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Biomedical subjects

Michael Bond

Publications and source records attributed to Michael Bond.

11 recordsLinked to original sources
PubMed2006

Psychotropic medication use, personality disorder and improvement in long-term dynamic psychotherapy.

Patients receiving long-term dynamic psychotherapy often have both depression and personality disorders (PDs) and take medications concurrently. Our goal was to determine the extent of medication use in an outpatient sample and the relationships of medication use and PD status to diagnostic and symptom measures. Fifty-three patients (25 of whom were taking medications at intake) who entered a long-term psychodynamic psychotherapy study for the treatment of chronic or recurrent depression, anxiety, and/or PDs were followed up to 7 years. PD patients who received combined therapy showed significant improvement in functioning and distress, while those receiving only psychotherapy showed significant improvement in depression and distress. Non-PD patients receiving only psychotherapy showed significant improvement in functioning. Long-term dynamic psychotherapy was associated with improvement in symptoms and functioning for the sample as a whole. PD pathology and being on medications at intake acted as moderator variables: PD predicted a smaller effect size in depression and functioning, while medications predicted a smaller effect size in depression only.

Adolescent↗
PubMed2006

Psychodynamic psychotherapy in the treatment of mood disorders.

PURPOSE OF REVIEW: This article summarizes recent studies of psychodynamic psychotherapy for mood disorders. It is important to note whether the therapy studied is adhering to the principles of psychodynamic psychotherapy, whether it is manual based or flexibly responsive to patient developments, whether it is short term or long term and whether it is combined with pharmacotherapy. RECENT FINDINGS: A review of recently published studies has found that all studies show a significant improvement in symptoms in patients who were depressed before treatment with psychodynamic psychotherapy. It is rare, however, for a study to meet the criteria of randomized clinical trials: use of treatment manuals and assured adherence, a sample of patients specifically diagnosed with depression and relevant measures. In one metaanalysis of studies meeting the above criteria, two of 17 studies included a sample with a diagnosis of depression, and short-term psychodynamic psychotherapy achieved similar results as other psychotherapies. Naturalistic studies show improvement with dynamic psychotherapy over time in both symptoms and dynamic measures, such as defense styles and frustration tolerance. SUMMARY: In the last year there were few randomized controlled studies specifically examining psychodynamic psychotherapy for mood disorders. Most evidence from naturalistic and various efficacy studies indicates that dynamic psychotherapy, with or without pharmacotherapy, is associated with improvement in symptoms and some character features. Longer follow-ups provide useful data for what can be a chronic or recurring illness. There are no data showing that psychodynamic therapy is more or less effective than other forms of psychotherapy.

Humans↗
PubMed2006

Do defense mechanisms vary according to the psychiatric disorder?

OBJECTIVE: The aim of this study was to evaluate the defense mechanisms used by depressive and anxious patients without comorbidities compared to those used by controls and to determine whether these patterns differ between diagnoses. METHOD: The sample was composed of 167 psychiatric patients and 36 controls that were evaluated using the Defense Style Questionnaire 40. All subjects were evaluated through a clinical interview, and each evaluation was confirmed through the application of the Mini International Neuropsychiatric Interview, a structured psychiatric interview. We used ANOVA and discriminant analysis to assess differences between groups. RESULTS: Neurotic defense mechanisms discriminated controls from all patients except those with social anxiety. Immature defense mechanisms differentiated controls from all patients, as well as distinguished depressive patients from panic disorder and obsessive disorder patients. The discriminant analysis indicated that depressive patients are characterized by projection, panic disorder patients by sublimation and obsessive-compulsive patients by acting out. CONCLUSIONS: Depressive and anxious patients differ from other individuals in their use of defense mechanisms, and each diagnosis has a particular pattern. These findings could lead to the development of specific psychotherapeutic interventions.

Adaptation, Psychological↗
PubMed2005

[Brazilian-Portuguese version of the Defense Style Questionnaire (DSQ-40) for defense mechanisms measure: a preliminary study].

