Immature Defense Research Articles

Defense mechanisms in individuals with depressive and anxiety symptoms: a network analysis

BackgroundDefense mechanisms play a crucial role in depression and anxiety. The current study aimed at estimating the network structure of defense mechanisms in individuals with symptoms of depression and anxiety to understand the most central defenses and relevant connections. Moreover, we aimed at examining the associations between defense mechanisms and symptoms.MethodsWe employed the Symptom Checklist-90 to recruit 655 individuals with depressive and anxiety symptoms during the first wave of the COVID-2019 Pandemic in Italy. Defense mechanisms were assessed with the DMRS-SR-30.ResultsResults showed a main component in the network graph featuring 16 defense mechanisms. Self-assertion was the most central node in the network, displaying positive and negative connections with an array of mature and immature defenses, respectively. Among immature defenses, passive aggression was the most interconnected node. Some mature defenses (i.e., humor, affiliation, and sublimation) were not connected to other nodes. A range of defense mechanisms were associated with anxiety and depressive symptoms.ConclusionsThis is the first research effort supporting the conceptualization of defense mechanisms as a complex system. Results suggest that defense mechanisms of the same cluster (e.g., mature defenses) play different roles in the network. Central defenses (i.e., self-assertion and passive aggression) detected in this study may be promising intervention targets.

Relationship between defense styles and neurochemical variables of the hippocampus in patients with obsessive-compulsive disorder.

This study aims to assess the correlation between NAA (N-acetyl-l-aspartate), CHO (choline), and CRE (creatine) levels in the hippocampus regions of individuals suffering from obsessive-compulsive disorder (OCD) and defensive styles of the ego. The study group was composed of twenty patients with OCD and twenty healthy controls. NAA, CHO, and CRE values in the hippocampal region using proton magnetic resonance spectroscopy (1H-MRS) were measured. Participants' defense styles were ascertained by administering the Defense Style Questionnaire-40. The patient group's NAA levels were considerably lower than the control group's on both sides of the hippocampus. The levels of CHO and CRE did not significantly differ between the two groups. The following statistically significant correlations were discovered: in the comparison group, there were negative correlations between the scores of mature defense styles and the right and left CHO levels, as well as between the immature defense mechanism scores and the right NAA levels in both the patient and control groups. In the patient group, there were also negative correlations between the left NAA values and the scores of mature defense styles. OCD patients have lower levels of NAA in the hippocampus. To validate and extend the current findings, more research involving a greater sample size is required.

Deciphering the Role of Maternal Microchimerism in Offspring Autoimmunity: A Narrative Review.

Feto-maternal microchimerism is the bidirectional transfer of cells through the placenta during pregnancy that can affect the health of both the mother and the offspring, even in childhood or adulthood. However, microchimerism seems to have different consequences in the mother, who already has a developed immune system, than in the fetus, which is vulnerable with immature defense mechanisms. Studies have shown that the presence of fetal microchimeric cells in the mother can be associated with reduced fetal growth, pre-eclampsia, miscarriage, premature birth, and the risk of autoimmune disease development in the future. However, some studies report that they may also play a positive role in the healing of maternal tissue, in cancer and cardiovascular disease. There are few studies in the literature regarding the role of maternal microchimeric cells in fetal autoimmunity. Even fewer have examined their association with the potential triggering of autoimmune diseases later in the offspring's life. The objectives of this review were to elucidate the mechanisms underlying the potential association between maternal cells and autoimmune conditions in offspring. Based on our findings, several hypotheses have been proposed regarding possible mechanisms by which maternal cells may trigger autoimmunity. In Type 1 diabetes, maternal cells have been implicated in either attacking the offspring's pancreatic β-cells, producing insulin, differentiating into endocrine and exocrine cells, or serving as markers of tissue damage. Additionally, several potential mechanisms have been suggested for the onset of neonatal lupus erythematosus. In this context, maternal cells may induce a graft-versus-host or host-versus-graft reaction in the offspring, function as effectors within tissues, or contribute to tissue healing. These cells have also been found to participate in inflammation and fibrosis processes, as well as differentiate into myocardial cells, potentially triggering an immune response. Moreover, the involvement of maternal microchimeric cells has been supported in conditions such as juvenile idiopathic inflammatory myopathies, Sjögren's syndrome, systemic sclerosis, biliary atresia, and rheumatoid arthritis. Conversely, no association has been found between maternal cells and celiac disease in offspring. These findings suggest that the role of maternal cells in autoimmunity remains a controversial topic that warrants further investigation.

