Abstract
The current study was aimed to differentiate comorbid psychiatric symptoms on the basis of defense styles used by convicts imprisoned in all nine Central Jails of Punjab, Pakistan. Data were collected from 509 male respondents by using the self-reported Cross-Cutting Symptoms Measure and Defense Style Questionnaire (DSQ-40). Translated versions of both scales were used. Results of MANCOVA showed that participants who scored above the threshold on 13 comorbid psychiatric symptoms scored high on Immature Defense Style (IMDS). Participants scoring above the threshold for depressive symptoms also scored high on Mature Defense Style (MDS). Participants with above threshold psychiatric symptoms of mania scored high on all three defense mechanisms. Above threshold, suicidal ideation symptoms, on the other hand, are linked with lower scores on MDS and Neurotic Defense Style (NDS), high scores on IMDS. Convicts with comorbidity above threshold symptoms also scored high on IMDS. Findings have empirically highlighted IMDS as the area be targeted for therapeutic intervention to improve prisoner's mental health.
Similar content being viewed by others
Data availability
Data was collected from prison setting and needs third party approval before sharing so, the data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
References
Acquadro, C., Conway, K., Giroudet, C., & Mear, I. (2012). Linguistic validation manual for health outcome assessments. Mapi Institute.
Alwin, D. F. (2007). Margins of error: A study of reliability in survey measurement (Vol. 547). John Wiley & Sons.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, text revision (DSM-IV TR®). Washington, D.C: American Psychiatric Publication.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Andrews, G., Singh, M. K., & Bond, M. (1993). The defense style questionnaire. Journal of Nervous and Mental Disease, 181(4), 246–256.
Auty, K. M., Cope, A., & Liebling, A. (2017). Psychoeducational programs for reducing prison violence: A systematic review. Aggression and Violent Behavior, 33, 126–143.
Baillargeon, J., Penn, J. V., Knight, K., Harzke, A. J., Baillargeon, G., & Becker, E. A. (2010). Risk of reincarceration among prisoners with co-occurring severe mental illness and substance use disorders. Administration and Policy in Mental Health and Mental Health Services Research, 37(4), 367–374.
Boag, S. (2018). Freudian repression, the unconscious, and the dynamics of inhibition. Routledge.
Bond, M. (2004). Empirical studies of defense style: Relationships with psychopathology and change. Harvard Review of Psychiatry, 12(5), 263–278.
Bonta, J., & Andrews, D. A. (2017). The psychology of criminal conduct (6th ed.). Routledge. https://doi.org/10.4324/9781315677187
Brown, T. A. (2015). Confirmatory factor analysis for applied research. Guilford publications.
Busch, F. N. (2014). Clinical approaches to somatization. Journal of Clinical Psychology, 70(5), 419–427. https://doi.org/10.1002/jclp.22086
Calati, R., Oasi, O., De Ronchi, D., & Serretti, A. (2010). The use of the defence style questionnaire in major depressive and panic disorders: A comprehensive meta-analysis. Psychology and Psychotherapy: Theory, Research and Practice, 83(1), 1–13.
Cheema, A., Hameed, Z., & Naseer, M. F. (2017). Safeguarding Pakistanis: Punjab’s crime problem, its pathology and priority for action (No. 01–17). Working Paper: Institute of Development and Economic Alternatives.
Chiu, M., Lebenbaum, M., Cheng, J., de Oliveira, C., & Kurdyak, P. (2017). The direct healthcare costs associated with psychological distress and major depression: A population-based cohort study in Ontario, Canada. Plos One, 12(9), e0184268.
Chung, M. C., Di, X., & Wan, K. H. (2016). Exploring the interrelationship between alexithymia, defense style, emotional suppression, homicide-related posttraumatic stress disorder and psychiatric co-morbidity. Psychiatry Research, 243, 373–381.
Ciocca, G., Rossi, R., Collazzoni, A., Gorea, F., Vallaj, B., Stratta, P., & Santarnecchi, E. (2020). The impact of attachment styles and defense mechanisms on psychological distress in a non-clinical young adult sample: a path analysis. Journal of Affective Disorders, 273, 384–390.
Coleman, D., & Casey, J. T. (2007). Therapeutic mechanisms of suicidal ideation: The influence of changes in automatic thoughts and immature defenses. Crisis, 28(4), 198–203.
