Studies have provided evidence for the effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in treating medically unexplained symptoms (MUS). This study aimed to examine the effectiveness of ISTDP on individuals living with irritable bowel syndrome (IBS) in terms of, emotion regulation (ER) abilities, defense mechanisms, quality of life (QOL), and IBS symptoms. A total of 30 patients diagnosed with IBS were recruited and randomly assigned to either the intervention (n = 15) or control (n = 15) group. Pre- and post-treatment assessments were conducted, along with a follow-up assessment after ten weeks. Repeated measures analyses of variance were employed to analyze the data. The findings revealed that ISTDP led to significant improvements in ER, defense mechanisms, and QOL, as well as a reduction in the severity and frequency of IBS symptoms. These results provide further support for the efficacy of ISTDP as a treatment modality for individuals with IBS.

OBJECTIVE: To evaluate the effect of psychotherapies on ego defense mechanisms and the reduction of depressive symptoms in a 12-month follow-up period.
METHODS: This longitudinal and quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. Two models of psychotherapy were used: Supportive Expressive Dynamic Psychotherapy (SEDP) and Cognitive Behavioral Therapy (CBT). Defense Style Questionnaire 40 was used to analyze defense mechanisms and the Beck Depression Inventory was used to measure the depressive symptoms.
RESULTS: The total sample comprised 195 patients (113 SEDP and 82 CBT), with the mean age was 35.63 (11.44) years. After adjustments, increased mature defenses was significantly associated with reduced depressive symptoms at all follow-up times (p < 0.001) and the decrease in immature defenses was significantly associated with the reduction of depressive symptoms at all follow-up times (p < 0.001). While neurotic defenses were not associated with a reduction in depressive symptoms at any time of follow-up (p > 0.05).
CONCLUSIONS: Both models of psychotherapy were effective in increasing mature defenses and decreasing immature ones, as well as decreasing depressive symptoms at all evaluation times. With this, it is understood that a greater understanding of these interactions will allow a more adequate diagnostic and prognostic evaluation and the design of useful strategies that adapt to the patient\'s reality.

Despite the clinical relevance of defense mechanisms, there are no published studies in nationally representative samples of their prevalence, correlates, and association with psychosocial functioning. We sought to estimate the prevalence and correlates of 12 defense mechanisms in the general adult population by approximating from items used to assess personality traits in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a representative sample of US adults (N = 36,653). We examined the associations between sociodemographic characteristics and prevalence of 3 types of defenses mechanisms (pathological, immature, and neurotic). For each defense mechanism, we used the Short-Form 12 to compare psychosocial functioning among 3 groups: those who (1) endorsed the mechanism with self-recognized impairment, (2) endorsed the mechanism without self-recognized impairment, and (3) did not endorse the defense mechanism. The prevalence of defense mechanisms ranged from 13.2% (splitting) to 44.5% (obsessive/controlling behavior). Pathological defenses were more strongly associated with immature defenses (OR = 5.4, 95% CI = 5.2-5.6) than with neurotic defenses (OR = 2.0, 95% CI = 1.9-2.0), whereas the association between immature and neurotic defenses had an intermediate value between the other two (OR = 2.2, 95% CI = 2.1-2.2). Pathological and immature defenses were associated with younger age, having been never married, lower educational attainment, and lower income. After adjusting the crude results for age and sex, individuals who did not endorse a given defense generally had higher scores on the mental health component of the SF-12 than those who endorsed the defense without self-recognized impairment who, in turn, had on average higher scores than those with self-recognized impairment. These results suggest that neurotic, immature, and pathological defense mechanisms are prevalent in the general population and associated with psychosocial impairment. Recognizing defense mechanisms may be important in clinical practice regardless of treatment modality.

