Au cours de ces dernières années, des études ont montré l’existence d’une compartimentation latéraledes composants de la membrane plasmique végétale, de manière analogue à ce qui avait été montréchez les animaux et les levures. L’objectif de cette thèse était d’apporter de nouveaux éléments decaractérisation de cette compartimentation (propriétés physiques de domaines particuliers, mécanismesde mise en place de ces domaines, de contrôle de leur taille, etc…) et d’étudier son rôle dans laphysiologie de la cellule végétale.Le développement d’une méthodologie de microscopie confocale spectrale couplée à l’utilisationd’une sonde environnementale a permis d’apporter la première description à l'échellesubmicrométrique de l’organisation du plasmalemme en territoires aux propriétés physiquesdifférentiées. Ces domaines coexistent au sein de la membrane plasmique de cellules en suspension,comme à celle de membranes artificielles composées de lipides modèles ou de lipides de membranescellulaires, de vésicules géantes constituées de membrane plasmique purifiée, ou de protoplastes.Cependant, les différences de l’organisation latérale observées chez ces différentes membranes ontpermis de montrer l’importance des phytostérols qui seraient, par le biais d'interactions spécifiquesavec d’autres lipides végétaux tels que les GIPCs, des composés essentiels pour la formation locale dedomaines lipidiques ordonnés. La grande diversité des lipides végétaux organiserait ainsi lacompartimentation de la membrane plasmique permettant la ségrégation dynamique des composantsmembranaires. Si les stérols augmentent de manière importante le degré de compaction de la bicouche,les protéines le diminuent. Le cytosquelette et la paroi ne semblent, quant à eux, modifier ni laprésence, ni l’organisation des domaines ordonnés de la membrane plasmique. Nous avons égalementmontré que l’organisation de ces domaines évolue transitoirement lors des étapes précoces de lacascade de signalisation induite par des réactions de défense. De fait, nous avons identifié desmodifications des propriétés physiques globales et de l’organisation fine de la membrane provoquéespar différents éliciteurs de réactions de défense, dont la cryptogéine, une protéine sécrétée parl’oomycète Phytophthora cryptogea. Nous avons montré que ces modifications sont un élémentgénérique de la signalisation de défense, sous la dépendance de phénomènes de phosphorylation, leburst oxydatif étant également une étape clé de l’augmentation du degré d’ordre observé dans lesphases précoces de cette signalisation. La cryptogéine, qui présente une aptitude singulière pour piégerles stérols, a également montré une capacité spécifique à augmenter la fluidité membranaire, ceparamètre pouvant contrôler l’intensité de la cascade de signalisation, mesurée par la production deformes actives d’oxygène.Ces résultats ouvrent de nouvelles perspectives dans la compréhension des interactions cellule-élicitineet apportent un nouvel éclairage sur le rôle des lipides végétaux dans l’organisation latérale de lamembrane plasmique végétale et positionne la dynamique membranaire comme un élément designalisation de défense des plantes. / Recent studies have shown the existence of lateral sub-compartmentalization of plant plasmamembrane similar to that of animal cells and yeasts. The aim of this thesis was to provide newelements to characterize this compartmentalization (physical properties of specific domains,mechanisms of their formation, determination of their size, etc...) and to study its role in thephysiology of plant cells.The development spectral confocal microscopy coupled with the use of an environment-sensitiveprobe enabled to obtain the first description at the submicron scale of plasma membrane organizationinto domains exhibiting various physical properties. These domains coexist at the plasma membranesurface of tobacco suspension cells as well as the membrane of vesicles composed of models lipids orcell plasma membrane lipids, purified plasma membrane vesicles, and protoplasts. However,differences in the lateral organization observed in these membranes have shown the importance ofphytosterols which are, through specific interactions with neighboring plant lipids such as GIPCs,essential for local formation of ordered domains. The huge diversity of plant lipids drives thecompartmentalization of the plasma membrane allowing the dynamic segregation of membranecomponents. Sterols greatly increase membrane order, whereas proteins tends to decrease it.Cytoskeleton and cell wall do alter neither presence nor organization of ordered domains of the plasmamembrane. We have also shown that the organization of these domains is transiently modified duringthe early stages of defense signaling cascade. In fact, we have identified changes in overall physicalproperties and fine lateral organization of the membrane caused by various elicitors of defensereactions, including cryptogein, a protein secreted by the oomycete Phytophthora cryptogea. We haveshown that these changes are a generic element of defense signaling cascade and depend onphosphorylation processes; oxidative burst being also a major actor of the control of the increase ofmembrane order observed during the very early stages of the signalling process. Cryptogein, whichexhibits the particular ability to trap sterols, also showed a specific capacity to increase membranefluidity and amplify the intensity of the signalling cascade, as measured by the production of reactiveoxygen species.These results open new perspectives in the understanding of cell-elicitin interactions and provide anew view on the central role of sterol composition in the lateral organization of plant plasmamembrane. They also identify membrane dynamics as a new player in the signalling cascade occurringduring plant defense.

