The mediating role of defense mechanisms in predicting perceived stress based on attachment styles in patients with COVID-19

The aim of this study was to investigate the mediating role of defense mechanisms in predicting perceived stress based on attachment styles in patients with COVID-19. The research method was descriptive-correlational. The statistical population included all people in Tehran who were infected with COVID-19 in 1399, who completed the questionnaires online. 300 people were selected by available and voluntary sampling method. The research instruments included Collins and Reader attachment style questionnaires, Cohen et al. perceived stress questionnaires, and Andrews et al. Data analysis was performed by path analysis method. The results showed that the hypothetical model had a good fit and was confirmed. Also, the results of path coefficients showed that the path coefficient of immature attachment style to the defense mechanism was immature and psychotic, negative and significant. Also, the results of indirect path coefficient showed that the relationship between undeveloped defense mechanism and perceived stress with mediated secure attachment was significant. Thus, secure attachment style mediated by underdeveloped defense mechanisms predicted the perceived stress level of patients with COVID-19. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The impact of COVID-19 lockdown on perceived stress: The role of defence mechanisms and coping strategies

The COVID-19 pandemic represents a unique global challenge. To deter its spread, several countries have put lockdown and physical distancing measures in place that could have potentially harmful consequences on people's mental health. Therefore, the aim of this study is to explore the relationship between anxiety and perceived stress in individuals who were experiencing the COVID-19 lockdown measures, while also analyzing the impact of coping strategies interacting with defence mechanisms. A sample of 1408 individuals (Mage = 34.69;SD = 11.87) completed the Ten Item Perceived Stress Scale, State-Trait Anxiety Inventory-Form X3, Coping Orientation to Problems Experienced and Forty-Item Defense Style Questionnaire, after providing written informed consent. Results highlighted the significant impact of state anxiety levels on perceived stress, both directly and indirectly. The indirect pathways have been explored by performing three mixed serial-parallel mediation analyses, where significant associations between coping strategies (Social Support, Avoidance Strategies, Positive Attitude, Problem-solving and Turning to Religion) and mature, neurotic, or immature defences have been found. These findings may contribute to orientate prevention and intervention activity during the several management phases of COVID-19. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Distributed denial of service attack prediction: Challenges, open issues and opportunities

Distributed Denial of Service (DDoS) attack is one of the biggest cyber threats. DDoS attacks have evolved in quantity and volume to evade detection and increase damage. Changes during the COVID-19 pandemic have left traditional perimeter-based security measures vulnerable to attackers that have diversified their activities by targeting health services, e-commerce, and educational services. DDoS attack prediction searches for signals of attack preparation to warn about the imminence of the attack. Prediction is necessary to handle high-volumetric DDoS attacks and to increase the time to defend against them. This survey article presents the classification of studies from the literature comprising the current state-of-the-art on DDoS attack prediction. It highlights the results of this extensive literature review categorizing the works by prediction time, architecture, employed methodology, and the type of data utilized to predict attacks. Further, this survey details each identified study and, finally, it emphasizes the research opportunities to evolve the DDoS attack prediction state-of-the-art.

Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model.

BACKGROUND: The COVID-19 pandemic has considerably influenced all domains of people's lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning. METHODS: The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37, SD = 12.79) who completed an online survey, including an instrument assessing four response styles to the pandemic and lockdown(s), the Personality Inventory for DSM-5-Brief Form, the Defense Mechanisms Rating Scales-Self-Report-30, the Reflective Functioning Questionnaire, and the Epistemic Trust, Mistrust, Credulity Questionnaire. RESULTS: Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology were predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others' mental states, and high epistemic credulity. CONCLUSIONS: Recognizing and understanding dysfunctional psychological pathways associated with individuals' difficulties in dealing with the pandemic are crucial for developing tailored mental-health interventions and promoting best practices in healthcare services.

COVID-19 related conspiracy beliefs and their relationship with defense strategies, emotions, powerlessness, attitudes, and time perspective.

