探究物质使用障碍患者的防御功能和述情障碍。
Investigating defensive functioning and alexithymia in substance use disorder patients.
机构信息
Department of Education, Psychology, Communication, University of Bari, Palazzo Chiaia-Napolitano, Via Scipione Crisanzio 42, 70122, Bari, Italy.
Section of Clinical Psychology and Neuropsychology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy.
出版信息
BMC Psychiatry. 2021 Jul 6;21(1):337. doi: 10.1186/s12888-021-03340-w.
BACKGROUND
Substance Use Disorder (SUD) causes a great deal of personal suffering for patients. Recent evidence highlights how defenses and emotion regulation may play a crucial part in the onset and development of this disorder. The aim of this study was to investigate potential differences in the defensive functioning between SUD patients and non-clinical controls. Secondly, we aimed at investigating the relationships between alexithymia and maladaptive/assimilation defenses.
METHODS
The authors assessed defensive functioning (Response Evaluation Measure-71, REM-71), personality (MMPI-II), and alexithymia (TAS-20) of 171 SUD patients (17% female; mean age = 36.5), compared to 155 controls. Authors performed a series of ANOVAs to investigate the defensive array in SUD patients compared to that of non-clinical controls. Student t test for indipendent samples was used to compare clinical characteristics between the SUD group and the controls. To investigate the role of single defenses in explaining alexithimia's subscores, stepwise multiple regression analysis were carried out on socio-demographic characteristics of participants (gender, age, and years of education), with REM-71 defenses as predictors.
RESULTS
SUD patients presented a more maladaptive/assimilation (Factor 1) defensive array (p < .001). Among SUD sub-groups, Alcohol Use Disorder patients showed more disfuncional defenses. Factor 1 defenses were related to a worse psychological functioning. In addition, alexyhimia (particularly DIF) was strongly related to Factor 1 defenses, expecially Projection (38% of variance explained, β = .270, p < .001).
CONCLUSION
The REM-71 and the TAS-20 might be useful screening instruments among SUD patients.
背景
物质使用障碍（SUD）给患者带来了极大的痛苦。最近的证据强调了防御和情绪调节在这种障碍的发生和发展中可能起着至关重要的作用。本研究旨在调查 SUD 患者与非临床对照组之间防御功能的潜在差异。其次，我们旨在调查述情障碍与适应不良/同化防御之间的关系。
方法
作者评估了 171 名 SUD 患者（17%为女性；平均年龄 36.5 岁）和 155 名对照组的防御功能（反应评估量表-71，REM-71）、人格（MMPI-II）和述情障碍（TAS-20）。作者进行了一系列方差分析，以研究 SUD 患者与非临床对照组的防御模式。独立样本的 t 检验用于比较 SUD 组和对照组的临床特征。为了研究单个防御在解释述情障碍亚量表中的作用，对参与者的社会人口统计学特征（性别、年龄和受教育年限）进行了逐步多元回归分析，将 REM-71 防御作为预测因子。
结果
SUD 患者表现出更适应不良/同化（因子 1）的防御模式（p<0.001）。在 SUD 亚组中，酒精使用障碍患者表现出更多功能失调的防御。因子 1 防御与较差的心理功能有关。此外，述情障碍（特别是 DIF）与因子 1 防御密切相关，尤其是投射（解释方差的 38%，β=0.270，p<0.001）。
结论
REM-71 和 TAS-20 可能是 SUD 患者的有用筛查工具。
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