Psychological defence mechanisms during the COVID-19 pandemic: A case series

Background and objectives: COVID-19 has had a negative effect on mental health across the world's population. Healthcare workers in particular have experienced increased levels of psychological distress, depression and anxiety. Any perceived stress to an individual can provoke psychological defence mechanisms. Using psychoanalytic theory, a defence mechanism is described as an unconscious psychological strategy, with or without resulting behaviour, which aims to reduce or eliminate anxiety arising from unacceptable or potentially harmful stimuli. This paper aims to describe a range of psychological defence mechanisms encountered within colleagues in relation to the COVID-19 pandemic.MethodsUsing the methodology of a case series, specific defence mechanisms are explored with reference to further literature in the field.ResultsThe author has encountered varying psychological defence mechanisms, both within himself and in other members of the multidisciplinary team. These have been illustrated in the attached clinical vignettes, relating to the specific psychological coping mechanisms of; denial, hypochondriasis, altruism, sublimation and humour.ConclusionWe encourage acknowledgement of psychological defence mechanisms and their implications on day to day practice. Whilst defence mechanisms can have a number of negative consequences as described in this article, they also have an important role, particularly in the case of mature defence mechanisms, as protective factors against psychological distress and symptom formation. Deeper understanding of the gold-standard hierarchical organisation of defence mechanisms could help increase utilisation of specific therapeutic interventions for enhancing changes from immature to mature defensive responses to stressful experiences as the COVID-19 pandemic progresses.(AU)

Differentiation between defensive personality functioning and psychopathology as measured by the DSQ-42 and MMPI-2-RF

Defensive functioning is considered one of the core aspects of personality functioning and its maturity level is regarded an important predictor of psychopathology and more specific personality pathology. The current investigation assesses the relation between overall defensive functioning, as measured by the Defense Style Questionnaire-42 (DSQ-42), and higher order models of psychopathology as measured by the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). The DSQ-42 and MMPI-2-RF was completed by 383 patients. We analysed the MMPI-2-RF personality and psychopathology as measured with the Restructured Clinical scales and the Personality Psychopathology Five-revised scales using Goldberg’s Bass Ackwards Method. Higher order dimensions of personality and psychopathology in the current investigation demonstrated structural similarity with previously reported higher order models. Next we examined the optimal level of differentiation of defensive functioning, as measured by the DSQ-42 Total and Overall Defensive Functioning scores, to personality and psychopathology at each succeeding level of the hierarchical factor structures. Results indicated that immature defense mechanisms exemplify strong correlations with internalizing pathology (i.e., Demoralisation and Introversion), but not with externalizing pathology and thought disorder. The differentiation of defensive functioning from higher order models of psychopathology and maladaptive personality traits seems to be limited, based on the current results. The DSQ-42 appeared to have a large overlap and correlations with internalizing pathology, which appeared to be due to its item content: mostly intrapsychic and immature defenses. Theoretical and clinical implications considering the use of the DSQ are discussed

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Duelo y causalidad / Luto e causalidade / Bereavement and causality

El presente artículo profundiza en el mundo de quienes viven un proceso de duelo y de cómo las creencias, el azar y la naturaleza se entretejen para conformar una red de significados que suma humanidad al proceso de vivir. Abordamos la reconstrucción de los significados en el duelo y en el entendimiento de dicho proceso. La reconstrucción de los significados ayuda a los dolientes a rehacer un mundo nuevo que ha propiciado la pérdida. Buscamos pues, comprender lo que sucede cuando una serie de acontecimientos desvelan el significado adaptativo de las nuevas creencias y la comprensión de la pérdida, proporcionado explicaciones que sean fieles a lo narrado por quienes lo vivieron. Muchos acontecimientos forman parte de historias de padres que perdieron hijos, y algunos sucesos por sí mismos tienen consideración de extraordinarios y dan un sentido o significado a los personajes, al relato y al desenlace de modo diferente y especial. A dichos acontecimientos los denominamos "coincidencias", que obran un efecto y poder en nosotros y que trascienden los significados de lo que ha acontecido, superando lo emocional o intelectual por la confluencia de sucesos y el significado, y a lo que Carl G. Jung denominó "sincronicidad" (AU)

