Research on cognitive processes has primarily focused on cognitive control and inhibitory processes to the detriment of other psychological processes, such as defense mechanisms (DMs), which can be used to modify aggressive impulses as well as self/other images during interpersonal conflicts. First, we conducted an in-depth theoretical analysis of three socio-cognitive models and three psychodynamic models and compared main propositions regarding the source of aggression and processes that influence its enactment. Second, 32 participants completed the Hostile Expectancy Violation Paradigm (HEVP) in which scenarios describe a hostile vs. non-hostile social context followed by a character's ambiguous aversive behavior. The N400 effect to critical words that violate expected hostile vs. non-hostile intent of the behavior was analyzed. Prepotent response inhibition was measured using a Stop Signal task (SST) and DMs were assessed with the Defense Style Questionnaire (DSQ-60). Results showed that reactive aggression and HIA were not significantly correlated with response inhibition but were significantly positively and negatively correlated with image distorting defense style and adaptive defense style, respectively. The present article has highlighted the importance of integrating socio-cognitive and psychodynamic models to account for the full complexity underlying psychological processes that influence reactive aggressive behavior. Here, defense mechanisms (DMs) represent the psychological processes that mediate the person's reaction and have been the subject of empirical studies over the last 50 years. While the role they play in modifying certain human behaviors has received little attention from the socio-cognitive literature in the past, there has recently been a growing interest in developing integrative models that connect psychodynamic data and cognitive neuroscience to enrich our understanding of the mind and brain  , as well as two key processes in socio-cognitive and psychodynamic models that influence aggressive reactions (prepotent response inhibition and DMs).Socio-cognitive models of aggression developed from early social learning and social cognitive theories and expand on the idea that aggressive behavioral tendencies emerge from the development and activation of aggression-related scripts. More generally, scripts are the product of learning through observation and experiences in social environments and are stored in a person's long-term memory. Behavioral scripts contain information about how a person should behave in various social situations and are used to guide their interpretations of social stimuli and events, orientate their goals and decision making, shape their outcome expectations, mediate their behavior, and inform subsequent appraisals. From a socio-cognitive perspective, aggressive scripts develop from having learned that using aggressive strategies is an effective way of achieving our goals. Studies of aggression support the importance of distinguishing between different types of aggressive behaviors according to the goal that is pursued , in which case the person engages in a process of reappraisal and considers alternative ways to interpret the situation. Importantly, reappraisals are controlled cognitive processes and require explicit, intentional effort. Like the SIP model, however, the GAM provides little information about how these cognitive processes operate to inhibit aggressive impulses.A key component of the GAM model is the notion of aggressive priming. Briefly, the priming (in this case) is conceptualized as the activation of a thought, which then initiates a chain-like reaction involving the activation of associated thoughts, and results in making them more accessible , as well as their counterparts, the DMs. Also, psychodynamic models of personality usually shed light on the motivations that underlie defensive operations and point to how they may be useful in countering aggressive impulses.per se because he believed that the pressure that pushes a person into irrepressible action is characteristic of all drives  to find a way to rid the pressure and elicit a discharge through a motor response. Because phenomena from the drive are internal and thus cannot be avoided with a flight response , mental action is required in response. Contrary to the Ego drives, which push the person to develop adaptive ways of interacting in their real-life environment and discover appropriate objects to reduce tension , the sexual drive can become a source of conflict for the Ego because its demands are unrealistic and satisfying its desires is either forbidden or inappropriate. Accordingly, repression is a DM that can be used to counteract the pressure of the sexual desires by pulling them back into the unconscious parts of the mind or blocking their access to the conscious mind .and aggressive desires that threaten the Ego. With the help of feelings of anxiety , the Ego then faces its conflict with the Id by making use of DMs. The drive coming from the Id  is composed of representations that are attached to distinct emotions . DMs  operate on these representations so that the energy from the drive is free to be displaced onto other, non-threatening representations.After being confronted with soldiers coming back from World War I who had traumatic nightmares, as well as seeing patients with other disorders who showed patterns of thoughts or behaviors that brought them suffering, Freud  introducvia the transformation of negative thoughts and feelings into more nuanced, less intense ones. In addition, there was a gradual shift in the importance given to the social environment as a source of aggression. Finally, because early (immature) DMs during child development played a major role in the formation of self/other representations, their operations could distort the image of the self and others.Contrary to Freud, the object relations theorists who followed shortly after gave aggression a central role in their models, seeing it as being in a reciprocal relationship with personality structures. Indeed, while DMs still contributed to modifying the manifestation of aggressive tendencies, the notion of degrees of maturity for the personality structures was introduced. This allowed for aggressive tendencies to be reduced upstream  projection. The object is then perceived as either good or bad, which creates a feeling of protection for the infant (from the good object), as opposed to anxieties of persecution (from the bad object). With the help of another mechanism called introjection (which is inseparable from projection), the infant now tries to place what is experienced as good (during the interaction with the mother) inside the self. This results in the infant feeling as though it possesses the good object. Bad objects may also be introjected into the self so that the infant can identify with them and control them (projective identification). As the good and bad objects are taken back into the infant's psyche (with the good objects needing protection from the bad ones), a new cycle of fantasies will follow.As the founder of object relations theory , Melanie Klein Klein, ,b,c follIn Klein's model, the goal of the death drive is the destruction of internalized objects that generate negative feelings such as envy and greed. Here, envy is both the desire to acquire the idealized aspects of the object and attack it (the object) because of the suffering caused by not possessing those idealized aspects. Greed, on the other hand, only desires to extract all the good aspects and ultimately results in the object's destruction. During development, the infant will go through a stage called paranoid-schizoid (briefly described above), followed by a stage of depression during which they are less concerned about protecting the self and more concerned (or worried) about the damage they may have caused to the object when acting out their aggressive phantasies. This sets the stage for several other transformations in the formation of their personality, allowing them to develop new capacities such as being able to tolerate ambivalent feelings, have more realistic perceptions of external objects, and begin to feel gratitude toward them. In parallel, the core of the Ego is formed by internalizing objects that are good, secure, and whole. Klein preferred to call these developmental stages “positions,” as she believed that—unlike stages, which are progressed through in somewhat of a linear fashion— positions represent ways of perceiving and relating that may oscillate throughout development and into adulthood Klein, . Therefoself can be defined in several ways, object relations theorists primarily conceptualize it as an intrapsychic representation of the person as a whole entity. For Kohut, the self is the central agency in the structure of personality and represents the core of the individual's experiences, their initiatives and all their impressions. Unlike the Id described in classical psychoanalytic interpretations, Kohut proposed that the self was gradually accessed through the therapist's ability to empathically immerse themselves into the inner life of the patient. In his early writings, his work with patients who suffered from narcissistic problems  led him to revise Freud's theory of narcissism. For Freud, narcissism was one of the first stages in the development of the libido , wherein it is invested in the Ego as its first love object. Only during a subsequent stage does the libido detach itself from the Ego and then attach itself to external objects. Kohut, rather, made a distinction between the narcissistic libido and the object libido and suggested that they developed independently. Through interactions with the parent, the child initially develops a cohesive (archaic) self that separates into two types: a grandiose self that is all-powerful and demands admiration, and a perfect idealized object with which the self identifies. During this period, the parent is not perceived as a separate entity from the child's self, but rather as a self-object, one that assumes the responsibility of meeting the child's narcissistic needs. Kohut believed that, in healthy development, the parent responded empathically to these needs, and so the child's self would develop normally and ultimately take over the role of supplying the admiration and idealization that had initially been provided by the parent.Heinz Kohut's psychology of the self Kohut, , 1977 raAlthough these needs are thought to persist throughout the person's life, the need for empathic support from  others to maintain