [PMID: 39366165 DOI: 10.1016/j.ajp.2024.104259] [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: 07/07/2024] [Revised: 09/25/2024] [Accepted: 09/27/2024] [Indexed: 10/06/2024]
Abstract
Updates regarding the dimensional model of personality disorder in the DSM-5 and ICD-11 have stimulated interest in the concept of personality functioning (PF). A growing number of literature has demonstrated the extensive empirical basis, validated evaluation tools, and clinical utility of the concept of PF. The concept of PF provides a construct for the diagnosis and evaluation of personality disorders. As a trans-diagnostic factor, PF is of great significance in the etiology and development of many mental and physical conditions. PF can be improved per se, primarily through psychotherapy. The evaluation and treatment of low PF should be considered in all relevant cases. The current study aims to provide a comprehensive review of the concept, pathogenesis, measurement, prevalence, psychopathological significance, as well as intervention for disordered PF.
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Affiliation(s)
- Dandan Ma
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Yufei Wang
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
| | - Jinya Cao
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China.
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Di Giuseppe M, Lo Buglio G, Cerasti E, Boldrini T, Conversano C, Lingiardi V, Tanzilli A. Defense mechanisms in individuals with depressive and anxiety symptoms: a network analysis. Front Psychol 2024; 15:1465164. [PMID: 39582994 PMCID: PMC11581944 DOI: 10.3389/fpsyg.2024.1465164] [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: 07/15/2024] [Accepted: 10/25/2024] [Indexed: 11/26/2024] Open
Abstract
Background Defense mechanisms play a crucial role in depression and anxiety. The current study aimed at estimating the network structure of defense mechanisms in individuals with symptoms of depression and anxiety to understand the most central defenses and relevant connections. Moreover, we aimed at examining the associations between defense mechanisms and symptoms. Methods We employed the Symptom Checklist-90 to recruit 655 individuals with depressive and anxiety symptoms during the first wave of the COVID-2019 Pandemic in Italy. Defense mechanisms were assessed with the DMRS-SR-30. Results Results showed a main component in the network graph featuring 16 defense mechanisms. Self-assertion was the most central node in the network, displaying positive and negative connections with an array of mature and immature defenses, respectively. Among immature defenses, passive aggression was the most interconnected node. Some mature defenses (i.e., humor, affiliation, and sublimation) were not connected to other nodes. A range of defense mechanisms were associated with anxiety and depressive symptoms. Conclusions This is the first research effort supporting the conceptualization of defense mechanisms as a complex system. Results suggest that defense mechanisms of the same cluster (e.g., mature defenses) play different roles in the network. Central defenses (i.e., self-assertion and passive aggression) detected in this study may be promising intervention targets.
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Affiliation(s)
| | - Gabriele Lo Buglio
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Erika Cerasti
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Tommaso Boldrini
- Department of Psychology and Educational Science, Pegaso Telematic University, Naples, Italy
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, 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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Di Giuseppe M, Aafjes-van Doorn K, Békés V, Gorman BS, Stukenberg K, Waldron S. Therapists' defense use impacts their patients' defensive functioning: a systematic case study. RESEARCH IN PSYCHOTHERAPY (MILANO) 2024; 27. [PMID: 39221906 PMCID: PMC11417673 DOI: 10.4081/ripppo.2024.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
Research into defensive functioning in psychotherapy has thus far focused on patients' defense use. However, also the defensive functioning of therapists might be significant because of its potential in promoting changes in the patient's overall defensive functioning by sharing their higher-level understanding of a given situation and letting the patient have the opportunity to learn how to cope more successfully. This exploratory case study is the first to examine therapist's defense mechanisms and their relationship to changes in the patient's defensive functioning evaluated at different times throughout psychoanalytic treatment. We assessed the use of defense mechanisms with the Defense Mechanisms Rating Scales in 20 sessions collected at three phases (early, middle and late) of the psychoanalytic treatment. For each session, we identified therapist's and patient's defenses, defense levels and overall defensive functioning, with particular attention to the sequence of consecutively activated defenses within the therapeutic dyad. Results showed that the patient's defensive functioning tended to gradually improve over the course of the treatment, with a slight decrease at the end. Therapists' overall defensive functioning remained stable throughout the treatment with values in the range of high-neurotic and mature defenses. Assessment of the dyadic interaction between therapist and patient's use of defenses showed that within-session, the patient tended to use the same individual defenses that the therapist used, which was especially pronounced in the initial phases of the treatment. Towards the end of the treatment, once there was a stable shared knowledge, the patient started to explore using new, higher-level defenses on her own, independent from what defenses the therapist used. Our findings emphasized the analyst's role in encouraging the development of more effective ways of coping in the patient, confirming previous theoretical and empirical research regarding the improvement of patient's defensive functioning in psychotherapy. The alterations in these coping strategies, also called high-adaptive defenses, as part of the therapist-patient interaction demonstrate the importance of studying defenses as an excellent process-based outcome measure. The measurement of the degree to which the analyst models and illustrates these superior coping methods to the patient is a prime vehicle for supporting internalization of these skills by the patient.
