A pilot study of defenses in adults with personality disorders entering psychotherapy

Further reliability, convergent and discriminant validity of overall defensive functioning

The reliability, convergent and discriminant validity of the Defensive Functioning Scale (DFS) and the overall defensive functioning score (ODF) has been previously examined. This study aims to address gaps in the literature as well as to replicate and extend the initial positive clinical validity data emerging on the DFS ( Blais et al., 1996; Hoglend and Perry, 1998; Lingiardi et al., 1999; Perry 2001; Perry and Hoglend, 1998; Perry et al., 1998). Fifty-three outpatient clients were rated by clinicians trained on the DFS. The relationship between the ODF with both clinician-rated and self-report measures of psychopathology was examined. The mean interrater reliability for the DFS levels rated in this study was found to be moderate to high, and reliability for the ODF score was found to be excellent. Coefficient alpha of individual defense levels as well as across the entire DFS indicated high levels of internal consistency. Factor analysis revealed that the ODF represents a construct different from various aspects of patient self-report and clinician ratings of psychopathology. These results provide further support for the clinical application and relevance of the DFS system.

A study of stability and change in defense mechanisms during a brief psychodynamic investigation

This study investigated the stability of defensive functioning over the course of a 4-session Brief Psychodynamic Investigation (BPI). The sample included 61 outpatients from the Adult Psychiatry Department of the University of Lausanne, Switzerland. Defenses were measured from session transcripts using the DMRS quantitative method. Specific changes in defenses were found over the course of the ultrabrief investigation. First, the overall defensive functioning (ODF) score and the proportion of obsessional level defenses increased significantly, with a significant increase in intellectualization. Second, the number of defenses used and the proportion of narcissistic level defenses decreased, with a decreasing prevalence of devaluation and idealization. Third, high adaptive (mature) level defenses increased then decreased over the course of BPI, returning to their level at intake by the 4th session. Relief from distress and attending to the tasks of BPI tends to improve defensive functioning, but more likely returns it to usual levels rather than producing permanent change. Future studies will need to use designs that allow estimation of state changes while taking sufficient measurements to estimate potential changes in trait levels of defenses.

Correspondence among observer ratings of Rorschach, Big Five Model, and DSM-IV personality disorder constructs

Observer ratings were collected using instruments designed to measure the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorders (Personality Diagnostic Questionnaire-4+ [PDQ-4+]; Hyler, 1994), the Big Five model (B5M; Goldberg's [1999] International Personality Item Pool), and Rorschach-derived constructs. For the latter, we revised the Rorschach Rating Scale (Meyer, Bates, & Gacono, 1999) to lower its reading level and renamed it the Rorschach Construct Scale (RCS) to emphasize its reliance on rated constructs. The RCS consists of 6 factors. Joint factor analysis of RCS, PDQ-4+, and B5M items also resulted in 6 factors: Self-Centeredly Exploitative, Poor Ego Resiliency, Extraversion, Task Conscientiousness, Openness to Ideas, and Emotional and Expressive Constriction. The first 2 factors received high loadings from RCS, PDQ-4+, and B5M variables. The sixth factor received high loadings from just RCS variables.