The Relationship Between Childhood Trauma with Defense Styles in Depression Patients

Year 2022, , 298 - 303, 01.08.2022

Ömer Faruk Uygur , Taha Can Tuman , Onur Hurşitoğlu

https://doi.org/10.54005/geneltip.1091974

Cited By: 1

Abstract

Objective: We aimed to investigate the relationship between childhood trauma with defense styles in depression patients.
Materials and Methods: Fifty-seven patients with depression and 51 age-sex-matched healthy volunteers participated in this study. All participants completed the Socio-demographic Form, Beck Depression Inventory (BDI), Defense Style Questionnaire-40 (DSQ-40), and Childhood Trauma Questionnaire (CTQ). We compared defense style and childhood trauma scores between the two groups. Spearman correlation analysis was conducted between the BDI, DSQ-40, and CTQ. Also, defense styles and depression levels were investigated between groups with and without childhood trauma according to CTQ.
Results: The mean age of the patients was 30.93 ± 8.43 years and the mean age of the control group was 30.94 ± 7.05. Mature defense styles scores were statistically significantly higher in the control group than in the depression group. Immature defense styles scores and all sub-dimensions except for dissociation scores were statistically significantly higher in the patient group. There was a significant positive correlation between BDI score and CTQ (r = 0.560; p < 0.001), immature defense styles (r = 0.527; p < 0.001), and a negative significant correlation with mature defense styles. The BDI score (p < 0.001) and immature defense styles (p = 0.013) were statistically significantly higher in the childhood trauma group than the group without childhood trauma.
Conclusions: Our study results show that there is a significant correlation between childhood trauma and decreased mature defense styles and increased immature defense styles in depression patients than the healthy control group.

Keywords

Childhood trauma, Depression, Defense styles

Depresyon Hastalarında Çocukluk Çağı Travması ile Savunma Biçimleri Arasındaki İlişki

Abstract

Amaç: Bu çalışmanda depresyon hastalarında çocukluk çağı travmaları ile savunma biçimleri arasındaki ilişkiyi araştırmayı amaçladık.
Materyal ve Metod: Bu çalışmaya depresyonlu 57 hasta ve 51 yaş-cinsiyet uyumlu sağlıklı gönüllü katıldı. Tüm katılımcılar Sosyodemografik Formu, Beck Depresyon Envanteri (BDE), Savunma Biçimleri Testi-40 (SBT-40) ve Çocukluk Travma Anketi'ni (ÇÇTÖ) doldurmuştur. İki grup arasında savunma tarzı ve çocukluk çağı travma skorlarını karşılaştırdık. Ayrıca depresyon grubunda CTQ'ya göre çocukluk çağı travması olan ve olmayan gruplar arasında savunma stilleri ve depresyon düzeyleri araştırıldı.
Bulgular: Hastaların yaş ortalaması 30.93 ± 8.43, kontrol grubunun yaş ortalaması 30.94 ± 7.05 idi. Olgun savunma biçimleri puanları, kontrol grubunda depresyon grubuna göre istatistiksel olarak anlamlı derecede yüksekti. İmmatür savunma biçimleri puanları, dissosiasyon dışındaki tüm alt boyutlarda hasta grubunda istatistiksel olarak anlamlı derecede yüksekti. BDE puanı ile ÇÇTÖ (r = 0,560; p < 0.001), olgunlaşmamış savunma biçimleri (r = 0,527; p < 0.001) arasında anlamlı bir pozitif korelasyon ve olgun savunma biçimleri ile negatif anlamlı bir korelasyon vardı. BDE puanı (p < 0.001) ve olgunlaşmamış savunma biçimleri (p = 0,013) çocukluk çağı travması grubunda çocukluk çağı travması olmayan gruba göre istatistiksel olarak anlamlı derecede yüksekti.
Sonuç: Çalışma sonuçlarımız, çocukluk çağı travması ile depresyon hastalarında azalmış olgun savunma biçimleri ve artmış immatür savunma biçimleri arasında sağlıklı kontrol grubuna göre anlamlı bir ilişki olduğunu göstermektedir.

