Assessment of Defense Styles and Mechanisms in Iranian Patients Suffering from Obsessive Compulsive or Panic Disorders versus Normal Controls Using Persian Version of Defense Style Questionnaire-40

Article excerpt

Objective: The aim of this study was to compare defense styles and mechanisms in adult patients suffering from obsessive-compulsive disorder (OCD), and panic disorder (PD) with normal subjects in Iran .

Methods: Defensive patterns of 22 patients with OCD, 28 patients with PD and those of 116 normal individuals (as a control group) were assessed using the Farsi version of Defense Style Questionnaire-40 (DSQ-40). The content validity of this questionnaire was done prior to the initiation of the present study.

Results: Both groups of patients with OCD or PD used more immature and less mature styles compared to the control group. No significant difference was observed in the use of neurotic style between the two groups .

Conclusion: It is suggested that immature defenses may have an important role in the pathogenesis of OCD and PD.

Keywords: Defense mechanism, Obsessive-compulsive disorder, Panic disorder

Iran J Psychiatry 2012; 7:31-35

One of the most important duties of ego is to provide individual's psychological homeostasis; that is why defense mechanisms are among the most important functions of ego (1). Andrews et al. noted the definition of defense mechanisms by Anna Freud as "the ways and means by which the ego wards off unpleasure and anxiety, and exercises control over impulsive behavior, affects and instinctive urges" (2).

According to DSM-IV Adaptive Functioning Scale, defense mechanisms are defined as "automatic psychological processes that protect the individual against anxiety and from the awareness of internal or external dangers or stressors" (3).

The relationship between defense mechanisms and psychopathology is an issue of interest in many clinical studies (4). In order to conduct these studies, there is a crucial need for a reliable self-rating scale that is able to measure defense mechanisms (5). Bond et al. developed the first questionnaire, named Defense Style Questionnaire (DSQ) for this purpose (6).This questionnaire was designed to assess 24 sets of defense mechanisms. The first 67-item questionnaire was

revised by Bond himself, and an 88-item version was then proposed in 1986 (7). Andrews adapted this questionnaire with DSM III (5), and because it was rather long, a shorter version was finally suggested (2). The shorter version consists of 40 items which rates twenty defense mechanisms, mentioned in DSM III, as well as three defense styles or factors consisting of mature, neurotic and immature styles (2). Two statements are advocated to each defense, and each statement is evaluated on a scale from 1 to 9. One indicates complete agreement and 9 indicates complete disagreement. This version is now considered as the most frequently used self-report scale for assessment of defense mechanisms (8).

After development, DSQ was translated to several languages (9, 10, 11, 12) and made it possible to study defense mechanisms in different psychiatric disorders. Some of these works were reported by Bond in a review article (13). Defense mechanisms have been studied in patients with anxiety disorders, particularly, in those with OCD or PD (14, 15, 16, 17). The present study evaluated the defense styles and defense mechanisms in Iranian patients with OCD and PD compared with normal subjects. The secondary aim of this trial was to assess changes in the patterns of defenses that could be dependent on different cultures. For this purpose, DSQ-40 was translated to Persian, and then its content validity was assessed. Finally, the questionnaires were given to the participants to rate their defense mechanisms.

Materials and Method

Participants

This study was designed to assess three groups of subjects (normal subjects, patients with OCD and PD) by the Persian DSQ-40. The normal subjects included those individuals who did not have any psychiatric disorders, and did not take any psychotropic medications at the time of the study. …