Iranian Rehabilitation Journal, Vol.

13, Issue 4, Winter 2015

Original Article

Prediction of Rehabilitation Nurses’ Psychological Well-Being

Through Personality Traits and Defense Mechanisms
Morteza Ghadimianfar
Islamic Azad University, Science and Research Branch, Tehran, Iran
Asghar Dadkhah*
University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Objectives: In clinical practice, nurses who have shown consternation at the psychological well being are
more motivated in practice. The stigma of needing mental health care remains a concern for most people.
The purpose of the study was to predict the psychological well-being of rehabilitation nurses based on
personality traits and defense mechanisms.
Methods: In a co relational research, the participants consisted of all married female nurses in
rehabilitation hospitals of the Qom city. The sample size estimated by Tabachnik and Fidel method 114
and with Overestimate attain to 120 people. The participants were selected by cluster random sampling
method. Data collected by Ryff's Scales of Psychological well-being, Big Five Personality Inventory
short form (NEO FFI) and defense style questionnaire (DSQ - 40). Data analyzed by Pearson correlation
coefficient and multivariate regression by the use of SPSS software (V20).
Results: Analysis of research data indicated that traits of extroversion (P  0.01), neuroticism (P  0.01),
agreeableness (P  0.01), mature defensive style (P  0.01) and immature defense style (P  0.01) could
explain variance of psychological well-being of nurses significantly.
Discussion: Considering to the findings of this research can concluded that personality traits and defense
styles be able to predict the psychological well-being significantly.
Keywords: psychological well-being, nurses, personality traits, defense mechanisms
Submitted: 10 November 2015
Accepted: 14 December 2015

Introduction interaction, feeling of self-efficacy and autonomy

Health and well-being is an integral component of (2). One of the main models that conceptualize and
one's identity and affects every aspect of life. In fact, operationalize psychological well-being is Ryff et al
well-being is integration of all existential aspects of multi-dimensional models. Carol Ryff defines
a person, including spiritual aspect. Empirically, psychological well-being as a person attempts to
mental health and mental illness are not on the fulfill his true potential. This model has been formed
opposite ends of a single continuum. Mental illness and developed by integrates theories of Maslow’s
symptoms related inversely with well-being and concept of self-actualization, Rogers’ view of the
mental health symptoms (1). Approximately the fully functioning person, Jung’s formulation of
1960s emerged new perspectives that insisted on individuation, Allport’s conception of maturity,
preventing of psychological problems rather than Erikson’s psychosocial stage model, Buhler’s basic
treating them. Mental health models focused mainly life tendencies, Neugarten’s executive processes of
on the positive aspects of health, Such as human personality, and Jahoda’s concept of mental health
potentials, personal growth, well-being and increase (3). Ryff’s theory includes six basic dimensions of
well-being. In fact, the emergence of positive psychological well-being: Autonomy (A sense of
psychology changes approach of psychologists from independence and effectiveness in the live events
the medical or pathological to positive models about and having an active role in behaviors),
of mental health. In the new approach, someone has environmental mastery (Sense of dominate on the
a mental health or psychological well-being that has environment, external activities and effective use of
features such as self-esteem, broad social the opportunities), personal growth(Sense of
 All correspondences to: Asghar Dadkhah, email: <[email protected]>