UNLABELLED: The aim of this study is to describe the translation and adaptation process of the Defense Style Questionnaire (DSQ-40) into Brazilian-Portuguese version. The instrument has also contended validation evaluation. METHODS: The first version of the scale was presented to five individuals with different schooling for language adaptation. Afterwards the instrument was presented to three experts that evaluated its content validation. The final version was back-translated and accepted by the original author. RESULTS: Vocabulary adjustments were needed in 9 items and language adaptation in 4 items in order to render the final DSQ-40 Brazilian-Portuguese version. The mean of experts' correlation to each defense was 89%, being 100% to mature, neurotic and immature factors. CONCLUSION: The adaptation of DSQ-40 by different individuals and the group of experts enabled the necessary adjustment to the Brazilian socio-cultural reality.

Brazil↗
PubMed2005

Evaluation of defense mechanisms in adult patients with panic disorder: before and after treatment.

Patients with acute panic disorder (PD) use a more maladaptive pattern of defense mechanisms. This study investigated the use of defense mechanisms by patients with acute symptomatic PD and those in complete remission. Thirty-three patients and 33 controls were evaluated by the Mini International Neuropsychiatric Interview. The defense mechanisms were evaluated by the Defense Style Questionnaire at the beginning of the study and after 16 weeks of sertraline treatment. Panic disordered patients used more neurotic (4.6 vs. 3.6; p = 0.003) and immature (3.6 vs. 3.0; p = 0.024) defenses at baseline. Patients who achieved complete remission (N=25) differed from the control group in the use of neurotic defenses at the baseline (4.4 vs. 3.6; p = 0.033). After treatment, they showed a reduction in the use of neurotic (4.4 vs. 3.7; p=0.014) and immature (3.4 vs. 3.1; p = 0.019) defenses. Defense mechanisms in PD are influenced by the presence of symptoms, severity, and outcome of the disease.

Adult↗
PubMed2004

Brazilian patients with panic disorder: the use of defense mechanisms and their association with severity.

This study aims to evaluate the defense mechanisms most frequently used by Brazilian patients with panic disorder when compared with a control group. The study also examines the association between severity of disease and comorbidity and the use of specific defense mechanisms. Sixty panic-disordered patients and 31 controls participated in the study. The Mini International Neuropsychiatric Interview was used to confirm the panic disorder diagnosis and to establish the comorbid diagnosis. The Clinical Global Impression (CGI) was used to assess severity and the Defensive Style Questionnaire (DSQ-40) was used to evaluate the defense mechanisms. Panic patients used more neurotic (mean = 4.9 versus 3.6; p < 0.001) and immature (mean = 3.9 versus 2.8; p < 0.001) defenses as compared with controls. Panic patients with severe disease (n = 37; CGI>4) had more depression comorbidity and used more immature defenses than patients with CGI<or=4 (n = 23; mean = 4.2 versus 3.5; p < 0.001). It was concluded that the panic severity and depression comorbidity found in Brazilian panic-disordered patients are associated with the use of maladaptive mechanisms, namely immature defenses.

Adult↗
PubMed2004

Attachment styles and violence within couples.

This study examined whether an individual's attachment style and/or a couple's combination of attachment styles predicted violence within the marriage and explored whether other variables moderated the risk of violence. Measures of attachment style were administered to 41 discordant couples who presented to four different clinics. The couples' presenting complaints were not violence, and those who did report violence on questioning did not manifest severe violence, i.e., requiring shelters or legal intervention. Self-report measures of violence and marital satisfaction, including problem-solving communication, were also given. Using analysis of covariance and logistic regression, the relative contributions to strength of predicting being a victim of conjugal violence were calculated. An anxious attachment style was a significant predictor of females being victims of violence and of men not being victims. A dismissive style in men was predictive of men being victims when entered into the model with problem solving communication. The combination of anxiously attached females and dismissive males was a potent predictor of violence, and longer duration of marriage and poor problem-solving communication added power to the prediction. Marital interaction, which is influenced by couples' attachment styles and problem-solving communication, is a significant factor in marital partners experiencing physical violence. For couples with milder levels of violence, a more nuanced approach (compared with the legally based approach used for severe violence) seems indicated.

