Personality, personality disorders, and defense mechanisms

Denial, Attention-Seeking, and Posting Online While Intoxicated: Three Key Predictors of Collegiate Sadfishing

Sadfishing, or the exaggeration of one's emotional state online to generate sympathy, is a maladaptive behavior that can negatively affect mental health. A better understanding of the characteristics of individuals who sadfish could inform tailored interventions to decrease sadfishing and improve quality of life. However, to date, the phenomenon of sadfishing remains understudied. Thus, the current project was designed to identify some of the key psychological and behavioral characteristics that may be associated with sadfishing. Undergraduate college students (N = 374) recruited from introductory psychology courses at a large, Hispanic-serving institution completed an anonymous online survey assessing sadfishing and other online behaviors, psychological characteristics (coping, stress, resilience, and social support), and alcohol use. Both univariate and multivariate statistical analyses were conducted. Results of the binary logistic regression analysis found that students who reported using denial as a coping strategy (p = 0.005), who endorsed the attention-seeking behaviors associated with histrionic personality disorder (p = 0.021), and who used social media while intoxicated (p = 0.017) were most likely to report sadfishing. This study furthers our knowledge of the maladaptive online behavior of sadfishing and identifies several key predictors that could become targets for tailored interventions. In particular, our results highlight the importance of coping skills training for individuals who sadfish.

Maladaptive (dark-side) and adaptive (bright-side) personality traits and defense styles

This study explores the relationship between bright- and dark-side personality traits and four major styles of defense mechanisms (DMs) as this relationship remains unexplored and important in understanding the DMs. In all, 435 adult working participants (241 men; 194 women; Mean age 46.06 yrs) mainly in middle management jobs, completed a 78-item, six-trait measure of bright-side personality (HPTI: High Potential Type Indicator), a 25-item five-trait measure of the dark-side personality (PID-5;BF: DSM-5-Brief Form) and 88-item, four-styles measure of defense mechanisms (Defense Style Questionnaire). The aim was to examine demographic (sex, age, education), ideological and personality trait correlates of the DMs. It was hypothesized that the dark-side traits, particularly Detachment would be most strongly related to the DMs. Thereafter, a hierarchical linear regression was performed with each DM factor as criterion and predictors being demography, ideology, self-esteem as well as bright- and dark-side personality traits. Detachment was associated with all DMs, particularly Maladaptive (r = 0.68) and Image Distorting Style (r = 0.38) while Conscientiousness was associated with none. One implication concerns the assessment of DMs by standard tests. Limitations are acknowledged and include method invariance and sample homogeneity.

Probabilistic graphical model for the evaluation of the emotional and dramatic personality disorders

Personality disorders are psychological ailments with a major negative impact on patients, their families, and society in general, especially those of the dramatic and emotional type. Despite all the research, there is still no consensus on the best way to assess and treat them. Traditional assessment of personality disorders has focused on a limited number of psychological constructs or behaviors using structured interviews and questionnaires, without an integrated and holistic approach. We present a novel methodology for the study and assessment of personality disorders consisting in the development of a Bayesian network, whose parameters have been obtained by the Delphi method of consensus from a group of experts in the diagnosis and treatment of personality disorders. The result is a probabilistic graphical model that represents the psychological variables related to the personality disorders along with their relations and conditional probabilities, which allow identifying the symptoms with the highest diagnostic potential. This model can be used, among other applications, as a decision support system for the assessment and treatment of personality disorders of the dramatic or emotional cluster. In this paper, we discuss the need to validate this model in the clinical population along with its strengths and limitations.

Three Dimensional Approaches to Personality Disorders: a Review on Personality Functioning, Personality Structure, and Personality Organization

PURPOSE OF REVIEW

The concept of personality functioning (Alternative DSM-5 Model of Personality Disorders) has led to increased interest in dimensional personality disorder diagnosis. While differing markedly from the current categorical classification, it is closely related to the psychodynamic concepts of personality structure and personality organization. In this review, the three dimensional approaches, their underlying models, and common instruments are introduced, and empirical studies on similarities and differences between the concepts and the categorical classification are summarized. Additionally, a case example illustrates the clinical application.

RECENT FINDINGS

Numerous studies demonstrate the broad empirical basis, validated assessment instruments and clinical usefulness of the dimensional concepts. Their advantages compared to the categorical approach, but also the respective differences, have been demonstrated empirically, in line with clinical observations. Evidence supports the three dimensional concepts, which share conceptual overlap, but also entail unique aspects of personality pathology, respectively.