self-esteem is thought to gradually decrease with age. At the same time, the child's perception of themselves and others becomes more realistic; their grandiose self slowly transforms into personal ambitions and the idealized object becomes their values and ideals. In the case that the parent is unable to empathically support the child's need for admiration or is inadequate in serving as a figure of admiration (often due to psychopathology), an archaic self will persist, be repressed, and come into conflict with the real ego . For the adult who persistently needs self-objects to be admired or continues to idealize people with whom they identify, the self remains in its primitive form. Since the person with an archaic self is “perfect”, and their surrounding environment is simply an extension of themselves, an environment that fails or frustrates the person (by not meeting narcissistic demands) will quickly threaten the self with the fear of disintegration (an anxiety resembling psychic death). According to Kohut, the person reacts to this humiliation and injury to self-esteem with “narcissistic rage,” a form of reactive aggression ranging from a simple annoyance to anger, to intense fury. The motivations underlying narcissistic rage are revenge, restoration of the person's sense of omnipotence, and absolute control over their environment. For Kohut, the purpose of DMs  is not to reduce anger or destructive behaviors, but rather to protect the individual's fragile self. As such, Kohut believed that narcissistic rage is under the service of the restoration of the archaic self.reversal into its opposite, the aggressive impulse can result from the transformation of a fear, as exemplified by the child who transforms their anxiety into aggressive behaviors by identifying with their aggressor . When the defense acts on the object of the drive, aggressive desires that target the object will be displaced onto a less threatening object, leaving the pressure from the aggressive drive entirely. Finally, when the defense acts on the goal of the drive (as demonstrated with sublimation) aggressive desires can be satisfied by goals that are socially sanctioned and encouraged, leading to new and adaptive ways to express aggressive impulses.While the relationship between inhibition processes and reactive aggression is relatively straightforward , it is comparatively more complex between DMs and aggression and may yield different results. The three psychoanalytic models presented above may be useful for understanding this relationship. In Freud's model, DMs can either increase or suppress aggressive impulses, or maintain their initial level. They can operate on the action, the object , or the goal of the aggressive drive. For example, in the case of repression, an aggressive impulse that seeks satisfaction through a reduction of tension (with the help of the Ego) may be refused access to consciousness. This totally deprives the individual of the opportunity to deal with their psychological reality, and so it is as though the aggressive desire never existed. In the case of In Klein's model, the DMs appearing most related to aggressive impulses are found in the paranoid-schizoid position . Here, both the drive seeking the object and the DMs are expressed through phantasy. To survive, the infant needs to possess  an image of a good/ideal object that will bring them love and security and with whom they can identify. In contrast, the bad object would evoke a feeling of persecution, and experiences of frustration are experienced as a type of sadistic attack on the good/ideal object by the persecutory object. To avoid this from occurring, the early ego makes use of various primitive DMs, such as introjection for the good parts, projection for the bad parts, or splitting the ego and the object into good and bad images to keep them as separate as possible. It may also use projection identification, in which the ego projects the bad split-part of the self and the bad internal object onto the external object, followed by introjection of the bad object that remains under its control. Each of these mechanisms results in distorting the image of the self and the object, which creates a vicious cycle between the defenses, persecutory anxiety, hatred, anger, and aggression. As revealed in clinical settings, all of these inferred processes have been described by Klein in her account of the infant during the first year of life and have also been reported in adult individuals functioning at the level of the paranoid-schizoid position  aggressive behaviors represent a DM in the form of The comparative analysis revealed various similarities and differences between socio-cognitive and psychodynamic conceptualizations of sources, motivations, and processes that influence aggression. A major focus in socio-cognitive models is on the interaction between the person and the situation during a social encounter. Relatedly, one of the main sources of aggression in these models consists of factors that are external to the individual. As briefly mentioned above, situational factors represent an important causal source of aggression and include any potentially triggering antecedents of the social situation, such as interpersonal provocations . Aggressive scripts (comprised of associated concepts stored in long-term memory) are thought to develop through past experiences and gain accessibility with frequent rehearsals in real-life situations. As such, a person who was repeatedly exposed to aggression early in life  is proposed to have highly accessible aggressive scripts that are carried over into many social situations and essentially “hijack” interpretive processes, resulting in a HAB. In psychodynamic models, the interpretation of the social situation is influenced by unconscious workings of the mind , and so the person is not in control of these processes. Rather, the pressure that these domains exert on the person's thoughts and feelings force them to develop defensive maneuvers to protect themselves from anxiety. Depending on the defensive strategies they use, the drive (Freud), the unconscious phantasies (Klein), or the archaic self (Kohut) may manifest as aggressive thoughts, emotions, or behaviors.When attempting to understand the source of aggression, both the socio-cognitive and psychodynamic models acknowledge that the situation alone cannot fully explain a person's behavior. Rather, the The causal contribution of emotions is also addressed in all the models, albeit to varying degrees of influence. All socio-cognitive models acknowledge that negative emotions, such as anger, affect the way a person perceives, interprets, and reacts to social events. While the SIP model remains vague about the impact of anger While the proposed motivations of aggression in socio-cognitive models are described differently in psychodynamic models, we find similar themes in almost all of them. For example, because socio-cognitive models characterize reactive aggression as a behavioral response to a perceived threat or offense, its principal motives are self-protection or an impulsive means to get revenge. Along a similar vein, Kohut's later theories posit that the goal of aggression is to protect the person's self-esteem, get revenge on the object that destroyed their illusion of omnipotence, and restore their grandiose self. Klein also described a need to protect, but for her, it was through phantasies of destruction to preserve good/ideal objects. Freud had a slightly different view from the others and thought that aggressive drives were motivated by the need for a discharge of tension through satisfaction. In some ways, however, the result of not satisfying these needs would likely be unbearable for the person, and so perhaps Freud's explanation concurs with the overall notion that aggression is motivated, in part, by the need to protect oneself.this conflict that motivates the implementation of control/protective processes. Socio-cognitive models derive this conflict from social learning theory, in which people learn normative rules about aggression from external sources within their social environment . They also learn and acquire prosocial values, which serve as guidelines for appropriate social behavior. When social situations become hostile or threatening (whether it is perceived as such or objectively the case), these social values will  motivate people to practice self-control by suppressing or delaying an aggressive impulse and finding alternative, non-hostile, ways to interpret the situation and/or clarify ambiguous social cues . This notion of a conflict between having a behavioral impulse and resisting the urge to act on it has effectively been operationalized in experimental settings using a stop-signal task (discussed below). The task involves having the participant perform a speeded choice reaction task (the “go” task) and occasionally withhold their response whenever the “go” stimulus is followed by a “stop” signal. Given that the participant must inhibit a response that has already been primed with the go stimulus, it is somewhat analogous to situations in which external cues trigger an automatic response, yet the appropriate response is no response at all. The inherent dilemma in this analogy is that to successfully stop a process that is already set in motion, the person must be able to recruit control resources at the conscious level. During social conflicts, socio-cognitive models propose that this possibility is strengthened by having personal values that prioritize interpersonal relationships. In psychodynamic models, the “conflict” that could potentially provide an opportunity for resisting or modifying an aggressive impulse happens entirely at the unconscious level. Also, these impulses manifest in unconscious desires and phantasies, and so it becomes difficult to describe counteracting forces from an objective point of view. For example, an individual might have feelings of guilt simply because they had an unconscious hostile thought toward a close relative. In psychodynamic models, prohibitions from the Superego and DMs could intervene in this type of conflict, but they do so without the intervention of human awareness.Another similarity between socio-cognitive and psychodynamic models pertains to the assumed presence of a conflict between aggressive impulses and some form of resistance to the realization of these impulses. According to all accounts, it is Lastly, the way control processes are characterized in socio-cognitive models differs considerably from self-protective processes in psychodynamic