Este artigo investiga o mundo daqueles que vivem um processo de luto e como as crenças, o acaso ea natureza se entrelaçam para formar uma rede de significados que acrescenta a humanidade ao processo de viver. Abordar a reconstrução de significados na partida e na compreensão desse processo. A reconstrução de significados ajuda quem perdeu alguém para reconstruir um novo mundo criado a partir de perda. Procuramos, portanto, para entender o que acontece quando uma série de eventos revelam o significado adaptativo de novas crenças e compreensão da perda, forneceu explicações que são fiéis ao narrado por aqueles que viveram. Muitos eventos são parte de histórias de pais que perderam seus filhos, e alguns eventos próprios considerada extraordinária e dar um sentido ou significado para os personagens, a história e o resultado de maneira diferente e especial. Nestes eventos que chamamos de "coincidências" que agem um efeito e poder em nós e que transcendem os significados do que aconteceu, superando emocional ou intelectual pela confluência de eventos e significado, e que Jung chamou Carl G. "sincronicidade" (AU)

The present article investigates into the world of those who live a process of bereavement and how beliefs, chance, and nature in-terweave to form a network of meanings that adds humanity to the process of living. The paper addresses the reconstruction of meanings in bereavement and in understanding the process. The reconstruction of meanings allows the mourners to remake a new changing world that has led to the loss. We, therefore, seek to understand what happens when a series of events reveal the adaptive meaning of new beliefs and the self-understanding of the loss, providing faithful explanations narrated by those who have lived it. Many events are part of stories of parents who lost children, and some events by themselves are considered extraordinary, giving sense to the characters, the story, and the consequences in a different and special way. We call these events "coincidences" which have an effect and power, and transcend the meanings of what has been, surpassing the emotional or intellectual by the confluence of events and meaning, that of Carl G. Jung called "Synchronicity" (AU)

Development and evaluation of the psychometric properties of the Short Defense Style Questionnaire (DSQ-26) in sport

The purpose of the present study was to develop and evaluate a measure of defense mechanisms that is useable in sports research: the short Defense Style Questionnaire (DSQ-26). A total of 296 competitive athletes completed the DSQ-26 and other self-report questionnaires both before and after a sport competition. Results of Principal Component Analyses (PCA) on the pre-competitive data showed evidence for a 2-factor model that included adaptive (e.g., humor, anticipation, self-assertion, altruism, self-observation) and maladaptive defenses (e.g., help rejecting complaining, splitting other, projection, dissociation, intellectualization, devaluation/self, fantasy, devaluation of other). Confirmatory factor analyses conducted on both the pre- and intra-competitive data showed an acceptable fit of the data for the 2-factor, 13-defense model of DSQ-26, supporting the factorial structure identified within the PCAs. Correlations between DSQ-26 subscales, coping, affective states, perceived stress and control scores provided evidence for criterion-related validity of the DSQ-26 scores. Overall, this study provides support for the reliability and validity of the short DSQ-26 scores with recommendations for the use and development of this measure of defense mechanisms in stressful situations (AU)

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El tiempo detenido / Time at a standstill

En los pacientes que suelen presentar un funcionamiento narcisista se da un manejo del tiempo que afecta a la situación analítica y al proceso del tratamiento. A través de las viñetas clínicas de un caso, se describe cómo este particular manejo del tiempo puede ser debido al empleo de defensas obsesivas que tienen que ver con mecanismos muy primitivos, que se gestan en 105 primeros momentos del desarrollo, destinados a asimilar por medio del control omnipotente la relación con el otro. En este caso, se escenifica en la relación analítica esta forma de vincularse con la realidad donde este singular uso del tiempo parece cumplir la necesidad de la repetición pero también de elaboración y transformación (AU)

In patients presenting with narcissistic functioning, a management of time tends to occur which affects the analytic situation and treatment process. Through case vignettes the author describes how this particular management of time may be owing to the employment of obsessional defences connected to exceedingly primitive mechanisms. These emerge during very early development, designed to assimilate the relationship with the other by means of omnipotent control. Here, this form of linking with reality is played out in the analytic relationship, where this particular use of time appears to fulfil the need for repetition but also for elaboration and transformation (AU)

Cognitive distortions mediate the relationship between defense styles and depression in female outpatients