Keywords

Çocukluk çağı travması, Depresyon, Savunma biçimleri

References

• Malhi GS, Mann JJ. Depression. Lancet. 2018;392(10161):2299-2312.
• Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-38.
• Mathers C, Boerma T, Ma Fat D. The global burden of disease: 2004 update. Geneva, Switzerland:World Health Organization, 2004.
• Nelson J, Klumparendt A, Doebler P, Ehring T. Childhood maltreatment and characteristics of adult depression: Meta-analysis. British Journal of Psychiatry, 2017;210(2):96-104.
• World Health Organization (WHO). Child maltreatment [Internet]. 2022 [cited 2022 Feb 20]. www.who.int/news-room/fact-sheets/detail/child-maltreatment.
• Brown GR, Anderson B. Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. Am J Psychiatry. 1991;148(1):55-61.
• Walker E, Katon W, Harrop-Griffiths J, et al. Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse. Am J Psychiatry. 1988;145(1):75-807.
• Taner Y, Gökler B. Çocuk istismarı ve ihmali: Psikiyatrik yönleri. Acta Medica. 2004;35(2):82-6.
• Dakil SR, Cox M, Lin H, Flores G. Racial and ethnic disparities in physical abuse reporting and child protective services interventions in the United States. J Natl Med Assoc. 2011;103(9-10):926-31.
• Yurdakök K, İnce O. Duygusal istismar ve ihmal. Katkı Pediatri Dergisi. 2010;32(4):423-33.
• Vaillant GE. Ego mechanisms of defense and personality psychopathology. J Abnorm Psychol 1994;103:44‑50.
• Cramer P. Defense mechanisms and physiological reactivity to stress. J Pers 2003;71:221‑44.
• Andrews G, Pollock C, Stewart G. The determination of defense style by questionnaire. Arch Gen Psychiatry 1989;46:455‑60.
• Blaya C, Kipper L, Heldt E, et al. Brazilian‑Portuguese version of the defense style questionnaire (DSQ‑40) for defense mechanisms measure: A preliminary study. Braz J Psychiatry 2004;26:255‑8.
• Vaillant GE. Ego Mechanisms of Defense: A Guide For Clinicans And Researchers. 1992. Washington, DC: American Psychiatric Pub.
• Grebot E, Paty B, Girarddephanix N. Relationships between defense mechanisms and coping strategies, facing exam anxiety performance. Encephale 2006;32:315‑24.
• Bond M, Perry JC. Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders. Am J Psychiatry 2004;161(9):1665-71.
• Akkerman K, Lewin TJ, Carr VJ. Long-term changes in defense style among patients recovering from major depression. J Nerv Ment Dis 1999;187(2):80-7.
• Pollock C, Andrews G. Defense styles associated with specific anxiety disorders. Am J Psychiatry 1989;146(11):1500-2.
• Bond M. Empirical studies of defense style: relationships with psychopathology and change. Harvard Rev Psychiatry. 2004;12:263–278.
• Finzi-Dottan R, Karu T. From emotional abuse in childhood to psychopathology in adulthood: a path mediated by immature defense mechanisms and self-esteem. J. Nerv. Ment. Dis. 2006;194:616-21.
• Nickel R, Egle UT. Psychological defense styles, childhood adversities and psychopathology in adulthood. Child Abuse Neglect. 2006;30:157-70.
• Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio 1996;78(2):490–498
• Hisli N. A reliability and validity study of Beck Depression Inventory in a university student sample. J Psychol. 1989;7(1):3-13.
• Andrews G, Singh M, Bond M. The defense style questionnaire. J Nerv Ment Disord. 1993;181:246–256
• Yılmaz N, Gençöz T, Ak M. Savunma Biçimleri Testi'nin psikometrik özellikleri:güvenilirlik ve geçerlik çalışması Türk Psikiyatri Derg. 2007;18:244–253
• Bernstein DP, Stein JA, Newcomb MD, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169-90.
• Şar V, Öztürk PE, İkikardeş E. Çocukluk çağı ruhsal travma ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2012;32(4):1054-63.
• Kessler RC, Davis CG, Kendler KS. Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med 1997;27:1101–1119.
• Kendler KS, Bulik CM, Silberg J, et al. Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Arch Gen Psychiatry 2000;57:953–959.
• Hovens JG, Wiersma JE, Giltay EJ, et al. Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls. Acta Psychiatr Scand 2010;122:66 74.
• Spinhoven P, Elzinga BM, Hovens JG, et al. The specificity of childhood adversities and negative life events across the life span to anxiety and depressive disorders. J Affect Disord 2010;126:103–112.
• Wiersma JE, Hovens JG, van Oppen P, et al. The importance of childhood trauma and childhood life events for chronicity of depression in adults. J Clin Psychiatry 2009;70:983–989.
• Bernet CZ, Stein MB. Relationship of childhood maltreatment to the onset and course of major depression in adulthood. Depress Anxiety 1999;9:169–1674.
• Kaya A, Bozkurt B. Kadercilik Eğilimi ile Özyeterlik İnancı ve Savunma Mekanizmaları Arasındaki İlişkinin İncelenmesi. Ege Eğitim Dergisi. 2017;18:124-45.
• Bond M. Empirical studies of defense style: relationships with psychopathology and change. Harv Rev Psychiatry. 2004;12(5):263-78.
• Hovens JG, Giltay EJ, Wiersma JE, et al. Impact of childhood life events and trauma on the course of depressive and anxiety disorders. Acta Psychiatr Scand. 2012;126(3):198-207.
• Zlotnick C, Warshaw M, Shea MT, Keller MB. Trauma and chronic depression among patients with anxiety disorders. J Consult Clin Psychol 1997;65:333–336.
• Brown GW, Moran P. Clinical and psychosocial origins of chronic depressive episodes: a community survey. Br J Psychiatry 1994;165:447–456.
• Brody S, Carson CM. Brief report: self-harm is associated with immature defense mechanisms but not substance use in a nonclinical Scottish adolescent sample. J Adolesc. 2012 Jun;35(3):765-7.