It's Not That Great Anymore: The Central Role of Defense Mechanisms in Grandiose and Vulnerable Narcissism

Objectives: The concept of narcissism contains a yet unresolved paradox: Its grandiose facet depicts the psychopathological core but is often associated with life-satisfaction and overall functioning, whereas its vulnerable facet is associated with psychological distress, but still not included in the international classification systems. Our goal was to investigate the relationship between the two facets of narcissism expecting underlying defense mechanisms to be core elements. First, we aimed to identify defense mechanisms specific to grandiose and vulnerable narcissism. Second, we explored how both facets are differentially associated with psychological distress, assuming that grandiose narcissism would be associated with less psychological distress than vulnerable narcissism. Third, we investigated the mediating role of defense mechanisms between narcissism and psychological distress. Methods: In a non-clinical sample of N = 254 individuals, the Pathological Narcissism Inventory was used for the assessment of grandiose and vulnerable facets of narcissism, the Defense Style Questionnaire for defense mechanisms, and the Brief Symptom Inventory for psychological distress. Structural equation modeling was employed to identify distinct factors of grandiose and vulnerable narcissism. Associations between specific defense mechanisms and both facets were calculated. Furthermore, the direct association between both facets and psychological distress was examined. We finally explored whether defense mechanisms mediate the association between distress and both grandiose and vulnerable narcissism. Results: A distinct pattern of defense mechanisms for each facet of narcissism could be extracted: Both facets showed significant positive correlations with specific intermediate and all maladaptive defense mechanisms. Only grandiose narcissism showed significant positive correlations with adaptive defenses. Vulnerable narcissism showed negative correlations with all adaptive defenses. Specifically, grandiose narcissism was significantly related to anticipation, pseudo-altruism, rationalization, and dissociation, whereas vulnerable narcissism was negatively related to all these defense mechanisms. While grandiose narcissism was not related to psychological distress, vulnerable narcissism showed high correlations with psychological distress. Intriguingly, mediator analysis found that grandiose narcissism was related to psychological distress when mediated by maladaptive defense mechanisms. Discussion: The role of defense mechanisms is central for a differentiated understanding of the two different faces of narcissism. The relevance of assessing defense mechanisms in clinical settings, and related empirical findings are discussed.

The Role of Interpersonal Problem Solving in Using the Immature Defense Mechanisms in Adolescents

The purpose of this study was to examine associations between interpersonal problem solving and immature defense mechanisms in addition to whether interpersonal problem solving are predictors of immature defense mechanisms. The participants of the study consists of 428 high schools students (184 of the students were females). Interpersonal Problem Solving Inventory and Defense Style Questionnaire were applied. Results of multiple regression analyses indicated that all variables of interpersonal problem solving skills together accounted for 32% of the variance in defense mechanisms. Specifically, significant predictors of immature defense mechanisms levels were lack of self-confidence, negative approach to the problems, constructive problem solving respectively. Generally, the levels of adolescents resort to immature defense mechanisms, lack of self-confidence and negative approach to the problem of the increase, a decrease in constructive problem-solving skills are seen to be effective. The results of the study was discussd within the results of the previous studies.

Investigating Correlations Between Defence Mechanisms and Pathological Personality Characteristics

INTRODUCTION

The purpose of this study was to investigate the relationship between defence mechanisms and pathological personality traits.

MATERIAL AND METHODS

We analysed 320 participants aged from 18 to 64 years (70.6% women, 87.5% university students) who completed the Dimensional Clinical Personality Inventory (IDCP) and the Defence Style Questionnaire (DSQ-40). We conducted comparisons and correlations and a regression analysis.

RESULTS

The results showed expressive differences (d>1.0) between mature, neurotic and immature defence mechanism groups, and it was observed that pathological personality traits are more typical in people who use less mature defence mechanisms (i.e., neurotic and immature), which comprises marked personality profiles for each group, according to the IDCP. We also found correlations between some of the 40 specific mechanisms of the DSQ-40 and the 12 dimensions of pathological personality traits from the IDCP (r ≥ 0.30 to r ≤ 0.43), partially supported by the literature. In addition, we used regression analysis to verify the potential of the IDCP dimension clusters (related to personality disorders) to predict defence mechanisms, revealing some minimally expressive predictive values (between 20% and 35%).