The COVID-19 pandemic has greatly impacted individual's life and society, and such an emergency has increased the likelihood of recurring conspiratorial thinking. There is much research on broader conspiratorial thinking and studies on COVID-19-related conspiratorial thinking has been growing worldwide, moreover, the negative consequences of COVID-19 specific conspiratorial beliefs for people's health are clear. However, person-centered research aiming at identify groups of individuals who share patterns of relations between COVID-19 specific conspiratorial beliefs and other psychological features is still scarce. A sample of 1.002 people (18-40 years old, M = 23; SD = 5.19) responded to a questionnaire administered online. The aim was to identify groups of individuals based on their beliefs about COVID-19 conspiracy theories and to compare the groups identified in terms of psychological characteristics associated such as automatic defense mechanisms, coping strategies, powerlessness, emotions, emotional regulation, attitudes toward the COVID-19, social distancing discontent, perceptions of COVID-19 severity and temporal perspective. A k-mean cluster analysis identified the groups of Believers (22.26%), Ambivalent believers (34.3%), and Non-believers (43.21%). The three groups differ particularly in terms of defense mechanisms, and time perspective. Results suggested the need to tailor interventions for individuals believing in COVID-19 conspiratorial theories based on differences in the psychological characteristics among the three groups.

Mindfulness and Defense Mechanisms as Explicit and Implicit Emotion Regulation Strategies against Psychological Distress during Massive Catastrophic Events.

Emotion regulation is an important aspect of psychological functioning that influences subjective experience and moderates emotional responses throughout the lifetime. Adaptive responses to stressful life events depend on the positive interaction between explicit and implicit emotion regulation strategies, such as mindfulness and defense mechanisms. This study demonstrates how these emotion regulation strategies predict psychological health during the early phase of the COVID-19 pandemic. A convenience sample of 6385 subjects, recruited via snowball sampling on various social media platforms, responded to an online survey assessing psychological reaction to social restrictions imposed to limit the spread of COVID-19 in Italy. Psychological distress, post-traumatic stress symptoms, mindfulness, and defense mechanisms were assessed using SCL-90, IES-R, MAAS, and DMRS-30-SR, respectively. Higher mindfulness was significantly associated with higher overall defensive maturity and a greater use of high-adaptive defenses (p < 0.0001). Both mindfulness and defense mechanisms acted as good predictors of psychological health (R2 = 0.541) and posttraumatic symptoms (R2 = 0.332), confirming the role of emotion regulation in protecting against maladaptive responses to stressful situations.

Voice and Vision in Psychotherapy

Although telephone therapy has been generally employed by therapists and patients for many years, there has been little examination of its use compared to other remote therapies. When COVID-19 required remote therapy only, a number of patients chose to continue therapy via voice-only and without a visual component. This paper describes how voice-only therapy in the experience of one patient profoundly affected the treatment and outcome of a long-term therapeutic interaction. For this patient, her lifelong fear of being looked at or being seen at all emerged in our work, and we were able to uncover the history of her severe agoraphobic and traumatic reactions to being looked at by others.

Facing a Real Threat of Death: Dynamic Changes in Death-Thought Accessibility.

Purpose: This study explored the relationship between emotion and death-thought accessibility (DTA) in individuals experiencing true mortality salience (MS), specifically, patients with cancer. Patients and Methods: The study included 255 participants; among them, 132 patients had cancer and represented the MS group, and 123 had dental pain and served as a control group. Participants completed the Projective Diseases Attitude Assessment Questionnaire to induce priming, completed an affect scale, completed one of four calculation tasks as manipulation of cognitive load (all four were done over several sessions), and performed a Pinyin-Chinese characters exercise to measure DTA. Results: MS was associated with strong negative emotional arousal. When these negative emotions are generated, they enter an individual's consciousness and activate proximal defense mechanisms. At this point, DTA can be measured. Patients with cancer had significantly higher levels of DTA in the high-frequency cognitive load condition than in the other three conditions (no task, simple delay task, and single cognitive load task). Patients with dental pain had significantly higher levels of DTA in the no task and simple delay conditions than in the single cognitive load or high-frequency cognitive load conditions. This study also found that negative experiences without MS (specifically, dental pain) are associated with higher levels of DTA. Conclusion: These findings suggest that in addition to death-related events, both negative and stress-inducing events can produce DTA.

