Abstract
Background: Previously, we reported that the maturity of Psychological Adaptive Mechanism (PAM; alternatively, ego defense mechanism) endorsement, but not depression symptom severity, predicted 5-year survival rates in adult cancer patients and that study controlled for age as a significant variable. In this investigation, we hypothesized that greater PAM maturity would correlate significantly with age and with fewer depression symptoms in a larger sample.Methods: In this cross-section study, adult cancer outpatients (N=293) completed the Defense Style Questionnaire (DSQ), the Beck Depression Inventory (BDI), and provided additional clinical data. Spearman’s correlation and multiple regression modeling provided statistical tests of the study hypotheses.Results: Contrary to our hypothesis, DSQ PAM maturity endorsement did not correlate significantly with increasing age. Greater PAM maturity ratio on the DSQ (p<0.0001) and current antidepressant use (p<0.05), however, both provided inverse associations with total BDI symptom frequency (p<0.01). Age was inversely associated with BDI mood (p<0.0001) and somatic scores (p<0.04). Items that worsened BDI symptom frequency included self-reported mood-altering anti-cancer medications and any psychiatric history. Cancer stage, time since diagnosis, and chemotherapy treatment did not correlate with DSQ or BDI scores. Multiple regression analysis found that the correlated items accounted for 17.2% of the variance in mood symptoms and 4.9% in somatic symptoms. Specifically, adaptive maturity and age associated with fewer depression symptoms, while cancer medications affecting mood, and a previous psychiatric history each predicted higher frequency of depression scores.Conclusion: The results suggest that PAM maturity likely predicts fewer depression symptoms while younger age associates with more depression symptoms in this clinical sample. Centrally, acting cancer medications, such as glucocorticoids, and any history of psychiatric disorder correlated with increased depression symptom frequencies. In this cross-section study, antidepressant medications indicated higher frequencies of depressive symptoms, likely reflecting their use in persons previously diagnosed with depression. Further research should target factors that improve PAM maturity as a potential treatment target, especially in younger age groups.
Highlights
We reported that the Maturity level of Psychological Adaptive Mechanisms (PAMs; alternately, “ego defense mechanisms”) independently predicted survival in a small sample of late-stage cancer patients scoring at the extremes on the Defense Style Questionnaire (DSQ) while extreme scores on the Beck Depression Inventory (BDI) did not (Beresford et al, 2006)
20 participants were classified as Stage I (6.8%), 25 as Stage II (8.5%), 65 as Stage III (22.2%), and 174 as Stage IV (59.4%); nine participants (3.1%) had neoplasms for which stage was undetermined or unavailable
Age (t = 1.78, p = 0.077) and previous psychiatric history (t = 0.057, p = 0.95) did not predict somatic scores. Results revealed that both lower PAM maturity and younger age predicted depression mood symptoms in cancer patients, supporting our hypothesis that increasing age and PAM maturity are independently associated with fewer mood symptoms
Summary
We reported that the Maturity level of Psychological Adaptive Mechanisms (PAMs; alternately, “ego defense mechanisms”) independently predicted survival in a small sample of late-stage cancer patients scoring at the extremes on the Defense Style Questionnaire (DSQ) while extreme scores on the Beck Depression Inventory (BDI) did not (Beresford et al, 2006). We reported that the maturity of Psychological Adaptive Mechanism (PAM; alternatively, ego defense mechanism) endorsement, but not depression symptom severity, predicted 5-year survival rates in adult cancer patients and that study controlled for age as a significant variable. In this investigation, we hypothesized that greater PAM maturity would correlate significantly with age and with fewer depression symptoms in a larger sample
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