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Affiliation(s)
| | - Katie Aafjes-van Doorn
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA; Faculty of Arts and Sciences, New York University Shanghai.
| | - Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY.
| | - Bernard S Gorman
- Department of Psychology, Hofstra University, New York, NY; Psychoanalytic Research Consortium, New York, NY; Derner Institute, Adelphi University, New York, NY.
| | - Karl Stukenberg
- Psychoanalytic Research Consortium, New York, NY; School of Psychology, Xavier University, Cincinnati, OH.
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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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Yılmaz M, Taş B, Çelik D, Perry JC, Tanzilli A, Di Giuseppe M, Lingiardi V. Initial validation of the Turkish version of the defense mechanisms rating scales-self-report-30. Front Psychol 2024; 15:1432170. [PMID: 38988381 PMCID: PMC11233775 DOI: 10.3389/fpsyg.2024.1432170] [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: 05/13/2024] [Accepted: 05/30/2024] [Indexed: 07/12/2024] Open
Abstract
The Defense Mechanisms Rating Scales-Self Report-30 (DMRS-SR-30) was recently developed to add a self-report alternative to the assessment of defenses, reflecting their generally accepted hierarchical organization. In this study, we aimed to examine psychometric properties and factor structure of the Turkish language version of the DMRS-SR-30. The sample consisted of 1.002 participants who filled out a survey comprising the DMRS-SR-30, the Brief Symptom Inventory, and the Inventory of Personality Organization through Qualtrics. Confirmatory Factor Analysis indicated a three-factor structure (CFI = 0.89, RMSEA = 0.05) that confirms the DMRS theoretical frame with a relatively acceptable fit. Defensive categories and total scale scores showed good to excellent reliability (α values ranging from 0.64 to 0.89). Correlations between defenses, symptoms, and personality functioning demonstrated good convergent and discriminant validity. The individuals with clinically significant BSI scores (T-score ≥ 63) differed on the DMRS-SR-30 scores from the individuals in the non-clinical range. The Turkish version of the DMRS-SR-30 is a reliable and valid instrument to self-assess the hierarchy of defense mechanisms and overall defensive functioning. Moreover, the current study supports the validity of the tripartite model of defenses in a language and culture different from the origins of the DMRS and DMRS-SR-30.