OBJECTIVE: The present study aims to (1) follow up with 4-year changes in the efficacy outcome, defense style questionnaire (DSQ) score, and clinical features of patients with obsessive-compulsive disorder (OCD) and (2) analyze the relationship between different levels of efficacy and changes in the patients\' psychological defense mechanisms.
METHODS: The following data collection and 4-year follow-up were completed for 153 patients with OCD: (1) the treatment process, efficacy outcome, course of disease, and clinical features of OCD were collected using a self-made general information questionnaire and (2) the control method was used to analyze the changes in clinical symptoms (Yale-Brown obsessive compulsive scale [YBOCS], Hamilton anxiety score [HAMA], and Hamilton depression scale [HAMD]) in patients with OCD. Moreover, the changes in the psychological defense mechanism (measured by DSQ) and the relation between the prognosis and DSQ score were investigated.
RESULTS: (1) The HAMA score (8.7 ± 4.8 points), HAMD score (12.0 ± 6.6 points) and YBOCS score (16.4 ± 8.4 points) were significantly lower during the follow-up than at the time of enrollment (p < 0.01). In the two DSQ evaluations, there were no significant differences in the factors, with the exception of a significant decrease in the use of \"reaction formation\" (t = 2.533, p = 0.015). The changes of mature defense factors in the significant efficacy group significantly increased (p < 0.01). Which was mainly manifested in the significant increase in the score of \"sublimation\" item, and the difference was extremely significant (t = -3.093, p = 0.006).
CONCLUSIONS: An abnormal psychological defense mechanism plays an important role in OCD, and the use of a mature defense mechanism is significantly related to the treatment efficacy.

Defense mechanisms are unconscious processes that protect a person from excessive anxiety. They are part of everyday functioning, and mature defenses are associated with positive outcomes. However, the excessive use of defenses or the use of immature defenses is associated with psychopathology. The present study aims to analyze the defense mechanisms that characterize two types of heavy study investment: Studyholism and Study Engagement. We performed a path analysis, MANOVAs, and binary logistic regressions on 422 Italian college students (Mage = 22.56 ± 2.87; 63.5% females). Among the main findings, the strongest (and positive) predictor of Studyholism is regression (maladaptive defense), while for Study Engagement, it is task-orientation (adaptive defense). Hence, Studyholism might be defined as a new potential clinical condition. Additionally, a critical analysis of all the defense mechanisms predicting Studyholism supports the appropriateness of the OCD-related framework for conceptualizing Studyholism. Regarding Study Engagement, even if generally associated with a positive defense style, the finding that it is positively predicted by projection confirms previous studies suggesting that, for some students, it might constitute a coping strategy with paranoid symptoms (and social anxiety and anxiety). Hence, we recommend screening engaged students for social impairment and clinically relevant symptoms that might be hidden by hard studying.

The paper explores the impact of the corona virus disease-19 (COVID-19) pandemic on the Saudi higher education system. The research focuses on the relationship between digital learning in COVID-19 time, life satisfaction, and stress among female students. The study discusses measures, practices, defense mechanisms, and coping strategies to face challenges. Using an online survey based on psychological effects and its role in defense mechanisms and coping strategies, findings show that digital learning provides flexibility in terms of time and offers resources at a lower cost compared to traditional learning. In addition, results show that the coping strategy perception is higher in obtaining a good score and succeeding than to get over the pandemic and recovering from the illness itself. Finally, results confirm that a positive attitude influences positively life satisfaction.

BACKGROUND: Splitting, as a defense mechanism in Kernberg\'s theory, plays a significant role in the development and maintenance of polarized and oscillating representations of self/other characteristics of borderline personality disorder (BPD). Although the notion of splitting can be considered from a structural and a functional point of view, almost all empirical studies to date have focused on the former elements to the detriment of related cognitive processes.
METHODS: To further investigate the cognitive processes related to splitting, 60 participants were administered the Splitting Index and indexes of resistance to proactive interference (PI) using the interpersonal recent negative task with words that reflect negative or positive interactions compared to neutral words.
RESULTS: The use of splitting was uniquely and significantly predicted by a higher capacity to resist PI and a lower capacity to consistently maintain this resistance when presented with negative words, above and beyond BPD traits, primitive defenses, and the presentation of neutral words. Results showed no evidence of a relationship between splitting and resistance to PI with positive words.
CONCLUSIONS: Results appear compatible with Kernberg\'s conceptualization of splitting as an active defense process that relates to an unstable capacity to inhibit negative representations of the object from entering working memory.