Background and Objectives: Some clinicians use different psychotherapeutic methods in combination in their practice. These combinations reflect the need for more rigorous research on the common pathways which these different therapy orientations may be utilizing, and one way to identify these pathways would be to investigate some core assessment tools or conceptual foundations of these two different approaches. Aim: The aim of the present study was to evaluate the relationship between defense mechanisms and cognitive distortions, and to identify the mediating role of cognitive distortions between defense styles and depression. Methods: A total of 342 female psychiatric outpatients aged 18 and older were recruited. A diagnostic interview and rating of the depression severity were undertaken, and the Cognitive Distortion Scales and the Defense Style Questionnaire were completed by the participants. Hierarchical regression analyses were conducted to test for the direct and indirect effects of the defense styles. Results: Cognitive distortions and defense mechanisms were both correlated with the severity of depression, but the correlations were stronger for the former. Conclusions: The findings are suggestive of the mediating effect of cognitive distortions between defense mechanisms and the severity of depression (AU)

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Mecanismos de defensa, signos de alarma e intervención temprana en el autismo / Defense mechanisms, warning signs and early intervention in autism / Mecanismes de defensa, signes d’alarma i intervenció primerenca en l’autisme

El proceso autístico se va desarrollando con el aumento progresivo de un funcionamiento psíquico que se manifiesta en unas modalidades defensivas particulares. Éstas son las responsables de los signos de alarma que, presentes en el bebé de forma repetitiva, acumulativa y duradera, van llevando progresivamente al niño hacia un funcionamiento autista. Si, además de detectar estos signos, se pudieran observar los factores de riesgo interactivos entre el bebé y su cuidador, las defensas del bebé, y sobre todo, la evolución de la modalidad o estilo de interacción cuidador-bebé, sería posible plantear un tratamiento psicoterapéutico que ayude a modificar este estilo interactivo, interrumpiendo un proceso evolutivo autista patológico y permitiendo un desarrollo sano y normalizado en gran número de casos

The autistic process unfolds with a progressive increase in psychic, unconscious and unintentional operation, which manifests itself with particular defensive modalities. They are responsible for warning signs that are present in the baby and appear repeatedly, accumulate and last over a long period, gradually and locking the child in an inner world of autistic operation. If, in addition to these signs, risk factors are also apparent in the interactions between the baby and his or her caregiver, in the baby’s defences, and above all in the evolution of the form or style of caregiver-baby interactions, it is then possible to propose psychotherapeutic treatment to help to modify this style of interaction, thus interrupting the evolution of this pathological autistic process and in many cases enabling healthy, standardized development

El procés autístic es va desenvolupant amb l’augment progressiu d’un funcionament psíquic que es manifesta en unes modalitats defensives particulars. Aquestes són les res­ponsables dels signes d’alarma que, presents en el nadó de forma repetitiva, acumulativa i duradora, van portant progressivament el nen a un funcionament autista. Si, a banda de detectar aquests signes, es poguessin observar els factors de risc interactius entre el nadó i el cuidador, seria possible plantejar un tractament psicoterapèutic que ajudés a modificar aquest estil interactiu i a interrompre un procés evolutiu autista patològic per permetre així un desenvolupament sa i normalitzat en un gran nombre de casos

Defensive responses to early memories with peers: a possible pathway to disordered eating

Childhood and early adolescence experiences, specifically those that provide an adulthood enriched with warm and safe memories, are consistently stated in literature as powerful emotional regulators. In contrast, individuals who scarcely recall positive experiences may begin to believe that others see the self as inferior, inadequate and unattractive. In order to cope with a perceived loss of social desirability and achieve other’s acceptance, individuals may become submissive, and women, particularly, may resort to the presentation of a perfect body image. Both mechanisms are defensive responses suggested to be associated with mental health difficulties, particularly disordered eating behaviors. The present study aimed at exploring the association between early memories of warmth and safeness with peers and eating psychopathology. Also, a path analysis was conducted to investigate the mediator role of submissiveness and perfectionistic self-presentation focused on body image on this association, in a sample of 342 female students. Results revealed that the absence of early positive memories with peers holds a significant effect over eating psychopathology’s severity, and also that this effect is mediated through submissiveness and body image-related perfectionistic self-presentation. This model accounted for 13%, 19% and 51% of submissiveness, perfectionistic self-presentation of body image and eating psychopathology’s variances, respectively, and showed excellent model fit (AU)

