The Relationship Between Self- Harming Behavior, Suicide Attempt History and Defense Mechanisms in Patients with Opioid-Use Disorder

Objective: The aim of this study was to investigate the relationship between defense mechanisms and a history of self-harming behaviors (SHB) and suicide attempts (SA) in patients with opioid-use disorder (OUD). Method: The study group consisted of 100 inpatients diagnosed with OUD. A Sociodemographic and Clinical Data Form, Defense Style Questionnarie-40 (DSQ-40), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to all participants. Results: Subscale scores for passive aggression (p=0.001), somatization (p

Opioid kullanım bozukluğu tanılı hastalarda kendine zarar verme davranışı ve intihar girişimi öyküsü ile savunma mekanizmalarının ilişkisi

Amaç: Bu çalışmanın amacı, kendine zarar verici davranış (KZVD) ve intihar girişimi (İG) öyküsü olan opioid kullanım bozukluğu (OKB) tanılı hastalarda savunma biçimlerinin bu davranışlarla ilişkisini araştırmaktır. Yöntem: OKB tanısı almış yatarak tedavi gören 100 kişiden çalışma grubu oluşturuldu. Çalışmaya katılan tüm katılımcılara Sosyodemografik ve Klinik Veri Formu, Savunma Biçimleri Testi-40 (SBT-40), Beck Depresyon Envanteri (BDE) ve Beck Anksiyete Envanteri (BAE) uygulandı. Bulgular: OKB ve KZVD öyküsü olanlarda KZVD öyküsü olmayanlara göre pasif saldırganlık (p≤0.001), somatizasyon (p

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Favazza AR. The coming of age of self-mutilation. J Nerv Ment Dis 1998; 186:259-268. [CrossRef]

Gratz KL. Measurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. J Psychopathol Behav Assess 2001; 23:253-263. [CrossRef]

Briere J, Gil E. Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. Am J Orthopsychiatry 1998; 68:609-620. [CrossRef]

Evren C, Evren B. Self-mutilation in substance-dependent patients and relationship with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality. Drug Alcohol Depend 2005; 80:15-22. [CrossRef]

Evren C, Sar V, Evren B, Dalbudak E. Self-mutilation among male patients with alcohol dependency: the role of dissociation. Compr Psychiatry 2008; 49:489-495. [CrossRef]

Harned MS, Najavits LM, Weiss RD. Self-harm and suicidal behavior in women with comorbid PTSD and substance dependence. Am J Addict 2006; 15:392-395. [CrossRef]

Ross RR, McKay HB. Self-mutilation: Lexington Books Lexington, MA, 1979.

Maloney E, Degenhardt L, Darke S, Nelson EC. Investigating the co-occurrence of self-mutilation and suicide attempts among opioid-dependent individuals. Suicide Life Threat Behav 2010; 40:50-62. [CrossRef]

Maloney E, Degenhardt L, Darke S, Mattick RP, Nelson E. Suicidal behaviour and associated risk factors among opioid- dependent individuals: a case-control study. Addiction 2007; 102:1933-1941. [CrossRef]

Darke S, Ross J. Suicide among heroin users: rates, risk factors and methods. Addiction 2002; 97:1383-1394. [CrossRef]

Suominen K, Isometsa E, Haukka J, Lonnqvist J. Substance use and male gender as risk factors for deaths and suicide--a 5-year follow-up study after deliberate self-harm. Soc Psychiatry Psychiatr Epidemiol 2004; 39:720-724. [CrossRef]

Cooper J, Kapur N, Webb R, Lawlor M, Guthrie E, Mackway- Jones K, Appleby L. Suicide after deliberate self-harm: a 4-year cohort study. Am J Psychiatry 2005; 162:297-303. [CrossRef]

Taiminen TJ, Kallio-Soukainen K, Nokso-Koivisto H, Kaljonen A, Helenius H. Contagion of deliberate self-harm among adolescent inpatients. J Am Acad Child Adolesc Psychiatry 1998; 37:211- 217. [CrossRef]

Green JD, Kearns JC, Ledoux AM, Addis ME, Marx BP. The association between masculinity and nonsuicidal self-injury. Am J Mens Health 2018; 12:30-40. [CrossRef]

Darke S, Ross J, Lynskey M, Teesson M. Attempted suicide among entrants to three treatment modalities for heroin dependence in the Australian Treatment Outcome Study (ATOS): prevalence and risk factors. Drug Alcohol Depend 2004; 73:1-10. [CrossRef]

Alec R. Psychiatric Emergencies. Suicide. In Sadock BJ, Sadock VA (editors). Comprehensive Textbook of Psychiatry, Eight ed., Philadelphia: Williams and Wilkins, 2000; 2031-2040.