Iranian Rehabilitation Journal 40

sustainable growth and achieving new experiences self-regulation, development-oriented and
as a creature that has potential talents.), positive reasonable) (5).
relations with others(Satisfaction and intimacy of the Studies demonstrate a strong and significant
relationship with others and understand the correlation between psychological well-being and
importance of these attachments.), purpose in personality traits (7-9). Some Studies suggests that
life(Having purpose in life and the belief that past personality traits are able to explain the
and present life is significant.), and self- psychological well-being (4,5).
acceptance(Positive attitude and acceptance of Freud considered defense style (Rate of use defense
various aspects such as good and bad features and mechanisms in compared with others) as main
feeling positive about past life) (2). variable to identify the personality Pathology and
The nature of some occupations and experiences is adaptation (10). Defense mechanisms are regulator
such that inevitably creates problems in people; so automatic processes that reduce cognitive
that may be threaten their mental health. Recently dissonance and sudden changes in internal and
positive psychologist Focus on Personal and mental external reality by Impact on the how to perceive
capabilities that the person to help them be able to threatening events (11). According to Vaillant
resist in difficult situations and not damaged. As defense mechanisms: 1) are relatively unconscious,
well as in experience of difficult or critical 2) often create barriers against psychopathology, 3)
conditions people improvement in terms of with the aim of healing, often affects the mental
personality. Professions of medical because are structures 4) suppress, denial and distort the internal
responsible to provide comfort and treatment of and external reality. So often seem irrational and
patients, are influenced by stress. This tension is in bizarre (11). Andrews et al. according to Vaillant’s
the nursing profession over other medical hierarchical classification have divided 20
professions. Nursing because of the emotional mechanisms into three mature, neurotic and
demands that are expect of these people and it is immature defense styles. Mature defense style are
likely that they will experience intense emotional adaptive, normal and efficient confrontation
states, is a challenging profession (4). Studies show methods. However, the neurotic and immature
that efforts taken to explain the concept of well- defense styles are non-adaptive and inefficient
being, focused on the role of indicators of well-being confrontation methods (12). In addition to the
in two intrapersonal and interpersonal levels. Pekrun mature defensive style is associated with physical
et al introduce personality traits as an interpersonal and mental health (13). Immature defense styles is
effective source of the well-being (5). Allport associated with many negative health indicators such
considered personality traits to be predispositions to as personality disorders and depression (14). Finally,
respond, in the same or a similar manner, to different according to reviewed above and as well as Robert
kinds of stimuli. In other words, traits are consistent McCrea, Paul Costa and Bush theoretically believe
and enduring ways of reacting to our environment that understanding how the combination of
(6). Although there are many models of personality personality traits and defense mechanisms in
traits but Five Factor Model of personality traits is prediction of phenomena such as mental health and
the most important and influential most used models life success is very important. Defense styles and
in research in personality of recent decades (4). Five personality traits associated with health and
Factor Model that introduced by Robert McCrae and psychopathology (15). In addition, attention to the
Paul Costa has been of interest to researchers as an important and stressful occupation of nursing, taking
important framework for understanding the structure into account the psychological needs of nurses and
of human behavior. In addition, it considered an identify the factors that lead to mental health and
important variable to explain behavior. This model psychological well-being in nursing, is very
consists of five relatively stable factors of important. Considering the lack of coherent research
neuroticism (tendency to experience anxiety, stress, that examines these variables together, this study
hostility, impulsivity and low self-esteem), was performed aims to predict the psychological
extraversion (Tendency to positivity, courage and well-being of nurses based on personality traits and
energetic), openness (Tendency to curiosities, defense styles.
flexibility and wisdom), agreeableness (Tendency to
forgiveness, kindness, generosity and empathy) and
conscientiousness (Tendency to be regular, efficient,

