Personality, Defense Mechanisms and Psychological Distress in Women with Fibromyalgia, 2022, Romeo et al

[Andy]

Abstract

Background: Previous studies have shown that many personality traits are associated with fibromyalgia (FM), worsening both the quality of life and psychological distress of patients. Despite the high comorbidity of psychopathological disorders in this syndrome and their association with immature defense styles, few studies have examined the defense mechanisms used by FM patients. The main aim of our study was to investigate personality traits and defense mechanisms in FM patients compared to in a healthy control group (HC). Moreover, we investigated the effect of personality traits and defense mechanisms on psychological distress in both FM and HC groups.

Methods: A total of 54 women with FM and 54 healthy women completed the (1) Temperament and Character Inventory—Revised; (2) the Toronto Alexithymia Scale; (3) the Defense Style Questionnaire; and (4) the Hospital Anxiety and Depression Scale.

Results: The results indicated that FM patients display higher alexithymia, higher harm avoidance, lower self-directedness, lower persistence, and the higher use of a maladaptive defense style compared to HC. We found that alexithymia, harm avoidance, and maladaptive defense style are significant predictors of patients’ psychological distress. Moreover, harm avoidance and adaptive defense style significantly predicted psychological distress in the HC group.

Conclusion: The present study is the first to explore the contribution of both defense mechanisms and personality characteristics on the psychological distress of FM patients. Our findings have important clinical implications and may help diagnose and treat FM patients more in depth.

Open access, https://www.mdpi.com/2076-328X/12/1/10/htm

 

[Cheshire]

This is so bad.
1. "immature defense styles" is not science, it is f* judgement.
2. No sick control group. I keep repeating myself, but these "researchers" keep repeating basic and unacceptable mistakes. How do we know that this is due to FM or to be experimenting pain? There should be a painful disease patient group on top of the healthy control group. Patients experiment "higher harm avoidance" than healthy people ? No shit Sherlock.

 

[Ash]

Does anyone think it may be possible that the women subjected to this assessment may not be able to describe their emotions as clearly as these researchers expect, because women can actually read the room quite well.

Women understand the hostility and contempt with which they are viewed by those assessing them. That any distress they express will be viewed by the researchers as evidence of a lack of coping skills or bad emotional character. That any joy that they may express will be viewed as a disconnection to their bodies. That there is literally no answer that they possibly could give that would redeem their reputation in the eye of these researchers. Except perhaps….denial of any physical pain and acceptance that they are completely healthy and just accidentally thought that they had a pain condition for moment there, so sorry for the inconvenience. That they will go back to being mature women now and stop all this immaturity that they have been indulging in for no reason other than a bratty impulse that has now thankfully departed.

So probably women in such a situation express their frustrations at such predictable poor and prejudiced treatment. They appear discontent and hostile. Why not? Dish it out but can’t take it Ms and Mr researcher?

Or they just shut down answer ‘I don’t know’ and hope it’s all over soon.

 

[Ash]

I do remember something about Clitoris v Vaginal orgasms and how this would reveal the emotional and mental maturity level of a woman involved. I do also remember women themselves and other scientists having something to say about this. I wonder if this hypothesis has influenced our researchers here? I wonder if they followed the progress of that hypothesis?

 

[CRG]

From two of the above authors: Attachment style and parental bonding: Relationships with fibromyalgia and alexithymia

https://pubmed.ncbi.nlm.nih.gov/32287311/

Their sinecure: Psicologia clinica

https://www.clinicacomunita.unito.it/do/corsi.pl/Show?_id=g9v7

"The main aim of the laboratory is to provide the students with the knowledge and the competences useful to the diagnostic process in the psychosomatic settings, that is, in settings in which or the psychological distress can be experienced through the body or it can manifests itself together with somatic disorders."

"At the end of the class the student will have to know:


- the main principles of the diagnostic process in the psychosomatic setting.

- the main clinical syndromes usually associated with a psychosomatic component."


"The laboratory will be divided into three modules:

1) Introduction to the psychosomatic approach and to the clinical psychology for psychosomatic settings.

2) Diagnosis and classification. Somatization disorders according to the PDM-2 and the DSM 5: personality and symptoms. Presentation of the main clinical syndromes associated with a possible psychosomatic component: chronic pain syndromes (fibromyalgia), irritable bowel syndrome. Exemplifications thorough clinical cases.

3) Presentation and group discussion of clinical cases: from the diagnosis to the psychological treatment. "


It's a weird thing that while Psychology has become heavily represented at almost all levels by women (old white men inevitably occupy the top pay grades) there's still this huge impetus to psychologise women's health.

Women outnumber men in psychology graduate programs

https://www.apa.org/monitor/2018/12/datapoint

 

[Arnie Pye]

FM patients display higher alexithymia, higher harm avoidance, lower self-directedness, lower persistence, and the higher use of a maladaptive defense style

I'm guessing here, but I would guess that many patients with FM are probably on anti-depressants.