Digital Learning, Life Satisfaction, and Perceived Stress Due to COVID-19 Emergency: Case Study Among Female Saudi University Students.

The paper explores the impact of the corona virus disease-19 (COVID-19) pandemic on the Saudi higher education system. The research focuses on the relationship between digital learning in COVID-19 time, life satisfaction, and stress among female students. The study discusses measures, practices, defense mechanisms, and coping strategies to face challenges. Using an online survey based on psychological effects and its role in defense mechanisms and coping strategies, findings show that digital learning provides flexibility in terms of time and offers resources at a lower cost compared to traditional learning. In addition, results show that the coping strategy perception is higher in obtaining a good score and succeeding than to get over the pandemic and recovering from the illness itself. Finally, results confirm that a positive attitude influences positively life satisfaction.

Burnout in Italian hospital physicians during the COVID-19 pandemic: a pilot study on the roles of alexithymia and defense mechanisms

Background: COVID-19 pandemic placed unusual additional burden upon international healthcare systems. This study aims to explore the associations between burnout, alexithymia and defense mechanisms in a group of Italian hospital physicians during the COVID-19 pandemic. Methods: 96 hospital physicians completed self-reported questionnaires through Google Forms platform, including Maslach Burnout Inventory (MBI), Defense Style Questionnaire-40 (DSQ-40), and 20- item Toronto Alexithymia Scale (TAS-20). Results: Emotional Exhaustion (EE) and Depersonalization (DP) burnout dimensions were positively correlated with alexithymia and with immature and neurotic defenses, while negative associations were correlated with a mature defensive style. MBI Personal Accomplishment (PA) was negatively correlated with alexithymia levels but positively correlated with mature defenses. According to regression models, EE levels were predicted by female gender (beta = -0.20;p <.04) and DSQ mature defenses (beta= -.24;p<.02);DP levels were predicted by alexithymia total score (beta= 0.26;p <.04) and DSQ mature defenses (beta= -.20;p<.05);and PA levels were predicted by alexithymia total score (beta = -0.29;p <.02) and DSQ mature defense (beta=.45;p<.001). Conclusions: Consistent with the broader literature, an association between burnout and both alexithymia and defense mechanisms emerged. These findings highlight the importance of reducing occupational-related burden on healthcare workers and of promoting protecting strategies to deal with emergency situations.

"Dreams Drawer": Analysis of Dreams During Lockdown in the Italian Population

The COVID-19 pandemic has indiscriminately involved the whole world, producing a collective trauma that may have activated socially shared mental processes. It was hypothesized that the content of dreams could reflect a change in the way people are conceptualizing relationships, their environment, and the world in general after the emergency and the lockdown. We used data from "Dream Drawer," a free online forum where people could read about others' dreams or write about their own. Our sample consisted of 68 participants and 90 dreams. Most of them were students, and 85% of the participants were facing lockdown at home with families. To identify how dream content could reflect the impact of lockdowns, dreams were analyzed with the emotional text mining methodology. The analysis created a factorial space of 2 factors: "Relationship With the Outside" (between the containing and the losing) and "Relationship With the Inside" (between the processing and losing yourself). Each factor presents a symbolic and reflective dimension. In this space, there are 3 clusters ("holding," "refind the other," and "anguish defense"). The findings demonstrate that home isolation, which is portrayed in dreams as an extraordinary and novel event, appears to be the aspect of the pandemic that the unconscious has most exploited, detecting the activation of collective mental processes in dreams. Dreamwork could be the first step in beginning to process this collective catastrophic experience. The results of this research may be useful in determining collective changes in anxiety and distress.