Au cours des interactions plante/agent pathogène, la disponibilité en sucres est un des enjeux majeurs pour les deux partenaires. Il s'établit donc une compétition vis-à-vis des ressources carbonées entre l'agent pathogène hétérotrophe pour le carbone et la plante consommant de l'énergie pour se défendre. Les transporteurs de sucres sont les acteurs moléculaires qui interviennent dans cette compétition et probablement dans le devenir de l'interaction. L'objectif de cette étude est de déterminer l'implication des transporteurs de sucres au cours de l'interaction entre la plante modèle Arabidopsis thaliana et le champignon nécrotrophe Botrytis cinerea.Parmi la famille des transporteurs d'hexoses (STPs) d'A. thaliana, l'expression du gène STP13 est régulée positivement durant l'infection par B. cinerea. Le rôle potentiel de STP13 au cours de cette interaction a donc été étudié à l'aide de plantes transgéniques (Knock-Out et surexpresseur). Le suivi du développement des symptômes et la mesure d'absorption du glucose ont permis de montrer des modifications phénotypiques entre les différents génotypes étudiés. Les résultats indiquent une corrélation entre le niveau d'expression de STP13, le transport de glucose et le développement du champignon, confortant ainsi le rôle de STP13 dans la tolérance face à B. cinerea.Les résultats préliminaires de l'étude du transport de glucose à l'échelle cellulaire montrent une inhibition dans des conditions mimant l'infection. Ces analyses ont été effectuées grâce à un modèle constitué d'une suspension cellulaire d'A. thaliana subissant un traitement éliciteur à partir d'un extrait protéique de B. cinerea.Nous nous sommes également intéressés au transport de saccharose à l'échelle de la plante infectée. Nos résultats suggèrent que l'inoculation par le champignon modifie les flux de saccharose classiquement observés créant ainsi une nouvelle force d'appel. Ainsi, la feuille infectée se comporte comme un nouveau puits. Ces travaux de recherche s'inscrivent dans la nécessité d'une meilleure compréhension des mécanismes de transport des sucres qui permettra à terme d'agir sur les capacités de résistance des plantes vis-à-vis d'agents pathogènes. / During plant/pathogen interactions, sugar availability is one of the major issues for both partners. There is a competition for the same carbohydrates necessary for carbon supply on the pathogen's side and to support the additional energy demand for plant's defense. Sugar transporters are the molecular actors in this competition which is determinant for the final outcome of the interaction. In this study, we characterized the implication of sugar transporters in the interaction between the model plant Arabidopsis thaliana and the necrotrophic fungus Botrytis cinerea.Among the A. thaliana hexose transporter family (STPs), STP13 is induced during B. cinerea infection. A potential role of STP13 in this interaction was investigated using transgenic plants (Knock-Out and over-expressor lines). Disease symptoms characterization and glucose uptake assays showed phenotypical variations between the different genotypes. It seems that STP13 expression, glucose uptake and fungus spreading are correlated pointing to a role of STP13 in tolerance to B. cinerea. Other preliminary results showed an inhibition of the cellular glucose uptake upon condition mimicking B. cinerea infection. These analyses were performed on a model composed of an A. thaliana cell suspension elicited with a proteinaceous extract from B. cinerea.We also studied sucrose fluxes in the whole infected plant. Our results suggest that fungus inoculation modifies the usual fluxes creating a new sink.This study may lead to a better understanding of sugar transport mechanisms to improve plant resistance capacity against pathogens in the future.