Pathways towards posttraumatic stress symptomatology: A moderated mediation model including perceived stress, worry, and defense mechanisms.

The general aim of this study was to examine the psychological variables associated with post-traumatic stress disorder (PTSD) symptomatology, focusing on perceived stress, worry, as well as mature, neurotic, and immature defenses. Therefore, the differences in the study variables based on the levels of posttraumatic stress were explored, and a moderated mediation model was tested, controlling for gender and SARS-CoV-2 infection as covariates. A sample of 1,864 Italian participants completed the Impact of event scale-revised (IES-R), the 10-Item Perceived Stress Scale (PSS-10), the Penn State Worry Questionnaire (PSWQ), and the 40-Item Defense Style Questionnaire (DSQ-40). 41% (n = 764) of participants showed scores indicative of a probable presence of PTSD. They reported significantly higher levels of perceived stress, worry, neurotic and immature defenses than participants with lower PTSD symptomatology. Perceived stress was significantly associated with PTSD symptomatology, both directly and indirectly through the mediation of worry. Furthermore, neurotic and immature defenses were significant moderators in some relationships of this model. Such data can provide useful indications to elaborate tailored interventions and specific prevention activities for PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Central sensitization symptoms in vulvodynia: exploring the role of temperament, personality traits, childhood adverse events, defense mechanisms, and mental pain on quality of life.

Vulvodynia is a chronic pain syndrome characterized by persistent vulvar pain, occurring without clinically identifiable disorders. Central sensitization (CS) is suggested to play a role in the pathophysiology of vulvodynia, as for other nociplastic pain conditions. This study delves into the complex interplay between psychosocial factors and CS burden in women with vulvodynia, aiming to identify potential predictors (temperament, personality traits, childhood adverse events, defense mechanisms, and mental pain) and understand their impact on quality of life (QoL). A cohort-based cross-sectional web survey of 357 women with vulvodynia. Outcomes included 8 self-report measures to assess the Central Sensitization Inventory (CSI) and psychological variables, including sensory processing sensitivity, traumatic experiences, personality traits, defense mechanisms, and mental pain. Hierarchical multiple regression analyses were conducted in study 1, revealing that the following predicted higher CSI scores in women with vulvodynia: higher emotional overexcitability, decreased low sensory threshold, increased bodily threat experiences, elevated psychoticism, greater use of immature and neurotic defense mechanisms, and heightened mental pain. The final regression model identified the following as the strongest predictors of CS: low sensory threshold (β = 0.316), bodily threat experiences (β = 0.145), neurotic defenses (β = 0.210), and mental pain (β = 0.269). In study 2, the model presented interactions among these psychological factors in predicting CSI values explaining 48.9% of the variance in CS, 30.3% in psychological QoL, and 57.1% in physical QoL. This model opens discussion for tailored psychological interventions aimed to improve overall QoL in women with vulvodynia. Strengths of the study include innovative insights into the interplay between psychological variables and the construct of CS and quality of life. As a limitation, the research was conducted as a cross-sectional study with self-reported measures. The study calls for comprehensive assessments that consider physical and mental aspects, paving the way for holistic health care approaches in the management of vulvodynia.

Impact of Defense Mechanism Styles on Disease Progression in Patients with Gastrointestinal Cancer: Focusing on Clinical Staging.