Iranian Rehabilitation Journal 41

 Methods method was estimated respectively, 0.71, 0.77, 0.78,
This study was descriptive co relational. Statistical 0.77, 0.70 and 0.78 that significant statistically (17).
population included all married female nurses in Defense Style Questionnaires (DSQ - 40): Andrews
hospitals of Qom city, Iran. The sample size et al defense styles questionnaire have 40 items.
estimated by Tabachnik and Fidel method 114 and Assessed 20 defense mechanisms at three levels
with overestimate attain to 120 people. The mature, neurotic, and immature based on a 9 degree
participants were selected by cluster random scale (from strongly disagree to strongly agree).
sampling method. Criteria for entering the study immature defense style, including mechanisms such
Included: be married and being female. For as projection, passive-aggressive, acting out,
describing the data was used the descriptive statistics isolation, devaluation, autistic fantasy, denial,
techniques such as frequency distribution table and displacement, dissociation, somatization,
to analyze data and predict the criterion variable was rationalization, splitting; mature defense style,
used multiple regression method. All of these including mechanisms such as sublimation, humor,
operations performed using SPSS software (version anticipation, suppression and neurotic defense style,
20). Measures Ryff’s scale of Psychological well- including mechanisms such as pseudo-altruism,
being (RS-PWB): He designed this scale. The idealization, reaction formation, undoing (12). In
original version of the scale consisted 120 items. Iran Cronbach's alpha coefficient have reported for
However, in later review was designed shorter each of the mature, immature and neurotic styles,
version (84, 54,42,40,24,18,14,9,3 items) (16). Since respectively, 0.75, 0.73 and 0.74 (18).
Ryff believes that the 84-item version compared to Big Five Personality Inventory Short Form (NEO
the other versions is the ability to determine the FFI): Costa and McCrae (1992) developed this scale.
psychological well-being (2); in this study was used It consists of 60 items grouped into five subscales:
the 84-item version. This scale (84-item version) Extraversion, Neuroticism, Agreeableness, and
consists of six subscales of self-acceptance, positive Openness to experience and Conscientiousness. Each
relations with others, autonomy, environmental subscale has 12 items. Response to items based on
mastery, purpose in life and personal growth that five-point Likert scale (completely agree=o, agree=1,
each of them contains 14 items. The answer to each no comment=2, disagree=3 and completely
item based on 6 degrees range (from strongly disagree=4). Costa and McCrae (1992) have reported
disagree to strongly agree). A higher score indicates Cronbach's alpha coefficient between 0.68 to 0.86
a good psychological well-being. To determine the (for neuroticism). This scale is standardization in Iran
total scores of Psychological well-being, sum the by Grossi, reliability coefficient of this scale by test-
scores of all item subscales (2). In this study, was retest on 208 students at the interval of three months
used of total score for psychological well-being. The is reported for Neuroticism, extraversion, openness,
correlation between the scale of psychological well- agreeableness and conscientiousness, respectively
being with Satisfaction with life scale (SWLS), 0.83, 0.75, 0.80, 0.79 and 0.79 (19).
Oxford Happiness Inventory (OHI) and Rosenberg
Self-Esteem Scale (RSES), was estimated Results
respectively, 0.47, 0.58 and 0.46. In Iran reliability Indexes of mean and standard deviation of variables
coefficient of Psychological well-being scale 82.0 personality traits, defense style and psychological
and subscales of self-acceptance, positive relations well-being as well as sample size in each has are
with others, autonomy, environmental mastery, shown in Table (1).
purpose in life and personal growth, by test-retest
Table 1. Descriptive data of studied variables
Variables Subscales N S.D Mean
- 120 29.006 324
PWB Neuroticism 120 4.430 22.31
Extroversion 120 4.146 26.58
Personality Agreeableness 120 4.972 25.73
Trait Openness 120 4.11 26
Conscientiousness 120 3.952 28.22
Defense Mature 120 10.077 39.68
Style Immature 120 18.401 110.13
Neurotic 120 9.34 39.65

42 Vol. 13, Issue 4, Winter. 2015

The correlation coefficient between personality traits with psychological well-being of nurses is
and defense style with psychological well-being has significant. There are positive correlation between
shown in Table (2). The results of Table (2) shows the traits of extraversion, agreeableness,
that correlation coefficient between the components conscientiousness and mature defense style with
of personality traits (extraversion, neuroticism, PWB; whereas, the correlation between the traits of
conscientiousness Agreeableness) and components neuroticism, immature and neurotic defense styles
of defense styles (mature, immature and neurotic) with PWB are negative.
Table 2. Correlation between predictor variables and psychological well-being
Variables Sig. df r
Neuroticism 0.000 119 -0.35
Extroversion 0.000 119 0.57
Agreeableness 0.000 119 0.50
Openness 0.294 119 0.05
PWB
Conscientiousness 0.000 119 0.30
Mature 0.000 119 0.55
Immature 0.000 119 -0.36
Neurotic 0.05 119 -0.23

According to Table (3), there is a significant positive the model used to predict the criterion variable is
correlation (0.768) between personality traits and significant (F (8, 111) = 19.961, P 0.001). In
defense mechanisms with the psychological well- addition, predictor variables can explain 0.59 of
being of nurses. To predict psychological well-being psychological well-being changes Table (3).
by personality traits and defense style was used
regression analysis. Regression analysis shows that
Table 3. Results of regression analysis to predict the psychological well-being
Sum of squares df Mean squares F R squares R Sig.
Regression 59066.863 8
7383.358
Residual 41056.729 111 19.961 0.59 0.768 0.000
369.88
Total 100123.592 119

To determine which of the predictor variables were coefficients, respectively, -0.302, 0.340, and 0.145
effective in explaining the psychological well-being and between defense style subscales of mature and
of nurses was used the test regression coefficients immature, with coefficients regression respectively
(beta). The results (Table 4) show that between 0.209 and -0.272 can significant predict
personality traits subscales of neuroticism, psychological well-being of nurses.
extraversion and agreeableness with regression
Table 4. Regression analysis for predictor variables of psychological well-being
Un-standardized Standardized
Std. Error t Sig. VIF
Coefficient (B) Coefficient (B)
Constant 299.571 22.041 13.592 0.000
Neuroticism -1.974 0.435 -0.302 -4.53 0.000 1.197
Extroversion 2.38 0.549 0.34 4.332 0.001 1.302
Agreeableness 0.847 0.507 0.145 1.67 0.006 1.964
Openness 0.449 0.455 0.064 0.986 0.326 1.212
Conscientiousness -0.087 0.548 -0.012 -0.16 0.874 1.549
Mature 0.609 0.229 0.209 2.63 0.000 1.547
Immature -0.428 0.102 -0.272 -4.191 0.000 1.119
Neurotic -0.054 0.214 -0.017 -0.251 0.802 1.3