Countermeasures against COVID-19 from the viewpoints of dental diseases: strengthening innate immunity with the toothpick method of brushing. (Special Issue: COVID-19 and historical pandemics part 2.)

Coronavirus disease (COVID-19) patients with periodontal disease have an 8.8-fold higher mortality rate than those in the patients without periodontal diseases. This was higher than the odds ratio for patients with diabetes. Periodontal disease is associated with ulcers in the periodontal pocket, and gram-negative bacteria called periodontal pathogens invade the tissue through ulcers. Bacteria in the ulcer site are phagocytosed and sterilized by leukocytes. Following the autolysis of leukocytes, lipopolysaccharides (LPS) on the bacterial cell wall spread throughout the body, which is a major cause of multiple organ failure. Thus, periodontal disease is considered to contribute to the mortality rate of COVID-19. Ulcers in the periodontal pocket can be repaired using by a new developed brushing method called the toothpick method. The toothpick method can significantly improve gingival bleeding in one week, which is quicker than conventional periodontal treatment methods. Mechanical stimulation by the toothbrush causes gingival basal cells, fibroblasts, vascular endothelial cells and osteoblasts to proliferate and repair the tissue. However, these cell proliferations cease to occur 0.5 mm away from where the toothbrush bristles make contact with the gingiva. The toothpick method of brushing is characterized by its ability to stimulate the interdental gingiva, which is the initial site of periodontitis. As the toothpick method can repair periodontal ulcers, it will strengthen biological defense mechanisms against chronic degenerative and infectious diseases.

Which personality traits can mitigate the impact of the pandemic? Assessment of the relationship between personality traits and traumatic events in the COVID-19 pandemic as mediated by defense mechanisms

The COVID-19 pandemic has had a significant influence on the lives of people around the world and could be a risk factor for mental health diseases. This study aimed to explore the psychological impact of the COVID-19 pandemic by identifying patterns related to post-traumatic symptoms by considering personality and defensive styles. Specifically, it was hypothesized that neuroticism was negatively associated with impact of event, as opposed to extraversion, agreeableness, conscientiousness, and openness traits. The mediation role of mature, neurotic, and immature defenses in these relationships was also investigated. This study involved 557 Italian individuals (71.3% women, 28.7% men;Mage = 34.65, SD = 12.05), who completed an online survey including the Impact of Event Scale-Revised, Forty Item Defense Style Questionnaire (DSQ-40) and Ten Item Personality Inventory. Results showed a nonsignificant effect for extraversion and openness on impact of event. The negative influence of neuroticism was instead confirmed in a partial parallel mediation involving significant effects from immature and neurotic defenses in the indirect path. Finally, agreeableness and conscientiousness delineated two protective pathways regarding impact of event, determining two total parallel mediation models in which both these personality traits were negatively associated with immature defensive styles, and conscientiousness was also positively related to mature defenses. These findings provide an exploration post-traumatic symptom patterns during the COVID-19 pandemic, involving the big five personality traits and defense mechanisms. These results may be useful for developing interventions, treatments, and prevention activities. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The impact of self-reported depression, anxiety, traumatic stress, and utilization of immature defense mechanisms on bariatric surgery outcomes

