Psychological Factors as Determinants of Chronic Conditions: Clinical and Psychodynamic Advances

Conversano, Ciro; Giuseppe, Mariagrazia Di

doi:10.3389/fpsyg.2021.635708

Cited by 28 publications

(15 citation statements)

References 115 publications

(99 reference statements)

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“…Additionally, within a good therapeutic relationship (informed on these psychological dimensions) patients can increase their mentalizing abilities and learn to better symbolize their psychic contents, moving out from the immature defensive dimensions of acting-out and helpreject complaining to a more mature capacity for self-observation and expression of one's suffering (Hoglend & Perry, 1998;Conversano & Di Giuseppe, 2021).…”

Section: Discussionmentioning

confidence: 99%

Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation

Tanzilli

Giuseppe

Giovanardi

et al. 2021

ResPsy

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Mentalizing capacities depends on the quality of primary attachment interactions with caregivers who thinks of the child as a subject with mental states. Operationalized as reflective functioning, mentalization is crucial for regulating emotions and developing of a coherent sense of identity, for interacting with individuals making sense to own and others mental states, and for distinguishing internal and external realities without distortions. Although the clinical literature on interplay between mentalization, attachment, and emotional regulation is rich, the empirical research is limited. This study sought to explore connections between reflective functioning, attachment styles, and implicit emotion regulation, operationalized as defense mechanisms, in a group of depressive patients. Twenty-eight patients were interviewed using the adult attachment interview (AAI) and diagnosed using the Psychodynamic Chart-2 of the Psychodynamic Diagnostic Manual, Second Edition. The reflective functioning scale and the defense mechanisms rating scale Q-sort were applied to AAI transcriptions to assess reflective functioning and defensive profile. Patients with secure attachment showed significantly higher levels in reflective functioning and overall defensive functioning as compared to those with insecure attachment. Good reflective functioning and secure attachment correlated with mature defenses and specific defensive mechanisms that serve in better regulating affective states. Overall, the relationship between mentalization, attachment and emotion regulation lay the foundations for the delineation of defensive profiles associated with attachment patterns and reflective functioning in depressive patients. The systematic assessment of these psychological dimensions with gold-standard tools may help in tailoring personalized therapeutic interventions and promoting more effective treatments.

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Section: Discussionmentioning

confidence: 99%

Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation

Tanzilli

Giuseppe

Giovanardi

et al. 2021

ResPsy

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“…Starting from the considered defense mechanism, suppression emerged as a consistent way to manage internal/external stressors, as in the case of adaptation, pathological psychosomatic issues, and medical conditions due to psychological phenomena ( Warnes, 1982 ; Cramer, 2000 ; De Burge, 2001 ; Szwec, 2018 ; Settineri et al, 2019a ; Conversano et al, 2020b ; Conversano and Di Giuseppe, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

The Role of Suppression and the Maintenance of Euthymia in Clinical Settings

et al. 2021

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Background: Defense mechanisms serve as mediators referred to the subjects’ attempt to manage stressors capable of threatening their integrity. Mature defense mechanisms represent the high adaptive group, including suppression, which allows the subject to distance disturbing contents from consciousness. In line with general defensive intents, suppression would preserve stable mood states, as in the case of euthymia. Clinical issues usually disturb homeorhesis, so that the study of subjects’ suppressive tendencies would suggest possible existing relations among defense mechanisms, mood states, and clinical issues. The study highlighted the significant existing relations among factors such as suppression, euthymia, mood states, and clinical psychological phenomena.Methods: The observation group was composed of 150 participants, 51 males (34%) and 99 females (66%), aged from 25 to 30 years old, with a mean age of 26.63 years old (SD = 1.51). The study was conducted through the use of measures related to subjects’ characteristics, euthymia, psychological flexibility and psychological well-being (Euthymia Scale), suppression (Suppression Mental Questionnaire), well-being (Who-5), and compassion (ProQol-5).Results: The performed analyses consisted of descriptive statistics, correlations, differences, and regressions among the considered variables. Starting from the first hypothesis, SMQ factors appeared to be significantly and positively correlated with Euthymia factors, rather than Regression in the Ego service (-). In line with the previous result, significant and positive correlations emerged among SMQ and Well-being (WHO-5) variables, maintaining an inverse relation with Regression in the Ego service. Significant differences emerged between male and female groups concerning SMQ total score and rationalization, with higher male group scores. Finally, significant dependencies emerged among the selected predictors (SMQ variables) and Compassion satisfaction.Conclusion: The emerged results highlighted significant relations among the considered variables so that it was possible to highlight the common directions assumed by suppression variables, well-being, and euthymia. Moreover, suppression appeared as a significant predictor with a causal role in clinical satisfaction. The results that have emerged allow us to consider defenses through an empirical perspective, useful to suggest an extension to other groups, phenomena, and conditions.

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“…Numerous studies have demonstrated that the maturity of defensive functioning is a protective factor against the development of psychological and somatic diseases [ 42 , 43 , 44 , 45 ]. Traumatic experiences can provoke a decrease in overall defensive functioning and increase the use of mental inhibition defense mechanisms, also called neurotic defenses.…”

Section: Introductionmentioning

confidence: 99%

Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms

Giuseppe

Nepa²,

Prout

et al. 2021

IJERPH

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The experience of working on the frontlines of the COVID-19 healthcare crisis has presented a cumulative traumatic experience that affects healthcare professionals’ well-being. Psychological resources such as resilience and adaptive defense mechanisms are essential in protecting individuals from severe stress and burnout. During September 2020, 233 healthcare workers responded to an online survey to test the impact of demographic variables, COVID-19 exposure, and psychological resources in determining stress and burnout during the COVID-19 emergency. Frontline workers reported higher scores for stress, emotional exhaustion, and depersonalization (p < 0.001) as compared to colleagues working in units not directly serving patients with COVID-19. Mature defensive functioning was associated with resilience and personal accomplishment (r = 0.320; p < 0.001), while neurotic and immature defenses were related to perceived stress and burnout. Stress and burnout were predicted by lower age, female gender, greater exposure to COVID-19, lower resilience, and immature defensive functioning among healthcare professionals (R2 = 463; p < 0.001). Working on the frontlines of the COVID-19 pandemic appears to provoke greater stress and burnout. On the other hand, resilience and adaptive defense mechanisms predicted better adjustment. Future reaction plans should promote effective programs offering support for healthcare workers who provide direct care to patients with COVID-19.

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Psychological Factors as Determinants of Chronic Conditions: Clinical and Psychodynamic Advances

Cited by 28 publications

References 115 publications

Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation

Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation

The Role of Suppression and the Maintenance of Euthymia in Clinical Settings

Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms

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