Explaining The Structural Model of The Relationship Between Defense Mechanisms and Mental Pain with Suicidal Thoughts with the Mediation of Depression in Sailor Men

Karimi, Zahra; Karbalai Mohammad Migouni, Ahmad; Rezabakhsh, Hosein; Atai Far, Robabeh

Volume 13 - Articles-1402 MEJDS (2023) 13: 129 | Back to browse issues page

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Karimi Z, Karbalai Mohammad Migouni A, Rezabakhsh H, Atai Far R. Explaining The Structural Model of The Relationship Between Defense Mechanisms and Mental Pain with Suicidal Thoughts with the Mediation of Depression in Sailor Men. MEJDS 2023; 13 :129-129
URL: http://jdisabilstud.org/article-1-3086-en.html

Explaining The Structural Model of The Relationship Between Defense Mechanisms and Mental Pain with Suicidal Thoughts with the Mediation of Depression in Sailor Men

Zahra Karimi¹

, Ahmad Karbalai Mohammad Migouni ^*²

, Hosein Rezabakhsh²

, Robabeh Atai Far²

1- PhD student in general psychology, Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
2- Assistant Professor of Psychology Department, Karaj Branch, Islamic Azad University, Karaj, Iran

Abstract: (870 Views)

Abstract
Background & Objective: "Suicide" is a major public health problem and one of the main causes of death worldwide. Suicide is generally defined as an act of self-destruction with some degree of intent to end life. "Suicidal behavior" refers to death by suicide. Still, it also includes different types of suicidal actions, which range from lethal actions to die to less lethal actions that may occur in the context of a psychosocial crisis. It is varied and sometimes includes a part of the request for help. "Suicidal thoughts" is a broad term used to define thoughts and wishes of death and preoccupation with death. Suicidal thoughts are important because most suicidal actions happen after them. Suicidal thoughts are evaluated as the best predictor of suicidal actions. Identifying risk factors and cognitive processes that lead to suicidal thoughts can be effective in screening, prevention, evaluation, and treatment of suicide. Accurately identifying people who are at risk of committing suicide in the future is a big challenge in psychiatry and especially in patients with depression. Factors related to increasing the risk of suicidal thoughts and behaviors are numerous and diverse and include psychological and family characteristics and socio-economic and demographic dynamics. Tendency to suicidal thoughts and behaviors is the most disturbing symptom of depression, which is potentially the most deadly. Mental pain and defense mechanisms are strong predictors of suicide attempts in depressed people. The present study aimed to explain the structural model of the relationship between defense mechanisms and mental pain with suicidal thoughts with the mediation of depression in Iranian Seafaring men.
Methods: The research method was a descriptive-analytical type. The statistical population of this research included all seafaring men working in a tanker company in 2021 among them, 378 people entered the research voluntarily. The criteria for entering the present study include employment in the tanker company, work experience for at least 1 year, age 25 to 60 years, male gender, absence of physical disabilities and suffering from chronic diseases, not taking medication, and the lack of hospitalization during the last year due to the physical and mental condition, the lack of receiving psychotherapy simultaneously and during the last year. The criterion for leaving the research was the distorted and incomplete questionnaire. To collect data Beck Scale for Suicide Ideation (1979), Beck Depression Questionnaire (1961), Defense Style Questionnaire-40 by Andrews et al. (1993) and Mental Pain Scale by Orbach et al. (2003) were used. Structural equation model and SPSS-24 and AMOS-24 software and a significance level of 0.05 were used for data analysis.
Results: In the present study, the results showed that the hypothesized model had fitness with the collected data (χ²/df=2.16, CFI=.988, GFI=.990, AGFI=.893, and RMSEA=.092). The results of this study showed that the direct path coefficient between immature mechanisms (p=0.016, β=0.160) and neurotic mechanisms (p=0.010, β=0.156) and mental pain (p=0.010, β=0.627) with depression was positive and significant. The results also showed the indirect path coefficient between immature mechanisms (p=0.011, β=0.218), neurotic mechanisms (p=0.017, β=0.054), and mental pain (p=0.021, β=0.055) with suicidal thoughts with the mediation of depression were positive and significant.
Conclusion: The results of the present study showed that there is a relationship between immature and neurotic defense mechanisms and mental pain with suicidal thoughts mediated by depression in in sailor men. In the explanation of the present findings, it can be said that defenses are unconscious psychological mechanisms that are directed towards both pressures caused by internal impulses and external pressures, especially pressures that threaten a person's self-esteem and self-concept, and maybe their integration is guided by the conscious awareness of the individual's personality structure. Defense mechanisms arise in a specific developmental sequence and are a function of healthy personality development. More mature defense mechanisms require a greater ability to adapt to reality so that they can effectively eliminate threatening emotions without distorting reality. Improper and excessive use of them can prevent healthy coping responses. Psychological factors such as the belief that a person cannot effectively solve their problems lead to increased helplessness and despair, the use of immature defenses, and depression. Although some self-injurious behaviors may not be done with the motive of dying, the common motive in these behaviors is to escape from unbearable conditions and mental suffering.