models. While there are several proposed control processes in socio-cognitive theories, the ones most associated with models of aggression refer to intentional, effortful, and adaptive cognitive processes that operate to reduce hostile thoughts and inhibit aggressive behavioral responses. This usually encompasses any self-initiated cognitive process that interrupts automatic patterns of thought and allows the person to consider alternative ways to approach or understand the current situation. Examples include thinking about the negative consequences of the act, redirecting attention away from aggressive cues, or recognizing physiological indicators of anger and trying to “calm down.” To borrow Freud's metaphor, we could say that the Ego is attempting to mediate the situation and satisfy all the demands of the situation by finding an adequate solution to the problem. Evidently, if the person has deficits in processing social cues or is unable to control how they interpret the situation (possibly resulting from repeated activation of aggression-related associations in long-term memory), then this loss of cognitive control facilitates automatic cognitive processing and habitual response patterns will likely be repeated. In psychodynamic models, certain DMs are adaptative, while others are not. They are conceptualized as dynamic processes that, rather than being directed at the situation, are aimed at the individual for the purpose of protecting them from the distressing phenomena happening within them. There are several proposed DMs, each of which provides different solutions that produce different results regarding their impact on aggressive impulses. The compromise that lies between the defense and the drive represents the solution to the problem. However, if the defense fails to contain the unconscious desires, phantasies, or grandiose self, then the compromise may manifest as a symptom . Throughout a person's life, new DMs can be added to the original ones, or even take their place. When the forbidden desires give rise to symptoms, it is as though the repression of the Ego has failed to keep them in the unconscious part of the mind and the individual has lost control of their instinctual life insofar as these desires will remain inaccessible or even accessible but in a disguised and non-recognizable manner  to consciousness, the part of the mind that would be able to deal with them in an adaptative way. In this sense, the psychodynamic explanation for failed inhibition differs from the socio-cognitive perspective, as deficits or overridden control functions are not a part of the underlying process.Since the beginning of its construction, the concept of DMs has grown in popularity and has been applied to other fields of psychology and psychiatry. Objective instruments were developed so that empirical studies in clinical and normal populations could attempt to distinguish defenses according to their level of maturity and adaptability  behaviors among depressive patients. Results consistently showed that higher use of immature and image distorting styles and less use of mature style, as assessed with the DSQ-40 , were the best predictors of suicide attempts  is a paradigm that is often used to assess inhibitory control  aggressive behavior. A preliminary study using an SST task found that aggressive children showed weaker inhibitory control (probability of inhibition) and slower inhibitory processes (SSRT) compared to controls  measured in the HEVP task is a good index of HAB  reflect the change in electrical activity produced by the brain in response to an external stimulus or an internal  event Luck, . The N40A similar paradigm, the HEVP, was developed by Gagnon et al.  and usedIn a study by Stewart et al. , the N40Other ERP components have also been used to assess aggression-related cognitive biases and confirm associations between high aggression and the HAB , divided by short breaks, the duration of which was determined by the participant. For each trial, participants were asked to read the first two sentences  that were presented on the screen for a minimum duration of 1,500 ms and press the space bar once they had completed reading. Following this, a blank screen appeared for a duration of 500 ms, after which participants fixated a crosshair at the center of the screen for a duration of 1,000 ms. They were then presented with the third sentence  and asked to maintain fixation at the center of the screen as each word was displayed centrally for 300 ms, separated by 200 ms blank intervals. Following a 2,000 ms interval during which participants again fixated a crosshair, the next sentence (context) was displayed. The filler scenario was included among the 17 trials in each block and followed by a true or false comprehension question, which resulted in a mean correct response rate of 88%.After the ERP procedures, participants were administered the Stop-signal Task (SST). The version of the SST task used in the current study had participants view images of facial expressions  displaying neutral or angry emotion. The images were taken from the Karolinska Directed Emotional Faces (KDEF), a validated standardized database of facial expression images varying in emotional content  and consisted of four blocks  of 64 trials each, for a total of 256 trials, 25% of which were stop trials. To avoid potential order effects, participants were randomly assigned to one of two versions of the task in which the order of the emotional content across the four blocks was counterbalanced. The first stop-signal delay (SSD)—the time interval between an image presentation and the “stop” signal—was set at 250 ms and subsequent SSDs were determined based on a tracking procedure: if the participant successfully stopped a response during a trial, the subsequent SSD increased by 50 ms; if they were unsuccessful, it decreased by 50 ms  data was recorded using 64 Ag/AgCl electrodes (BioSemi Active Two system) mounted on an elastic cap according to the International 10–10 System Acharya et al.  and refeAll statistical analyses were performed using Statistical Package for Social Sciences Software (IBM SPSS Statistics 26). All 32 participants were included in the analysis. First, explorative analyses were performed using visual inspection of skewness and kurtosis parameters to verify the normality distribution assumption. To assess normality distribution, we performed Shapiro-Wilks test on all variables to be sure to detect all departures from normality. All the variables were normally distributed, except for the HN400RC effect. The HN400RC value of one participant was adjusted because it was an extreme value and thus undermined the normality of the distribution. The outlier's value has been replaced by 1 unit less than the adjacent lower value. The reaction time of the STT task was corrected when the standard deviation was greater than 2.n = 87), the 32 participants who completed the DSQ-60 were included in the present study. To verify if the present sample still demonstrates the N400 effects originally found in Gagnon et al.  = 10.23, p < 0.003, indicating that the waveforms were more negative for the for the mismatch condition than for the match condition underlying the presence of the N400. There was also a main effect of Location, F = 4.18, p < 0.041. There was also a significant interaction between the factors of Hostility and Consistency, F = 4.62, p < 0.040. In the non-hostile condition, the waveform was significantly more negative in the mismatch condition than in the match condition, F = 16.59, p < 0.000, confirming the presence of the N400  = 0.13, p = 0.72. Finally, there was a significant Consistency x Location interaction, F = 11.72, p < 0.000. The waveforms were significantly more negative in the mismatch condition than in the match condition at the central, F = 9.07, p < 0.005, and posterior, F = 19.68, p < 0.000 regions. There was no effect of Consistency in the anterior region, F = 0.74, p = 0.40. There was no other main effect nor interaction with the factor of Consistency.N400 see , 3, but F = 11.22, p < 0.002, and Location, F = 16.03, p < 0.000. There was no other significant main effect. Finally, there was a significant Consistency x Location interaction, F = 7.35, p < 0.003. The waveforms were more negative in the mismatch condition than in the match condition for the central, F = 12.16, p < 0.002, and posterior electrode, F = 18.66, p < 0.000, underlining the presence of an N400. However, there was no effect of Consistency at the anterior electrodes, F = 0.57, p = 0.46. In sum, lateral and midline electrodes analysis showed the presence of the N400 when there is a mismatch between the expected intention and the intention from the target word, and that the component was larger in the non-hostile condition than in the hostile condition , and larger over central and posterior than anterior sites.The midline electrodes ANOVA showed main effects of Consistency, n = 32) to obtain the mean (M) as a measure of central distribution and the standard deviation (SD) as a measure of variability. More precisely, it was calculated on RPAQre , on image distorting style , affect regulating style , and adaptive style . In addition, it was calculated on SSRT Neutral , SSRT Angry  and SSRT Total .Descriptive statistics were computed on our behavioral variables of interest and among all our participants  and moderately positively associated with HN400RC effect . Furthermore, the correlations were not significant between RPAQre and SSRT Neutral , SSRT Angry  and SSRT Total .Correlation analyses were computed between all variables of interest and are reported in the correlation matrix , SSRT Angry  and SSRT Total . Likewise, HN400RC effect did not correlate with SSRT Neutral , SSRT Angry  and SSRT Total .Finally, NHN400RC effect did not correlate with SSRT Neutral  and reactive aggression, as well as between the defense styles and prepotent response inhibition. Overall, the findings largely supported these hypotheses and provide support for the development of integrative operationalizations of aggression-related variables.less use of mature defenses converge on the idea that aggressive individuals have difficulties in suppressing inappropriate impulses and thus are unable to convert them into more socially acceptable behaviors  and moderately positively correlated with the N400 effect in the hostile condition (violation of non-hostile expectations). To our knowledge, this is the first study to show an association between the HIA bias and DMs that distort the image of self and others. A study