This diploma thesis is focused on storytelling in the state of moderate stress. The theoretical part includes an introduction to the issue of stress, defense mechanisms, Thematic Apperception Test and then explains in detail theory of defense mechanism according to Phebe Cramer and also Defense Mechanism Manual which is used for evaluation of TAT defenses. The aim of empirical part of this thesis is to find out whether moderate pain which is caused by the fact that participants holds their hand in front of them (in position of "staying power") has effect on number of occurrence of defense mechanisms in narratives according to TAT. The stories are narrated during the staying power position. The second aim is to verify whether number and quality of used defenses has effect on the duration of the staying power position. The simple regression analysis was used to find out that there is no significant relationship between number of used defense mechanisms and the level of experienced pain. However, it is shown that higher usage of defense mechanisms has positive effect on duration of staying power position. This effect is even stronger if only matured defense mechanisms are included in the model, which is projection and identification.

El presente trabajo de investigación se titula “Acciones estratégicas para Prevenir y Atender la Violencia contra la Mujer en el Plan Nacional Contra la Violencia de Género 2016-2021 durante la Emergencia Sanitaria Declarada por el Covid-19”, el cual tiene por objetivo identificar el nivel de implementación de los mecanismos y de la acción estratégica para prevenir y atender la violencia contra la mujer en el marco de la declaratoria de emergencia sanitaria originada por el Covid-19 en el distrito de San Juan de Lurigancho, en Lima. Con el propósito de alcanzar los objetivos propuestos de la presente tesis se elaboró una investigación con enfoque mixto, es decir cuantitativo y cualitativo, en base a la aplicación de cuestionarios y entrevistas aplicadas tanto a funcionarios relacionados a las políticas de violencia de género, como a los usuarios de los Centros de Emergencia Mujer (CEM) del distrito de San Juan de Lurigancho, así como, analizar e identificar el nivel alcanzado por parte de la ejecución de mecanismos y acciones estratégicas que se emplearon en función de los hechos registrados por casos de violencia familiar y de género durante la emergencia sanitaria. Al respecto en base a este análisis, se presentará una propuesta y recomendaciones a fin de que el Ministerio de la Mujer y Poblaciones Vulnerables tome en consideración y a futuro se puedan implementar mejoras en la gestión, diseño de los planes y programas orientados al fortalecimiento institucional en favor de la igualdad de género y el bienestar de las mujeres de nuestro país en situaciones de emergencia. / This research work is titled "Strategic Actions to Prevent and Address Violence against Women in the National Plan Against Gender Violence 2016-2021 during the Health Emergency Declared by Covid-19", which aims to identify the level of implementation of the mechanisms and strategic action to prevent and address violence against women during the health emergency declared by Covid-19 in the district of San Juan de Lurigancho, in Lima. In order to achieve the proposed objectives of this thesis, an investigation was developed with a mixed approach, that is, quantitative and qualitative, based on the application of questionnaires and interviews applied both to officials related to gender violence policies, as well as to the users of the Women's Emergency Centers (CEM) of the district of San Juan de Lurigancho, as well as, analyze and identify the level reached by the implementation of mechanisms and strategic actions that were used in the framework of violence against women and gender during the health emergency declared by Covid-19. In this regard, based on this analysis, a proposal and recommendations will be presented so that the Ministry of Women and Vulnerable Populations take into consideration and in the future improvements can be implemented in the management and design of plans and programs oriented to the fight against violence against women and gender, in emergency situations. / Trabajo de investigación

The Master thesis investigates the procrastination phenomenon i.e. deliberate putting off the decisions and the most significant issues to the last moment before the deadline, that tends to be very common among the students. There is a theoretical framework of the procrastination with the focus on the psychodynamic, behavioral and cognitive approaches. The work scrutinizes the factors such as the perfectionism and the anxiety sensitivity those have the influence on frequency and intensity of the procrastination display tendencies. Moreover there have been identified the interconnection between the coping strategies and the procrastination among the students. Finally, the work analysis the variation of the procrastinatory aspects those are peculiar to the students of different university majors. / В магистерской диссертации исследуется феномен прокрастинации – сознательного откладывания принятия решений и самых важных дел до момента «дедлайна», – распространенный среди студентов. Представлен теоретический обзор проблемы прокрастинации, особое внимание уделено психодинамическому, поведенческому и когнитивному подходам. Анализируются факторы, влияющие на частоту и интенсивность проявления прокрастинации, в частности, перфекционизм и оценочная тревожность, а также выявляется взаимосвязь между копинг-стратегиями и прокрастинацией у студентов. Устанавливаются различия в проявлениях прокрастинации у студентов различных направлений подготовки.