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Cardiovascular profile of defensive hostile women in a real stressful situation / Perfil cardiovascular de mujeres hostiles defensivas en una situación de estrés real

The main objective of this study was to analyze the impact of defensive hostility on cardiovascular response in a stressful situation. By measuring three of the most commonly used cardiovascular indexes (heart rate, systolic blood pressure and diastolic blood pressure) over three experimental phases (adaptation, task and recovery), the evolution of cardiovascular response was analyzed minute by minute throughout the entire experimental session, to check if the defensive hostility influences the cardiovascular function. Two scales were used: the Cook-Medley Composite Hostility Scale and the Marlowe-Crowne Social Desirability Scale. Based on the scores on these scales, there were formed four groups (high hostility and high defensiveness, high hostility and low defensiveness, low hostility and high defensiveness, and low hostility and low defensiveness). The stressful situation which was used in the task phase was a real academic examination (exam of the Psychology degree). The hypothesis was that cardiovascular response, activation and recovery, minute by minute, will be greater in hostile defensive women, with an intra-phase evolution profile characterized by maintenance or sensitization and slow recovery. Results show that defensive hostile individuals present the highest values in the physiological variables recorded, and less adaptive profile

El objetivo del presente estudio ha sido analizar el impacto de la hostilidad defensiva sobre la respuesta cardiovascular en una situación estresante. Mediante la medición de la frecuencia cardiaca, la presión sistólica y la presión diastólica, a través de las tres fases del experimento (adaptación, tarea y recuperación), hemos analizado la evolución de la respuesta cardiovascular minuto a minuto a lo largo de toda la sesión experimental, para comprobar si la hostilidad defensiva influye sobre la función cardiovascular. Se utilizaron dos escalas: la Escala Compuesta de Hostilidad del inventario de hostilidad de Cook-Medley y la escala de deseabilidad social de MarloweCrowne. Basándonos en las puntuaciones de estas escalas, se formaron cuatro grupos (alta hostilidad-alta defensividad, alta hostilidad-baja defensividad, baja hostilidad-alta defensividad, y baja hostilidad-baja defensividad). La situación de estrés utilizada en la tarea fue un examen real. La hipótesis propuesta fue que la respuesta cardiovascular, la activación y la recuperación, minuto a minuto, serían mayores en las mujeres hostiles defensivas, con un perfil de evolución caracterizado por el mantenimiento o la sensibilización y la recuperación lenta. Los resultados muestran que las personas hostiles defensivas presentan los valores más altos en las variables fisiológicas registradas, así como perfiles menos adaptativos

Exploring drive for thinness as a perfectionistic strategy to escape from shame experiences

Perfectionistic self-presentation defines the attempt at presenting the self as perfect through the public concealment of personal defects and/or through the display of attributes perceived as capable to gather positive attention of others. Although perfectionism has long been considered a central aspect of eating psychopathology mediational studies between this construct and these conditions are scarce. This study aimed at examining the mediational role of body image-related perfectionistic self-presentation in the effects of external shame and internal shame on drive for thinness, in a sample of young women. Results revealed body image-related perfectionistic selfpresentation as a significant mediator (p < .05) of the relationships between external and internal shame, and drive for thinness. Furthermore, 86% and 69% of the effects of external shame and internal shame, respectively, were explained by their indirect effects through body image-related perfectionistic self-presentation on drive for thinness (95% CI). These results highlight that the control over eating may emerge as a maladaptive strategy to deal with shame when mediated by an endorsement in the belief that presenting a perfect body image is crucial to be accepted and valued by others. Study findings suggest that this perfectionistic strategy should be targeted while treating eating psychopathology (AU)

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Examining the Defense Style Questionnaire 88 (DSQ-88) in an employee sample: Items and a two-factor model

