The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Defensive Functioning Scale: a validity study

Initial validation of the Turkish version of the defense mechanisms rating scales-self-report-30

The Defense Mechanisms Rating Scales-Self Report-30 (DMRS-SR-30) was recently developed to add a self-report alternative to the assessment of defenses, reflecting their generally accepted hierarchical organization. In this study, we aimed to examine psychometric properties and factor structure of the Turkish language version of the DMRS-SR-30. The sample consisted of 1.002 participants who filled out a survey comprising the DMRS-SR-30, the Brief Symptom Inventory, and the Inventory of Personality Organization through Qualtrics. Confirmatory Factor Analysis indicated a three-factor structure (CFI = 0.89, RMSEA = 0.05) that confirms the DMRS theoretical frame with a relatively acceptable fit. Defensive categories and total scale scores showed good to excellent reliability (α values ranging from 0.64 to 0.89). Correlations between defenses, symptoms, and personality functioning demonstrated good convergent and discriminant validity. The individuals with clinically significant BSI scores (T-score ≥ 63) differed on the DMRS-SR-30 scores from the individuals in the non-clinical range. The Turkish version of the DMRS-SR-30 is a reliable and valid instrument to self-assess the hierarchy of defense mechanisms and overall defensive functioning. Moreover, the current study supports the validity of the tripartite model of defenses in a language and culture different from the origins of the DMRS and DMRS-SR-30.

Comparing Psychoanalytic Process in Consulting Room and Teleconference: A Naturally Occurring Controlled Experiment

BACKGROUND

In response to COVID-19, clinicians migrated psychoanalyses to videoconference platforms, creating an opportunity for a controlled empirical study in which only the site varied.

HYPOTHESES

There will be no differences in the quality of the psychoanalytic process (QAP) in the consulting room (CR) and in videoconference (VC). Individuals' defensive functioning (adaptive style) will be associated with their capacity to maintain the analytic process when treatment moves from CR to VC. Underlying was the concept that empirical research of clinical psychoanalysis is possible.

PARTICIPANTS AND METHODS

Forty psychoanalysts of all ranks in the Accreditation Council for Psychoanalytic Education, Inc., accredited programs contributed 50 cases. Participants scored QAP at each site on a 0-to-100 scale. They reported patients' characteristic defense mechanisms using the Defensive Functioning Scale (DFS).

DATA ANALYSIS

To minimize bias, investigators calculated median DFS scores from data provided by clinicians. They compared QAP scores in CR and VC for the entire group without and with DFS scores, and for each DFS level (when feasible) using the related-samples Wilcoxon signed-rank test.

FINDINGS

There was no difference in QAP between CR and VC for the group as a whole; but QAP of the Minor Image Distorting group degraded significantly from CR to VC. This was the only group showing a significant difference.

CONCLUSIONS

While statistical significance may not reflect clinical significance, individual differences in adaptation to telepsychoanalysis warrant further study. Empirical research of phenomena occurring naturally in clinical psychoanalysis appears feasible.

Changes in Defense Mechanisms in Mothers From Pregnancy to 2 Years Postpregnancy

ABSTRACT

The objective of this study was to assess changes in maternal defensive functioning from the third trimester of pregnancy to 2 years postpregnancy. A community sample of at-risk mothers ( N = 84; non-White [61%], unmarried [67%], high school or less education [72%], and income less than $20,000 [50%]) were recruited for this longitudinal study. Mothers responded to a semistructured interview during pregnancy and at 2 years postpregnancy about the parent-infant relationship; interview transcripts were coded using the Defense Mechanism Rating Scale (DMRS). Results indicated a significant increase in both total defense mechanisms used and the relative percentage of immature defense mechanisms used over time. A significant decrease in the relative percentage of healthy/adaptive defenses was noted. When all seven levels of defenses of the DMRS were assessed, it was an increase in minor image-distorting defenses, mechanisms that supported vulnerable self-esteem, that accounted for most of the change in immature defenses. Stability coefficients of defense mechanisms were reported, with large effect sizes, for overall defensive functioning, and mature and immature defenses over a 2-year period. These findings lend support to the importance of assessing defense mechanisms to better understand stressful life transitions in mothers.

Thriving in midlife: The roles of childhood nurturance and adult defense mechanisms

The current study examined whether reliance on more adaptive defense mechanisms throughout early adulthood may help explain previously documented relationships between childhood nurturance and better midlife functioning. Utilizing a unique longitudinal study, data were from age 18 through midlife (age 63) on 135 males. Childhood nurturance was assessed upon study entry and defense mechanism usage was assessed throughout earlier adulthood. Percentage of 'engaging' (more adaptive) vs. 'avoidant' (less adaptive) defenses mediated the relationship between childhood nurturance and 3 midlife outcomes: participants' relationship quality with their children, marriage stability, and maximum earned income. Results suggest that greater childhood nurturance relates to more adaptive defensive styles in early adulthood, which is then associated with healthier midlife functioning at work and in relationships.

Understanding Defense Mechanisms

Understanding defense mechanisms is an important part of psychotherapy. In this article, we trace the history of the concept of defense, from its origin with Freud to current views. The issue of defense as an unconscious mechanism is examined. The question of whether defenses are pathological, as well as their relation to pathology, is discussed. The effect of psychotherapy on the use of defenses, and their relation to a therapeutic alliance is explored. A series of empirical research studies that demonstrate the functioning of defense mechanisms and that support the theory is presented. Research also shows that as part of normal development, different defenses emerge at different developmental periods, and that gender differences in defense use occur.

A response to Kyle Arnold's "intellectualization and its lookalikes": contributions from the empirical literature

In this article, we provide a response to Kyle Arnold's paper, "Intellectualization and Its Lookalikes." We provide a general review of the empirical literature on the study of the defense of intellectualization. We highlight the paucity of empirical findings on this topic, though note that the extant findings do provide some support for the utility of assessing intellectualization. We note how the concept of interrater reliability is an important part of any study of intellectualization, albeit empirically or clinically. We conclude that assessing the entire range of a patient's defenses can be most helpful in understanding his or her level of functioning.