Cyber-attacks are an increasing problem for organizations across the world. The attacks on systems are getting more and more sophisticated and thereby more and more difficult to protect against. The security of systems is crucial to protect your data from unauthorized access. One approach for testing the resilience of these systems is the use of threat modelling and attack simulations. The use of threat models also enables you to identify vulnerabilities in your infrastructure. The overall resilience of the system can then be increased by implementing protection against these vulnerabilities which can take many forms. There can be security issues regarding a single component in the infrastructure and more structural issues concerning more than one component in the system. Meta Attack Language (MAL) is a meta language to write threat languages of different systems. In MAL there exits different components called assets, these assets can have defenses. The problem is that structural weaknesses cannot be identified in the current state of the language. This thesis work will provide a solution to identify vulnerable patterns in a threat model and translate these pattern to secure patterns. A prototype has been created that take a threat model as input and outputs a new updated threat model. The prototype will translate the input to a graph database and run a series of predefined queries on the database that will identify and replace vulnerable patterns. A formal logic for finding vulnerable patterns is suggested and an API to change these patterns is implemented. The result shows that by running a model through the prototype, structural vulnerabilities can be identified and mitigated. This could potentially increase the overall resilience of the system. / Attacker på IT system är ett ökande problem för organisationer runt om i världen. Attackerna blir mer och mer sofistikerade och därmed svårare att skydda sig emot. Säkerheten av systemen är väldigt viktigt för att skydda data från obehörig åtkomst. Ett tillvägagångssätt för att testa säkerheten mot attacker är att använda hotmodeller och attack-simuleringar. Resultatet av en sådan simulering kan sedan användas för att göra systemet säkrare genom att implementera skydd mot kända sårbarheter. Dessa sårbarheter kan komma i många olika former. De kan finnas på en enskild komponent i arkitekturen eller så kan de bero på mer strukturella svagheter där flera komponenter berörs. Meta Attack Language (MAL) är ett meta-språk som kan användas för skapa hot-språk. I MAL så finns det olika komponenter som kan ha försvar associerat till sig. Problemet är att i det nuvarande stadiet av MAL så går det inte att identifiera strukturella svagheter där fler än en komponent är en del av problemet. Det här arbetet föreslår en lösning till att identifiera skadliga mönster och översätta dessa mönster till säkra mönster. En prototyp har tagits fram som tar en hotmodell som in-data och returnerar en uppdaterad hotmodell. Prototypen översätter hotmodellen till en grafdatabas och exekverar en serie av sökningar som identifierar och uppdaterar skadliga mönster. En logik för att hitta mönster föreslås och ett API av funktioner för att ändra mönster har utvecklats. Resultaten visar att genom körning av en modell genom prototypen så skulle detta potentiellt kunna öka systemens säkerhet.