DISCUSSION

The results indicate that those who tend to use immature defence mechanisms are also those most likely to present pathological personality traits.

CONCLUSIONS

The findings indicate the importance of investigating these correlations as a possible improvement to clinical assessment and intervention.

Narcissism and Interpersonal Problems Among Psychiatric Outpatients: What Is the Role of Defensive Style?

A growing body of evidence points to significant interpersonal problems associated with narcissism in clinical samples. Less well understood are the mechanisms by which narcissism negatively impacts one's interpersonal functioning. The present study investigated defensive style as a possible mediator of the relationship between narcissism and interpersonal problems. A sample of 53 adult psychiatric outpatients completed measures of narcissism, defensive style, interpersonal problems, and current symptom distress. Mediation analysis was conducted, controlling for current symptom distress, using 95% bootstrapped confidence intervals to examine the indirect effect of narcissism on interpersonal problems via defensive style. Narcissism was significantly associated with immature and neurotic defensive styles. Although narcissism was not directly related to interpersonal problems, a significant indirect effect was observed for narcissism on interpersonal problems via neurotic defensive style. This finding suggests that narcissism contributes to the use of neurotic defenses, which in turn influence one's interpersonal functioning.

The Relationship between Defense Patterns and DSM-5 Maladaptive Personality Domains

Aim: Research has extensively examined the relationship between defense mechanisms (DM) and personality traits. However, no study to date has explored if specific defenses (alone or in combination) are able to predict dysfunctional variants of personality domains, as conceived in the alternative DSM-5 model for personality disorders. This study aimed to investigate the relationship between DMs and DSM-5 maladaptive personality domains among adults.

Materials and Methods: Three hundred and twenty-eight adults aged between 18 and 64 years old completed measures on DMs and maladapive personality domains. Regression analyses were performed to determine which DMs predicted the maladaptive personality domains of negative affectivity, detachment, antagonism, disinhibition, and psychoticism.

Results: According to psychoanalytic literature, results showed that immature defenses positively predicted maladaptive personality domain scores, whereas mature defenses were generally related with better personality functioning. Moreover, different defense patterns emerged as significant predictors of the maladaptive personality domains comprised in the alternative DSM-5 model for personality disorder.

Discussion: Our findings support the view that defense patterns represent core components of personality and its disorders, and suggest that an increased use of immature defenses and a reduced use of mature defenses have a negative impact on the development of personality.

Changing views of emotion regulation and neurobiological models of the mechanism of action of psychotherapy

Influential neurobiological models of the mechanism of action of psychotherapy attribute its success to increases of activity in prefrontal areas and decreases in limbic areas, interpreted as the successful and adaptive recruitment of controlled processes to achieve emotion regulation. In this article, we review the behavioral and neuroscientific evidence in support of this model and its applicability to explain the mechanism of action of psychotherapy. Neuroimaging studies of explicit emotion regulation, evidence on the neurobiological substrates of implicit emotion regulation, and meta-analyses of neuroimaging studies of the effect of psychotherapy consistently suggest that areas implicated in coding semantic representations play an important role in emotion regulation not covered by existing models based on controlled processes. We discuss the findings that implicate these same areas in supporting working memory, in encoding preferences and the prospective outcome of actions taken in rewarding or aversive contingencies, and show how these functions may be integrated into process models of emotion regulation that depend on elaborate semantic representations for their effectiveness. These alternative models also appear to be more consistent with internal accounts in the psychotherapeutic literature of how psychotherapy works.

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.

Defense Mechanism Card Pull in TAT Stories

This study investigates the question of whether different Thematic Apperception Test (TAT; Murray, 1943 ) cards are likely to prompt stories that are characterized by different defense mechanisms. This condition is known as card pull and refers to the probability that different TAT cards elicit different personality scores for the same variable. If so, the assessment of defense use would be importantly influenced by the TAT cards used in an assessment. TAT stories from 3 different community samples were examined (Ns = 91, 98, 121), using a statistical method developed by Stein et al ( 2014 ). The results indicated that different TAT cards pull for different defenses, as assessed by the Defense Mechanism Manual (DMM: Cramer, 1991b ). However, the nature of card pull was not always consistent across samples. These dissimilarities could be due to group differences, or to the presence of different TAT cards used in the test battery, indicating that card pull is importantly determined by context.