Cramer, P. (2012). The development of defense mechanisms: Theory, research, and assessment. Springer Science & Business Media.
Croicu, C., Chwastiak, L., & Katon, W. (2014). Approach to the patient with multiple somatic symptoms. Medical Clinics, 98(5), 1079–1095.
Di, X., Chung, M. C., & Wan, K. H. (2018). Investigating the impact of past trauma and defense styles on posttraumatic stress following homicide and psychiatric co-morbidity. Psychiatric Quarterly, 89, 439–449.
Etchegoyen, R. H. (2018). The fundamentals of psychoanalytic technique (p. 294). Routledge.
Granieri, A., La Marca, L., Mannino, G., Giunta, S., Guglielmucci, F., & Schimmenti, A. (2017). The relationship between defense patterns and DSM-5 maladaptive personality domains. Frontiers in Psychology, 8, 1926.
Haeberlein, K., Evans, L., Champaigne, B., & Handal, P. J. (2020). Differences in distress and utilization of mental health services between 2005 and 2018: A potential trend? Psychiatric Quarterly, 91(1), 11–19.
Hooper, D., Coughlan, J., & Mullen, M. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6(1), 53–60.
Ishfaq, N., & Kamal, A. (2019). Mental health and imprisonment: Measuring cross-cutting symptoms among convicts in Punjab, Pakistan. Asian Journal of Psychiatry, 44, 127–132.
Jones, K. D. (2012). Dimensional and cross-cutting assessment in the DSM-5. Journal of Counseling & Development, 90(4), 481–487.
Jun, J. Y., Lee, Y. J. G., Lee, S. H., Yoo, S. Y., Song, J., & Kim, S. J. (2015). Association between defense mechanisms and psychiatric symptoms in North Korean Refugees. Comprehensive Psychiatry, 56, 179–187.
Junaedi, F., Hanurawan, F., JanuSetiowati, A., & Ramli, M. (2022). Reducing the new inmates’ anxiety through rational emotive behavior therapy with patronage counseling technique. Emerging Science Journal, 6(2), 306–321.
Kalsoom, U., & Gul, S. (2020). Correlating personality disorders with Types (I, II) of crimes in prisoner population. Pakistan Journal of Criminology, 12(2), 34–44.
Karta, I. W., Rasmini, N. W., Widiana, I. W., & Ujianti, P. R. (2022). The effect of remote learning, family condition, and mental resilience on depression symptoms of early childhood. Emerging Science Journal, 6(6), 1430–1443.
Laaksonen, M. A., Sirkia, C., Knekt, P., & Lindfors, O. (2014). Self-reported immature defense style as a predictor of outcome in short-term and long-term psychotherapy. Brain and Behavior, 4(4), 495–503.
Lace, J. W., & Merz, Z. C. (2020). DSM-5 Level 1 cross-cutting measure in an online sample: Evaluating its latent dimensionality and utility detecting nonspecific psychological distress. Psychiatry Research, 294, 113529.
Maher, J. M., Markey, J. C., & Ebert-May, D. (2013). The other half of the story: effect size analysis in quantitative research. CBE—Life Sciences Education, 12(3), 345–351.
Mahoney, M. R., Farmer, C., Sinclair, S., Sung, S., Dehaut, K., & Chung, J. Y. (2020). Utilization of the DSM-5 self-rated level 1 cross-cutting symptom measure-adult to screen healthy volunteers for research studies. Psychiatry Research, 286, 112822.
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed., pp. 62–63). Guilford Press.
Meaklim, H., Swieca, J., Junge, M., Laska, I., Kelly, D., Joyce, R., & Cunnington, D. (2018). The DSM-5 self-rated level 1 Cross-Cutting symptom measure identifies high levels of coexistent psychiatric symptomatology in patients referred for insomnia treatment. Nature and Science of Sleep, 10, 377.
Miklowitz, D. J., Alatiq, Y., Geddes, J. R., Goodwin, G. M., & Williams, J. M. G. (2010). Thought suppression in patients with bipolar disorder. Journal of Abnormal Psychology, 119(2), 355.
Muck, P. M., Hell, B., & Gosling, S. D. (2007). Construct validation of a short five-factor model instrument: A self-peer study on the German adaptation of the Ten-Item Personality Inventory (TIPI-G). European Journal of Psychological Assessment, 23(3), 166.
