The Defense Mechanism And Personality Structure In In-patients With Depression

Objective: This dissertation aims to explore defense mechanism use and personality organization and their interactions and associations in psychiatric in-patients with depression.Methods: The study used mixed methods,including quantitative survey and qualitative inquiry.All data were collected from a group of in-patients diagnosed with depressive disorder(n= 52)and a healthy control sample(n=52),both from the first hospital afflicted Shanxi medical university and all participants fulfilled the inclusion and exclusion criteria.The in-patients meet the ICD-10 criteria and diagnosed by two senior psychiatrists.The quantitative method based on defensive style questionnaires(DSQ)and Eysenck personality questionnaires(EPQ)survey aimed to examine the pattern of defensive mechanism use and personality organization and explore the relationship between defense mechanism factors and personality characters by using independent samples t tests and X2.The statistics analysis results also facilitated the construction of Interpretative phenomenological analysis(IPA).In order to support the association between defense mechanism and personality structure in in-patient with depression and highlight the subjective experience of defense mechanism use,A semi-structured interview was then conducted with purposive samplings of 3 depressive individuals and 3 normal individuals about their life events.Interviews were transcribed and analysed using Interpretative phenomenological analysis(IPA).Thematic analysis was used to systematically interpret the data.Codes were created in an inductive process using a constant comparative approach.Results: 1.Depression scored significantly higher on projection,passive aggression,acting out,fantasy,splitting,regression,somatization,complain,while in neurotic defensive mechanism sectors,the depressive group scored higher on reversal into the opposite,isolation all capacity with incapacity.Even though the controlled group had higher scores than depressive in the field of mature defense mechanism,the statistical difference is minor.2.The result shows the significant difference between the two groups in terms of neuroticism,extraversion and psychoticism.Most of depressive individuals present unstable introverts and few illustrate stable introvert,while the healthy group tend to be more stable extrovert and less stable introvert.3.Extroversion is negatively related to the use of maladaptive defense mechanism of projection,passive aggression,acting out,fantasy,somatization,regression.Similarly,it also have negative relationship with intermitted defense mechanism of dissociation,isolation and reaction formation.By contrary,Neuroticism tend to be associated with the maladaptive defense mechanism of projection,passive aggression,acting out,fantasy,complain,somatization as well as intermitted defense mechanism of determent,denial.Finally,psychoticism is positively related to projection?passive aggression ?acting out?fantasy in immature defense mechanism sector and reaction formation,denial in mature mechanism defense.4.The qualitative study identified seven subordinate themes(codes).They concerned regression,denial,projection,projection(intro-projection),somatizaion,reaction formation,passive aggression.Reasons for employing these maladaptive defense mechanism included avoiding and suppressing unbearable strong emotions,the control of impulsive caused by inappropriate cognition and maintaining self-esteem.Conclusion: 1.Depressive individuals are found to be more introvert and neurotic than healthy people and most of traits demonstrate stable introverts and unstable extroverts.The specific associations of the depressive symptom and personality traits in the in-patient sample may have important clinical implications.2.Depressive individuals were more likely to take a immature and neurotic defense style as their domain defense mechanism,such as projection,passive aggression,acting out,fantasy,splitting,regression,somatization,complain,reversal into the opposite,isolation all capacity with incapacity.3.The personality structure of depressive individuals(high psychoticism,high and introversion tendency)have positive relationship with maladaptive defense mechanism and intermitted one,indicating that unstable temperate and introverts were associated with projection,passive aggression,acting out,fantasy,splitting,regression,somatization,complain,reversal into the opposite,isolation all capacity with incapacity.