Keywords: Depression, Suicidal Thoughts, Mental Pain, Defense Mechanisms, Sailor

Full-Text [PDF 978 kb] (268 Downloads)

Type of Study: Original Research Article | Subject: Psychology

References

1. Nordin N, Zainol Z, Mohd Noor MH, Chan LF. An explainable predictive model for suicide attempt risk using an ensemble learning and Shapley Additive Explanations (SHAP) approach. Asian J Psychiatr. 2023;79:103316. [DOI]

2. Sher L, Oquendo MA. Suicide: an overview for clinicians. Med Clin North Am. 2023;107(1):119–30. [DOI]

3. Donnelly HK, Han Y, Kim S, Lee DH. Predictors of suicide ideation among South Korean adolescents: a machine learning approach. J Affect Disord. 2023;329:557–65. [DOI]

4. Christensen K, Chu C, Silverman AL, Peckham AD, Björgvinsson T, Beard C. Prevalence and correlates of past-month suicidal thoughts, suicide attempts, and non-suicidal self-injury among adults in a partial hospital program. J Psychiatr Res. 2021;144:397–404. [DOI]

5. Batterham PJ, Ftanou M, Pirkis J, Brewer JL, Mackinnon AJ, Beautrais A, et al. A systematic review and evaluation of measures for suicidal ideation and behaviors in population-based research. Psychol Assess. 2015;27(2):501–12. [DOI]

6. Kim H, Ryu S, Jeon HJ, Roh S. Lifestyle factors and suicide risk: a nationwide population-based study. J Affect Disord. 2023;328:215–21. [DOI]

7. Ronzitti S, Kraus SW, Hoff RA, Clerici M, Potenza MN. Problem-gambling severity, suicidality and DSM-IV Axis II personality disorders. Addict Behav. 2018;82:142–50. [DOI]

8. Giupponi G, Innamorati M, Baldessarini RJ, De Leo D, De Giovannelli F, Pycha R, et al. Factors associated with suicide: case-control study in South Tyrol. Compr Psychiatry. 2018;80:150–4. [DOI]

9. Qayyum Z, Taylor SM, Schneider MR. Training and education related to suicide prevention. Adv Psychiatry Behav Health. 2022;2(1):211–9. [DOI]

10. Busby Grant J, Batterham PJ, McCallum SM, Werner-Seidler A, Calear AL. Specific anxiety and depression symptoms are risk factors for the onset of suicidal ideation and suicide attempts in youth. J Affect Disord. 2023;327:299–305.. [DOI]

11. Bornheimer LA, Wastler H, Li Verdugo J, Im V, Burke H, Holzworth J, et al. Depression, suicide intent, and plan among adults presenting in an emergency department after making a suicide attempt: exploratory differences by psychosis symptom experience. J Psychiatr Res. 2023;157:197–201. [DOI]

12. O’Brien E, Whitman K, Buerke M, Galfalvy H, Szanto K. Life-satisfaction, engagement, mindfulness, flourishing, and social support: do they predict depression, suicide ideation, and history of suicide attempt in late life? Am J Geriatr Psychiatry. 2023;31(6):415–24. [DOI]

13. Hao Z, Li H, Lin Y. The characterization of static and dynamic brain functional networks in suicide attempters with major depressive disorder and its relation to psychological pain. Psychiatry Res Neuroimaging. 2022;327:111562. [DOI]

14. O’Connor RC, Platt S, Gordon J. International handbook of suicide prevention: research, policy and practice. First edition. Wiley; 2011. [DOI]

15. Verrocchio MC, Carrozzino D, Marchetti D, Andreasson K, Fulcheri M, Bech P. Mental pain and suicide: a systematic review of the literature. Front Psychiatry. 2016;7:108. [DOI]

16. Abbaspour Z, Fathalipour Z, Mombeini I. Identifying factors affecting attempt to suicide in Izeh and Masjed Soleyman. Quarterly of Social Studies and Research in Iran. 2020;9(1):215–33. [Persian] [Article]

