Academic journal article Cognitie, Creier, Comportament

Psychological Defense Mechanisms Associated with Disfunctional Attitudes in Non-Psychotic Major Depressive Disorder

Academic journal article Cognitie, Creier, Comportament

Psychological Defense Mechanisms Associated with Disfunctional Attitudes in Non-Psychotic Major Depressive Disorder

Article excerpt

Various reports by international institutions, such as the World Health Organization (2002, 2012) and various authors (David, 2006a; Krug, Mercy, Dahlberg, & Zwi, 2002; Stiemerling, 2006), show an increase in the incidence of mental disorders. In mental disorders, depression in its various forms has increased considerably. According to some authors (Stiemerling, 2006), it affects 5% of the world population, becoming "the disorder of the contemporary era" (David, 2006b), affecting all age groups and social environments, and constantly increasing. According to the last report of the World Mental Health Day (2012), it is estimated that 350 million people of the world population are currently affected by depression.

Through symptoms, clinical depression in its various forms, in this case non-psychotic major depressive disorder (see DSM IV R[APA, 2000/2003]), can cause a number of difficulties for the person affected, patients showing almost daily a depressed mood, significant reduction in interest or pleasure for any activity, rhythm sleep disturbances, psychomotor agitation or retardation nearly every day, inadequate feeling of guilt, impaired cognitive level, the fear of death with suicidal ideation, all of which affecting the ill person socially, at work and in the family.

A number of relatively recent studies performed by Marton, Churchard, and Kutcher (1993), Weich, Churchill, and Lewis (2003), and Renner, Lobbestael, Peeters, Arntz, and Huibers (2012) argue that depression is associated with dysfunctional attitudes, regarded as general descriptive and inferential cognitions (cognitive schemas) inherent to the subject and which generally underlie the idiosyncratic thinking involved in psychopathology (David, 2006b). In this context, some authors (Beck, Brown, Steer, & Weissman, 1991) believe that dysfunctional attitudes are the result of information processing through the "filter" of cognitive schemes considered stable knowledge structures that interact with the new data entries, with consideration, expectations, information stored and information interpretation (Williams, Watts, MacLeod, & Mathews, 1997).

Other authors (Ebrahimi, Afshar, Doost, Mousavi, & Moolavi, 2012) consider dysfunctional attitudes as predisposing risk factors for depressive episodes or, indirectly, as a vulnerability factor under stress, vulnerability also being considered as a dysfunctional attitude (irrational beliefs) being operationalized in the Dysfunctional Attitudes Scale (Weissman & Beck, 1978).

In the current context of increased incidence of mental illness (David, 2006a; Krug et al., 2002; Stiemerling, 2006) the importance given to psychological defense analysis (Ionescu, Jacquet, & Lhote, 2002), used in various fields of psychology (Cramer, 1991a; 1991b; 1998; 2006), has led to considering mental defense analysis as an effective method in the psychotherapy of various psychopathological conditions (Bond, 2004; Blackman, 2009; Ionescu et al., 2002). A number of studies (Kronström, Salminen, Hietala, Kajander, Vahlberg, Markkula, et al., 2009; Van, Dekker, Peen, Abraham, & Schoevers, 2009) have demonstrated the predictive capability of psychological defense mechanisms in depressive disorders. Defense mechanisms are considered to be "unconscious psychic processes, which aim to reduce or annul the unpleasant effects of real or imaginary dangers, by reshuffling the internal and/or external reality, whose manifestations and behaviors, ideas or affects can be conscious or unconscious" (Ionescu et al, 2002, p. 35).

Thus Van et al. (2009) explored the predictive capability of defensive functioning in the psychotherapy of depression, both for a self-reporting situation and for the situation where defensive operation is assessed by observers. The study provides evidence of the relevance of defense styles in the psychotherapeutic treatment of depression. Moreover, Kronström et al. (2009) showed that for patients diagnosed with major depressive disorder that have immature defenses, a brief psychotherapy is relatively more effective than antidepressive medication. …

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