The escalating incidence of cancer and the concurrent rise in mental health issues necessitate investigation into the potential for psychological factors to impede timely and effective treatment. This study examines the association between defense mechanism styles and disease progression, specifically focusing on clinical staging, in patients diagnosed with gastrointestinal (GI) cancer. Employing a descriptive correlational design, the study recruited 205 patients with GI cancer admitted to Javad Al-Aeme Hospital in Kerman, Iran, during the year 2022. Convenience sampling was utilized for participant selection. Data collection instruments included the Defense Style Questionnaire-40 (DSQ-40) and patients' documented clinical stage information. Correlation coefficients and ordinal logistic regression were employed for data analysis. Over half of 205 GI cancer patients were female (53.2%). The majority were married (85.8%) with an average age of 53.86 ± 8.21years. Nearly a quarter (23.9%) were in disease stage 1, with similar proportions in stages 2 (25.4%), 3 (27.3%), and 4 (23.4%). The findings revealed a significant inverse correlation between mature defense mechanism styles and clinical stage (r = - 0.55, p < 0.001), indicating that patients who employed more adaptive defense mechanisms had lower-stage cancer. Conversely, a significant positive correlation was observed between immature defense mechanism styles and clinical stage (r = - 0.49, p < 0.001), suggesting that patients who relied on less effective defense mechanisms had more advanced-stage cancer. However, no significant association was found between neurotic defense mechanism styles and clinical stage (r = - 0.12, p = 0.079). This study provides preliminary evidence that defense mechanism styles are associated with disease progression in patients with GI cancer. Mature defense mechanisms may promote slower disease progression, while immature defense mechanisms may contribute to more advanced disease stages. Further research is needed to confirm these findings and develop interventions to improve psychological well-being in this patient population.

Understanding Adolescent Mental Health in the COVID-19 Era: A Psychodynamic Approach.

This cross-sectional, case-control study aimed to explore the psychodynamic characteristics that influenced adolescents' mental health during the COVID-19 pandemic. Personality structure impairments, psychodynamic conflicts, defense styles, and mental health issues were examined using the OPD-Structure- and Conflict-Questionnaires, the Defense Style Questionnaire, and the Patient Health Questionnaire in adolescents before (n = 288) and after (n = 451) the COVID-19 pandemic in Germany. Adolescents with mental health issues exhibited greater impairments in personality structure, more immature defense styles, and higher levels of psychodynamic conflicts both before and after the pandemic onset. Comparisons between pre-pandemic and pandemic samples indicated a lower level of the conflict of taking care of oneself versus being cared for in passive mode among adolescents during the pandemic. In-depth analysis of adolescents with mental health issues from the pandemic group revealed significant associations between personality structure impairments and a maladaptive defense style with somatoform, depressive, anxiety, eating, and alcohol use disorders. The findings provide clinically relevant insights into the psychodynamic factors that contributed to the psychological vulnerability of adolescents during the COVID-19 pandemic. These insights can guide the development of targeted psychodynamic interventions to support adolescents' mental health in similar future crises.

The Complexity of Borderline Personality Disorder: Network Analysis of Personality Factors and Defense Styles in the Context of Borderline Personality Organization.

Borderline personality disorder (BPD) is known to share characteristics with a variety of personality disorders (PDs) and exhibits diverse patterns of defense mechanisms. To enhance our understanding of BPD, it's crucial to shift our focus from traditional categorical diagnostics to the dimensional traits shared with other PDs, as the borderline personality organization (BPO) model suggests. This approach illuminates the nuanced spectrum of BPD characteristics, offering deeper insights into its complexity. While studies have investigated the comorbidity of BPD with other PDs, research exploring the relationship between various personality factors and defense mechanisms within BPD itself has been scarce. The present study was undertaken to investigate the complex interrelationships between various personality factors and defense styles in individuals diagnosed with BPD. Using a network analysis approach, data from 227 patients diagnosed with BPD were examined using the Defense Style Questionnaire and Personality Disorder Questionnaire-4+ for assessment. Intricate connections were observed between personality factors and defense styles. Significant associations were identified between various personality factors and defense styles, with immature defense styles, such as maladaptive and image-distorting being particularly prominent in BPD in the centrality analysis. The maladaptive defense style had the highest expected influence centrality. Furthermore, the schizotypal, dependent, and narcissistic personality factors demonstrated relatively high centrality within the network. Network analysis can effectively delineate the complexity of various PDs and defense styles. These findings are expected to facilitate a deeper understanding of why BPD exhibits various levels of organization and presents with heterogeneous characteristics, consistent with the perspectives proposed by the BPO.

