Cruciani Gianluca, Lo Buglio Gabriele, Tanzilli Annalisa, Liotti Marianna, Scalzeri Matteo, Tanzilli Gaetano, Galli Federica, Lingiardi Vittorio
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy.
Behav Sci (Basel). 2025 Apr 14;15(4):528. doi: 10.3390/bs15040528.
Myocardial infarction (MI) is associated with emotional distress, depression, and anxiety. Defense mechanisms and mentalized affectivity play key roles in affective regulation; however, their roles in individuals with MI remain underexplored. This study examined the relationship between depressive and anxiety symptoms, defensive functioning, and mentalized affectivity in MI patients. Sixty-seven patients with MI and 80 healthy controls completed the DSM-5 Self-Rated Level 2 Cross-Cutting Symptom Measures-Depression and Anxiety-Adult, the Defense Mechanisms Rating Scales-Self-Report-30, and the Brief-Mentalized Affectivity Scale. Multivariate analyses were used to compare the MI and healthy groups, while correlations and mediation models were used to evaluate associations between variables within the MI group. Compared to controls, patients with MI exhibited more severe depressive and anxiety symptoms, maladaptive defenses, and lower levels of mentalized affectivity. Within the MI group, the severity of depressive and anxiety symptoms was associated with immature defensive functioning and poorer abilities to regulate affects. Notably, the relationship between worse defensive functioning and severe depressive and anxiety symptoms was mediated by the capacity to process emotions. The mediating role of this specific dimension of mentalized affectivity emphasizes the potential of affect regulation as a target for tailored psychosocial interventions aimed at improving clinical outcomes.
心肌梗死（MI）与情绪困扰、抑郁和焦虑有关。防御机制和心理化情感在情感调节中起关键作用；然而，它们在心肌梗死患者中的作用仍未得到充分研究。本研究探讨了心肌梗死患者抑郁和焦虑症状、防御功能和心理化情感之间的关系。67名心肌梗死患者和80名健康对照者完成了《精神疾病诊断与统计手册》第5版成人自评二级交叉症状测量——抑郁和焦虑量表、防御机制评定量表——自我报告——30项版以及简易心理化情感量表。采用多变量分析比较心肌梗死组和健康组，同时使用相关性分析和中介模型评估心肌梗死组内变量之间的关联。与对照组相比，心肌梗死患者表现出更严重的抑郁和焦虑症状、适应不良的防御方式以及更低水平的心理化情感。在心肌梗死组中，抑郁和焦虑症状的严重程度与不成熟的防御功能以及较差的情感调节能力有关。值得注意的是，较差的防御功能与严重抑郁和焦虑症状之间的关系是由情绪处理能力介导的。心理化情感这一特定维度的中介作用强调了情感调节作为旨在改善临床结局的个性化心理社会干预目标的潜力。