The original 88-item version of the Defense Style Questionnaire (DSQ) has been ignored in recent studies. The current study examined the scoring instructions in the DSQ-88 manual by investigating how the items used to score specific defense styles loaded in an exploratory factor analysis. It also sought to confirm a two-factor model of ego defense styles in a sample of 493 employees at a large, established university in Jamaica, West Indies. The DSQ-88 was administered to employees by research assistants during work hours as part of a larger study. Twenty-six of the 33 items used to score maladaptive action in the DSQ-88 loaded above .40 on a general maladaptive factor in the current data. Principal components analyses resulted in two factors (maladaptive and adaptive) which accounted for 39.4% of the variance and included items from 18 defense mechanisms. Confirmatory factor analysis supported a two-factor model with items from acting out, fantasy, help-rejecting complaining, splitting, inhibition, omnipotence-devaluation, passive-aggression, projective identification, regression, somatization and projection loading on a maladaptive factor and items from humor, sublimation, suppression and denial on an adaptive factor. Recommendations are made for the development of another shortened version of the DSQ-88 for use with employee populations (AU)

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Traumas infantiles y su influencia en la edad adulta / infantile traumas and their influence in adulthood / Traumes Infantils I La Influència En L'edat Adulta

Este texto pretende insistir y evidenciar, a través de algunos casos clínicos, como el abandono, los traumas, las pérdidas, la muerte durante la infancia de los miembros de la familia o sus ausencias, pueden provocar e impactar en la mente de un bebé y de un niño con marcas que perduran y que es posible detectarlas en los pacientes adultos, jóvenes o adolescentes

This paper intends to evince, through several clinical cases, how abandonment, trauma, loss, the death of family members during childhood, or their absence, can produce a long lasting impact in the mind of the baby and infant, with marks that live on and can be detected in adolescent and adult patient

Aquest text pretén insistir i evidenciar, a través d'alguns casos clínics, com l’abandonament, els traumes, les pèrdues, la mort durant la infància dels membres de la família o les seves absències, poden provocar i impactar en la ment d’un bebè i d’un nen amb marques que perduren i que és possible detectar-les en els pacients adults, joves o adolescents

Psicofarmacología psicodinámica: Reflexiones teórico y clínicas / Psicofarmacologia Psicodinàmica: Reflexions Teòricoclíniques / Psychodynamic psychopharmacology: clinical and theorical reflexions

Este trabajo reflexiona, desde una perspectiva psicodinámica, sobre los aspectos del funcionamiento mental del niño que pueden resultar de utilidad para la prescripción de psicofármacos, su ajuste y modificación en el contexto de un abordaje psicoterapéutico que incluye necesariamente el trabajo conjunto con psicoterapeutas. Se propone que las angustias movilizadas, en primer lugar, así como los mecanismos de defensa empleados, secundariamente, son criterios que ofrecen una guía útil para la selección de la medicación

This paper reflects, from a psychodynamic perspective, on those aspects of the child's mental functioning which may be useful for prescribing psychotropic drugs in the context of a psychotherapeutic approach that necessarily includes working with psychotherapists. It is proposed that the initial anxieties mobilized and the subsequent defence mechanisms employed are criteria that can provide a useful guide for the selection of medicatio

Aquest treball reflexiona, des d'una perspectiva psicodinàmica, sobre els aspectes del funcionament mental del nen que poden resultar d'utilitat per a la prescripció de psicofàrmacs, l'ajustament I la modificació en el context d'un tractament psicoterapèutic que inclou necessàriament el treball conjunt amb psicoterapeutes. Es proposa que les angúnies mobilitzades, en primer lloc, així com els mecanismes de defensa emprats, secundàriament, són criteris que ofereixen una guia útil per a la selecció de la medicació

Defense Mechanisms and Gender: An Examination of Two Models of Defensive Functioning Derived from the Defense Style Questionnaire

Different models have been developed to capture an individual’s defensive functioning, including the DSM-IV Defensive Functioning Scale (DFS). These different models are often used to distinguish between psychologically healthy individuals and individuals presen- ting with a mental disorder, or to demonstrate change in patients over the course of and following treatment. Yet, despite evidence that men and women rely on different defence mechanisms, most if not all studies into defences rely on the same model for both genders. Using samples of 517 women and 124 men, this study aimed to examine the extent to which a proxy of the DFS model of defence mechanisms, and the model underlying the Defense Style Questionnaire, can be adequately applied to men and women. Confirmatory factor analyses indicated that neither model accurately reflects men or women´s defensive functioning. Implications of this for research and practice are discussed (AU)