대학생의 내면화된 수치심과 전위공격성의 관계에서 방어기제유형의 매개효과

Objectives The purpose of this study was to examine the mediating effect of defense mechanism style on the relationship beꠓtween internalized shame and displaced aggression. Methods A self-report questionnaire was distributed in order to measure internalized shame, displaced ag-gression and defense mechanism style, targeting university students enrolled in 3 different universities in Seoul during the period from March to April 2019. A total of 300 questionnaires were distributed and all of them were retrieved. As a total, 287 samples excluding 7 non-Korean participants (international students) and 6 participants who responded incompletely were analyzed using the SPSS 22.0 program. For statistical analysis, a regression analysis and a three-stage multiple regression analysis were performed in order to establish the correlation among internalized shame, displaced aggression, and defense mechanism style. Finally, we conducted a Baron and Kenny’s three-stage multiple regression analysis (1986) to verify the mediating effect of the defense mechanism style. Results First, significant correlations have been identified among university students' internalized shame, dis-placed aggression, and defense mechanism style. Second, There were both a complete mediating effect of im-mature defense mechanism style and a partial mediating effect of self-regulation defense mechanism style on the relationship between university students’ internalized shame and displaced aggression. Conclusions In conclusion, the results of this study show that in students who display displaced aggression, the manner in which they used this psychological mechanism to handle internal conflicts in daily life significantly influ-enced their internal displaced aggression variably. Therefore, this study concludes that examining and under-standing the defense mechanism of counselees must precede specific counseling in order to mitigate university students’ displaced aggression.

A Study on the Impact of Ego Defense Mechanisms on the Formation of Close Relationships in Young Adults

A Study on the Impact of Ego Defense Mechanisms on the Formation of Close Relationships in Young Adults

Associations between Personality Structure, Psychodynamic Conflicts and Defense Styles in Adolescents with Mental Health Problems

An exploration of the interrelationships between central psychodynamic constructs in adolescents with mental health problems was conducted. 230 adolescents (Mage=18.0±1.9) were assessed using the Structure and the Conflict Questionnaire of the Operationalized Psychodynamic Diagnosis System in Childhood and Adolescence and the Defense Style Questionnaire for Adolescents. Controlling for the influence of gender, age, and socioeconomic status, low to moderate associations were revealed between increased psychodynamic conflict levels and immature defense styles (r=0.20 to 0.39, p<0.05 to 0.001) as wells as deficits in the personality structure and increased psychodynamic conflict levels (r=0.15 to 0.55, p<0.05 to p<0.001) or immature defense styles (r=0.30 to 0.69, p<0.001). Psychodynamic conflicts as well as defense styles could be predicted by the structural dimensions as well as age and sex (R2=0 .04 to 0.49, p<0.05 to 0.001). Theory-compliant correlations were demonstrated. The findings are particularly relevant against the background of the revision of the classification of personality functioning (ICD-11) in childhood and adolescence.

Intervening Effect of Maladaptive Personality on the Relationship Between Defense Styles and Psychiatric Symptoms Among Prisoners.

Prison settings are stress-inducing environments that make individuals more vulnerable to psychopathology. Defense styles and personality traits have long been associated with psychopathology. The current study aimed to explain the intervening role of maladaptive personality domains on the relationship between defense styles and psychiatric symptoms among male convicts imprisoned in nine Central Jails of Punjab, Pakistan. Through cross-sectional design, data was collected through purposive sampling. 509 respondents (who were serving their sentence for the crime committed) with a Mean age of 35 years (10.21) provided data on self-reported translated versions of the Cross-Cutting Symptoms Measure, Personality Inventory for DSM 5 - Adult version (Short Form), and Defense Style Questionnaire. Findings of the mediation analysis showed that negative affectivity, disinhibition, and psychoticism mediated the relationship between immature defense style and psychiatric symptoms whereas moderation analysis showed a significant interactional effect of antagonism with mature and neurotic defense style on psychiatric symptoms exclusively. Findings have highlighted that defense styles and certain personality domains intervene to have a combined indirect effect on psychiatric symptoms. The study also contributes to the literature by specifying the interactional effect of antagonism and mature defense style on predicting psychiatric symptoms.

Defense mechanisms are associated with mental health symptoms across six countries.

Defense mechanisms are adaptative processes that are related to mental health and psychological functioning and may play an important role in adaptation to distress, as well as in mental health interventions. The present study aimed to compare the use of defense mechanisms and their relationship to mental health symptoms across six countries. In a large-scale descriptive study, we collected data from community- based individuals (N=19,860) in the United States, Australia, Canada, Germany, Italy, and the United Kingdom about the use of defense mechanisms and experienced mental health symptoms during the early phase of the pandemic. We found that the use of defense mechanism categories was similar across countries. Moreover, lower defensive functioning, specifically, neurotic and immature defenses were related to experiencing higher distress across countries, whereas mature defenses were generally inversely related to symptoms. Furthermore, these findings were relatively similar across the six countries. Cross-cultural research on defense mechanisms and mental health has important clinical implications. Our results are consistent with the goal of promoting more adaptive defensive functioning to increase psychological well-being and mitigate the detrimental impact of situational stress.