Alexithymia often affects people on anti-depressants. Doctors shove anti-depressants at women obsessively and FM is one of those conditions often assumed to be rooted in depression.

Harm avoidance - Anyone who has ever been ill or injured will protect themselves from further harm. I would think this is instinctive and totally normal behaviour, so why categorise it as some kind of mental illness?

Self-directedness - From wikipedia :

Self-directedness is a personality trait of self-determination, that is, the ability to regulate and adapt behavior to the demands of a situation in order to achieve personally chosen goals and values.[1] It is one of the "character" dimensions in Cloninger's Temperament and Character Inventory (TCI). Cloninger has described it as "willpower", defined as "a metaphorical abstract concept to describe the extent to which a person identifies the imaginal self as an integrated, purposeful whole individual, rather than a disorganized set of reactive impulses."[1] Cloninger's research has found that low self-directedness is a major common feature of personality disorders generally. Self-directedness is conceptually related to locus of control.[2] That is, low self-directedness is associated with external locus of control, whereas high self-directedness is associated with internal locus of control.[1] In the five factor model of personality, self-directedness has a strong inverse association with neuroticism and a strong positive association with conscientiousness.[2]

If someone is in severe pain that is not believed, is not treated, and the sufferer is left to try and work, have social relationships, bring up children, maintain themselves and their homes, determination to achieve anything can run out, particularly with the addition of anti-depressants. The only people who could believe otherwise have never suffered from severe and untreated pain that goes on and on and on and on for years. These comments also apply to lower persistence. It's as if these researchers are pretending that everyone puts up with these conditions and manages fine, but women in severe pain are just mentally and physically weak.

Maladaptive defense style - From my web searching it would appear that defense styles in patients are usually examined by questionnaire.

https://www.ijpsy.com/volumen14/num2/389/examining-the-defense-style-questionnaire-EN.pdf

If a patient seeks treatment from a doctor who doesn't believe the patient's symptoms are real, scowls at the patient, rolls eyes at the patient, doesn't engage with the patient other than as a brick wall, who won't treat the pain the patient is suffering, the patient will obviously become distrusting of the doctor and it is likely to have an impact on the way the patient presents themselves to the doctor. How can a normal person keep up the pretense of being happy, trusting, open and believing in the doctor when this behaviour is never reciprocated?

If a child is frequently abused (any kind of abuse) by either or both parents the child will try to find ways in which to identify the parents' triggers that lead to abuse so that they avoid that abuse, will try to communicate with their parents in a way that doesn't trigger abuse, or will try to avoid them entirely. They may do this as a sensible defense mechanism or style. In my opinion this is instinctive behaviour that should not be psychologised and treated as a "sickness" in any way.

Anyone who can write about these issues without accepting that the behaviour is normal and mostly instinctive is basically non-human as far as I'm concerned.

 

[Trish]

I did a quick skim through the paper. It's so bad. They even quote Freud. And despite saying they recognise it's not possible to find causative direction from cross sectional studies, they do just that. And such judgemental interpretations of what seems to me to be normal behaviour by people in a lot of pain.

I hope someone has the energy to write to them to call them out on all their unscientific assumptions.

Oh and then at the very end they somehow manage to deduce that the solution is psychodynamic therapy, even though it's not a therapy trial. I feel very sorry for their patients.

 

[CRG]

I did a quick skim through the paper. It's so bad. They even quote Freud. And despite saying they recognise it's not possible to find causative direction from cross sectional studies, they do just that. And such judgemental interpretations of what seems to me to be normal behaviour by people in a lot of pain.

I hope someone has the energy to write to them to call them out on all their unscientific assumptions.

Oh and then at the very end they somehow manage to deduce that the solution is psychodynamic therapy, even though it's not a therapy trial. I feel very sorry for their patients.

Any members here have contact with: https://www.cfsme.it/chi-siamo/ ?

 

[Snowdrop]

Just posting to say . . . I don't trust myself to post on this.

Oh wait, I did just leave to wayback archive this. For posterity.

And since they pull interpretations out of thin air I think I will too. I'm thinking they implicitly hoped that the treatment was in their interpretation of their 'findings'.

Too bad that laughter therapy (at their conclusions) really doesn't work on FM. Although they missed the mark there too as their conclusions are not so much hilarious as . . . (must stop now)

 

[DigitalDrifter]

2. No sick control group. I keep repeating myself, but these "researchers" keep repeating basic and unacceptable mistakes. How do we know that this is due to FM or to be experimenting pain? There should be a painful disease patient group upon top of the healthy control group.

Better still, a control group of painful disease patients who have been gaslighted, mistreated, neglected, told their symptoms are not real, etc.

 

[alktipping]

people with victorian type values born from privilege and ignorance should have no place and garner no respect for dragging up this personality based nonscience and producing trash like this ,