Identification of psychological defense mechanisms in non-psychotic major depressive disorder. Using the Romanian version of the defense style questionnaire – 60
Keywords:
non-psychotic major depressive disorder; psychological defense analysis; psychological defense mechanisms; DSQ-60, gender differences.Abstract
Related to the topic of the study, the first objective aims to identify the psychic defense mechanisms specific to major depressive disorder without psychotic elements, respectively, in the case of objective number two, to identify gender differences in the psychic defense mechanisms used by patients diagnosed with major depressive disorder without psychotic elements. Thus, the identification of psychic defense mechanisms specific to major depressive disorder without psychotic elements was performed by comparing two groups, clinically (N = 103; 42 male participants [40.8%] and 61 female participants [59.2 %], age = 51.16 years; 12.6% of participants are graduates of higher education) and non-clinical (N = 770; 330 male participants [42.86%] and 440 female participants [57, 14%], age = 31.16 years; 54.4% of participants are graduates of higher
education). For this purpose, one used the only psychological defense analysis tool that includes all psychological defense mechanisms present in DSM IV R (APA, 2003/2000); and also one of the most common psychological defense analysis tools, namely Defense Style Questionnaire – 60/DSQ 60 (Thygesen et al., 2008), the translated version being adapted to the Romanian sample (Crașovan & Maricuțoiu, 2012). The results confirm a number of five psychological defense mechanisms specific to non-psychotic major depressive disorder: passive-aggressive, projection, dissociation, withdrawal and help-rejecting complaining. Thus, the identification of patients’ specific defense mechanisms may increase the efficiency of psychotherapeutic treatment.
References
AKKERMAN, K., LEWIN, T.J., & CARR, V.J., Long-term changes in defense style among patients recovering from major depression, Journal of Nervous and Mental Disease, 187, 2, 1999, p. 80–87, http://dx.doi.org/10.1097/00005053-199902000-00003.
AMERICAN PSYCHIATRIC ASSOCIATION, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Washington, DC, American Psychiatric Association, 2000.
AMERICAN PSYCHIATRIC ASSOCIATION, Manual de Diagnostic și Statistică a Tulburărilor Mentale, ediția a patra revizuită (DSM-IV-TR) [Diagnostic and Statistical Manual of Mental Disorders, ed. 4 (DSM-IV-TR)]. București, Editura Asociației Psihiatrilor Liberi din România, 2003.
BECK, A.T., RUSH, A.J., SHAW, B.F., & EMERY, G., Cognitive Therapy of Depression, New York, The Guilford Press, 1979.
BECK, A.T., WARD, C.H., MENDELSON, M., An inventory for measuring depression, Arch.Gen.Psychiatry, 4, 1981, p. 561–571, doi:10.1001/archpsyc.1961.01710120031004.
BIGGS, J.T., WYLIE, L.T., ZIEGLER, V.E., Validity of the Zung Self-rating Depression Scale, British of the Journal of Psychiatry, 132, 1978, p. 381–385, DOI:10.1192/bjp.132.4.381.
BLACKMAN, J.S., 101 defenses: How the mind shields itself, Routledge, 2004.
BLAYA, C., DORNELLES, M., BLAYA, R., KIPPER, L., HELDT, E., ISOLAN, & MANFRO, G.G., Do defense mechanisms vary according to the psychiatric disorder?, Revista brasileira de psiquiatria (Sao Paulo, Brazil: 1999), 28, 3, 2006, p. 179–183, http://dx.doi.org/10.1590/S1516-44462006000300007 .
BOND, M., Empirical studies of defence style: Relationships with Psychopathology and change, Harvard Review of Psychiatry, 12, 2004, p. 263–278. DOI: 10.1080/10673220490886167.
BOND, M., GARDNER, S.T., CHRISTIAN, J., & SIGAL, J.-J., Empirical study of self-rated defense styles, Archives of General Psychiatry, 40, 1993, p. 333–338, http://dx.doi.org/10.1001/archpsyc.1983.01790030103013.