Immature defense mechanisms mediate the relationship between negative life events and depressive symptoms.

This study aimed to analyze the patterns of life events (LEs) and defense mechanisms in outpatients with depression and investigate the mediating role of defense mechanisms in the association between LEs and depressive symptoms in a psychosomatic outpatient sample in China. All of 2,747 outpatients (aged 18-65) from psychosomatic department were investigated in this study. LEs, depressive symptoms, and defense mechanisms were assessed by the Life Events Scale (LES), Patient-Health-Questionnaire-9 (PHQ-9), and the Defense Style Questionnaire (DSQ), respectively. Based on the optimal cut-off point of PHQ-9, 1840 (67.0%) patients had a PHQ-9 score of 10 or higher (depression group), and 907 (33.0%) had a score below 10 (non-depression group). The scores of Negative Life Events (NLEs), immature and intermediate defense mechanisms in the depression group were significantly higher than those in the non-depression group, while the scores of mature defense mechanisms were the opposite (p < 0.001). NLEs was directly related to depressive symptoms (b = 0.010, p < 0.001), and significant indirect effect via immature defense mechanisms (b = 0.008, p < 0.001) was observed. Immature defense mechanisms play an important mediating role in the relationship between NLEs and depressive symptoms. Helping patients improving defense mechanisms and dealing with NLEs may be of great help in the treatment of relevant patients.

Coping Styles and Defense Mechanisms Mediate Associations Between Exposure to Adverse Childhood Experiences and CPTSD Symptoms in Faroese Adolescents.

The experience of several adverse childhood experiences (ACEs) has been shown to be associated with Post-Traumatic Stress Disorder (PTSD) and Disturbances in Self-Organization (DSO) symptoms among adolescents. Defense mechanisms and coping styles are psychological processes involved in the association of ACEs with PTSD and DSO symptoms. However, there is a lack of research on the joint association of these variables among Faroese adolescents. The aim of this study was to analyze the effect of exposure to ACEs on PTSD and DSO symptoms trough the indirect effect of defense mechanisms and coping styles in a sample of Faroese adolescents. Six hundred and eighty-seven Faroese adolescents were recruited from 19 schools. Participants responded to validated self-report questionnaires. A multiple step mediation and a serial mediation methodology were conducted through structural equation modeling. Exposure to ACEs was linked to PTSD and DSO symptoms through the indirect effect of immature defense mechanisms, emotional coping, and detachment coping. Exposure to ACEs was linked to PTSD symptoms through rational coping. The results suggest a mutual relationship between defense mechanisms and coping styles in coping with multiple adversity among adolescents.

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

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.

Polytraumatization, defense mechanisms, PTSD and complex PTSD in Indian adolescents: a mediation model

BackgroundAdolescence is recognized as a particularly susceptible developmental period for experiencing multiple types of Adverse Childhood Experiences (ACE), increasing the vulnerability to higher levels of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD symptoms. Some studies found that defense mechanisms play an important role on the association between ACE and psychological symptoms.MethodsWe analyzed the associations between direct and indirect exposure to ACE and PTSD and Complex PTSD (affective dysregulation, negative self-concept and disturbances in relationships) through the mediation role of mature defense mechanisms: mature, neurotic, and immature defense mechanisms in Indian adolescents. A sample of 411 Indian adolescents (M = 14.2 years old; S.D. = 0.5) completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modelling employing Preacher and Hayes’ procedures (2008).ResultsImmature and neurotic defense mechanisms mediated the association between direct exposure to ACE with PTSD symptoms. Immature defense mechanisms were mediators of the relationship between direct exposure to ACE and Complex PTSD symptoms clusters.ConclusionsMaladaptive defense mechanisms can disturb the process of self-regulation and emotion regulation capabilities in coping with traumatic experiences, leading to higher PTSD and Complex PTSD symptoms severity.

Correlation Between Defense Mechanisms and Parenting Style of Adolescents With Non-Suicidal Self-Injury.

