Academic journal article International Journal of Psychology and Psychological Therapy

Differentiation between Defensive Personality Functioning and Psychopathology as Measured by the DSQ-42 and MMPI-2-RF

Academic journal article International Journal of Psychology and Psychological Therapy

Differentiation between Defensive Personality Functioning and Psychopathology as Measured by the DSQ-42 and MMPI-2-RF

Article excerpt

Although defensive mechanisms stem from psychoanalytic theory, research has led to their general acceptance (Cramer, 2010, 2015). They were included in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; APA, 1994; Perry et alii, 1998), and were defined as "automatic psychological processes that protect the individual against anxiety and from the awareness of internal and external dangers or stressors. Individuals are often unaware of these processes as they operate" (DSM-IV; APA, 1994). The alternative model for personality disorders in DsM-V (APA, 2013) differentiates between A-type and B-type criteria referring to personality functioning and maladaptive personality traits. Bender, Morey, and Skodol (2011) referred to defensive functioning as a criteria for personality functioning. Over time, diverse concepts have been associated with maladaptive or disordered personality functioning, such as ineffectiveness, lack of empathy, impulsivity and many others (Parker et alii, 2002). Concepts such as defense mechanisms (e.g., Cramer, 2000; PDM Taskforce, 2006; Zimmerman, Ehrenthal, Cierpka, Schauenburg, Doering, & Benecke, 2012) and ego strength (Lake, 1985) have traditionally been considered core aspects of personality functioning. For instance, Millon stated that a systematic assessment of defense mechanisms "is central to a comprehensive personality assessment" (1984, p. 460).

Several authors have also described hierarchical models of psychological defenses; at the bottom level are primitive defenses such as delusional projection (usually of a persecutory nature) and splitting whereas at the top of the hierarchy, mature and socially adaptive forms are positioned such as humor and acceptance. Individuals' characteristic level of defenses is correlated over time with mental health and different forms of psychopathology (e.g., Finzi-Dottan & Karu, 2006; Vaillant, 1971, 1992; Vaillant, Bond & Vaillant, 1986; Vaillant & McCullough, 1998). Immature defenses differentiate between the presence and the absence of a personality disorder (e.g., Birendra & Watson, 2004, Bond, 2004; Bond & Perry, 2004; Muris, Winands, & Horselenberg, 2003). Also, Kernberg has identified the maturity level of defensive functioning as one of the core characteristics of the structure of personality organization in that immature or primitive defenses are characteristic for borderline and psychotic personality organization (Kernberg, 1993). Further, defense mechanisms seem to have a unique role in addition to predominant affective temperament in the formation of depressive symptoms (Carvalho et alii, 2013), and, finally, the relation between therapeutic benefits (i.e., symptom relief) and defense use (i.e., use of more adaptive defenses) has been demonstrated in several clinical studies (e.g., Bond & Perry, 2004).

Several self-report measures to assess defense mechanisms have been developed. The value of these measures has been doubted (e.g., Cramer, 2000; Davidson & MacGregor, 1998; Funder & Colvin, 1988). Two points addressed by Andrews, Singh, & Bond (1993) may be supportive for the use of self-report assessment of defense mechanisms. First, they state that we are -in hindsight- often aware of the operations of unconscious processes and, secondly, they postulate that "the habitual use of any particular defense will leave tracks in an individual's belief or attitude system and that endorsement of certain attitudes or beliefs can be taken as an indicator of the habitual use of that defense" (1993, p. 246).

One of the most widely used self-report measures of defense-mechanisms is the Defense Style Questionnaire (DSQ; Andrews et alii, 1993). The DSQ tradition has produced numerous versions with different items and items-to-defense ratios. Attempts to synchronize the DSQ with the DSM-III-R and DSM-IV DFS and recurrent psychometric problems of the DSQ instruments (such as the low item inter-correlation within defenses) have encouraged researchers and clinicians to develop new versions (Andrews et alii, 1993; Wilkinson & Ritchie, 2015). …

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