by Cramer and Kelly  examininonly when the individual has difficulties paying attention to social cues do they become susceptible to feelings of frustration and to misinterpreting the intention of their peers. To our knowledge, this is also the first study to examine the association between response inhibition and the HIA. Our findings indicated a trend toward this association, as seen between the SSRT in the neutral condition of the SST and the N400 effect in the non-hostile condition of the HEVP , perhaps resulting from lack of statistical power due to the small size of the sample. Furthermore, to capture meaningful relationships between the HAB and prepotent response inhibition, it may be necessary that the sample comprises a sufficient portion of high trait aggression participants, a condition that was likely not met with our sample.Regarding prepotent response inhibition, contrary to what was expected, SSRT, in both emotional and neutral stop-signal trials, was not significantly correlated with reactive aggression. This finding diverges from previous studies showing that difficulties with inhibiting information within emotional contexts are significant predictors of aggressive behaviors  was positively correlated with anticipation and omnipotence, and negatively correlated with passive aggression. These findings suggest that mature defenses (anticipation) are not necessarily correlated with stronger inhibition capacities, whereas defenses that aim at controlling manifestations of aggression (passive-aggression) may relate to stronger prepotent response inhibition capacities. Alternatively, DMs characterized by phantasies of having unlimited power and potential (omnipotence) may relate to weaker inhibition. Given that the manner with which the defense styles cluster defensive processes risks eclipsing meaningful associations with other variables some psychodynamic authors have expressed doubts about grouping together such a great diversity of DMs with unique functions Laplanche and Pontalis, This article serves a twofold purpose. In part 1, it bridges the gap between socio-cognitive and psychodynamic concepts of psychological processes that influence aggression and, by exploring various associations between them, advances our understanding of factors underlying aggressive behaviors. Using a theoretical approach, we identified similarities and differences by reviewing three prominent models from each perspective and comparing their respective conceptualizations of sources, motivations, and regulatory processes of aggression.Our comparisons between socio-cognitive and psychodynamic models of aggression allowed us to identify certain themes that resonated across most of the models, as well as distinguish apparent conceptual differences.Each of the models converged on three main ideas. First, both perspectives emphasize the importance of the manner with which a person interprets the social event and considers this factor a critical determinant in the emergence of hostility and aggression. They also share in proposing that the underlying motivation for reactive forms of aggression is either for self-protection or related to vengeance. Lastly, each describes a type of conflict or tension existing between two opposing forces—one that supports aggression and one that condones it—and acting as an antecedent for implementation of control/protective processes.Our comparisons also revealed important theoretical differences. Proposed sources of aggression in socio-cognitive models place an important emphasis on the interaction between situational influences and maladaptive cognitive factors. Psychodynamic models prioritize the role of unconscious processes that can influence perceived environmental influences. While all the models (socio-cognitive and psychodynamic) acknowledge that some form of negative affective state  influences the person's reaction to the situation, socio-cognitive models propose that it generates aggression only to the extent that it influences cognitions, whereas psychodynamic place it at the very origin of aggressive impulses.Similarly, in socio-cognitive models, motivations are fueled by internal reactions to external events, whereas Freud and Klein believed that they were relatively independent of from the social situation, and because Kohut proposed that the self was indistinguishable from the provoking object (in the environment), the internal/external divide here is also less significant.Lastly, socio-cognitive models prioritize effortful, controlled processes that act to reduce negative affective states, redirect attention away from provoking stimuli, or suppress aggressive impulses. When overridden or defective, the combination of increase negative affect and a loss of control over cognitions increases the likelihood of an aggressive behavioral response. In contrast, while there is no self-initiated implementation of protective process in psychodynamic models (since the conflict takes place below conscious awareness), DMs are proposed to have different functions. Regarding the subsequent effects they have on aggressive impulses, depending on type, they can either increase, reduce, or have no effect at all.per se, and socio-cognitive models of aggression [underpinned by Bandura's  rather than a mature defense (anticipation).With this theoretical synthesis as well as the empirical findings in view, we propose an integrative framework that conceptualizes all the proposed psychological processes that influence aggression along a continuum of time, according to whether they are implemented before or after the aggressive act. To begin, several unconscious and/or automatic regulatory processes could occur before the aggressive act and result in an increase of negative affect . They would include image distorting DMs such as splitting, projective identification, and projection, as well as automatic cognitive processes such as aggressive priming, angry rumination, and HIA. When deployed, any one of these processes would increase the likelihood of an aggressive behavioral response. In parallel, processes resulting in a reduction of negative affect would comprise DMs such as repression, reaction formation, and sublimation, as well as cognitive inhibitory processes related to attention , emotion regulation , resistance to proactive interference, and prepotent response inhibition. In the case that the person is consciously aware of the source of their aggressive impulse, then implementing these latter resources might also provide an opportunity for alternative interpretations of the situation . Lastly, in the case that the aggressive impulse was acted upon, DMs such as rationalization, suppression, and undoing, may help deescalate the situation by reducing negative affect, which may, in turn, reduce the risk of subsequent aggressive acts.Although these hypotheses need to be verified with further experimental studies, they point to the prospect that converging multiple levels of analysis could further our efforts to unravel complex processes. Indeed, Westen  made intAs a result of having integrated knowledge from socio-cognitive and psychodynamic theories and research, this study provides insights and novel information. However, it also has limitations. First, the theoretical study was based on a small selection of socio-cognitive and psychodynamic models and was not intended to be representative of all theories of aggression within these fields. Regarding the empirical study, the first limitation relates to our reliance on a self-report questionnaire measure of DMs. Certain participants may have lacked insight regarding their defensive behaviors or had distorted or biased views of how they relate (or behave toward) others. Also, because of the correlational design of this study, we cannot make causal inferences about the relationships observed between DMs and aggression, HIA and response inhibition. For this to be possible, further development of experimental conditions that capture the effects of the DMs is necessary. The other limitation concerns our small sample, which may have prevented sufficient statistical power for verifying certain hypotheses.The present article has highlighted the importance of integrating socio-cognitive and psychodynamic models to account for the complexity underlying psychological processes that increase or decrease the likelihood of aggressive behavior. Notably, the theoretical part of the article identified two types of conflicts that play a critical role in whether processes are implemented. One is set at the conscious level and facilitates the recruitment of effortful, intentional control processes that promote conflict resolution by interrupting automatic thoughts and attenuating aggressive impulses. The other is set at the unconscious level and gives rise to defensive processes aiming to protect the self and resolve the conflict by either increasing or reducing the aggression. To integrate the processes taking place at these two levels of analysis, we proposed conceptualizing them along a continuum of time, according to whether they are implemented before or after the aggressive act. The empirical study included a sample of non-clinical participants and demonstrated that reactive aggression and the HIA were not significantly correlated with performance on a response inhibitory task but were significantly correlated with image distorting and adaptive defense style. Our results are consistent with previous research demonstrating significant relationships between aggression and defense styles among clinical samples and extend their findings to a non-clinical sample. Taken together with our integrative analysis, they provide insights for innovative studies exploring relationships between DMs and various inhibitory processes. Finally, our findings also suggest that, in addition to cognitive interventions for HABs, aggression prevention programs geared at young adults could benefit from interventions specifically targeted at increasing the use of mature DMs and decreasing the use of immature DMs.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by the Comité d'Éthique de la Recherche en Psychologie et en Éducation (CEREP) (No. 2014-15-126-D). The patients/participants provided their written informed consent to participate in this study.JG conceptualized the study and provided the data. JG, JQ, and PM analyzed and interpreted the data and contributed to the writing of the manuscript. All authors have approved the submitted version of this manuscript.This study was supported by a research grant to JG from the Social Sciences and Humanities Research Council (SSHRC) (No. 430-2014-00729).