Defense mechanisms in individuals with depressive and anxiety symptoms: A network analysis

Introduction: Defense mechanisms are crucial in understanding depression and anxiety. However, the interpaly among defenses in individuals with depressive and anxiety symptoms is understudied. This study aimed at estimating the network structure of defense mechanisms in people with depressive and anxiety symptoms, focusing on identifying most central defenses (nodes) and significant connections (edges). Methods: Using the Symptom Checklist-90, we enrolled 655 participants experiencing depressive and anxiety symptoms during the first wave of the COVID-2019 Pandemic in Italy. Defense mechanisms were evaluated using the DMRS-SR-30, from which a network structure was derived. Results: The results revealed a main component consisting of 16 defense mechanisms. Self-assertion emerged as the most central node, connected positively and negatively with mature and immature defenses, respectively. Among the immature defenses, passive aggression showed the highest connectivity. Some mature defenses, such as humor, affiliation, and sublimation, were not connected to other nodes. Acting out was isolated, with its only significant edge being a positive connection to help-rejecting complaining. Conclusion: This study pioneers the conceptualization of defense mechanisms as a complex network and suggests that not all mechanisms within the same cluster (e.g., mature defenses) serve equivalent functions. Central defenses like self-assertion and passive aggression could be valuable focal points for therapeutic interventions.