Self‐reported defence mechanisms as an outcome measure in psychotherapy: A study on the German version of the Defence Style Questionnaire DSQ 40

Abstract

The psychoanalytically informed construct of 'defence mechanisms' is of central importance for the understanding of the dynamics of inner conflicts and the onset of neurotic symptoms. Objective and valid assessment of 'defence' is difficult. There are a number of observer rating instruments but only few self-report questionnaires. The German version of the 'Defence Style Questionnaire - DSQ 40' (Andrews, Singh, & Bond, 1993) was examined with regard to its factorial and content validity, and its sensitivity to change during inpatient psychotherapy. One hundred and fifty-five patients with mixed diagnoses were administered the DSQ 40 and the SCL-90-R before and after 3 months of inpatient psychotherapy. Diagnoses were mostly affective and anxiety disorders as well as eating disorders, and there was a high comorbidity of personality disorders. After deletion of some items due to insufficient pairwise item-intercorrelation or false classification to a defence mechanism by experienced clinicians, we found three stable factors of defence (maladaptive, intermediate-neurotic and adaptive) consistent with the previous research. After 3 months of therapy, a decrease in maladaptive mechanisms and an increase in adaptive patterns were found, while neurotic mechanisms did not change on average. Our shortened version of the DSQ 40 was shown to be a valid instrument for the assessment of defence mechanisms and change in these mechanisms after psychotherapy. Our design did not permit an assessment of whether or not the change in defence mechanisms was due to the therapeutic treatment.

Defense Mechanisms in Adolescence as Predictors of Adult Personality Disorders

“…Whereas the immature defense style was a significant predictor of an adulthood PD only in the univariate analyses, the neurotic defense style emerged as the most prominent predictor of any adulthood PD when adjusting for baseline covariates, including PD and depression in adolescence. Earlier studies have shown that neurotic mechanisms have not changed on average during treatment (Schauenburg et al, 2007). In accordance to these results, our findings indicate that the neurotic mechanisms are more independent from psychiatric disorders.…”

“…A recent meta-analysis (Calati et al, 2010) showed that individuals with major depressive disorder had lower scores in mature defense style (Bond, 2004;Bond and Perry, 2004;Schauenburg et al, 2007) and higher in immature and neurotic defense styles. Successful psychotherapeutic treatment has been associated with a change in defense style from immature toward a more mature style, whereas neurotic mechanisms tend to be stable (Schauenburg et al, 2007).…”

“…Successful psychotherapeutic treatment has been associated with a change in defense style from immature toward a more mature style, whereas neurotic mechanisms tend to be stable (Schauenburg et al, 2007). Also, mature defenses tend to be quite stable already in adolescence (TuulioHenriksson et al, 1997).…”

Personality dimensions and defense styles that are related with relapse during 12 month follow-up in male alcohol dependents

“…The DSQ 40 was shown to be a valid instrument for the assessment of defense mechanisms and change in these mechanisms after psychotherapy among those with personality disorder comorbidity (61). Several studies among patients with personality disorder reported positive associations between immature (maladaptive or nonadaptive) defenses and personality disorders and negative relations between mature (adaptive) defenses and personality pathology (48,(62)(63)(64).…”

Identifying indicators of defensive activity in narration about important interpersonal relations

“…Both supporters of self-descriptive tools (Blaya et al, 2007;Bond, 2004;Davison & McGregor, 1998;Gould, Prentice, & Ainslie, 1996;Juni, 1998;Schauenburg, Willenborg, Sammet, & Ehrenthal, 2007) and narration analyses from interviews and projection tests (Berney et al, 2014;Kramer et al, 2013;Perry, 2001;Cramer, 1998b) focus on identification of defence types (considering maturity hierarchy) and attempts to determine overall defensive functioning scores (Bond & Perry, 2004;Sinha & Watson, 2004). Processual analyses of mental defences in specific natural contexts are the least frequent (Feldman Barret et al, 2002).…”