Se han desarrollado diferentes modelos para explicar el funcionamiento defensivo indi- vidual, incluyendo la Escala de Funcionamiento Defensivo DSM-IV. Estos modelos se emplean para distinguir entre individuos psicológicamente sanos e individuos que presentan un desorden mental, o para demostrar el cambio terepéutico en pacientes en tratamiento. Aunque existen evidencias de que hombres y mujeres difieren en sus mecanismos de de- fensa la mayoría, si no todos, de los estudios emplean el mismo modelo para ambos sexos. Este estudio examina en una muestra de 517 mujeres y 124 hombres hasta qué punto un sustituto del modelo DFS de mecanismos de defensa y el modelo subyacente al Defense Style Questionnaire pueden aplicarse adecuadamente con hombres y mujeres. El análisis factorial indica que ninguno de los dos modelos refleja adecuadamente el funcionamiento defensivo de hombres y mujeres. Se discuten las impliaciones para la investigación y la práctica clínicas de estos hallazgos (AU)

Papel de los reflejos arcaicos del primer mes de vida en el desarrollo de la inteligencia y del aparato psicoemocional / Role of the archaic reflections of the first month of life in the development of intelligence and psychoemotional apparatus

A partir de las observaciones de tres lactantes durante la consulta pediátrica, dos de ellas realizadas personalmente por mí, en bebés que no superaban el mes de vida, he podido identificar algunos recursos adaptativo / protectores tales como la somnolencia, alguna parte del cuerpo cerrada, la succión, el giro de la cabeza hacia ambos lados, vocalizaciones y gemidos hasta el llanto, el cierre y apertura del cuerpo a través de sus extremidades, la rigidez del cuerpo, la suspensión de la actividad respiratoria, el parpadeo, la fijación de la mirada en un objeto estático, el vómito, el movimiento hacia atrás de la cabeza, la contemplación del rostro de la madre, el contacto dirigido con las manos, el arqueado del tronco, la vasodilatación periférica, la posición en decúbito ventral, la posición del esgrimista. Algunos de estos recursos, serán ejemplificados a partir de las situaciones observadas en los tres bebés: Vladimiro, Brian y Naara, de 8, 10 y 34 días de vida, respectivamente; para luego correlacionarlos con dos teorías basadas en el Psicoanálisis como son los Mecanismos de Defensa (Anna Freud) y la Psicogénesis (Piaget)

From the observations of three infants in the pediatric consultation, two of them made by myself, in babies who did not exceed the month of life, I could identify some adaptive resources / protectors such as drowsiness, some part of the body closed, suction, turning the head to both sides, vocalizations to tears and groans, closing and opening of the body through his limbs, body rigidity, suspension of respiratory activity, blinking, staring at a static object, vomiting, backward movement of the head, contemplating the face of the mother, contact directed with hands, the arching of the trunk, peripheral vasodilation, the prone position, the position of fencing. Some of these resources will be exemplified from the situations observed in three infants: Vladimir, Brian and Naarah, 8, 10 and 34 days old, respectively, and then correlate them with two theories based on psychoanalysis as are the defensive mechanisms (Anna Freud) and psychogenesis (Piaget)

Defense mechanisms in patients with fibromyalgia and major depressive disorder

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Background and objectives: Fibromyalgia (FM) and depression has been suggested to share a common underlying etiology. Few studies have investigated the role of emotional regulation processes in FM compared to depressive disorders. The purpose of the current study was to explore the use of defense mechanisms in FM patients with and without comorbid lifetime depressive disorder (LDD), and to compare their use of defenses to healthy control subjects and patients with Major Depressive Disorder (MDD).Methods: A total of 91 participants were included (17 with FM and LDD, 25 with FM but not LDD, 24 with MDD, and 25 healthy controls). Depressive disorders were identified by using the Structured Clinical Interview for DSM Axis I disorders (SCID-I). All diagnosis of FM were confirmed to meet the American College of Rheumatology’s criteria for FM. The Life Style Index (LSI) was used to measure defense mechanisms. Results and Conclusions: Group comparisons indicated that MDD patients and FM patients with LDD made significantly more use of defenses than healthy controls, whereas FM patients without LDD made significantly less use of defenses than both MDD patients and FM patients with LDD, but did not differ from healthy controls. Follow up analyses indicated significant main effects for the defense mechanisms of regression, compensation and displacement. This study suggests that FM and depression do not share common risk factors in terms of restricted affects or avoidance of conflicted feelings (AU)