BOND, M., & PERRY, J.C., Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders, American Journal of Psychiatry, 161, 2004, p. 1665–1671, https://doi.org/10.1176/appi.ajp.161.9.1665.
CARVER, C.S., SCHEIER, M.F., & WEINTRAUB, J.K., Assessing coping strategies: A theoretically based approach, Journal of Personality and Social Psychology, 56, 1989, p. 267–283. doi:10.1037/0022-3514.56.2.267.
CRAMER, P., Development of defense mechanisms: Theory, research, and assessment, New York: Springer-Verlag, 1991 a.
CRAMER, P., Anger and the use of defense mechanismsin college students, Journal of Personality, 59, 1, 1991 b, p. 39–55, DOI: 10.1111/j.1467-6494.1991.tb00767.x.
CRAMER, P., Coping and Defense Mechanisms: What's the Difference?, Journal of Personality, 66, 1998, p. 919–946, DOI: 10.1111/1467-6494.00037.
CRAMER, P., Protecting the self: Defense mechanisms in action, New York, NY, The Guilford Press, 2006.
CRAȘOVAN, D.I., Psychological defense mechanisms associated with disfunctional attitudes in non-psychotic major depressive disorder, Cognition, Brain, Behavior. An Interdisciplinary Journal, XVIII, 1, 2014, p. 39–55, ISSN: 1224-8398. http://cbbjournal.ro/index.php/en/2014/79-18-1/534
CRAȘOVAN, D.I., & MARICUȚOIU, L.P., Adaptation of the Defensive Style Questionnaire 60 (DSQ-60) within a Romanian sample, Cognition, Brain, Behavior. An Interdisciplinary Journal, XVI, 4, 2012, p. 509–528, http://www.cbbjournal.ro/index.php?option=com_content&task=view&id=509&Itemid=59.
CRAȘOVAN, D.I., & SAVA, A.F., Translation, adaptation and validation on Romanian population of COPE Questionnaire for coping mechanisms analysis, Cognition, Brain, Behavior. An Interdisciplinary Journal, XVII, 1, 2013, p. 61–76. ISSN: 1224-8398, http://www.cbbjournal.ro/index.php?option=com_content&task=view&id=515&Itemid=60
DAVID, D., Tratat de psihoterapii cognitive şi comportamentale [Treaty of Cognitive and Behavioural Psychotherapies], Iaşi, Editura Polirom, 2006 a.
DAVID, D., Metodologia cercetării clinice [Methodology of the Clinical Research], Iaşi, Editura Polirom, 2006 b.
DRAPEAU, M., THOMPSON, K., PETRAGLIA, J., THYGESEN, K.L., & LECOURS, S., Defense Mechanisms and gender: An Examination of Two Models of Defensive Functioning Derived from the Defense Style Questionnaire, International Journal of Psychology and Psychological Therapy, 11, 1, 2011, p. 149–155, b200df62971db964c61c15894ba5983a.pdf.
DE PAGE, L., DE WEERDT, M., EGGER, J.I., & ROSSI, G., Differentiation between Defensive Personality Functioning and Psychopathology as Measured by the DSQ-42 and MMPI-2-RF, International journal of psychology and psychological therapy, 18, 3, 2018, p. 331–343, https://www.ijpsy.com/volumen18/num3/499.html.
GRANIERI, A., LA MARCA, L., MANNINO, G., GIUNTA, S., GUGLIELMUCCI, F., & SCHIMMENTI, A., The relationship between defense patterns and DSM-5 maladaptive personality domains, Frontiers in psychology, 8, 1926, 2017, doi: 10.3389/fpsyg.2017.01926.
HERSOUG, A.G., SEXTON, H.C., & HOLGLEND, P., Contribution of defensive functioning to the quality of working alliance and psychotherapy outcome, American Journal of Psychotherapy, 56, 2002, p. 539–554, https://doi.org/10.1176/appi.psychotherapy.2002.56.4.539.