17. Bagian MJ, Karami J, Momeni Kh, Elahi A. The investigation of the role of childhood trauma experience, cognitive reactivity, and mental pain in suicide attempted and normal individuals. Thought & Behavior in Clinical Psychology. 2019;14(53):77–89. [Persian] [Article]

18. Kiani Chalmari A, Safdarian Z, Jafari Banafshedaragh A, Ahmadbookani S. Three-step structural assessment of suicide (hopelessness, ache, depression, interpersonal needs, acquired capability for suicide, and suicide attempt) in students. Journal of Counseling Research. 2021;19(76):92–117. [Persian] [DOI]

19. Li X, Mu F, Liu D, Zhu J, Yue S, Liu M, et al. Predictors of suicidal ideation, suicide attempt and suicide death among people with major depressive disorder: a systematic review and meta-analysis of cohort studies. J Affect Disord. 2022;302:332–51. [DOI]

20. Angelakis I, Gooding P. Associations of anxiety and depression with suicide experiences in individuals with and without childhood trauma: the role of social support. Psychiatry Res. 2022;309:114424. [DOI]

21. Gvion Y, Horresh N, Levi-Belz Y, Fischel T, Treves I, Weiser M, et al. Aggression–impulsivity, mental pain, and communication difficulties in medically serious and medically non-serious suicide attempters. Compr Psychiatry. 2014;55(1):40–50. [DOI]

22. Nikfallah R, Barekat A. The mediating role of emotion regulation difficulties and experiential avoidance in the relationship between defense mechanisms and suicidal ideation in adolescents. Journal of Applied Psychology. 2022;16(1):202–183. [Persian] [DOI]

23. Cramer P, Porcerelli JH. Defense mechanisms. In: Friedman HS; editor. Encyclopedia of mental health. Second edition. Oxford: Academic Press; 2016. [DOI]

24. Colman AM. A dictionary of psychology. Oxford University Press; 2009.

25. Babl A, Grosse Holtforth M, Perry JC, Schneider N, Dommann E, Heer S, et al. Comparison and change of defense mechanisms over the course of psychotherapy in patients with depression or anxiety disorder: Evidence from a randomized controlled trial. J Affect Disord. 2019;252:212–20. [DOI]

26. Plutchik R. The circumplex as a general model of the structure of emotions and personality. In: Plutchik R, Conte HR; editors. Circumplex models of personality and emotions. Washington, DC, US: American Psychological Association; 1997. [DOI]

27. Abdi R, Pak R. The mediating role of emotion dysregulation as a transdiagnostic factor in the relationship between pathological personality dimensions and emotional disorders symptoms severity. Pers Individ Dif. 2019;142:282–7. [DOI]

28. Vaillant GE. Defense Mechanisms. In: Ramachandran VS; editor. Encyclopedia of human behavior. Second edition. San Diego: Academic Press; 2012. [DOI]

29. Schauer M, Elbert T. Dissociation following traumatic stress: etiology and treatment. J Psychol. 2010;218(2):109–27. [DOI]

30. Vaillant GE. Ego mechanisms of defense and personality psychopathology. J Abnorm Psychol. 1994;103(1):44–50. [DOI]

31. Nikooseresht T, Shomali Oskoei A. Structural relationships between emotional regulation and stress with dissociation symptoms: the mediating role of depression. Journal of Applied Psychological Research. 2021;12(1):333–49. [Persian] [Article]

32. Rahimzadeh Yinghi A, Kord B, Aprouz K. The relationship between self-defense styles and emotional intelligence with suicidal ideation. Journal of Analitical-Cognitive Psycholoy. 2020;11(40):13–24. [Persian]

33. De Roten Y, Djillali S, Crettaz Von Roten F, Despland JN, Ambresin G. Defense mechanisms and treatment response in depressed inpatients. Front Psychol. 2021;12:633939.. [DOI]

34. Cunningham KC, Aunon FM, Patel TA, Mann AJ, DeBeer BB, Meyer EC, et al. Nonsuicidal self-injury disorder, borderline personality disorder, and lifetime history of suicide attempts among male and female veterans with mental health disorders. J Affect Disord. 2021;287:276–81. [DOI]

35. Kline RB. Principles and practice of structural equation modeling. New York, US: Guilford Press; 2016.

36. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979;47(2):343–52. [DOI]

37. Beck AT, Steer RA, Ranieri WF. Scale for suicide ideation: psychometric properties of a self-report version. J Clin Psychol. 1988;44(4):499–505. [DOI]

38. Anisi J, Fathi-Ashtiani A, Soltani Nejad A, Amiri M. Prevalence of suicidal ideation in soldiers and its associated factors. Journal of Military Medicine. 2006;8(2):113–18. [Persian] [Article]

39. Esfahani M, Hashemi Y, Alavi K. Psychometric assessment of beck scale for suicidal ideation (BSSI) in general population in Tehran. Med J Islam Repub Iran. 2015;29:268.

40. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561. [DOI]

41. Taheri Tanjani P, Garmaroudi G, Azadbakht M, Fekrizadeh Z, Hamidi R, Fathizadeh S, et al. Validity and reliability Beck Depression Inventory-II among the Iranian elderly population. Journal of Sabzevar University of Medical Sciences. 2015;22(1):189–98. [Persian] [Article]

42. Andrews G, Singh M, Bond M. The Defense Style Questionnaire. J Nerv Ment Dis. 1993;181(4):246–56. [DOI]

43. Heidari Nasab L, Mansouri M, Azadfallah P, Shaieeri MR. Validity and reliability of Defens Style Questionaire (DSQ-40) in Iranian samples. Clinical Psychology & Personality. 2007;5(1):11–27. [Persian] [Article]

44. Orbach I, Mikulincer M, Sirota P, Gilboa‐Schechtman E. Mental pain: a multidimensional operationalization and definition. Suicide Life Threat Behav. 2003;33(3):219–30. [DOI]

45. Karami J, Bagian MJ, Momeni Kh, Elahi A. Measurement of mental pain: Psychometric properties and confirmatory factor analysis of multidimensional mental pain questionnaire. Health Psychology. 2018;7(25):146–72. [Persian] [Article]

46. Granieri A, La Marca L, Mannino G, Giunta S, Guglielmucci F, Schimmenti A. The relationship between defense patterns and dsm-5 maladaptive personality domains. Front Psychol. 2017;8:1926. [DOI]

47. Prout TA, Malone A, Rice T, Hoffman L. Resilience, defense mechanisms, and implicit emotion regulation in psychodynamic child psychotherapy. J Contemp Psychother. 2019;49(4):235–44. [DOI]

48. Diehl M, Chui H, Hay EL, Lumley MA, Grühn D, Labouvie-Vief G. Change in coping and defense mechanisms across adulthood: longitudinal findings in a European American sample. Dev Psychol. 2014;50(2):634–48. [DOI]

49. Rice TR, Hoffman L. Defense mechanisms and implicit emotion regulation: a comparison of a psychodynamic construct with one from contemporary neuroscience. J Am Psychoanal Assoc. 2014;62(4):693–708. [DOI]

50. Hussein Shehata AG, Ramadan F. Relationship between emotional regulation strategies and self –reported ego defense styles among nursing interns at Alexandria main university hospital. Indian Journal of Psychiatric Nursing. 2017;14(1):3. [DOI]

51. Sala MN, Testa S, Pons F, Molina P. Emotion regulation and defense mechanisms. Journal of Individual Differences. 2015;36(1):19–29. [DOI]

52. Iwanicka K, Gerhant A, Olajossy M. Psychopathological symptoms, defense mechanisms and time perspectives among subjects with alcohol dependence (AD) presenting different patterns of coping with stress. PeerJ. 2017;5:e3576. [DOI]

53. Vaillant GE. Ego mechanisms of defense and personality psychopathology. J Abnorm Psychol. 1998;103(1):44–50. [DOI]

54. Caligor E, Kernberg OF, Clarkin JF. Handbook of dynamic psychotherapy for higher level personality pathology. First edition. Arlington, VA: American Psychiatric Publishing, Inc; 2007.

55. Javaheri A, Ghanbari S, Zarandi AR. Relationship between defense mechanisms with experience and express of anger in female university students. Journal of Applied Psychology. 2011;5(2):97–110. [Persian] [Article]

56. Whitman CN, Gottdiener WH. Implicit coping styles as a predictor of aggression. J Aggress Maltreat Trauma. 2015;24(7):809–24. [DOI]

57. Yates TM. The developmental psychopathology of self-injurious behavior: Compensatory regulation in posttraumatic adaptation. Clin Psychol Rev. 2004;24(1):35–74. [DOI]

58. Williams JMG. The Cry of Pain. London: Penguin; 2001.

59. Britton PC, Bryan CJ, Valenstein M. motivational interviewing for means restriction counseling with patients at risk for suicide. Cogn Behav Pract. 2016;23(1):51–61. [DOI]

60. Den Hartogh G. Two kinds of suicide. Bioethics. 2016;30(9):672–80. [DOI]