Defense mechanisms as predictors of psychological adjustment during the first week of lockdown for COVID-19 in Italy

Aim: Defense mechanisms are psychological factors that influence the individual response to emotional distress. The rapid and massive spread of the COVID-19 pandemic imposed an urgent systematic assessment of psychological consequences on large multicultural populations. Aiming to provide a valid and reliable instrument based on the gold-standard theoretical hierarchical organization of defenses, we developed a 30 item questionnaire based on the Defense Mechanisms Rating Scale (DMRS), the DMRS-SR-30. This study investigated the role of defense mechanisms as protective factors against distress during the first week of government imposed lockdown in Italy. Methods: We extracted 30 items from the Q-sort version of the DMRS and adjusted them for a self-report format. From March 13 to March 18, 2020, a sample of 5,683 Italian residents responded to an online survey assessing socio-demographics, psychological distress (SCL-90), post-traumatic symptoms (IES-R), mindfulness (MAAS) and defense mechanisms (DMRS-SR-30). Results: Younger age, female gender, and having positive cases nearby and more days on lockdown were associated with greater distress. Lower defensive functioning was related to higher levels of depression, anxiety, and post-traumatic stress symptoms. Conversely, more adaptive defensive functioning was associated with better adjustment. Conclusion: Defensive functioning mediates the psychological impact of COVID-19. The systematic assessment of defense mechanisms with valid and reliable measures as the DMRS-SR30 is crucial for detecting vulnerable individuals among the general population. Psychological interventions fostering the use of more adaptive defenses may be an important component of building resilience and promoting higher quality of life during the pandemic.