Giovanardi Guido, Mirabella Marta, Di Giuseppe Mariagrazia, Lombardo Francesco, Speranza Anna Maria, Lingiardi Vittorio
Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy.
Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy.
Front Psychol. 2021 Aug 10;12:665547. doi: 10.3389/fpsyg.2021.665547. eCollection 2021.
Defense mechanisms are relevant indicators of psychological functioning and vulnerability to psychopathology. Their evaluation can unveil individuals' unconscious strategies for mediating reactions to emotional conflict and external stressors. At the beginning of their journey toward gender reassignment, individuals diagnosed with gender dysphoria (GD) may experience conflict and stressful experiences that trigger a wide range of defense mechanisms. Mature defenses may strengthen these individuals as they travel along this important path, while neurotic and immature defenses may exacerbate their body dissatisfaction (BD) and hinder their processing of change. Only a few studies have investigated self-reported defensive functioning in transgender people, finding a higher frequency of maladaptive defense mechanisms relative to controls. The present study was the first to apply an in-depth clinician-rated tool to assess the entire hierarchy of defense mechanisms within a sample of transgender people. Defensive functioning and personality organization were assessed in 36 individuals diagnosed with GD (14 trans women, 22 trans men, mean age 23.47 years), using the Defense Mechanisms Rating Scales (Perry, 1990) and the Shedler-Westen Assessment Procedure-200 (Shedler et al., 2014). Body uneasiness was assessed using the Body Uneasiness Test (BUT; Cuzzolaro et al., 2006). The findings showed that defensive functioning correlated positively with healthy personality functioning and negatively with BD. Compared to cisgender controls, participants with GD who presented greater defensive functioning were found to be more immature and to demonstrate significant differences in many levels of functioning. The clinical implications of the results suggest that psychological interventions aimed at improving defensive functioning in individuals with GD will be important in helping them manage the challenges posed by their gender transition.
防御机制是心理功能和易患精神病理学的相关指标。对其进行评估可以揭示个体调节对情感冲突和外部压力源反应的无意识策略。在开始性别重新分配之旅时，被诊断患有性别焦虑症（GD）的个体可能会经历冲突和压力经历，从而触发多种防御机制。成熟的防御机制可能会在这些个体沿着这条重要道路前行时增强他们的心理，而神经质和不成熟的防御机制可能会加剧他们的身体不满（BD），并阻碍他们对变化的处理。只有少数研究调查了跨性别者自我报告的防御功能，发现与对照组相比，适应不良防御机制的出现频率更高。本研究首次应用深入的临床医生评定工具来评估跨性别者样本中防御机制的整个层次结构。使用防御机制评定量表（佩里，1990年）和谢德勒-韦斯顿评估程序-200（谢德勒等人，2014年）对36名被诊断患有GD的个体（14名跨性别女性，22名跨性别男性，平均年龄23.47岁）的防御功能和人格组织进行了评估。使用身体不适测试（BUT；库佐拉罗等人，2006年）评估身体不适情况。研究结果表明，防御功能与健康的人格功能呈正相关，与身体不满呈负相关。与顺性别对照组相比，防御功能更强的GD参与者被发现更不成熟，并且在许多功能水平上存在显著差异。结果的临床意义表明，旨在改善GD个体防御功能的心理干预对于帮助他们应对性别转变带来的挑战将非常重要。