Assessing Defense Styles: Factor Structure and Psychometric Properties of the New Defense Style Questionnaire 60 (DSQ-60)

The Defense Style Questionnaire (DSQ) has undergone numerous revisions in an effort to improve reliability and validity. More recently, another version, the DSQ-60, was designed to be congruent with the DSM-IV. The present study examined the underlying structure of the DSQ-60 using both exploratory and confirmatory factor analytic procedures. The scale was administered to a group of students attending an English-speaking university (n= 305) and a French-speaking university (n= 212). Three factors (image distorting, affect regulating, and adaptive) accounted for 47.93% of the variance. Confirmatory factor analysis corroborated a three factor model. A new factor reflecting defensive functioning in healthy individuals was found. Cronbach’s alpha for the three styles was .64, .72, and .61, respectively. Results are compared with prior research on the DSQ and suggest that the psychometric properties of the scale remain to be improved before broad use is warranted (AU)

El Cuestionario de Estilos de Defensa (DSQ) ha experimentado numerosas revisiones y esfuerzos para mejorar su fiabilidad y su validez Recientemente, se diseñó otra versión, el DSQ-60, para hacerlo congruente con el DSM-IV. El presente estudio examina la estructura subyacente del DSQ-60 mediante procedimientos de análisis factorial exploratorio y confirmatorio. l cuestionario se administró a un grupo de estudiantes universitarios de lengua inglesa (n= 305) y a otro de lengua francesa (n= 212). Tres factores explicaron el 47,93% de varianza (distorsión de la imagen, regulación del afecto y adaptación), modelo de tres factores que fue corroborado por el análisis factorial confirmatorio, aunque se encontró un nuevo factor que refleja el funcionamiento defensivo en individuos sanos. El alfa de Cronbach para los tres estilos fue de .64, .72 y .61, respectivamente. Los resultados se comparan con la investigación previa sobre el DSQ y se sugiere que las propiedades psicométricas de laescala deben ser mejoradas antes de su uso a gran escala (AU)

Stress and ego-defense mechanisms in medical staff at oncology and physical medicine departments FC09=F

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Background and Objectives: Work on the oncology department has proved to be very stressful, so the medical staff indirectly copes with it by trying to escape it through the ego-defense mechanisms. On the other hand, working on the physical medicine department does not seem to be so stressful. The objective of this study was to determine the main ego- defense mechanisms at oncology and physical medicine department and to explain the differences between their frequencies. The other part was to obtain data about socio- demographic status and working environment of the participants. Methods: General structural interview for collecting data on socio-demographic status and working environment and Life Style Questionnaire and Defense Mechanisms for obtaining data about ego-defense mechanisms were carried out among a random sample of 40 medical staff members at each department. Results: A significantly higher level (p ¡Ü .05) of the following ego-defense mechanisms has been found at the oncology department: regression, intellectualization, projection and dislocation. Also, statistically significant difference (p ¡Ü .05), showing higher score on oncology department is observed in following variables: death of patients, facing the patient or his family with possible death, being overloaded with number of patients, facing pain, suffering and handicap, insufficiency of medications, insufficient positive feedback from the patients and bad interpersonal relations at work as well as lack of support from the colleagues. Conclusions: Extreme exposure to stressful events at the oncology department favours development of inadequate defensive mechanisms among the medical staff, which may enhance the risk of burnout (AU)

La vieja batalla entre la especie humana y el bacilo de Koch. ¿Es posible soñar con erradicar la tuberculosis? / The old battle between the human species and Koch’s bacillae. Can one dream of eradicating tuberculosis?