HOGLEND, P., & PERRY, J.C., Defensive functioning predicts improvement in treated major depressive episodes, Journal of Nervous and Mental Disease, 186, 1998, p. 238–243, https://doi.org/10.1097/00005053-199804000-00006.
HOVANESIAN, S., ISAKOV, I., & CERVELLIONE, K.L., Defense mechanisms and suicide risk in major depression, Archives of Suicide Research, 13, 1, 2009, p. 74–86. DOI: 10.1080/13811110802572171.
HOWITT, D., & CRAMER, H., Introducere în SPSS pentru psihologie [Introduction to SPSS for Psychology], 16th version, Iaşi, Editura Polirom, 2010.
KENNEDY, B.L., SCHWAB, J.J., & HYDE, J.A., Defense styles and personality dimensions of research subjects with anxiety and depressive disorders, Psychiatric Quarterly, 72, 3, 2001, p. 251–262, http://dx.doi.org/10.1023/A:1010353116016.
KNEEPKENS, R.G., & OAKLEY, L.D., Rapid improvement in the defense style of depressed women and men, Journal of Nervous and Mental Disease, 184, 6, 1996, p. 358–361, http://dx.doi.org/10.1097/00005053-199606000-00005.
KWON, P., & LEMON, K.E., Attributional style and defense mechanisms: A synthesis of cognitive and psychodynamic factors in depression, Journal of Clinical Psychology, 56, 2000, p. 723–735, https://doi.org/10.1002/(SICI)1097-4679(200006)56:6<723::AID-JCLP3>3.0.CO;2-3.
IONESCU, Ş., JACQUET, C.-L., & LHOTE C., Mecanismele de apărare. Teorie şi aspecte clinice [Defense mechanisms. Theory and clinical aspects], Iaşi, Editura Polirom, 2002.
LACZKOVICS, C., FONZO, G., BENDIXSEN, B., SHPIGEL, E., LEE, I., SKALA, K., ... & HUEMER, J., Defense mechanism is predicted by attachment and mediates the maladaptive influence of insecure attachment on adolescent mental health, Current Psychology, 1–9, 2018, b200df62971db964c61c15894ba5983a.pdf.
MACGREGOR, M.W., DAVIDSON, K.W., ROWAN, P., BARKSDALE, C., & MACLEAN, D., The use of defenses and physician health care casts: Are physician health care costs lower in individuals with more adaptive defense profiles?, Psychotherapy and Psychosomatics, 72, 2003, p. 315–323, https://doi.org/10.1159/000073028.
MALONE, J.C., COHEN, S., LIU, S.R., VAILLANT, G.E., & WALDINGER, R.J., Adaptive midlife defense mechanisms and late-life health, Personality and individual differences, 55, 2, 2013, p. 85–89. doi.org/10.1016/j.paid.2013.01.025
MULLEN, L.S., BLANCO, C., VOUGHN, S.C., & ROOSE, S.P., Defense mechanisms and personality in depression, Depression and Anxiety, 10, 1999, p. 168–174, https://doi.org/10.1002/(SICI)1520-6394(1999)10:4<168::AID-DA5>3.0.CO;2-5.
OLSON, T.R., PRESNIAK, M.D., & MACGREGOR, M.W., Differentiation of depression and anxiety groups using defense mechanisms, The Journal of nervous and mental disease, 197, 11, 2009, p. 834–840, doi: 10.1097/NMD.0b013e3181beab34
PERRY, J.C., & BOND, M., Change in defense mechanisms during long-term dynamic psychotherapy and five-year outcome, American Journal of Psychiatry, 169, 9, 2012, p. 916–925, https://doi.org/10.1176/appi.ajp.2012.11091403.
PETRAGLIA, J., BHATIA, M., DE ROTEN, Y., DESPLAND, J.N., & DRAPEAU, M., Investigating defense interpretation depth using lag sequential analysis, Archives of Psychiatry and Psychotherapy, 4, 2018, p. 7–16, DOI: 10.12740/APP/94400.