This study investigated the contribution of self-reported depression, anxiety, traumatic stress, and utilization of immature defense mechanisms on bariatric surgery outcomes at 18-month follow-up. There were two research questions: 1. Does the presence of self-reported psychopathology impact percentage weight loss and quality of life after bariatric surgery, at long-term follow-up, when controlling for a patient's having received individual or group psychotherapy, and time elapsed since surgery? 2. Does the use of immature defense impact the outcomes of bariatric surgery at long-term follow-up, when controlling for a patient's having received individual or group psychotherapy, and time elapsed since surgery? In a sample of 117 participants, Pearson correlations (r) revealed no significant relationship between self-reported psychopathology and percentage weight loss after bariatric surgery. For the quality of life outcome, repeated measures mixed model analyses of variance (ANOVAs) were run, which included the repeated measures factor time of measurement (pre- vs. post-operation score), and the between-subjects pre-operation psychopathology level (clinically significant vs. non-clinically significant elevations). These analyses were followed up by paired-samples t-tests to determine the direction and significance of change in these measures from pre- to post-operation in the two groups separately. Results for the participants with clinically significant psychopathology were non-significant. For the participants with non-clinically significant elevations, quality of life worsened from pre-operation to post-operation follow-up. Pearson's r correlations revealed a marginally significant negative relationship between immature defense mechanism usage and percentage weight loss. Answers to the open-ended question, "Besides weight loss, how has the surgery impacted your life?", were thematically coded to yield 12 different thematic codes. Nine of the codes appeared to place the surgery experience in a positive light, while only three placed the surgery in a negative light. The fact that this follow-up was conducted during a COVID-19 pandemic year may have decreased the quality of life scores. This study could also have been improved by measuring immature defense mechanisms scores before surgery rather than just at post-operation follow-up. Finally, the small number of patients who obtained clinically significant elevations on psychopathology scores was another study limitation. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Students' Defense Mechanisms and Coping Strategies in Terms of COVID-19 Pandemic

The COVID-19 pandemic has forced the human psyche to intensify the protection mechanisms and coping strategies to optimally cope with the problem situation. The aim of the article was to study the peculiarities of the use of mental defense mechanisms and coping strategies by students in quarantine isolation caused by COVID-19, and their comparison with the protections and copings used by students before the pandemic. The study involved 108 students (future psychologists and preschool teachers). The sample is homogeneous. The average age of the subjects was 18.4 years. The empirical study used the following techniques: "Ways of Coping Questionnaire" (WCQ;Folkman & Lazarus, 1988);The Life Style Index (LSI;Plutchik et al., 1979);"SVF120" (Janke & Erdmann, 1997). Methods of descriptive statistics, Spearman correlation analysis and Mann-Whitney U were used. Mathematical data processing and graphical representation of the results were performed using the computer software package SPSS 22.0. The results of our study confirmed the hypotheses of the work on the connection of protection mechanisms with copings and on the change in the quantity and quality of protection mechanisms and coping strategies in a situation caused by quarantine isolation compared to the usual life of students. In general, this suggests a mutually reinforcing effect of copings and protections in order to effectively influence the adaptation of the individual to the circumstances through COVID-19. Understanding this pattern can help improve students' mental protection by using more mature and adequate life situations in COVID-19 protections and copings. [ FROM AUTHOR] Copyright of Romanian Journal for Multidimensional Education / Revista Romaneasca pentru Educatie Multidimensionala is the property of Lumen Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Personality, Defense Mechanisms and Psychological Distress in Women with Fibromyalgia.

BACKGROUND: Previous studies have shown that many personality traits are associated with fibromyalgia (FM), worsening both the quality of life and psychological distress of patients. Despite the high comorbidity of psychopathological disorders in this syndrome and their association with immature defense styles, few studies have examined the defense mechanisms used by FM patients. The main aim of our study was to investigate personality traits and defense mechanisms in FM patients compared to in a healthy control group (HC). Moreover, we investigated the effect of personality traits and defense mechanisms on psychological distress in both FM and HC groups. METHODS: A total of 54 women with FM and 54 healthy women completed the (1) Temperament and Character Inventory-Revised; (2) the Toronto Alexithymia Scale; (3) the Defense Style Questionnaire; and (4) the Hospital Anxiety and Depression Scale. RESULTS: The results indicated that FM patients display higher alexithymia, higher harm avoidance, lower self-directedness, lower persistence, and the higher use of a maladaptive defense style compared to HC. We found that alexithymia, harm avoidance, and maladaptive defense style are significant predictors of patients' psychological distress. Moreover, harm avoidance and adaptive defense style significantly predicted psychological distress in the HC group. CONCLUSION: The present study is the first to explore the contribution of both defense mechanisms and personality characteristics on the psychological distress of FM patients. Our findings have important clinical implications and may help diagnose and treat FM patients more in depth.