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Many people with psychosis experience difficulties in everyday social situations. Anxiety can make life challenging, leading to withdrawal. Cognitive therapy, using active in vivo learning, enables people to overcome fears. These treatments are not readily available to people with psychosis. Automated virtual reality (VR) therapy is a potential route to increase accessibility. The gameChange automated VR cognitive therapy is designed to help people overcome anxious avoidance and build confidence in everyday social situations. A virtual coach guides the person through the treatment. Understanding user experience is key to facilitating future implementation. Peer research methods, in which people with lived experience of the issues being studied are involved in collecting and analyzing data, may be useful in developing this understanding. This encourages researchers to draw on their lived experience to explore participant perspectives and co-create knowledge.The primary objective is to use a peer research approach to explore the participant experience of a novel automated VR therapy for anxious social avoidance. This includes understanding (1) the experience of anxious social avoidance in people with psychosis, (2) the experience of the gameChange automated VR cognitive therapy, and (3) any potential impact of the therapy in people’s lives. This will inform future implementation strategies. The secondary objective is to explore how peer research can be used to co-create knowledge.Semistructured interviews will be conducted with approximately 25 people with psychosis participating in the gameChange trial (ISRCTN17308399). Participants will be recruited from the five trial centers based in National Health Service mental health trusts across England. Interviews will be conducted by two researchers. One is a peer researcher with similar lived experience to the trial participants. The other has lived experiences of mental health issues that do not directly overlap with those of the trial participants. Interview questions will focus on an individual’s experience of anxious social avoidance, experiences of participating in the gameChange VR therapy, and any changes or impact following therapy. The interview schedule was developed in collaboration with the gameChange Lived Experience Advisory Panel (LEAP), comprising 10 project advisors with lived experience of psychosis. Interpretative phenomenological analysis and template analysis will be used to explore individual accounts. The LEAP will contribute to the analysis.Data collection will be conducted from April to September 2021, and analysis will be conducted from June to October 2021. As of September 28, 2021, 20 participants had been interviewed, and coding is underway.The study, employing a peer research approach, may provide a unique insight into the experiences of anxious social avoidance in people with psychosis and its treatment using automated VR therapy. This will inform potential future implementation of VR automated therapies in mental health services.DERR1-10.2196/31742 Many people with psychosis withdraw from everyday social situations due to anxiety, leaving them isolated and inactive. In a survey of 1800 people with nonaffective psychosis attending National Health Service (NHS) mental health services, two-thirds had levels of anxious avoidance comparable to agoraphobia [The anxiety is likely to arise from several sources, such as hearing threatening or critical voices, social anxiety, paranoia, or low self-esteem. These fearful cognitions lead to avoidance or, when this is not possible, the use of in situ defense (or safety-seeking) behaviors, which prevent the receipt and processing of disconfirmatory evidence and thus maintain the anxious thought. Cognitive treatments for anxiety target the fearful cognitions and defense (or safety-seeking) behaviors . BehavioVirtual reality  provides a route to test anxious cognitions by entering simulations of feared situations. VR elicits similar cognitive and emotional responses to real-world situations . HoweveUsing a socially inclusive design process, the trial team has developed a novel automated VR cognitive treatment targeting anxious avoidance of social situations by people with psychosis: the gameChange therapy (see ). The 6-Interpretative phenomenological analysis (IPA) is a qualitative approach that focuses on understanding an individual’s lived experience and how they make sense of it . IPA aimA multiple perspective design provides a structure to explore different perspectives on an experience while allowing for the homogeneity of the sample, as required for IPA ,20. IndiWe are conducting a qualitative study using a peer research approach to explore experiences of anxious social avoidance and participation in the gameChange VR therapy. A complementary implementation study is being conducted to identify and understand issues affecting how the therapy will be adopted into health care services within the context of the trial.The study has two objectives. The first is to gain an in-depth, first-person perspective on the experience of taking part in the gameChange VR therapy, which is designed to help people build confidence in everyday social situations. This includes understanding (1) the experience of anxious social avoidance in people with psychosis, (2) the experience of the automated VR therapy, and (3) any potential impact of the therapy. The second objective is to explore how peer research approaches can be used to co-create knowledge.The gameChange trial, including this qualitative study, received Health Research Authority approval, Health and Care Research Wales approval , and ethical approval from the NHS South Central – Oxford B Research Ethics Committee (19/SC/0075). The trial has been registered (ISRCTN17308399) and the protocol published .To increase the methodological quality and reporting, the presentation of the study will follow the guidance from the 32-item Consolidated Criteria for Reporting Qualitative Research (COREQ) .There has been extensive patient and public involvement throughout the gameChange project. This includes the design and conduct of the trial as well as the development of the treatment. For example, more than 50 people with lived experience of psychosis contributed to the design of the gameChange therapy . The LivThe LEAP has been involved in the design of this study. To date, the LEAP has contributed to developing the interview schedule, completing pilot interviews, refining the recruitment procedure, and conducting a review of all study documentation (including the information sheet and consent form) for accessibility and clarity. In response to the pilot interviews, the order of the topics was revised. The LEAP will form part of the analysis team and complete sample validation of the data.This study takes a peer research approach, including employing a researcher with relevant lived experience of psychosis and social anxiety as part of the study team. This individual has not received the gameChange VR therapy but has explored the intervention to become familiar with the participants’ experience. They have been involved in developing the research proposal and designing data collection methods, they are interviewing participants, and they will be analyzing data and disseminating findings. Another researcher who has experience of poor mental health but is not a peer in this context will bring their experience of using IPA research methods and a connection to relevant experiences of mental health issues that are generic rather than specific to people with psychosis and social avoidance.The participants will be a subsample of approximately 25 people who took part in the gameChange trial as participants. The trial participants are people with psychosis and self-reported difficulties going outside among other people due to anxiety. There are five gameChange trial centers based in NHS mental health trusts across the United Kingdom: Avon and Wiltshire Mental Health Partnership NHS Trust, Greater Manchester Mental Health NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Nottinghamshire Healthcare NHS Foundation Trust, and Oxford Health NHS Foundation Trust. Participants for this study will be recruited from each of the trial centers. The inclusion criteria are:Participating in the gameChange trial and randomized to receive the gameChange VR therapy in addition to usual care.Willing to have the interview audio recorded.Willing and able to give informed consent to participate in the interview.The project included people with a psychosis diagnosis attending NHS mental health services who experience anxious avoidance in everyday social situations. The full inclusion and exclusion criteria for participating in the gameChange trial are provided in the published trial protocol . A partiParticipants will be recruited through the gameChange trial. IPA requires samples to be constructed around a conceptualized shared perspective: in this case, as outlined above, this is operationalized in terms of adults experiencing psychosis and social anxiety, in receipt of NHS mental health care, who have received the gameChange VR therapy.Multiple perspective designs in IPA allow this homogeneity to be supplemented by some dimensions of further variability, with each conceptualized additional perspective constituting its own subsample. We are recruiting approximately 25 participants, with 3-8 participants from each of the trial centers via liaison with local trial coordinators. This is a relatively large total sample for IPA, but in this study, IPA’s commitments to depth of analysis and idiographic detail will be met via the multiple perspective design  and with the additional support of a template analysis component.The primary sampling method is to invite consecutive participants as they reach the final phase of the trial. Whenever possible, this will be supplemented by purposive sampling to recruit people with a range of views and experiences of the VR intervention. This will be ascertained through therapy completion rates .Sampling will also be sensitive to the demographic characteristics of the participants, aiming for a balance of gender and a range of age and ethnicity. Other dimensions of interest include the profession of the staff member facilitating VR therapy sessions ; location of the treatment delivery ; and referring clinical service .In this study, decisions about the main subsamples for the multiple perspectives design will be