Exploring clusters of defence styles, psychiatric symptoms, and academic achievements among medical students in Saudi Arabia

Abstract

Objective: This study aimed to identify clusters of defence mechanisms and their relationship with academic performance and mental health outcomes among medical students at five different universities in Saudi Arabia. Methods: This cross-sectional study was conducted using a self-administered online-based validated questionnaire. The questionnaire included sections on demographics, grades obtained in annual examinations, the Hospital Anxiety and Depression Scale (HADS), and the Defense Style Questionnaire-40 (DSQ-40). Results: A total of 997 medical students were included in the analysis, with 47.2% being male. Majority of the participants were in their 3rd and 6th year of college, and most were single. Among the participants, 16.8% reported being smokers. Based on academic achievements, 54.9% students were classified as low achievers, while 45.0% were classified as high achievers. The high achievers cluster was much larger than the low achievers cluster, with a ratio of sizes of 7.51. The low achievers cluster exhibited higher mean scores for traits such as immaturity, neuroticism, and suppression compared to the high achievers cluster. However, depression scores were similar in both clusters, while anxiety scores were significantly higher in the high achievers cluster. The high achievers cluster showed lower values for characteristics such as autistic fantasy, suppression, and anticipation. Conclusions: This study identified two distinct clusters of defence mechanisms among medical students in Saudi Arabia, which were associated with differences in academic performance and personality traits. High achievers demonstrated a higher proportion of mature defence mechanisms, while low achievers exhibited a higher prevalence of immature defence mechanisms.