Les états mentaux réfèrent à la qualité de la capacité d’un individu à élaborer mentalement et à s’ouvrir à son expérience subjective dans l’ici et maintenant. Les divers états mentaux varient quant à la disponibilité des ressources représenta-tionnelles et affectives pouvant être activées afin d’organiser l’expérience vécue, ainsi que dans leur utilisation de stratégies défensives et d’autorégulation. La présente thèse avait pour objectifs 1) d’approfondir l’évaluation des états mentaux par le développement et la validation d’un instrument pratique, le Mental States Task (MST), développé afin d’évaluer différentes qualités d’états mentaux et 2) d’investiguer les propriétés psychiques et les répercussions des différents états mentaux. Le premier article avait pour but de valider le MST. La première partie de l’article est consacrée à la validation du MST dans sa version francophone, et la deuxième partie porte sur la traduction et la validation du MST dans sa version anglophone. Les résultats fournissent des indices convaincants de validité et de fidélité, ainsi qu’une valeur prédictive adéquate. Le MST semble représenter de façon conforme autant les états mentaux de bas niveau que de haut niveau selon le continuum de réflexivité. De fait, les états mentaux de bas niveau et de haut niveau ont été respectivement associés à un large spectre de construits négatifs/immatures et positifs/matures. De plus, chaque état mental évalué par le MST semble posséder des propriétés particulières relativement aux processus mentaux et émotionnels utilisés pour traiter l’expérience. Le second article avait pour objectif d’approfondir l’étude de la valeur prédictive du MST par le biais de l’évaluation des coûts psychiques engendrés par les différentes qualités d’états mentaux—coûts présumés dépendant des ressources représentationnelles disponibles et du type de stratégies de régulation utilisées. Les résultats suggèrent que les états mentaux de bas niveau génèrent des coûts énergétiques plus élevés, ayant pour répercussion d’entraîner subséquemment un effet de déplétion du moi. Inversement, les états mentaux de haut niveau engendrent de moindres coûts, protégeant contre un état subséquent de déplétion du moi. Le MST s’est avéré être un outil efficace d’évaluation des répercussions énergétiques occasionnées par les divers états mentaux. / Mental states refer to the quality of one’s capacity to mentally elaborate and open up to his/her subjective experience in the here-and-now moment. Mental states differ relatively to the availability of the representational and affective resources triggered in order to organize the experience, and in the type of defensive and self-regulatory strategies used. The aims of this thesis were 1) to deepen the evaluation of mental states through the creation and validation of a practical measure, the Mental States Task (MST), in order to evaluate differences in quality of mental states, and 2) to investigate the psychic properties and repercussions of the different mental states. The goal of the first article was to validate the MST. The first part of this article was dedicated to the validation of the French version of the MST, and the second part to the translation and validation of its English version. Results provide convincing evidence of validity and reliability, as well as an adequate predictive value with respect to a large range of related concepts, in both its French and English versions. The MST appears to well represent both low- and high-level mental states according to the reflective continuum, which were found to be linked to a large range of negative/immature and positive/mature constructs, respectively. In addition, each mental state measured by the MST appears to have particular characteristics relative to the mental and emotional processes used to deal with the experience. The purpose of the second article was to deepen the investigation of the predictive value of the MST, through the evaluation of the psychic costs generated by the different qualities of mental states—the costs presumably depending on the representational resources available and the regulatory strategies used. Results suggest that using low-level mental states generates higher energetic costs, resulting in a subsequent ego-depletion effect. Conversely, high-level mental states generate fewer costs, protecting from a subsequent ego-depletion effect. The MST appeared to be an efficient tool in the assessment of the energetic repercussions produced by the different mental sates.