POPA, M., Statistică pentru psihologie. Teorie şi aplicaţii SPSS [Statistics for Psychology. Theory and Applications SPSS], Iaşi, Editura Polirom, 2008.
PORCERELLI, J.H., OLSON, T.R., PRESNIAK, M.D., MARKOVA, T., & MILLER, K., Defense Mechanisms and Major Depressive Disorder in African American Women, The Journal of Nervous and Mental Disease, 197, 10, 2009, p. 736–741, doi: 10.1097/NMD.0b013e3181b977f7.
SAVA, F.A., Analiza datelor în cercetarea psihologică [Data Analysis in Psychological Research], Cluj Napoca, Editura ASCR, 2011.
SAVA, F., & MARICUŢOIU, L.-P., PowerStaTim. Manualul utilizatorului [PowerStaTim. User's Manual], Timişoara, Editura Universităţii de Vest, 2007.
STIEMERLING, D., 10 abordări psihoterapeutice ale depresiei [10 Wege aus der Depression], Bucureşti, Editura Trei, 2006.
THYGESEN, K.L., DRAPEAU, M., TRIJSBURG, R.W., LECOURS, S., & DE ROTEN, Y., Assessing defence styles: Factor structure and psychometric properties of the new Defence Style Questionnaire 60 (DSQ-60), The International Journal of Psychology and Psychological Therapy, 8, 2008, p. 171–181, https://www.ijpsy.com/volumen8/num2/193/assessing-defense-styles-factor-structureEN.pdf.
TRIJSBURG, R.W., BOND, M., DRAPEAU, M., THYGESEN, K.L., DE ROTEN, Y., & DUIVENVOORDEN, H.J., Defense Style Questionnaire 60: Development and psychometric evaluation, Paper presented at the University of Lausanne, Switzerland, 2003.
VAN, H.L., DEKKER, J., PEEN, J., ABRAHAM, R.E., & SCHOEVERS, R., Predictive value of self-reported and observer-rated defense style in depression treatment, American Journal of Psychotherapy, 63, 1, 2009, p. 25–39.
VAILLANT, G.E., Wisdom of the ego: Sources of resilience in adult life. Cambridge, Harvard University Press, 1993 a.
VAILLANT, G.E., The wisdom of the ego, Cambridge, Harvard University Press, 1993 b.
VAILLANT, G., Adaptive mental mechanisms: Their role in positive psychology, American Psychologist, 55, 2000, p. 89–98. doi:10.1037/0003-066X.55.1.89.
VAILLANT, G.E., Involuntary coping mechanisms: a psychodynamic perspective, Dialogues in clinical neuroscience, 13, 3, 2011, p. 366–370.
VAILLANT, G., Lifting the Field’s “Repression” of Defenses, American Journal of Psychiatry, 169, 9, 2012, p. 885–887, https://doi.org/10.1176/appi.ajp.2012.12050703.
VAILLANT, G.E., BOND, M., & VAILLANT, C.O., An empirically validated hierarchy of defense mechanisms, Archives of General Psychiatry, 43, 1986, p. 786–794, DOI: 10.1001/archpsyc.1986.01800080072010.
WEISSMAN, A.N. & BECK, A.T., Development and validation of the Dysfunctional Attitudes Scale: a preliminary investigation, in: Proceedings of the meeting of the American Educational Research Association, Toronto, ON, 1978.
WORLD HEALTH ORGANIZATION, Depression and other common mental disorders: global health estimates (No. WHO/MSD/MER/2017.2), World Health Organization, 2017.
WORLD MENTAL HEALTH DAY (2012), DEPRESSION: A Global Crisis. Downloaded at 03.01.2013, from www. wfmh.org/00WorldMentalHealthDay.htm/2012, 2012.
ZUNG, W.W., A Self-Rating Depression Scale, Archives of General Psychiatry, 12, 1965, p. 63–70, DOI: 10.1001/archpsyc.1965.01720310065008.
