Relationship between psychodynamic functioning, defensive mechanisms and trauma in patients with PTSD?

Objective: Patients with Post-Traumatic Stress Disorder (PTSD) present a variety of symptoms, with different intensities, causing impairments in the individual, social and occupational functioning areas. The aim of this study was to understand the psychodynamic functioning of patients with PTSD, exploring the relationship between symptom severity, quality of life, subjective suffering, conflicts and psychic structure regarding sociodemographic characteristics, styles and defensive mechanisms.

Methods: This is a cross-sectional quantitative study with 60 participants. The following were used: sociodemographic questionnaire, the Operationalized Psychodynamic Diagnosis-2 (OPD-2) and the Defensive Style Questionnaire (DSQ-40).

Results: Participants had moderate to high symptom severity, with significant subjective suffering and isolation. The main conflict was Need for care x Self-sufficiency and the level of Total Structure was moderate/low. The use of immature, neurotic, and mature defensive styles was observed. More primitive personality structures, more rigid defenses and greater dependence were found in patients with history of past trauma. Other mental disorders were also associated.

Conclusion: OPD-2 was effective to assess the psychodynamic functioning characteristics of patients with PTSD. Therapeutic treatment should focus on the psychic structure and not only on symptom control. Prevention strategies should target vulnerability factors and strengthening of protective factors.