In order to investigate the lack of co linearity, the model of present study, all of the VIF scores are
between the predictor variables was used the VIF smaller than 10; so it confirms the lack of co
score (VIF scores above 10 indicate a problem). In linearity in regression model.

Iranian Rehabilitation Journal 43

 Discussion significantly explain it. Trait of openness trait did
The present study purpose to predict psychological not show significant correlation with the
well-being of nurses based on personality traits and psychological well-being. So could not account and
defense style. The results of this study revealed that predict the psychological well-being.
among five personality traits, traits of extraversion, Defense styles studied along personality traits in
neuroticism and agreeableness, and among defensive explaining the psychological well-being.
style, the styles of mature and immature can Theoretically, mature defense mechanisms and
significantly explained the variance of psychological styles are associated with the physical and mental
well-being. Neuroticism correlated with health consequences. Several studies support the
psychological well-being and was able negatively assumption that people's physical and mental health
predict it. To explain this result theoretically, people significantly associated with their defense
with high neuroticism are prone to negative mechanisms (21). The result of this study suggest
emotions such as anxiety and depression. They are that mature defense style can positively and
perception the mild failures hopelessly, threatening immature defense style can negatively predict the
and difficult. Such features can limit and block psychological well-being. Direct research not been
positive relationships with others, self-worship, self- done on the relationship between defense styles with
actualization, purpose life and personal growth (20). the psychological well-being. However, some
This result is consistent with previous results (4,5,7). research has been performed in relation to these
Extroversion could significant negatively predict the findings indirectly. For example, in a study (14)
psychological well-being. Extroverts enjoy being demonstrated that addicts relative to the normal
around others, talkative and cheerful, and the people more use neurotic and immature defense
tendency to experience positive emotions. However, styles than mature defense style. In the study of (22)
introverts need less external stimulation. They are found that immature mechanisms are dominant
quiet, taciturn and prefer to be alone or with a small defenses for people with depression, neurotic
group of close friends; therefore are more expose to mechanisms are dominant defenses for people with
negative emotions (20). This result consistent with the anxiety disorders, and mechanisms mature are
results of the study (5) that showed extroversion dominant defenses for normal people. Also in the
significant positively predicted the number of study of (15) showed that depressed people different
components of psychological well-being (self- with non-depressed in use of neurotic and immature
acceptance, personal growth and environmental defense mechanisms.
mastery); As well as consistent with results of the
study (7) that revealed extraversion significantly Conclusion
predicted all of psychological well-being components. Results indicated that considering that nurses
In this study trait of agreeableness could significant experience same and difficult working conditions,
positively predict the psychological well-being. personality traits and defense mechanisms could
Theoretically, People with high agreeableness are explain and predict psychological well-being. People
friendly, generous, kind and cooperative, as well as who use of mature defense style in stress and anxiety
they have optimistic view to nature of human. situations have better psychological well-being than
Individuals with low agreeableness more attention to the people who use of neurotic and immature
their personal interests than match the others. They defense styles. Personality traits destruction or
are toward others suspicious, antagonistic and facilitate the process of adaptation and psychological
hostile (20). Result of this study consistent with and physical health by affecting person’s
results of the study of (7), which showed the trait of interpretations of events. People who have adaptive
agreeableness significant negatively correlated the traits such as high extraversion, high agreeableness,
autonomy, environmental mastery, self-acceptance, down neuroticism will be better in the psychological
positive relations with others, personal growth and well-being.
purpose life. As well as this result consistent with
the results of the study of (5) which revealed the trait Acknowledgment
agreeableness predict the positive relationships with We would like to thank all participants in this study.
the others and self-acceptance. Trait of We also appreciate the coordination and help of
conscientiousness was positively associated with the research unit at the university. This article retrieved
psychological well-being, but was not able from master’s thesis.

44 Vol. 13, Issue 4, Winter. 2015

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