El presente trabajo trata de analizar la complejidad de la vieja batalla que lleva librando, desde hace millones de años, la especie humana contra Mycobacterium tuberculosis, intentando realizar un repaso de todos los conocimientos que se tienen sobre esta enfermedad y de lo más importante de lo que puede acontecer en el futuro, con el fin de llegar a la conclusión de si es posible acabar soñando con erradicar esta enfermedad que tanto daño ha causado a la humanidad. A pesar de que la especie humana tiene suficientes conocimientos para vencer la batalla a M. tuberculosis, importantes condicionantes, sobre todo sociales (pobreza, inmigración, VIH, MDR), están favoreciendo la guerra del lado del bacilo. Y que, incluso aplicando adecuadamente todos los buenos conocimientos adquiridos para el control de la TB (detección y curación de casos, quimioprofilaxis, vacunación BCG, etc.), se tardaría aún varios siglos en poder conseguir la erradicación. Sólo la posibilidad de descubrir una vacuna 100% eficaz, o el descubrimiento de nuevas asociaciones antimicrobianas que pudiesen curar la enfermedad en un plazo no superior a 15 días, podría acelerar este ritmo hacia la erradicación. Pero, lamentablemente, no existen fundamentos que permitan soñar con que cualquiera de estas dos posibilidades pueda cumplirse en los próximos 10-20 años. Por lo tanto, el sueño de erradicar la TB es un sueño muy antiguo, pero, lamentablemente, aún muy lejano

This article analyses the complexity of the age-old battle that the human species has been waging for millions of years against Mycobacterium tuberculosis. We review all of the knowledge available about this disease, and the most important future developments, in order to reach the conclusion that it is indeed possible to dream of eradicating this disease that has caused such harm to humanity. In spite of the human species possessing sufficient knowledge to win the battle against Mycobacterium tuberculosis, important conditioning factors, above all social in character (poverty, immigration, HIV, MDR), are favouring the bacteria in this war. And, in spite of suitably applying all of the positive knowledge acquired for the control of TB (detection and cure of cases, chemoprofilaxis, BCG vaccination, etc.), it will still take several centuries to achieve its eradication. Only by discovering a vaccine that is 100% efficient, or the discovery of new anti-microbial associations that could cure the disease in no longer than 15 days, could accelerate this advance towards its eradication. But, unfortunately, there are no reasons allowing us to dream that either of these two possibilities can be fulfilled in the next 10 to 20 years. Therefore, the dream of eradicating TB is a very old dream, but one that unfortunately remains very distant

Efecto del tiempo de subida del estímulo acústico sobre la respuesta cardíaca de defenca y el reflejo motor de sobresalto / Effect of manipulating the risetime of an acoustic stimulus on two protective reflexes: cardiac defense and motor startle

El tiempo de subida es una característica paramétrica del estímulo que permite diferenciar entre reflejos psicofisiológicos. El objetivo del presente estudio fue examinar el efecto del tiempo de subida de un estímulo acústico en dos reflejos protectores: la respuesta cardiaca de defensa y el reflejo motor de sobresalto. 100 participantes realizaron una prueba de reactividad psicofisiológica ante cinco presentaciones de un estímulo auditivo intenso (ruido blanco de 105 dB) bajo una de cinco condiciones de tiempo de subida: 0, 24, 48, 96 y 240 milisegundos. La energía total del estímulo se mantuvo constante mediante el incremento de la duración base del estímulo (1.000 milisegundos) en un tercio del tiempo de subida. Los resultados indican que el tiempo de subida afecta significativamente al reflejo motor de sobresalto pero no a la respuesta cardiaca de defensa. La amplitud del sobresalto disminuye linealmente a partir de tiempos de subida superiores a 24 milisegundos. Por otra parte, la repetición del estímulo afecta significativamente a la respuesta cardiaca de defensa pero no al reflejo motor de sobresalto. Estos resultados cuestionan la diferenciación tradicional entre sobresalto y defensa basada en el tiempo de subida

The risetime is a parametric characteristic of the eliciting stimulus frequently used to differentiate among psychophysiological reflexes. The aim of the present study was to examine the effect of manipulating the risetime of an acoustic stimulus on two protective reflexes: cardiac defense and motor startle. 100 participants underwent a psychophysiological reactivity test to five presentations of an intense acoustic stimulus (105 dB white noise) under one of five risetime conditions: 0, 24, 48, 96, and 240 ms. Total energy of the stimulus was controlled by increasing the base duration of the stimulus (1000 ms) by one third of the risetime. Results showed that risetime significantly affected motor startle but not cardiac defense. Startle amplitude decreased linearly with increasing risetime after 24 ms. On the other hand, repetition of the stimulus significantly affected cardiac defense but not motor startle. These results question the traditional differentiation between startle and defense based on risetime