ArticleFrontiers in psychology2023
Case report: Changes in defense mechanisms, personality functioning, and body mass index during psychotherapy with patients with anorexia nervosa.
Article in Frontiers in psychology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Role of Defense Mechanisms in Self-Injurious Behaviors: A Systematic Review.Journal of clinical psychology · 2026Pooled it
- Personality, Emotion Regulation, and Psychological Distress in Italian Women with Feeding and Eating Disorders: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- The relationship between overall defensive functioning and the Personality Assessment Inventory borderline and treatment outcome scales.Research in psychotherapy (Milano) · 2025Article
- Revisiting defense mechanisms in contemporary clinical practice: evidence and perspectives.Research in psychotherapy (Milano) · 2025Article
- Defense mechanisms and social mentalities in grandiose narcissism: an empirical investigation.Research in psychotherapy (Milano) · 2025Article
- Applying the Defense Mechanisms Rating Scales Q-sort to assess patients' level of overall defensive functioning in interview data: validity and reliability.Research in psychotherapy (Milano) · 2025Article
- The Weight of Words: An analysis of Autobiographical Narratives and Psychopathological Measures in Anorexia Nervosa.Journal of psycholinguistic research · 2025Article
- Defense mechanisms and inflammatory bowel diseases: a narrative review.Research in psychotherapy (Milano) · 2025Article
- Therapists' defense use impacts their patients' defensive functioning: a systematic case study.Research in psychotherapy (Milano) · 2024Article
- Transference interpretation and psychotherapy outcome: a systematic review of a no-consensus relationship.Research in psychotherapy (Milano) · 2024Article
- Initial validation of the Turkish version of the defense mechanisms rating scales-self-report-30.Frontiers in psychology · 2024Article
- Defense mechanisms in individuals with depressive and anxiety symptoms: a network analysis.Frontiers in psychology · 2024Article
- Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms.Research in psychotherapy (Milano) · 2023Article
- Defense mechanisms are associated with mental health symptoms across six countries.Research in psychotherapy (Milano) · 2023Article
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Authors and funding
3 authors.
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Abstract
Eating disorders (EDs) are difficult to treat in psychotherapy due to their pervasive symptomatology and frequent and rapid relapses. Restrictive anorexia nervosa (AN) is the most challenging ED, often associated with severe physical and mental conditions. Perceived as an ego-syntonic syndrome that somehow protects the patient from a number of developmental tasks, treating AN requires extensive multidisciplinary long-term intervention. As with other emotion regulation strategies, defense mechanisms mediate an individual's reaction to internal or external stressors, including those related to ED conditions. Improving defensive functioning adaptiveness predicts psychotherapy outcomes and is an essential component of the therapeutic process. In this study, we qualitatively described changes in the use of defense mechanisms, personality functioning (PF), and body mass index (BMI) in two patients with severe AN in treatment with intense dynamic psychotherapy. Changes in personality functioning and defense mechanisms were periodically assessed every 6 months using clinician report measures such as the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Defense Mechanisms Rating Scales Q-sort (DMRS-Q), respectively. BMI was also monitored throughout the treatment. A qualitative description of the patient's defensive profile and the quantitative score on all ranges of defense mechanisms were used for studying changes in patients' use of defenses during the treatment and relationships between defenses and outcome indexes. Personality and defensive functioning improved after 1 year of intense dynamic psychotherapy, independently from BMI improvement. All outcome indexes dramatically decreased before a scheduled interruption of the treatment, underling that an integrated therapeutic approach is essential for improving and eventually orienting toward complete ED symptoms remission. Long-term dynamic psychotherapy fosters self-awareness of psychological distress and enhances more mature ways of coping. Monitoring changes in personality and defense mechanisms helps in understanding patients' reactions to stressful life events and in developing specific therapeutic interventions.
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