Data showing that post-traumatic stress symptoms and defense mechanisms change based on perceived stress levels: A multivariate analysis of variance approach during the COVID-19 pandemic

The present research article provides data about the differences in post-traumatic stress symptoms, and defense mechanisms based on the levels of perceived stress (low, average, high), using a large national sample of 1100 Italian individuals, collected during the first wave of the COVID-19 pandemic. Participants completed an online survey through the Google Form platform, where the Ten-Item Perceived Stress Scale, Impact of Event Scale - Revised, and Forty Item Defense Style Questionnaire were included. First, the cut-offs of the perceived stress scale were calculated by determining the 25^th and 75^th percentile scores for the sample of this survey. Then, MANOVA analyses were performed, together with ANOVAs and the Bonferroni Post hoc analyses as a follow-up. The dataset (.xlsx) includes the survey scores, while the tables and figures provide the analysed data, where the differences are shown. This data article may provide useful bases for future research on perceived stress and for suggesting associated factors on which focus clinical intervention and preventive programs.

Factors related to the adverse events of antiepileptic drugs

OBJECTIVE

The aim of the present study was to explore the factors related to the severity of the adverse effects of antiepileptic drugs (AEDs), experienced by patients with epilepsy.

MATERIALS AND METHODS

A case study was conducted in adult patients with epilepsy and followed up at the Epilepsy Outpatients of the University Hospital of Ioannina in Northwest Greece. The Adverse Event Profile (AEP) questionnaire for AEDs adverse effects assessment, the Defense style questionnaire (DSQ-88) and the Patient Health Questionnaire (PHQ-9) for depression' severity evaluation were used to estimate the severity of adverse effects, the defense style, and the depressive symptoms, respectively.

RESULTS

Sixty-three patients with epilepsy (M/F:28/35), with a mean age of 37.6 ± 13.41, were recruited in the study. The univariate analysis showed that both the Maladaptive style of defense and the PHQ-9 score were significantly associated with the AEP score. After multivariate regression analysis female gender, the load of AEDs, the PHQ-9 score, and the Adaptive defense style remained significant coefficients.

CONCLUSION

There are also nonpharmacological factors that may contribute to the severity of the adverse effects of AEDs, experienced by the patients with epilepsy.

Psychological Development during Medical School Clerkship: Relationship to Resilience

OBJECTIVE

The authors investigated changes in medical students' defenses during clerkship and examined the effects of these changes on students' resilience.

METHODS

Between 2012 and 2014, all year-2 preclinical students (N = 249) at Gyeongsang National University Medical School were asked to participate. Those who agreed to participate (N = 237) completed the Korean version of the Defense Style Questionnaire (K-DSQ) and the Connor-Davidson resilience scale-10 (CD-RISC-10). After clerkship, students who proceeded to year 4 in 2 years (n = 187 (93 females), aged 24-38 years (mean, 28.9 ± 2.8 years)) completed the K-DSQ, CD-RISC-10, and the Korean version of the Hospital Anxiety and Depression Scale (K-HADS) in September 2014, 2015, and 2016.

RESULTS

The use of adaptive (W = 11,603.5, p < 0.001, r = 0.39) and self-inhibiting (W = 10,901.5, p < 0.001, r = 0.32) styles increased significantly after clerkship. A multiple linear regression analysis showed that changes in adaptive defense styles (B = 1.336, SE = 0.386, β = 0.218, p = 0.001) during clerkship were significantly related to resilience after adjusting for age, sex, depression, and anxiety.

CONCLUSIONS

Both positive personality development and maladaptive changes in defenses were evident. An increase in the adaptive defense style score was related to resilience.

Differences in Personality, Defense Styles, and Coping Strategies in Individuals with Depressive Disorder According to Age Groups Across the Lifespan

OBJECTIVE

This study aimed to examine the differences in personality, defense style, and coping styles among patients with depression according to age groups.