Ma recherche vise à la vie psychique et sociale des enfants dans les orphelinats chinois. Ces enfants sont souvent abandonnés à cause de leur handicap. Ils sont placés aussi du fait de la défaillance de leurs parents consécutive à un décès, un paupérisme, un emprisonnement, ou des difficultés qu'ils subissent les conduisant à l'abandon de l'enfant. Je m'interroge sur la façon dont les enfants dans les orphelinats chinois vont s'organiser psychiquement et socialement pour faire face à ce double traumatisme : celui de l'abandon, celui du placement. Pour vérifier les effets de la carence affective croisée avec l'abandon et l'institutionnalisation, une recherche exploratoire qui consiste en l'observation sur le terrain et les entretiens avec 3 nurses est réalisée au sein de deux orphelinats chinois. Et puis, le recueil des données s'est déroulé auprès de 16 enfants de 7 à 12 ans avec ces outils méthodologiques: l'entretien auprès des enfants, le dessin et le test des contes. L'analyse des données recueillies est basée sur trois vecteurs qui fondent l'organisation de la vie psychique d'un individu : la représentation de soi, la représentation de son lien à l'autre, les mécanismes de défense et d'adaptation mis en oeuvre. La présentation des résultats est scindée en deux parties : étude globale des données (étude globale des entretiens ; étude globale de dessins ; étude globale du test des contes) et études de cas (7 cas parmi les échantillons sont choisis pour des études approfondies). Les résultats montrent que les enfants présentent des défaillances dans lareprésentation de soi qui se décèlent par les atteintes dans l'estime de soi et par des sentiments négatifs, des défaillances dans la relation à l'autre de l'ordre de la pathologie du lien, et que pour faire face à leur situation, certains enfants peuvent entrer dans un processus de résilience qui s'observe par les mécanismes de défense qu'ils utilisent ou par la référence à un tuteur de résilience. / My research aims to psychic and social life of children in Chinese orphanages. These children are often abandoned because of their disability. They are placed as a result of the failure of their parents following a death, pauperism, imprisonment, or the difficulties they face leading to the abandonment of the child. I wonder how these children in Chineseorphanages will organize themselves socially and psychologically to deal with the double trauma: abandonment and placement. To test the effects of emotional deprivation crossed with the abandonment and institutionalization, an exploratory research, which consists of field observation and interviews with three nurses is carried out in two Chinese orphanages. And then, the data collection was conducted with 16 children from 7 to 12 years with the methodological tools: the interview with children, drawing and testing stories. The analysis of data collected is based on three vectors that underlie the organization of the psychic life of an individual : self-representation, representation of his relationship with others, defense mechanisms implemented. The presentation of results is divided into two parts: comprehensive study of data (comprehensive study of the interviews, comprehensive study of the drawings, comprehensive study of the test stories) and case studies (7 cases among the samples are selected for in-depth studies). The results show that these children have deficiencies in self-representation which are detected by the self-esteem damaged and negative feelings, deficiencies in their relationship with others of the order of pathology of the link, and to deal with their situation, some children may enter into a process of resilience which is observed by the defense mechanisms they use or by reference to a guardian of resilience.

INTRODUÇÃO: A Psicodinâmica é o estudo da interação das forças psíquicas que subsidiam o funcionamento mental. A dinâmica mental interfere na qualidade de vida de um indivíduo, na medida em que modifica a percepção que ele tem da própria existência. O papel da psicodinâmica sobre a qualidade de vida ainda é pouco estudado. OBJETIVOS: Estudar, de forma transversal, a relação entre psicodinâmica e qualidade de vida na população de médicos de Botucatu, para testar a hipótese de que quanto melhor a psicodinâmica do médico melhor a sua qualidade de vida. MÉTODOS: Foram enviados questionários, com carta-resposta, para 602 médicos (população referenciada). As variáveis independentes (Psicodinâmica) foram obtidas por meio de duas escalas: a) Defense Style Questionnaire (DSQ-40), que avalia e classifica os mecanismos de defesa do ego em maduros, neuróticos e imaturos; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), que avalia e classifica as relações objetais (alienação, egocentrismo, vinculação insegura e incapacidade social) em normais e patológicas. As variáveis dependentes (qualidade de vida) foram avaliadas pelo World Health Organization Quality of Life (WHOQOL-Abreviado), que fornece escores para os quatro domínios: físico, psicológico, relações sociais e meio ambiente. As variáveis moderadoras foram obtidas por meio de um questionário sóciodemográfico. A análise estatística foi feita por meio dos seguintes