Childhood Precursors of Adult Borderline Personality Disorder Features: A Longitudinal Study

This study identifies childhood personality traits that are precursors of adult Borderline Personality Disorder (BPD) features. In a longitudinal study, childhood personality traits were assessed at age 11 (N = 100) using the California Child Q-set (CCQ: Block and Block, 1980). A number of these Q-items were found to be significantly correlated (p < 0.001) with a prototype-based measure of BPD features at age 23. Factor analysis of these Q-items suggested that they could be characterized by two underlying personality dimensions: Impulsivity and Nonconformity/Aggression. The findings thus provide evidence that childhood personality traits predict adult BPD features. Identifying such childhood precursors provides an opportunity for early intervention.

The physician's quality of life: Relationship with ego defense mechanisms and object relations

OBJECTIVE

To assess whether ego defense mechanisms and object relations (the way an individual subjectively experiences his/her relationships with others) are related to quality of life among physicians.

METHODS

In this cross-sectional mail survey, 602 physicians from Botucatu, SP, Brazil, were sent a socio-demographic questionnaire, the Bell Object Relations and Reality Testing Inventory-Form O (BORRTI-O), the Defense Style Questionnaire-40 (DSQ-40), and the World Health Organization Abbreviated Instrument for Quality of Life Assessment (WHOQOL-BREF).

RESULTS

198 questionnaires (33%) with valid responses were obtained. High BORRTI-O scores (indicative of pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health and social relationship domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for all domains. No significant associations of WHOQOL-BREF scores with working hours, workplace or monthly income were observed in the study population

CONCLUSIONS

WHOQOL-BREF scores correlated with mature defense mechanisms and normal object relations, suggesting an association between psychological maturity and quality of life among physicians.

Defense mechanisms: 40 years of empirical research

This article reviews research on defense mechanisms carried out over the past 40 years with children, adolescents, adults, and psychiatric patients. Both experimental and observational studies are included.

Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders

Numerous authors have theorized that defense mechanisms play a role in personality disorders. We reviewed theoretical writings and empirical studies about defenses in schizotypal, borderline, antisocial, and narcissistic personality disorders, developing hypotheses about these differential relationships. We then examined these hypotheses using dynamic interview data rated for defenses in a study of participants (n = 107) diagnosed with these four personality disorder types. Overall, the prevalence of immature defenses was substantial, and all four disorders fit within the broad borderline personality organization construct. Defenses predicted the most variance in borderline and the least variance in schizotypal personality disorder, suggesting that dynamic factors played the largest role in borderline and the least in schizotypal personality. Central to borderline personality were strong associations with major image-distorting defenses, primarily splitting of self and other's images, and the hysterical level defenses, dissociation and repression. Narcissistic and antisocial personality disorders shared minor image-distorting defenses, such as omnipotence or devaluation, while narcissistic also used splitting of self-images and antisocial used disavowal defenses like denial. Overall, differential relationships between specific defenses and personality disorder types were largely consistent with the literature, and consistent with the importance that the treatment literature ascribes to working with defenses.

Preliminary study of relationships between hypnotic susceptibility and personality disorder functioning styles in healthy volunteers and personality disorder patients

BACKGROUND

Hypnotic susceptibility is one of the stable characteristics of individuals, but not closely related to the personality traits such as those measured by the five-factor model in the general population. Whether it is related to the personality disorder functioning styles remains unanswered.

METHODS

In 77 patients with personality disorders and 154 healthy volunteers, we administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC) and the Parker Personality Measure (PERM) tests.

RESULTS

Patients with personality disorders showed higher passing rates on SHSSC Dream and Posthypnotic Amnesia items. No significant correlation was found in healthy volunteers. In the patients however, SHSSC Taste hallucination (β=0.26) and Anosmia to Ammonia (β=-0.23) were significantly correlated with the PERM Borderline style; SHSSC Posthypnotic Amnesia was correlated with the PERM Schizoid style (β=0.25) but negatively the PERM Narcissistic style (β=-0.23).

CONCLUSIONS

Our results provide limited evidence that could help to understand the abnormal cognitions in personality disorders, such as their hallucination and memory distortions.