METHODS

A total of 211 participants ranging from 19 to 81 years old were recruited for the study. To assess participants' five dimensions of personality, the Neuroticism-Extraversion-Openness Personality Inventory-Revised (NEO-PI-R) was administered. In addition, the Korean-Defense Style Questionnaire and the Korean version of the coping checklist were administered to examine the defense and coping style.

RESULTS

In the analysis of NEO-PI-R, the mean value of Agreeableness, Conscientiousness, and Neuroticism showed significant differences between the young adult age group (20-34 years) and the late middle age group (50-64 years) (p<0.05). The young age group used more immature defense styles and made less use of problem-focused coping strategy than the old age patients (65 years and older) (p<0.05).

CONCLUSION

In the young age group associations with lower Agreeableness and Conscientiousness, as well as higher Neuroticism than the late middle age group were observed. Moreover, the young age group had a higher usage of immature defense style, and restricted use of problem-focused coping style than other age groups.

Mindfulness dispositions and defense style as positive responses to psychological distress in oncology professionals

PURPOSE

Working in oncology departments is a stressful and emotionally consuming experience and oncology professionals are particularly at risk for developing stress-related syndromes. Defense mechanisms (high-adaptive) and mindfulness dispositions are known as facilitators of well-being and adaptation. In this study we analysed the role of these unconscious and conscious strategies in protecting the oncology clinicians from stress-related symptoms.

METHOD

A convenience sample of 63 oncology professionals was assessed on defense style, mindfulness disposition, depression and anxiety symptoms using self-reported questionnaires. Demographic and professional information was included in data collection.

RESULTS

Results did not show significance differences in demographic and professional characteristics among all studied variables. Mature defense style and mindfulness were highly and negatively correlated with depression and anxiety, while a positive association was found between immature defense style and both depression and anxiety symptoms. Hierarchical multiple regression analyses found defense styles and mindfulness as predictors of depression, whereas only immature defense style predicted anxiety.

CONCLUSIONS

The present study provides the first empirical evidence of the influence of unconscious defense mechanisms and conscious mindfulness dispositions in protecting oncology professionals from depression and anxiety symptoms. Defense mechanisms and mindfulness share several common-points and should be seen as complementary in enhancing physical and psychological well-being. Further studies are required for a deeper understanding of the impact of mindfulness and defenses in improving adaptation.

Exploring the interrelationship between alexithymia, defense style, emotional suppression, homicide-related posttraumatic stress disorder and psychiatric co-morbidity

This study investigated the interrelationship between alexithymia, defense style, emotional suppression, posttraumatic stress disorder (PTSD) following homicide and psychiatric co-morbidity. One hundred and fifty male homicide perpetrators and 156 male perpetrators of non-violent crime completed the Posttraumatic Stress Diagnostic Scale (except for non-violent perpetrators), the General Health Questionnaire-28, the Defense Styles Questionnaire, the Courtauld Emotional Control Scale and the Toronto Alexithymia Scale-20. The results showed that 44% of homicide perpetrators met the criteria for PTSD. No significant differences were found between groups in alexithymia, defense style and psychiatric co-morbidity. Homicide perpetrators suppressed depression significantly more than the non-violent group. PLS analyses showed that alexithymia was significantly correlated with defense style. Defense styles were significantly correlated with emotional suppression which, in turn, was associated with homicide-related PTSD and psychiatric co-morbidity. To conclude, perpetrators can experience PTSD reactions following the act of homicide. The severity of these reactions and other psychological problems were related to difficulty getting in touch with distressing emotions, the defenses they used to protect themselves psychologically and the way they suppressed their emotion.