Non-suicidal self-injury (NSSI) is highly prevalent among adolescents. The current study aimed to explore defense mechanisms and parental styles of adolescents with NSSI behaviors. The Egna Minnen Barndoms Uppfostran (EMBU [One's Memories of Upbringing]) and Defense Style Questionnaire (DSQ) were used to evaluate 31 participants with NSSI behaviors in the experimental group and 60 participants with non-NSSI behaviors in the control group. There were significant differences in Father Factors II, V, and VI, and Mother Factors III and IV on the EMBU between the experimental and control groups. On the DSQ, there were significant differences in immature defense mechanism, mature defense mechanism, and camouflage factors between the experimental and control groups. In the experimental group, Father Factors I and IV and Mother Factors I and V were significantly correlated with mature defense mechanism. Father Factor VI and Mother Factors III and IV were significantly correlated with immature defense mechanism. Father Factors II and V were significantly correlated with camouflage factors. Defense mechanisms and parental styles of participants in the experimental group were different than those of the control group, and immature parental styles affect the formation of defense mechanisms. [Journal of Psychosocial Nursing and Mental Health Services, 61(11), 17-22.].

The Medical, Sociological, Psychological, Religious, and Spiritual Aspects of Masturbation and a Potential Approach to Therapy Based on Catholic Teaching and Virtues Psychology.

Masturbation is common and generally accepted in Western society as a normal, healthy activity. In contrast, the Catholic Church holds that masturbation is immoral. Noting that the human person is a profound unity of body and spirit, if the Church is correct, masturbation should have negative effects on the human person. If the secular view is correct, masturbation should have conversely positive effects. This paper is divided into three parts. An in-depth literature survey was performed to evaluate the physical, medical, psychological, sociological and spiritual correlates of masturbation. The second part is a theological summary of the Catholic understanding of masturbation. The third part is an approach to therapy. Physically, masturbation was found to be less sexually satisfying than intercourse. Medical complications include penile injury and self-asphyxial behavior. Psychologically, masturbation was found to be associated with depression, anxiety, immature defenses, hypersexuality, guilt, poor body self-image and stress in the workplace. Sociologically most studies indicate a negative correlation between masturbation and relationship satisfaction, quality, intimacy, relational happiness, emotional satisfaction with the partner, trust, passion, and love. Spiritually, masturbation is highly positively correlated with pornography consumption and negatively with religion and religiosity. There is a higher rate of masturbation in homosexuals and bisexuals than in heterosexuals. Theologically, masturbation and pornography directly violate the religious virtue of chastity, undermining one's prayer life and the motivation to develop a spiritual life. Therapeutically, positive psychology, which emphasizes cultivating what it identifies as virtues, including justice, courage, temperance, wisdom (similar to prudence), transcendence (similar to hope) and humanity (similar to charity), can be used to counsel individuals struggling with masturbation. Once the harms are understood, a person can be counseled that this temptation represents a challenge, an opportunity to build self-control, and with self-control the capacity to develop character strengths and major virtues.

The Mediating Role of Emotion Regulation in the Relationship Between Defense Styles and Psychological Vulnerability Among Emergency Medicine Physicians

Background: Excessive work-related psychological pressures can endanger health by causing physical, mental, and behavioral complications. Objectives: The present study aimed to investigate the mediating role of emotion regulation in the relationship between defense styles and psychological vulnerability among emergency medicine physicians. Methods: The statistical population of this descriptive correlational study comprised all emergency medicine physicians working in Tehran hospitals in 2021 - 2022, from whom a sample of 380 was selected using cluster sampling. The research instruments included the symptom checklist-25 (SCL-25), The Defense Style Questionnaire (DSQ), and Cognitive Emotion Regulation Questionnaire (CERQ). The data were analyzed by structural equation modeling (SEM) in LISREL 8.8. Results: Based on the results, the research model had a good fit (CFI = 0.96, root mean square error of approximation (RMSEA) = 0.058). There was an indirect relationship between the defense styles of emergency medicine physicians and psychological vulnerability, mediated by emotion regulation (P &lt; 0.001). There were direct relationships between defense styles and psychological vulnerability, between emotion regulation and psychological vulnerability, and between defense styles and emotion regulation (P &lt; 0.001). Conclusions: Health professionals and therapists can thus reduce psychological vulnerability among emergency medicine physicians by improving their immature and neurotic defense styles and enhancing their cognitive emotion regulation.