testes: Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Coeficiente de Spearman e modelos de regressão linear com resposta Gamma. Foram utilizados os softwares SPSS versão 17, R versão 2.11.0 e Graph Pad versão 5.0. RESULTADOS: Foram respondidos 198 (33%) questionários válidos. Os seguintes resultados foram obtidos: a média (± desvio padrão) de idade foi de 47,6 (± 11,12) anos e o sexo masculino foi de 53,5%. A presença de perfil patológico nas relações objetais do tipo alienação, egocentrismo e vinculação insegura reduziu os escores dos domínios psicológico (p < 0,001) e relações sociais (p < 0,001), da qualidade de vida. A presença do fator imaturo das defesas do ego reduziu os escores dos domínios físico (p < 0,0001) e meio ambiente (p < 0,0001), da qualidade de vida. DISCUSSÃO: Defesas imaturas do ego dificultam a adaptação do indivíduo à vida profissional e conjugal, enquanto que a presença do perfil patológico das relações objetais leva à dificuldade em manter relacionamentos estáveis e à tendência a manipular as pessoas, apresentando-se socialmente inapto. Ou seja, médicos com esse perfil (de defesas e de relações objetais) devem enfrentar dificuldades para conviver com outras pessoas, inclusive com pacientes. Sua qualidade de vida é pior do que a de médicos com defesas maduras do ego e perfil normal de relações objetais. CONCLUSÕES: A psicodinâmica e a qualidade de vida do médico estão significativamente relacionadas. Os escores da qualidade de vida caem à medida que aumentam os escores das defesas imaturas do ego. Médicos com perfil patológico nas relações objetais apresentam menores escores de qualidade de vida, em relação àqueles com perfil normal / INTRODUCTION: Psychodynamics is the study of the psychological forces that underlie mental action. Ego defense mechanisms and object relations are psychodynamic aspects that affect quality of life as they alter people\'s perceptions of their own life. OBJECTIVES: To assess the influence of ego defense mechanisms and object relations on quality of life in a population of physicians, and thus test our hypothesis that mature ego defenses and normal object relations are associated with better physician quality of life. METHODS: In this cross- sectional study, questionnaires and pre-stamped return envelopes were sent to the population of physicians (602 individuals) living in the city of Botucatu, São Paulo. Psychodynamics was evaluated using the following instruments: a) Defense Style Questionnaire (DSQ-40), which assesses and classifies ego defense mechanisms as mature, neurotic, or immature; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), which assesses and classifies object relations (alienation, egocentricity, insecure attachment, and social incompetence) as either normal or pathological. Quality of life was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) that was developed in the context of four domains of quality of life: physical health, psychological health, social relationships, and environment. Demographic data were obtained via a specific questionnaire. Statistical analyses were performed using the tests of Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Spearman\'s coefficient, and Gamma linear regression models with SPSS v. 17, R v. 2.11.0 and Graph Pad v. 5.0 software. RESULTS: A total of 198 questionnaires (33%) with valid responses were obtained. Among respondents, mean age was 47.6 ± 11 years, and the rate of males was 53.5%. High BORRTI scores (pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health (p < 0,001) and social relationships (p < 0,001) domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for the physical health (p < 0,0001) and environment (p < 0,0001) domains. DISCUSSION: Immature ego defenses impair adjustment to professional and marital life, while pathological object relations lead to difficulty in sustaining stable relationships and tendency to manipulate others, hence social ineptitude. Physicians with immature defenses and pathological object relations are, therefore, likely to find it hard to relate with other people, including patients. Their quality of life is worse in comparison with that of physicians with mature ego defenses and normal object relations. In the study population, both immature ego defenses and pathological object relations were associated with lower quality of life. CONCLUSIONS: Among physicians, quality of life is influenced by its psychodynamics, herein assessed through ego defense mechanisms and object relations