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Affiliation(s)
- Meltem Yılmaz
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Berke Taş
- Department of Psychology, TED University, Ankara, Türkiye
| | - Deniz Çelik
- Department of Psychology, Çankaya University, Ankara, Türkiye
| | - J. Christopher Perry
- Department of Psychiatry, McGill University and Institute of Community and Family Psychiatry at Jewish General Hospital, Montreal, QC, Canada
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | | | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Yilmaz M, Türkarslan KK, Zanini L, Hasdemir D, Spitoni GF, Lingiardi V. Transference interpretation and psychotherapy outcome: a systematic review of a no-consensus relationship. RESEARCH IN PSYCHOTHERAPY (MILANO) 2024; 27:744. [PMID: 38695607 PMCID: PMC11116935 DOI: 10.4081/ripppo.2024.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/18/2024] [Indexed: 05/26/2024]
Abstract
Despite its well-established importance in psychoanalytic theory, there is a scarcity of empirical evidence on the relationship between a therapist's transference interpretation (TI) and therapeutic outcome. The current scientific literature shows no consensus on the existence and nature of such an association. Therefore, the present study aimed to systematically review the literature on the link between TI and outcomes in psychodynamic psychotherapies. The American Psychological Association PsycInfo, MEDLINE, and the Web of Science Core Collection were selected as the primary databases for the literature search. Studies were included if they measured the frequency/ concentration of TI in psychodynamic psychotherapy [e.g., transference focused psychotherapy (TFP), supportive-expressive therapy] or compared a treatment group (e.g., high in TI and TFP) with a control group (e.g., low in TI supportive therapy) in an adult population with psychiatric symptoms. Out of 825 retrieved abstracts, 25 articles (21 studies) were included in the final synthesis. 13 out of 21 (62%) studies showed a significant improvement in at least one therapy outcome measure following the use of TI. The present systematic review also revealed high heterogeneity across studies in terms of TI measurement, outcome assessment (e.g., psychiatric symptoms, dynamic change, interpersonal functioning, therapeutic alliance), study design (e.g., experimental, quasi-experimental, naturalistic), patient population (e.g., anxiety disorders, personality disorders), and types of treatment (e.g., TFP, supportive-expressive therapy), preventing researchers from asserting solid conclusions. The results strongly highlight the urgent need for highquality research to understand which types of patients, how, and when TIs could be effective throughout the therapy process.
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Affiliation(s)
- Meltem Yilmaz
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | | | - Ludovica Zanini
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | - Dilara Hasdemir
- Steve Hicks School of Social Work, University of Texas at Austin, TX.
| | - Grazia Fernanda Spitoni
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
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Barrios V, Martín-Rivada Á, Guerra-Cantera S, Campillo-Calatayud A, Camarneiro RA, Graell M, Chowen JA, Argente J. Reduction in Pappalysin-2 Levels and Lower IGF-I Bioavailability in Female Adolescents With Anorexia Nervosa. J Clin Endocrinol Metab 2024; 109:e920-e931. [PMID: 38066647 DOI: 10.1210/clinem/dgad713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Indexed: 02/21/2024]
Abstract
CONTEXT Anorexia nervosa (AN) can cause severe undernutrition associated with alterations in the IGF axis. Pappalysins (PAPP-A, PAPP-A2) and stanniocalcins (STC-1, STC-2) modulate IGF binding-protein (IGFBP) cleavage and IGF bioavailability, but their implications in AN are unknown. OBJECTIVE We determined serum levels of PAPP-As and STCs in relationship with classical IGF axis parameters in female adolescents with AN and their association with nutritional status and secondary amenorrhea. METHODS Parameters of the IGF axis were determined in fasting serum samples of 68 female adolescents with AN at diagnosis and 62 sex- and age-matched controls. Standardized body mass index (BMI) and bone mineral density (BMD) were calculated. RESULTS Patients with AN had lower concentrations of total and free IGF-I, total IGFBP-3, acid-labile subunit (ALS), insulin, PAPP-A2, STC-1, and STC-2 and higher levels of IGF-II and IGFBP-2. Their free/total IGF-I ratio was decreased and the intact/total IGFBP-3 and -4 ratios increased. BMI was directly related to total IGF-I and intact IGFBP-3 and inversely with IGFBP-2 and intact IGFBP-4. Weight loss was directly correlated with intact IGFBP-4 and negatively with intact IGFBP-3, ALS, STC-2, and PAPP-A2 concentrations. BMD was directly related to intact IGFBP-3 and inversely with intact IGFBP-4 and PAPP-A2 levels. Patients with amenorrhea had lower levels of total IGF-I and IGFBP-3 than those with menses. CONCLUSION The reduction of PAPP-A2 in patients with AN may be involved in a decline in IGFBP cleavage, which could underlie the decrease in IGF-I bioavailability that is influenced by nutritional status and amenorrhea.