[Study of defense styles, defenses and coping strategies in alcohol-dependent population]

INTRODUCTION

Defense mechanisms have been seen to greatly change over time and across different definitions made by different theoretical currents. Recently with the definition provided by the DSM IV, defense mechanisms have integrated the concept of coping as a defensive factor. These mechanisms are no longer considered just through a psychodynamic approach but also through a cognitive and behavioral one. In recent years, new theories have therefore integrated these two components of the defensive operation. According to Chabrol and Callahan (2013), defense mechanisms precede coping strategies. In individuals with psychopathological disorders, these authors indicate a relative stability of these mechanisms. Also, we asked about the presence of unique characteristics among people with alcohol dependence. Indeed, studies conducted with people with alcohol dependence highlight the presence of a neurotic defense style and some highly immature defenses (projection, acting out, splitting and somatization). In terms of coping strategies, persons with alcohol dependence preferentially use avoidant strategies and strategies focused on emotion. However, although several studies have been conducted to assess coping strategies and defense styles within a population of individuals with an alcohol problem, at the present time none of them has taken into account all these aspects of defense mechanisms.

OBJECTIVE

The aim of this study is therefore to study the defenses and defense styles and coping strategies in an alcohol-dependent population.

METHOD

This multicenter study (3 CHU, 1 center of supportive care and prevention in addiction and 1 clinic) received a favorable opinion of an Institutional Review Board (IRB Registration #: 00001072). Eighty alcohol-dependent individuals responded to a questionnaire assessing sociodemographic characteristics and elements related to the course of consumption. Coping strategies were assessed by means of a questionnaire validated in French: the Brief Cope. The Defense Style Questionnaire-40 translated into French, but not validated, assessed defenses and defense style. Descriptive, comparative and correlational analysis was carried out using Statistica software - version 10.

RESULTS

The alcohol-dependent people preferentially use emotion focused coping blame and less the problem focused coping humor. The highest immature defense is acting out. Correlational analyses confirm the presence of some significant relationships between defense style and some coping strategies. Thus, the mature style is the only defense style, which is linked with the problem focused strategy humor, and another one coping called distraction. Some singular relationships were found with these two dimensions of coping. Alcohol and drug disengagement show particularly strong relationships with immature defenses such as projection and somatization. Another singular result is indicated by a negative relationship between immature defenses autistic fantasy with the strategy expression of feelings.

CONCLUSION

This study found a significant number of relationships between defensive styles, defenses and coping strategies. This research also highlights the value of an integrative approach of defense mechanisms for the analysis of defensive functioning of people with alcohol dependence. Indeed, the relationships between these elements are consistent and allow understanding the defensive operation as a whole to promote a new adapted means of support.

Exploring relationships over time between psychological distress, perceived stress, life events and immature defense style on disordered eating pathology

Background

Perceived stress, immature defense style, depression and anxiety and negative life events all are known to be associated with eating disorders. The present study aimed to investigate the relationships between these factors and their relative strength of association with eating disorder symptoms over time.

Methods

This research was embedded in a longitudinal study of adult women with varying levels of eating disorder symptoms and who were initially recruited from tertiary educational institutions in two Australian states. Four years from initial recruitment, 371 participants completed the Eating Disorder Examination- Questionnaire (EDE-Q) for eating disorder symptoms.

Kessler-10 Psychological Distress Scale (K-10) as a measure of depression and anxiety, a Life Events Checklist as a measure of previous exposure to potentially traumatic events, the Defense Style Questionnaire (DSQ) and the Perceived Stress Scale (PSS) to determine perceived stress. One year later, in year 5, 295 (878.7%) completed follow-up assessments including the EDE-Q. The questionnaires were completed online or returned via reply paid post.

Results

All four independent factors were found to correlate significantly with the global EDE-Q score in cross-sectional analyses (all Spearman rho (r_s) >0.18, p < 0.01) and at one year follow-up (all r_s > 0.15, all p < 0.05). In multivariate linear regression modeling adjusted for age and year 4 global EDE-Q scores, perceived stress and psychological distress scores were significantly associated with year 5 global EDE-Q scores (p = 0.046 and <0.001 respectively).

Conclusions

Psychological distress, and to a lesser degree perceived stress had the strongest association with eating disorder symptoms over time The findings support further investigation of interventions to reduce distress and perceived stress in adult females with disordered eating.