made at the midpoint of recruitment. This enables the design to be responsive to the key dimensions of interest emerging from the accounts. These may relate to therapy completion rate or the participants’ views of therapy. However, there may be indications that the other contextual/identity features described above are sharpening participants’ experiences of the intervention. If these are deemed more important to contrast systematically, the subsamples will be stratified accordingly.The trial coordinator at each center will facilitate recruitment. Participants will be invited to participate in the qualitative interview after the first follow-up assessment in the trial (immediately after the therapy window ends). The trial coordinator will provide potential participants with the information sheet in advance. The information sheet states that one of the researchers is a peer. The trial coordinator will introduce the participant to the researchers. The peer researcher will speak to the participant in advance of the interview. This discussion may include a further elaboration on their “peerness,” disclosing that they have some experiences in common in relation to the topic being studied, which will be documented in the research log. Written or oral informed consent will be taken at the time of the interview.Data will be gathered via semistructured interviews. Participants will be given as much choice as possible in how the interview is conducted. The primary method will be to complete the interview remotely, via video or telephone call.There will be a primary and secondary interviewer. Participants will be told that one of the interviewers has had experiences like those being explored in the gameChange study. The other researcher, who has experience of conducting research interviews for an IPA study, will lead the first interviews. The interviews will be audio recorded. The peer researcher will lead later interviews so that the interviewee will be able to respond directly to the researcher with shared experiences, similar to the approach outlined by Harding et al (2010) . The intPeer researchers, qualitative researchers, implementation researchers, clinical psychologists, and members of the gameChange LEAP contributed to the development of the interview schedule. The development process included a review of the literature on anxious avoidance in people with psychosis, consideration of the key principles and novel features of the gameChange treatment, the complementary implementation study, and routes to include peer research methods within the interview. For example, in preparation for the interviews, the two researchers who will be collecting the data interviewed each other about their relevant lived experience. This provided potentially valuable insights into how to approach topics and ensure the phrasing was understandable and engaging. The interview schedule was further refined following pilot interviews with members of the LEAP.The interview schedule was designed in line with IPA and phenomenological approaches ,24, emplA total of 6 transcripts will be coded using interpretative phenomenological analysis (IPA) ,25, and IPA aims to enable the researcher to step into the participant’s “lifeworld”  to underIPA complements a peer research approach because it acknowledges the role of the researcher in the interpretation of the data and resulting themes. The researcher will try to make sense of the participant trying to make sense of what has happened to them. Reflexivity is welcomed. Having multiple members of the research team conduct the analysis, including those with aspects in common with the participants, will increase the depth and sensitivity of the analysis .A total of 6 transcripts will be chosen for IPA by the interviewers and the wider analysis team, based on the richness of the data and the chosen perspective . The IPA will adopt analytic strategies described by Larkin and Smith (2011)  and SmitMultiple coding can reveal new insights and explanations, especially if the researchers have different backgrounds and, therefore, different standpoints, resulting in a richer interpretation of the data . The twoAfter these discussions, a provisional “template” will be agreed upon. This will be used to initiate the template analysis on the remaining data. The template evolves iteratively as more of the data are coded. Honoring the multiple perspective design, we will introduce each of the remaining groups of transcripts (based on treatment completion/uptake) one at a time, focusing on each in turn. After each group has been analyzed, we will review the template to see whether it needs to be updated as a result. We will use the steps outlined by King et al (2004) , namely The result will be a set of themes  that represents all interviews, 6 of which will also be in case study format from the IPA. The “lamination,” or layering, made feasible by this dual approach of IPA and template analysis within a multiple perspectives design will give the study both depth and breadth. All transcripts will be deleted after the analysis is complete.The four criteria for “trustworthiness” in qualitative research  will be monitored and addressed . To incrAll researchers conducting the interviews or analysis will consider how their own backgrounds may impact data collection and analysis. This will require the researchers to reflect on the different perspectives that they are bringing to the study design, setup, data collection, and analysis. Details of the research team and reflexivity will be reported in the full manuscript in line with COREQ guidelines .The research team includes a peer researcher, a nonpeer researcher, clinical psychologists who have been involved in the design and use of VR therapy, implementation researchers who are conducting a complementary study on the use of the gameChange VR therapy in mental health services, and a qualitative researcher who has pioneered the IPA approach. Therefore, existing knowledge, experiences, and hopes regarding VR therapy may impact the conduct of the interviews and analysis. We have explicitly set out to use the peer knowledge and examine peer research methods in this study. Therefore, the two interviewers will each keep a reflexive log to document the use of peerness during data collection and analysis.The secondary methodological objective of this study is to learn about peer research methods and co-creation of knowledge. We will investigate the impact of peerness from overlapping, related, and nonpeer perspectives. This includes (1) how peerness is negotiated and disclosed throughout interactions with participants, (2) the effect of peerness on the interview and data collection process, and (3) the impact on analysis. This will be achieved by drawing on the researcher logs and interview field notes, evaluating participant feedback at the end of the interview (when asked about the experience of being interviewed by a peer), and discussing sections of the transcripts that document disclosure of peerness with the LEAP. To assess the impact of peer methods on the analysis, we will compare the two sets of themes resulting from the independent analysis by the two interviewers to explore key differences and similarities in the insights and interpretations. However, to identify differences based on research expertise or identity, a much larger group of peer and nonpeer coders would be required , which iData collection will be conducted from April to September 2021, with analysis performed from June to October 2021. As of September 28, 2021, data collection with 20 participants had been conducted, and coding is underway. This study is expected to conclude in 2022.This protocol describes the plan for a multisite qualitative study using peer methods to explore experiences of anxious social avoidance in the context of psychosis and its treatment using an automated VR cognitive therapy program: the gameChange treatment. The gameChange VR cognitive therapy is designed to help people build confidence in everyday social situations. The qualitative study is being conducted in the context of VR therapy being tested in a multisite randomized controlled trial . This st


This paper proposes a strategy to measure economic insecurity in countries in the Global South. It builds a 'Multidimensional Economic Insecurity Index' (MEII) that combines four indicators of economic vulnerability that cause stress and anxiety: unexpected economic shocks, unprotected employment or non-workers in the household, over-indebtedness and asset poverty. The index offers a measure that directly relates economic uncertainty to stress and anxiety due to the lack of protection and buffers to face an unexpected economic shock. The MEII is applied to Chile using Survey of Household Finances (SHF) cross-sectional data . The results show that (i) about half of the Chilean households experienced, on average, two or more economic vulnerabilities during the last decade with an intensity of 2.3 vulnerabilities, and (ii) economic insecurity affects households on the entire income distribution, even in the highest income deciles groups. By identifying the groups of households most affected by economic insecurity and its trend in recent years, applying the MEII in countries such as Chile provides relevant information to monitor, evaluate and improve social safety nets besides labour market regulations. The design of better policies that could lead Latin American countries towards more inclusive and sustainable development requires new measures of progress and well-being , all of which have contributed to an increase in economic insecurity Hacker, .In , StiglitIn upper-middle-income economies such as Chile, Brazil, Colombia and Mexico, there is little theoretical or empirical debate around economic insecurity, even though a large proportion of the population is exposed to economic shocks that not only generate income losses for the households but also lead them to experience poverty. In the Latin American region, the social group most exposed to economic shocks has been described as the 'strugglers'  for two dimensions of economic insecurity: (i) household risk to an unexpected economic event, and (ii) lack of household buffers to face an economic shock. I combine these indicators using a multidimensional approach to build an adjusted multidimensional vulnerability rate called the 'Multidimensional Economic Insecurity Index' (MEII). This approach has two stages. First, I identify the economic vulnerabilities, and then, I apply an aggregation procedure to integrate the multidimensional