Blaya C, Kipper L, Heldt E, Isolan L, Ceitlin LH, Bond M, Manfro GG. Brazilian-Portuguese version of the Defense Style Questionnaire (DSQ-40) for defense mechanisms measure: a preliminary study. Rev Bras Psiquiatr 2004; 26:255-258. [CrossRef]

Vaillant GE. Ego mechanisms of defense and personality psychopathology. J Abnorm Psychol 1994; 103:44-50. [CrossRef]

Cramer P. Defense mechanisms and physiological reactivity to stress. J Pers 2003; 71:221-244. [CrossRef]

American Psychiatric Association. Diagnostic criteria from DSM- IV-TR. Washington, D.C.: American Psychiatric Association, 2000; xii, 370.

American Psychiatric Association. Diagnostic criteria from DSM- IV. Washington, D.C.: The Association, 1994; xi, 358.

Lewis AJ, White J. Brief report: the defense mechanisms of homophobic adolescent males: a descriptive discriminant analysis. J Adolescence 2009; 32:435-441. [CrossRef]

Vaillant GE, Vaillant CO. Natural history of male psychological health, XII: a 45-year study of predictors of successful aging at age 65. Am J Psychiatry 1990; 147:31-37. [CrossRef]

Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Publishing, 2013. [CrossRef]

Andrews G, Singh M, Bond M. The defense style questionnaire. J Nerv Ment Dis 1993; 181:246-256. [CrossRef]

Yilmaz N, Gencoz T, Ak M. Psychometric properties of the defense style questionnaire: a reliability and validity study. Turk Psikiyatri Derg 2007; 18:244-253. (Turkish)

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4:561-571. [CrossRef]

Hisli N. Effect of patients’ evaluation of group behavior on therapy outcome. Int J Group Psychother 1987; 37:119-124. [CrossRef]

Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56:893-897. [CrossRef]

Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: psychometric properties. Journal of Cognitive Psychotherapy 1998; 12:2.

Evren C, Ozcetinkaya S, Cagil D, Ulku M, Can Y, Mutlu E. Defense styles that are related with history of self-mutilation and suicide attempt in alcohol dependent inpatients. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2012; 25:345-352.

Parekh MA, Majeed H, Khan TR, Khan AB, Khalid S, Khwaja NM, Khalid R, Khan MA, Rizqui IM, Jehan I. Ego defense mechanisms in Pakistani medical students: a cross sectional analysis. BMC Psychiatry 2010; 10:12. [CrossRef]

Haines J, Williams CL. Coping and problem solving of self- mutilators. J Clin Psychol 1997; 53:177-186. [CrossRef]

Klonsky ED. The functions of self-injury in young adults who cut themselves: Clarifying the evidence for affect-regulation. Psychiatry Res 2009; 166:260-268. [CrossRef]

Waska RT. Self-mutilation, substance abuse, and the psychoanalytic approach: four cases. Am J Clin Psychother 1998; 52:18-27. [CrossRef]

Miller WR. Motivation for treatment: a review with special emphasis on alcoholism. Psychol Bull 1985; 98:84-107. [CrossRef]

Ward LC, Rothaus P. The measurement of denial and rationalization in male alcholics. J Clin Psychol 1991; 47:465- 468. [CrossRef]

Taskent V, Karadag F, Topcuoglu V, Akduman I, Evren C. Psychological defense mechanisms, childhood traumas and dissociative experiences in patients with drug and alcohol dependency. Turk Psikiyatri Derg 2011; 22:58.

Evren C, Cagil D, Ulku M, Ozcetinkaya S, Gokalp P, Cetin T, Yigiter S. Relationship between defense styles, alexithymia, and personality in alcohol-dependent inpatients. Compr Psychiatry 2012; 53:860-867. [CrossRef]

Evren C, Ozcetinkaya S, Ulku M, Cagil D, Gokalp P, Cetin T, Yigiter S. Relationship of defense styles with history of childhood trauma and personality in heroin dependent inpatients. Psychiatry Res 2012; 200:728-733. [CrossRef]

Evren C, Cinar O, Evren B, Celik S. History of suicide attempt in male substance-dependent inpatients and relationship to borderline personality features, anger, hostility and aggression. Psychiatry Res 2011; 190:126-131. [CrossRef]

Corruble E, Hatem N, Damy C, Falissard B, Guelfi JD, Reynaud M, Hardy P. Defense styles, impulsivity and suicide attempts in major depression. Psychopathology 2003; 36:279-284. [CrossRef]

Hovanesian S, Isakov I, Cervellione KL. Defense mechanisms and suicide risk in major depression. Arch Suicide Res 2009; 13:74-86. [CrossRef]