The COVID-19 pandemic and lockdown pose a threat for adolescents\' mental health, especially for those with an earlier vulnerability. Accordingly, these adolescents may need increased support from family and friends. This study investigated whether family functioning and peer connectedness protects adolescents with earlier internalizing or externalizing symptoms from increased depressive symptoms during the first Dutch COVID-19 lockdown in a low-risk community sample.
This sample comprised 115 adolescents (Mage = 13.06; 44% girls) and their parents (N = 111) and is part of an ongoing prospective study on child development. Internalizing and externalizing symptoms were self-reported a year before the COVID-19 lockdown. In an online survey during the first Dutch lockdown (April-May 2020), adolescents reported depressive symptoms and perceived peer connectedness, and parents reported family functioning.
Twenty-four percent of adolescents reported clinically relevant symptoms of depression during the first COVID-19 lockdown. Depressive symptoms were significantly predicted by earlier internalizing, but not externalizing symptoms. Furthermore, higher quality of family functioning, but not peer connectedness, predicted fewer adolescent depressive symptoms. Family functioning and peer connectedness did not moderate the link between pre-existing internalizing symptoms and later depressive symptoms.
In a low-risk community sample, one-in-four adolescents reported clinically relevant depressive symptoms at the first COVID-19 lockdown. Higher earlier internalizing symptoms and lower quality of family functioning increased risks. These results indicate that even in low-risk samples, a substantial group of adolescents and their families are vulnerable during times of crisis.

Using rpoS, tolC, ompF, and recA knockouts, we investigated their effect on the physiological response and lethality of ciprofloxacin in E. coli growing at different rates on glucose, succinate or acetate. We have shown that, regardless of the strain, the degree of changes in respiration, membrane potential, NAD+/NADH ratio, ATP and glutathione (GSH) strongly depends on the initial growth rate and the degree of its inhibition. The deletion of the regulator of the general stress response RpoS, although it influenced the expression of antioxidant genes, did not significantly affect the tolerance to ciprofloxacin at all growth rates. The mutant lacking TolC, which is a component of many E. coli efflux pumps, showed the same sensitivity to ciprofloxacin as the parent. The absence of porin OmpF slowed down the entry of ciprofloxacin into cells, prolonged growth and shifted the optimal bactericidal concentration towards higher values. Deficiency of RecA, a regulator of the SOS response, dramatically altered the late phase of the SOS response (SOS-dependent cell death), preventing respiratory inhibition and a drop in membrane potential. The recA mutation inverted GSH fluxes across the membrane and abolished ciprofloxacin-induced H2S production. All studied mutants showed an inverse linear relationship between logCFU ml-1 and the specific growth rate. Mutations shifted the plot of this dependence relative to the parental strain according to their significance for ciprofloxacin tolerance. The crucial role of the SOS system is confirmed by dramatic shift down of this plot in the recA mutant.

Weight bias internalization (WBI) is associated with a myriad of negative health outcomes, but there are few effective treatments that address this concern. This randomized controlled trial examined the preliminary effectiveness of a previously developed body gratitude journaling intervention (i.e., Expand Your Horizon) compared with an active control writing condition (i.e., expressive writing) in emerging adult women with WBI. Participants (N = 135) completed baseline measures and were then randomized to either Expand Your Horizon (n = 72) or the active control condition (n = 63). Participants in both conditions completed three writing tasks over one week. Assessments occurred at baseline, post-test, and follow-up (one-week). Participants in both conditions experienced improvements in WBI, functionality appreciation, and self-compassion at follow-up, though improvements were greater in the Expand Your Horizon condition. Further, participants in the Expand Your Horizon had greater improvement in healthcare stress at follow-up. In sum, Expand Your Horizon appeared accessible and demonstrated preliminary effectiveness in a sample of emerging adult women with WBI. Avenues for future research include evaluating this intervention in more diverse populations with a longer follow-up.