Favaretto Taís Cristina, Both Luciane Maria, Benetti Silvia Pereira da Cruz, Freitas Lúcia Helena Machado
Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Universidade do Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil.
Trends Psychiatry Psychother. 2024;46:e20220546. doi: 10.47626/2237-6089-2022-0546. Epub 2023 Apr 17.
Patients with post-traumatic stress disorder (PTSD) present a variety of symptoms, with different intensities, causing impairment in individual, social, and occupational functioning. The aim of this study was to understand the psychodynamic functioning of patients with PTSD, exploring relationships between symptom severity, quality of life, subjective suffering, conflicts, and psychic structure and sociodemographic characteristics, styles, and defensive mechanisms.
This is a cross-sectional quantitative study with 60 participants. The following instruments were used: a sociodemographic questionnaire, the Operationalized Psychodynamic Diagnosis-2 (OPD-2), and the Defensive Style Questionnaire (DSQ-40).
Participants had moderate to high symptom severity, with significant subjective suffering and isolation. The main conflict was need for care vs. self-sufficiency and the level of total structure was moderate/low. Use of immature, neurotic, and mature defensive styles was observed. More primitive personality structures, more rigid defenses, and greater dependence were found in patients with history of past trauma. Other mental disorders were also associated.
The OPD-2 was effective for assessment of the psychodynamic functioning characteristics of patients with PTSD. Therapeutic treatment should focus on the psychic structure and not only on symptom control. Prevention strategies should target vulnerability factors while strengthening protective factors.
创伤后应激障碍（PTSD）患者呈现出各种不同强度的症状，导致个体、社交和职业功能受损。本研究的目的是了解PTSD患者的心理动力功能，探讨症状严重程度、生活质量、主观痛苦、冲突、心理结构与社会人口学特征、风格和防御机制之间的关系。
这是一项横断面定量研究，有60名参与者。使用了以下工具：一份社会人口学问卷、操作性心理动力诊断-2（OPD-2）和防御方式问卷（DSQ-40）。
参与者的症状严重程度为中度至高度，伴有明显的主观痛苦和孤立感。主要冲突是对照顾的需求与自给自足之间的冲突，整体结构水平为中度/低度。观察到使用了不成熟、神经质和成熟的防御方式。有既往创伤史的患者存在更原始的人格结构、更僵化的防御和更强的依赖性。还发现与其他精神障碍有关。
OPD-2对评估PTSD患者的心理动力功能特征有效。治疗应侧重于心理结构，而不仅仅是症状控制。预防策略应针对脆弱因素，同时加强保护因素。