information on economic insecurity into a single scalar measure  and the intensity of the economic insecurity (number of vulnerabilities affecting it). The second advantage is that the MEII can be decomposed by population subgroups  and economic insecurity domains . Thus, it allows for monitoring each of the dimensions of insecurity that are targeted by multi-sectoral policy strategies such as unemployment insurance, investment in social and affordable housing, micro-finance interventions, cash transfers, and policies to stimulate saving, among others. It is the first time to apply the concept of economic insecurity to middle-income countries and complement other well-being measures, such as vulnerability to poverty and multidimensional poverty, which are more commonly used in these countries.The estimates for Chile between 2007/2017 show high levels of economic insecurity in regard to both the risk of an unexpected economic event and the lack of a household buffer to offset a potential loss. More than a third of households were exposed to unexpected economic shocks during this period. The indicators providing information about households’ lack of protection reveal that 62.8 per cent were asset poor, 30 per cent had only unprotected workers or non-workers, and 15.4 per cent faced over-indebtedness. Combining the measures in the MEII, we found that, on average, about half of Chilean households experienced two or more economic vulnerabilities during the last decade, with an intensity of 2.3 vulnerabilities. The index is correlated with more conventional macro indicators such as the GDP growth rate and labour informality rate. The highest index levels are between 2007 and 2011, followed by a significant decrease between 2011 and 2014, increasing again between 2014 and 2017.This paper makes three contributions. First, from a conceptual point of view, it uses two dimensions of economic insecurity related to an unexpected economic event and the household buffer to protect from this potential economic loss. Although both dimensions (and their respective indicators) are sources of insecurity, each of which may trigger stress and anxiety in individuals and households, the origin of these adverse psychological effects differs. In previous work, the focus in terms of the selection of indicators has either been on choosing between subjective and objective indicators  a significant reduction in absolute poverty coupled with a significant increase in vulnerability to poverty Prieto, ; (ii) anThird, from a social policy perspective, the new measure of economic insecurity makes a significant contribution to measuring progress in the region. The MEEI index goes above and beyond the Gross Domestic Product (GDP) per capita or the Human Development Index (HDI)  project  by the United Nations Development Program , which sSecond, economic insecurity can influence complex psychological processes that cause an increase in health problems throughout people’s lives  proposed by Osberg and Sharpe , and theUsing a one-dimensional-micro-based measurement approach, economic insecurity has been conceived of as (i) job insecurity  carried out by the Central Bank of Chile in 2007, 2011, 2014 and 2017. The SHF is representative of urban private households. It collected information on income, expenditure, household characteristics, household assets and debts with a high degree of detail.6I use the SHF household-level data, which not only contains variables on financial and non-financial assets and debts, but also include socioeconomic and demographic variables. The size of the sample in 2007 was 3827 households. The 2011 sample comprised 4057 households and the samples in 2014 and 2017 comprised 4502 and 4449 households respectively.In summary, the economic insecurity variables obtained from the SHF are (i) employment status and type of contract of household members; (ii) retrospective questions related to significant unexpected expenses or substantial unexpected income drops faced by the households in the last 2 years; (iii) information on the burden that debt imposes on the income of household; and (iv) household assets such as non-housing wealth.I use the Chilean national poverty line defined by the Ministry of Social Development (2015), which measures poverty in absolute terms. This threshold is based on the cost of a basic food bundle. I construct post-transfer household income as the sum of income from labour, imputed rent, and private transfers plus public transfers. Because I use assets as a stock of material resources that can support the current consumption of a household, it is appropriate to equivalise it in the same way as household income is equivalised OECD, , p. 141.7I break down the estimates of the Multidimensional Economic Insecurity Index by individual characteristics such as gender, age and education level and household characteristics such as family type , size of the household, housing (outright owner or owner with mortgage or tenant) and location (regions).To measure economic insecurity requires quantifying the level of stress or anxiety of a household attributed to an uncertain financial future. Given that stress or anxiety is not directly observable in the data sources that sociologists and economists usually work with, sources of economic insecurity rely on proxies. I classify these proxy measures into two dimensions. The first dimension is the risk of the household experiencing potential events related to negative economic consequences such as unemployment, losses in asset values, or unexpected medical expenses. The second dimension is the lack of household economic buffers, which generates stress such as not having enough assets to face an event that decreases incomes or increases expenses, or not having access to social protection mechanisms to offset these economic losses.Following an approach focused on the household-level measures, due to the existence of a shared decision-making process, the index uses four sources of stress distributed across two dimensions of the economic insecurity. As mentioned above, the first dimension is vulnerability to economic loss. I consider in this dimension a measure of unexpected large income loss or unanticipated expenses (known as downside income insecurity). The lack of household buffers is the second dimension. It includes three measures: (i) unprotected employment or non-workers in the household, (ii) over-indebtedness, and (iii) asset poverty.The starting point in the selection of these indicators is that the level of stress or anxiety of an individual or household depends on the combination of these four sources of economic insecurity. For example, a family facing a decrease in their income  might spend their savings or borrow money. However, families that have low levels of savings, or that have a limited ability to borrow, or are already allocating a large portion of their income to servicing a debt, may have trouble addressing this unexpected drop in earnings and be forced to give up food or fail to pay their debts or other receipts.I justify selecting the four sources of economic insecurity relying on the empirical evidence offered by the health economics literature. Several investigations have linked these economic vulnerabilities with health problems, in particular with the stress of the household’s members. These references are illustrated below in the description of the indicators for each source of economic insecurity.Income insecurity refers to the risk of large income drops or unexpected expenses faced by families should they encounter unpredictable events of social life  are informal workers ILO, .The SHF collects information on the occupational category and the type of contract of all the members of the household that are working at the time the survey is applied. Also, it asks whether or not household members pay social security contributions. This information allows me to construct a variable that distinguishes an informal worker from a formal one. I start from the assumption that formal jobs normally offer economic protection in the case of dismissal.(b)Over-indebtedness.For households without any labour market attachment, I consider that they are also unprotected against an unexpected economic shock. This consideration is important because these types of households could be classified as economically secure as they do not have informal workers. Thus, the objective indicator of economic insecurity for each household works as follows: I classify a household as economically insecure if (i) none of the workers in the household has access to unemployment insurance benefits or would receive any sort of compensation in the event of their dismissal, or (ii) the household does not have members working. This indicator takes the value of 1 when all workers are informal workers or there are non-workers in the household.There is abundant evidence on the effect of over-indebtedness and its associated financial difficulties , causing adverse psychological effects such as distress, anxiety, reduced life satisfaction and depression in the members of a household  but similar to the threshold used by Hojman et al. . I used (c)Asset poverty.Although the SHF asks the interviewee about their perception of the household level of indebtedness, I use only the observed information about this source of economic insecurity. By doing so, I avoid introducing potential subjective bias related to the idiosyncratic characteristics of individuals in the construction of the indicator.A household that does not have an adequate buffer  against major economic shocks is aware of its economic vulnerability generating stress and anxiety among its members . Although several studies use liquid assets in the asset-poverty operationalisation  the identification of households that are economically insecure, (ii) the aggregation of the different indicators into a scalar value, and (iii) the selection of dimensional weights for each indicator.As I described above, I have selected the two dimensions and their indicators which, in the framework are related to household risk to an unexpected economic event and lack of buffers to offset a potential economic loss. Also, I identified economic insecurity for each of the indicators using specific thresholds . Poverty vulnerability analyses indicate that in Chile, only the highest income decile groups (9 and 10) have a near zero risk of falling into poverty. This means that a low risk in terms of vulnerability to poverty does not exempt households or individuals from the risk of curtailing their well-being, a risk that is