Adult↗
PubMed2004

Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders.

OBJECTIVE: This study examined 1) whether patients with chronic and recurrent anxiety and depressive disorders and/or personality disorders demonstrate improvement in their defense styles with long-term dynamic psychotherapy and 2) what the relationship is between defense style change and symptomatic change. METHOD: Measures of defense (Defense Style Questionnaire) and symptoms and functioning were administered at regular intervals over the course of 3-5 years to adults who entered a naturalistic study of long-term psychodynamic psychotherapy. With hierarchical linear regression, the relative contributions of change in variables on the Defense Style Questionnaire to change in other outcome variables were calculated. RESULTS: Those with high initial scores on the maladaptive and self-sacrificing defense styles improved, with effect sizes of 0.80 and 0.67, while overall defensive functioning improved, with an effect size of 0.43. The effect size of the change in score on the Global Assessment of Functioning scale was 0.82. Depressed subjects improved their scores significantly on the Hamilton Depression Rating Scale, and there was a significant improvement in distress, as measured by the SCL-90-R. Changes in score on the Defense Style Questionnaire added substantially to the prediction of variance in these three outcomes above their initial levels. A higher level of defensive functioning also predicted a better self-reported therapeutic alliance. CONCLUSIONS: Defense styles became more adaptive and symptoms improved over time in patients who started with scores in the clinical range. Change in defense style predicts symptomatic change, but causation has not been established.

Adolescent↗
PubMedDate not supplied

Italian version of the defense style questionnaire.

The Defense Style Questionnaire (DSQ) assesses defensive behavior by empirically evaluating conscious derivatives of defense and coping mechanisms in everyday life. It was developed on the assumption that defenses can be ordered along a maturity-immaturity continuum and tend to group into clusters, or defensive styles. The original factor analytical study, by Bond et al. (1983) identified four styles, called maladaptive, image-distorting, self-sacrifice, and adaptive styles. Successive studies only partially confirmed this factor structure. We present the factor structure and the main psychometric features of the Italian version of the questionnaire. The DSQ was translated into Italian by the back-translation method and administered to a sample of 294 men (mean age, 33.33 years) and 333 women (mean age, 32.38 years). An exploratory factor analysis identified three factors largely corresponding to Bond's maladaptive, image-distorting, and adaptive defensive styles and to analogous factors identified by other authors. Accordingly, three defense style scales were constructed, containing respectively 37, 17, and 12 items. These scales showed intercorrelations compatible with the hierarchical model of defensive functioning at the base of the questionnaire, acceptable, though ameliorable, test-retest reliabilities (r's = .79, .63, and .81, respectively) and, with the exception of the Adaptive Style scale, sufficient internal consistencies (alphas: .85, .72, .57). However, only the Maladaptive Style scale, probably due to its greater length, showed values of reliability and internal consistency high enough to warrant clinical use in its present form. Further investigation is required to find new items that may improve the reliability of the Image-Distorting and the Adaptive Style scales.

Adaptation, Psychological↗
PubMedDate not supplied

Empirical studies of defense style: relationships with psychopathology and change.

The Defense Style Questionnaire (DSQ) is a widely used self-report measure of empirically derived groupings of defense mechanisms ranked on an adaptive hierarchy. A review of published studies indicates strong evidence that adaptiveness of defense style correlates with mental health and that some diagnoses are correlated with specific defense patterns-for example, borderline personality disorder with greater use of both maladaptive and image-distorting defenses and less use of adaptive defenses. For other diagnoses, the pattern of defenses is less clear but often reinforces theoretical formulations. Defense styles become more adaptive with improvement in symptoms, but intermediate defenses tend to be stable (traitlike) over time. Defenses are sometimes predictive of the quality of the therapeutic alliance. Although one might speculate that assessment of defenses can be useful in planning treatment, there are no studies supporting this hypothesis.

Adaptation, Psychological↗