What Do Therapist Defense Mechanisms Have to Do With Their Experience of Professional Self-Doubt and Vicarious Trauma During the COVID-19 Pandemic?

This is the first study to examine psychotherapists' levels of defense mechanisms, their concurrent relationship with professional work-related stress (professional self-doubt and vicarious trauma), and how their levels of defense mechanisms predict the changes in these professional stresses over the course of 3 months since the start of the COVID-19 pandemic. Data from two online studies (Study 1; N = 105 and Study 2; N = 336), using two self-report measures of therapists' defense mechanisms (Defense Style Questionnaire-40 in Study 1 and Defense Mechanism Rating Scales Self-Report-30 in Study 2), are presented. Therapists reported higher levels of mature defense mechanisms, and lower levels of immature defense mechanisms, compared to published community and clinical populations assessed before and during the pandemic. Therapists' lower level of mature defense mechanisms and higher levels of neurotic and immature defense mechanisms were related to higher concurrent levels of vicarious trauma and professional doubt. Therapists who reported higher levels of mature defense mechanisms at 3-month follow-up showed less vicarious trauma and professional self-doubt at follow-up, after controlling for these professional stressors at baseline. Implications for clinical supervision and training are discussed. The context and professional challenges during the pandemic are unique and future replications of the results outside the pandemic context are warranted.

Understanding terror states of online users in the context of COVID-19: An application of Terror Management Theory.

The COVID-19 pandemic has provided psych challenges for many in society. One such challenge is the anxiety that is created in many people faced with the risk of death from the disease. Another issue is understanding how individuals cope psychologically with the threat of death from the disease. In this study we examine the manifestation of death anxiety and various coping mechanisms through the lens of terror management theory (TMT) and online platforms. We take a novel approach to testing the theory using big data analytics and machine learning, focusing on the user-generated content of Twitter users. Based on a sample of all tweets in the UK mentioning COVID-19 terms over a 5-month period, we evaluate dictionary mentions of anxiety and death, and various TMT defense mechanisms, and calculate the pattern of latent death anxiety or 'terror' states of Twitter users via Hidden Markov Models. The research identifies four online 'terror' states, with high death and anxiety mentions during the peak of the pandemic. Further we examine various TMT defense mechanisms that have been proposed in the literature for coping with death anxiety and find that online social connection, achievement and religion all play important roles in improving the model and explaining movement between states. The paper concludes with various implications of the study for future research and practice.

Personality and Lockdown: A Study on Italian Undergraduates During the COVID-19 Pandemic.

The current study aimed at increasing our understanding of the psychological impact of the COVID-19 lockdown on undergraduate students, particularly with respect to the association between personality traits; defense mechanisms (DMs); depression, anxiety, and stress symptoms (DASSs); and compliance with the government recommended health measures. A sample of 1,427 Italian undergraduate students were administered the Personality Inventory for the DSM-5-Brief Form; the Defense Style Questionnaire-40; and the Depression, Anxiety and Stress Scale-21. Compliance with the COVID-19 behavioral recommendations was measured through a 10-item survey measure. Results showed that immature DMs and internalizing personality traits (i.e., detachment, negative affect, psychoticism) were risk factors of DASSs. Furthermore, subjects with higher levels of DASSs appeared less compliant with the health measures recommended by the Italian government. Experts may use these results to identify and subsequently support (via the Internet) young subjects at greater risk of mental health problems as a result of the COVID-19 pandemic.

The Impact of COVID-19 and Quarantine on Suicidality in Geriatric Inpatients-A Case Report.

The mental health burden of COVID-19 and associated quarantine can be enormous for the elderly. Being at higher risk for serious illnesses results in them being further isolated at a time of prolonged social distancing. In the following suicide-attempt cases, we examine the effects of quarantine and a global pandemic that expose the elderly to increased risk for negative mental health outcomes. Examining defense mechanisms and the effects of quarantine may help healthcare professionals better identify individuals at higher risk during times of crises that warrant isolation and quarantine, and provide appropriate interventions.