associated with significant stress at the household level.The second phenomenon that the results show is that although in Chile the levels of economic insecurity are high, these decreased significantly between 2011 and 2014. Figure Taking advantage of the decomposition properties of one of the MEII’s aggregated measures, I analyse the contribution of the dimensions to economic insecurity according to households’ position in the distribution of income. And, more specifically, I analyse whether the composition of the four dimensions in the index differs between the extremes of the income distribution. Table For the year 2017, the contribution of unexpected economic shocks is higher between deciles 3 and 8 than at the extremes of the income distribution. In the case of asset poverty, the contribution is relatively constant. It does not seem to be related to income decile, except in the highest income decile group (10), where the contribution falls to 33 per cent. The indicator unprotected employment or non-workers in the household is important in the lower part of the income distribution, and its contribution falls in the highest deciles. Conversely, over-indebtedness is more relevant for households at the top of the distribution, which reveals that over-indebtedness, falling revenues or increased expenditure are sources of greater stress among households with a higher income in Chile.The breakdown of the MEII aggregate measures into subgroups of the population also makes it possible to identify the types of families with the highest levels of economic insecurity. From the perspective of public policy design, this information is relevant because it allows for identifying where and how to focus public resources to reduce household stress due to economic vulnerabilities, thus complementing other welfare measures that are traditionally used in the targeting of social policies.Figure The last section of the results analyses the relationship between economic insecurity and some significant households’ characteristics variables. I use a probit model to estimate the probability of a household being economically unsafe. The dependent variable is the definition of the MEII for a cut-off of two vulnerabilities. The multivariate model was applied to pooled data from SHF household samples for the years 2007, 2011, 2014 and 2017. Specifically, the interest is in identifying the average marginal effect (AME) that each of the socioeconomic characteristics of the household has on economic insecurity for the studied period. Table Regarding the features of heads of households, i.e. gender, age and education, the results show first, that households headed by women are more vulnerable than households headed by men (7.7 per cent). An explanation of this result could be the gender inequalities that the Chilean labour market exhibits . Second, the age of the head of the household was not a significant variable. This result shows that the economic insecurity throughout the decade was transverse to the life cycle of households. Finally, it is worth noting that households with heads of households that have a university degree have a significantly reduced risk of being economically vulnerable. The AME for heads of households with a university degree was 26.0 percentage points.20As to the variables related to households' characteristics, i.e. type of family, number of children, number of members working, the results in Table Second, regarding the number of children in the household, an additional child increases the probability of a household being economically insecure by 3.1 percentage points. Third, the number of workers in the household has a reverse effect and is significant. When a member of the household gets a job the probability of the household being economically insecure decreases by 11.0 percentage points. Finally, renting, as opposed to owning, increases the probability of being economically vulnerable by 17.9 percentage points. Since housing was not included as a measure of asset poverty, this result does not have a mechanical explanation but rather directly relates this characteristic of the household to the level of insecurity that it experiences.This paper has studied both the nature and evolution of economic insecurity in Chile over the last 10 years (from 2007 to 2017). A Multidimensional Economic Insecurity Index (MEII) has been constructed to carry out this analysis, combining four sources of economic insecurity that causes stress and anxiety: unexpected economic shocks, unprotected employment, over-indebtedness, and asset poverty. In this way, the MEII offers a measure at the household level that directly relates economic uncertainty to stress due to the lack of both social protection and buffers to face unexpected economic shocks.The MEII incorporates sources of stress and anxiety that are characteristic of households located at the two ends of the income distribution in middle-income countries. This is the case for the unprotected jobs at the bottom of the distribution, and the over-indebtedness at the top. In this way, the MEII becomes a more versatile and useful tool for the diagnosis and design of social policies for the reality of countries such as Chile and others that are similar in the Latin American region. Furthermore, using a multidimensional approach to construct the MEII not only allows me to analyse the incidence and intensity of economic insecurity but also to decompose the index by dimension or subpopulation.After selecting the appropriate vulnerability cut-off to the MEII, a cut-off of two vulnerabilities and four indicators with uniform weights is proposed to analyse the level and intensity of economic insecurity in Chile. Applying this measure to the data from the Household Financial Survey shows that during the decade studied, economic insecurity, on average, affected almost 50 per cent of urban households in Chile, with an intensity of 2.3 out of 4 indicators. By considering both incidence and intensity, an adjusted rate of average economic insecurity of 0.286 is obtained. Although in the period of the economic crisis the level of insecurity did not change (measures taken in 2007 and 2011), its evolution in the subsequent years shows U-shaped behaviour where a significant fall in economic insecurity between 2011 and 2014 is followed by an increase between 2014 and 2017. This result shows a negative correlation with the country’s economic cycle. Other macroeconomic indicators also correlate with some of the indicators that make up the MEII, for example, the reduction of the levels of labour informality with the unprotected unemployment indicator, and the constant increase in the bank private credit rate with the over-indebtedness indicator.When considering the entire population, asset poverty is the indicator that contributes the most to economic insecurity. The other indicators follow in this order: unexpected economic shocks, unprotected employment, and over-indebtedness. Although insecurity is present throughout the income distribution, the composition of the four indicators varies according to the position of the household in the income deciles. Thus, although the asset-poverty contribution is similar throughout the income distribution, unprotected employment is more relevant in the lower deciles, while unexpected economic shocks and over-indebtedness make a more significant contribution in the higher deciles.The main determinants of economic insecurity are households headed by women who have children. Also, heads of households with low educational levels who work without a contract increase the household’s risk of being affected by economic insecurity. The number of workers in the household is the most critical determinant to predict their economic insecurity. These results are similar to studies that have used other economic welfare measures such as vulnerability to poverty. This allows for relating these forms of socioeconomic disadvantage to exposure to economic stress. In this way, one could argue that policies that seek to reduce the economic risk in the poorest households fulfil several desirable objectives simultaneously.The most significant difference between these welfare measures is that economic insecurity affects the entire income distribution, while the other measures do not provide relevant information on the highest deciles. The high economic insecurity experienced by all income groups finds an explanation in two critical and intertwined conditions: firstly, the low level of income and wealth collected through household surveys, even of those in decile groups 9 and 10, which are not enough to protect individuals from the stress of future economic shocks; and secondly, the weak social protection system, which is incapable of working as a buffer to offset households’ economic insecurity. It is worth noting that in 2015 the OECD ranked Chile as having the greatest economic vulnerability among its members, for almost 8 out of every 10 Chileans did not have liquid financial wealth to face a sudden adverse economic shock. In that same year a new reform was made to the unemployment insurance system based on individual savings to increase insurance coverage for a greater proportion of the unemployed.By identifying the groups of households most affected by economic insecurity and its trend in recent years, the application of the MEII in countries such as Chile provides relevant information to monitor, evaluate and improve social safety nets together with labour market regulations. Although this welfare measure has been criticised for not considering the fact that the perception of economic vulnerability varies among households, it is important to acknowledge that the contexts in which households decide to avoid or increase their economic risks are determined and informed by the support scheme offered through social policies. The question that arises is, what is the base level of hazard that as a society we want to have? In the case of Chile, to a certain extent, the state shares with people the financial risk of hazards such as unemployment or illness, through programmes such as unemployment insurance or public health insurance. Households decide how to cope with the additional costs of an illness or unemployment taking into consideration information about programme benefits (if eligible) and their own resources. However, regardless of the level of risk aversion on the part of the household, social policies should be able to effectively address economically insecure households, generating a more complete social welfare system than the current one.