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Minerva Psichiatrica 2013 September;54(3):239-46


language: Italian

Defensive strategies in a big obese group

La Grutta S. 1, Di Blasi M. 1, La Barbera D. 2, Alabastro V. 2, Alfano P. 1, Guttilla G. 1, Matranga D. 3, Epifanio M. S. 1, Roccella M. 2, Lo Baido R. 2

1 Dipartimento di Psicologia Università degli Studi di Palermo, Palermo, Italia; 2 Clinica psichiatrica Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università degli Studi di Palermo, Palermo, Italia; 3 Osservatorio di Area sul fenomeno della Dispersione Scolastica di Termini Imerese distretto 3 Termini Imerese, Palermo, Italia


Aim: The aim of this study was to explore the defense mechanisms of people with moderate and severe obesity. In fact, the defensive structure is an effective predictor for the best management of the disease.
Methods: 204 people (164 F-40 M) have been recruited: 40 with BMI between 30 and 34.9, with moderate obesity, 36 with BMI between 35 and 39.9, with severe obesity, and 128 with BMI>40, with serious obesity, all of them pertaining to the clinic for obesity treatment at University Hospital of Palermo. All subjects were administered the Defense Mechanisms Inventory (DMI), a type of reactive that explores defense mechanisms. The psychiatric comorbidity was excluded by the DSM (SCIDI and II).semi-structured interview.
Results: The DMI profile of the group of obese people is significantly different from normative people. In fact, the obese group uses a typically defensive pattern that leads to a faulty management of aggressiveness, either transformed into its opposite (conflict denial-avoidance, the inability to tolerate negative emotions) or redirected towards themselves (low self-esteem, self-devaluation and idealization of others). Age factors, sex and degree of obesity affect the defensive shape.
Discussion and conclusion: The exploration of the defense mechanisms in our group of obese people provides some important guidelines for treatment strategies. The prevailing use, in fact, of some specific defensive patterns is both a significant predictor of the person’s inability to adhere to the cure and, consequently, of the need to introduce treatment aids which, in some way, can bypass the subject’s compliance.

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