Nacher, M., Ayhan, G., Arnal, R., Basurko, C., Huber, F., Pastre, A., & Falissard, B. (2018). High prevalence rates for multiple psychiatric conditions among inmates at French Guiana’s correctional facility: Diagnostic and demographic factors associated with violent offending and previous incarceration. BioMed Central Psychiatry, 18(1), 159.
Noorbala, F., Ghorbani, N., & GholamaliLavasani, M. (2018). The mediatory role of self-knowledge in the relationship between defense styles and somatization. Journal of Psychological Science, 17(66), 200–212.
Parker, C., Scott, S., & Geddes, A., (2019). Snowball sampling. In P. Atkinson, S. Delamont, A. Cernat, J. W. Sakshaug, & R. A. Williams (Eds.), SAGE Research Methods Foundations. https://doi.org/10.4135/9781526421036831710
Pennebaker, J. W. (1995). Emotion, disclosure, & health (pp. xiv–337). American Psychological Association.
Revilla, M. A., Saris, W. E., & Krosnick, J. A. (2014). Choosing the number of categories in agree–disagree scales. Sociological Methods & Research, 43(1), 73–97.
Saint Martin, C., Valls, M., Rousseau, A., Callahan, S., & Chabrol, H. (2013). Psychometric evaluation of a shortened version of the 40-item defense style questionnaire. International Journal of Psychology and Psychological Therapy, 13(2), 215–224.
Sharma, P., & Sinha, U. K. (2010). Defense mechanisms in mania, bipolar depression and unipolar depression. Psychological Studies, 55(3), 239–247.
Strandholm, T., Kiviruusu, O., Karlsson, L., Miettunen, J., & Marttunen, M. (2016). Defense mechanisms in adolescence as predictors of adult personality disorders. The Journal of Nervous and Mental Disease, 204(5), 349–354.
Talik, E., & Skowroński, B. (2018). The sense of quality of life and religious strategies of coping with stress in prison inmates. Journal of Religion and Health, 57(3), 915–937.
Tanzilli, A., Di Giuseppe, M., Giovanardi, G., Boldrini, T., Caviglia, G., Conversano, C., & Lingiardi, V. (2021). Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation. Research in Psychotherapy: Psychopathology, Process, and Outcome 24(1), 31–41.
T-D'Alonzo, K. (2011). Evaluation and revision of questionnaires for use among low-literacy immigrant Latinos. Revista Latino-Americana De Enfermagem, 19(5), 1255–1264.
Turanovic, J. J., & Tasca, M. (2019). Inmates’ experiences with prison visitation. Justice Quarterly, 36(2), 287–322.
Vaillant, G. E. (2011). Involuntary coping mechanisms: A psychodynamic perspective. Dialogues in Clinical Neuroscience, 13(3), 366.
Waqas, A., Naveed, S., Aedma, K. K., Tariq, M., & Afzaal, T. (2018). Exploring clusters of defense styles, psychiatric symptoms and academic achievements among medical students: A cross-sectional study in Pakistan. BioMed Central Research Notes, 11(1), 1–6.
Worthington, R. L., & Whittaker, T. A. (2006). Scale development research: A content analysis and recommendations for best practices. The Counseling Psychologist, 34(6), 806–838.
Zadeh, Z., & Ahmad, K. (2012). Mental health issues of women prisoners in Karachi Pakistan. International Journal of Humanities and Social Science, 2(14), 310–318.
Zaman, S. (2021). Nexus of crime rate, misery index and urbanization in Pakistan. Iranian Economic Review. https://doi.org/10.22059/IER.2021.81926
Zerach, G., & Elklit, A. (2017). Poly-victimization and psychological distress in early adolescence: A mediation model of defense mechanisms and coping styles. Journal of Interpersonal Violence, 35(21–22), 4732–4756.
Funding
No research funding was obtained in the present study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Permission was taken for data collection from Inspector General Prisons Punjab and informed consent was taken from each participant separately after describing them purpose of research and they were made sure that data will be used for research purpose only and will not be share without their consent whereas their identity will be held hidden.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Conflicts of interests
Nimrah Ishfaq declares that she has no conflict of interest. Prof. Dr Anila Kamal declares that she has no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Ishfaq, N., Kamal, A. Defense styles and comorbid psychiatric symptoms among convicts, Pakistan. Curr Psychol 43, 18230–18241 (2024). https://doi.org/10.1007/s12144-024-05616-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-024-05616-2