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Affiliation(s)
- Vicente Barrios
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn, Instituto de Salud Carlos III, E-28009 Madrid, Spain
| | - Álvaro Martín-Rivada
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
| | - Santiago Guerra-Cantera
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
| | - Ana Campillo-Calatayud
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
| | - Ricardo A Camarneiro
- Department of Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain
| | - Montserrat Graell
- Department of Psychiatry and Clinical Psychology, Hospital Infantil Universitario Niño Jesús, E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, E-28009 Madrid, Spain
| | - Julie A Chowen
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn, Instituto de Salud Carlos III, E-28009 Madrid, Spain
- IMDEA, Food Institute, CEIUAM+CSI, Cantoblanco, E-28049 Madrid, Spain
| | - Jesús Argente
- Departments of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Research Institute "La Princesa", E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutriciόn, Instituto de Salud Carlos III, E-28009 Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, E-28009 Madrid, Spain
- IMDEA, Food Institute, CEIUAM+CSI, Cantoblanco, E-28049 Madrid, Spain
- Department of Pediatrics, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
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10
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Martino G, Viola A, Vicario CM, Bellone F, Silvestro O, Squadrito G, Schwarz P, Lo Coco G, Fries W, Catalano A. Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:731. [PMID: 38224215 PMCID: PMC10849073 DOI: 10.4081/ripppo.2023.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 01/16/2024]
Abstract
A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Anna Viola
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Carmelo Mario Vicario
- Department of Cognitive Science, Psychology, Education and Cultural Studies, University of Messina.
| | | | - Orlando Silvestro
- Department of Health Sciences, University Magna Graecia of Catanzaro.
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Peter Schwarz
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen.
| | - Gianluca Lo Coco
- Psychological, Pedagogical, Exercise and Training Sciences, University of Palermo.
| | - Walter Fries
- Department of Clinical and Experimental Medicine, University of Messina.
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina.
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Békés V, Starrs CJ, Perry JC, Prout TA, Conversano C, Di Giuseppe M. Defense mechanisms are associated with mental health symptoms across six countries. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:729. [PMID: 38226792 PMCID: PMC10849071 DOI: 10.4081/ripppo.2023.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/15/2023] [Indexed: 01/17/2024]
Abstract
Defense mechanisms are adaptative processes that are related to mental health and psychological functioning and may play an important role in adaptation to distress, as well as in mental health interventions. The present study aimed to compare the use of defense mechanisms and their relationship to mental health symptoms across six countries. In a large-scale descriptive study, we collected data from community- based individuals (N=19,860) in the United States, Australia, Canada, Germany, Italy, and the United Kingdom about the use of defense mechanisms and experienced mental health symptoms during the early phase of the pandemic. We found that the use of defense mechanism categories was similar across countries. Moreover, lower defensive functioning, specifically, neurotic and immature defenses were related to experiencing higher distress across countries, whereas mature defenses were generally inversely related to symptoms. Furthermore, these findings were relatively similar across the six countries. Cross-cultural research on defense mechanisms and mental health has important clinical implications. Our results are consistent with the goal of promoting more adaptive defensive functioning to increase psychological well-being and mitigate the detrimental impact of situational stress.
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Affiliation(s)
- Vera Békés
- Yeshiva University, Ferkauf Graduate School of Psychology, New York, NY.
| | - Claire J Starrs
- University of Quebec in Montreal (UQAM), Department of Psychology, Montreal, QC.
| | - J Christopher Perry
- McGill University, Department of Psychiatry at the Insitute of Community & Family Psychiatry, Jewish General Hospital, Montreal, QC.
| | - Tracy A Prout
- Yeshiva University, Ferkauf Graduate School of Psychology, New York, NY.
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa.
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