INTRODUÇÃO: A Psicodinâmica é o estudo da interação das forças psíquicas que subsidiam o funcionamento mental. A dinâmica mental interfere na qualidade de vida de um indivíduo, na medida em que modifica a percepção que ele tem da própria existência. O papel da psicodinâmica sobre a qualidade de vida ainda é pouco estudado. OBJETIVOS: Estudar, de forma transversal, a relação entre psicodinâmica e qualidade de vida na população de médicos de Botucatu, para testar a hipótese de que quanto melhor a psicodinâmica do médico melhor a sua qualidade de vida. MÉTODOS: Foram enviados questionários, com carta-resposta, para 602 médicos (população referenciada). As variáveis independentes (Psicodinâmica) foram obtidas por meio de duas escalas: a) Defense Style Questionnaire (DSQ-40), que avalia e classifica os mecanismos de defesa do ego em maduros, neuróticos e imaturos; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), que avalia e classifica as relações objetais (alienação, egocentrismo, vinculação insegura e incapacidade social) em normais e patológicas. As variáveis dependentes (qualidade de vida) foram avaliadas pelo World Health Organization Quality of Life (WHOQOL-Abreviado), que fornece escores para os quatro domínios: físico, psicológico, relações sociais e meio ambiente. As variáveis moderadoras foram obtidas por meio de um questionário sóciodemográfico. A análise estatística foi feita por meio dos seguintes testes: Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Coeficiente de Spearman e modelos de regressão linear com resposta Gamma. Foram utilizados os softwares SPSS versão 17, R versão 2.11.0 e Graph Pad versão 5.0. RESULTADOS: Foram respondidos 198 (33%) questionários válidos. Os seguintes resultados foram obtidos: a média (± desvio padrão) de idade foi de 47,6 (± 11,12) anos e o sexo masculino foi de 53,5%. A presença de perfil patológico nas relações objetais do tipo alienação, egocentrismo e vinculação insegura reduziu os escores dos domínios psicológico (p < 0,001) e relações sociais (p < 0,001), da qualidade de vida. A presença do fator imaturo das defesas do ego reduziu os escores dos domínios físico (p < 0,0001) e meio ambiente (p < 0,0001), da qualidade de vida. DISCUSSÃO: Defesas imaturas do ego dificultam a adaptação do indivíduo à vida profissional e conjugal, enquanto que a presença do perfil patológico das relações objetais leva à dificuldade em manter relacionamentos estáveis e à tendência a manipular as pessoas, apresentando-se socialmente inapto. Ou seja, médicos com esse perfil (de defesas e de relações objetais) devem enfrentar dificuldades para conviver com outras pessoas, inclusive com pacientes. Sua qualidade de vida é pior do que a de médicos com defesas maduras do ego e perfil normal de relações objetais. CONCLUSÕES: A psicodinâmica e a qualidade de vida do médico estão significativamente relacionadas. Os escores da qualidade de vida caem à medida que aumentam os escores das defesas imaturas do ego. Médicos com perfil patológico nas relações objetais apresentam menores escores de qualidade de vida, em relação àqueles com perfil normal / INTRODUCTION: Psychodynamics is the study of the psychological forces that underlie mental action. Ego defense mechanisms and object relations are psychodynamic aspects that affect quality of life as they alter people\'s perceptions of their own life. OBJECTIVES: To assess the influence of ego defense mechanisms and object relations on quality of life in a population of physicians, and thus test our hypothesis that mature ego defenses and normal object relations are associated with better physician quality of life. METHODS: In this cross- sectional study, questionnaires and pre-stamped return envelopes were sent to the population of physicians (602 individuals) living in the city of Botucatu, São Paulo. Psychodynamics was evaluated using the following instruments: a) Defense Style Questionnaire (DSQ-40), which assesses and classifies ego defense mechanisms as mature, neurotic, or immature; b) Bell Object Relations and Reality Test Inventory (BORRTI - Forma O), which assesses and classifies object relations (alienation, egocentricity, insecure attachment, and social incompetence) as either normal or pathological. Quality of life was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) that was developed in the context of four domains of quality of life: physical health, psychological health, social relationships, and environment. Demographic data were obtained via a specific questionnaire. Statistical analyses were performed using the tests of Shapiro-Wilk, Kolmogorov-Smirnov, Mann-Whitney, Spearman\'s coefficient, and Gamma linear regression models with SPSS v. 17, R v. 2.11.0 and Graph Pad v. 5.0 software. RESULTS: A total of 198 questionnaires (33%) with valid responses were obtained. Among respondents, mean age was 47.6 ± 11 years, and the rate of males was 53.5%. High BORRTI scores (pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health (p < 0,001) and social relationships (p < 0,001) domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for the physical health (p < 0,0001) and environment (p < 0,0001) domains. DISCUSSION: Immature ego defenses impair adjustment to professional and marital life, while pathological object relations lead to difficulty in sustaining stable relationships and tendency to manipulate others, hence social ineptitude. Physicians with immature defenses and pathological object relations are, therefore, likely to find it hard to relate with other people, including patients. Their quality of life is worse in comparison with that of physicians with mature ego defenses and normal object relations. In the study population, both immature ego defenses and pathological object relations were associated with lower quality of life. CONCLUSIONS: Among physicians, quality of life is influenced by its psychodynamics, herein assessed through ego defense mechanisms and object relations