What is the relationship between alexithymia and ego defense styles? A correlational study with Iranian students

The relationship between alexithymia and ego defense styles was investigated in a sample of Iranian students. The association between the components of alexithymia including difficulty in identifying and describing feelings and externally oriented thinking with ego defense styles including mature, neurotic, and immature defense styles was investigated in two hundred and eighty six students in the University of Tehran. All participants were asked to complete the Farsi version of the Toronto Alexithymia Scale (FTAS-20) and Defense Styles Questionnaire (DSQ). Results showed that there was a significant negative correlation between alexithymia and mature defense style as well as a significant positive association with neurotic and immature defense styles. It is concluded that alexithymia is associated with ego defense mechanisms. Results are discussed in terms of the implications of the present results in terms of designing possible modification and intervention programmes as well as answering important theoretical questions.

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

OBJECTIVE

We assess the convergent and predictive validity of the Defensive Functioning Scale (DFS) with measures of life events, including childhood abuse and adult partner victimization; dimensions of psychopathology, including axis I (depressive) and axis II (borderline personality disorder) symptoms; and quality of object relations.

METHOD

One hundred and ten women from a university-based urban primary care clinic completed a research interview from which defense mechanisms were assessed. The quality of object relations was also assessed from interview data. The women completed self-report measures assessing depression, borderline personality disorder symptoms, childhood physical and sexual abuse, and adult partner physical and sexual victimization.

RESULTS

Inter-rater reliability of the scoring of the DFS levels was good. High adaptive defenses were positively correlated with the quality of object relations and pathological defenses were positively correlated with childhood and adult victimization and symptom measures. Although major image distorting defenses were infrequently used, they were robustly correlated with all study variables. In a stepwise multiple regression analysis, major image distorting defenses, depressive symptoms, and minor image distorting defenses significantly predict childhood victimization, accounting for 37% of the variance. In a second stepwise multiple regression analysis, borderline personality disorder symptoms and disavowal defenses combined to significantly predict adult victimization, accounting for 16% of the variance.

CONCLUSIONS

The DFS demonstrates good convergent validity with axis I and axis II symptoms, as well as with measures of childhood and adult victimization and object relations. The DFS levels add nonredundant information to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition beyond axis I and axis II.

[Hysteria I. Histrionic personality disorder. A psychotherapeutic challenge]

What is left of Freud's hysteria in modern diagnostics is the histrionic personality. Psychological and somatic functional disorders, such as dissociative and somatoform disorders are freed from the label of being hysterical, but even the histrionic personality disorder does not enjoy professional agreement as far as diagnostics and therapy are concerned. This disorder is characterized by dramatization, suggestibility, superficial changing affects, impressionist cognitive style, preoccupation with outward appearance, seductive behavior and the wish to take centre stage, a compensatory attitude resulting from important childhood relationships. A comorbidity with narcissistic and antisocial personality exists and also with ADHS.

Defensive projection, superimposed on simplistic object relations, erodes patient-provider relationships in high-risk pregnancy: an empirical investigation

In an attempt to illustrate the relevance of psychoanalytic theory and research to behavior medicine, an empirical investigation was conducted of females treated at a high-risk pregnancy specialty clinic (N = 58). Drawing from psychoanalytic object relations theory, it was hypothesized and confirmed that use of projection as a defense mechanism during pregnancy, superimposed on simplistic object relations, predicted an erosion of patient-provider relationships during the pregnancy/postdelivery period. Findings are interpreted through the perspective of mentalization, pertaining to individuals' ability to understand the mental states of self and others, specifically under significant stress. Implications for psychoanalytically oriented assessment and treatment, and for the rift between psychoanalysis and research, are discussed.

Attachment style and defense mechanisms in parents who abuse their children

Adult attachment style, defense mechanisms, and personal history of abuse was studied in a group of abusive parents. As a group, these parents made unusually high use of the defense of denial; this was especially true of those with a Fearful attachment style. However, the use of Identification was characteristic of those with a Preoccupied attachment style. Further, personal abuse history was related to adult attachment style. Those who reported having been abused as a child were less likely to have a Secure attachment style, and a history of physical or sexual abuse was associated with a Preoccupied style. In general, these findings support the deactivating/hyperactivating defensive theory of Mikulincer et al (Emotion Regulation in Couples and Families: Pathways to Dysfunction and Health. 2006; pp 77-99. Washington (WA): American Psychological Association).

The role of defense mechanisms in borderline and antisocial personalities

We examined whether borderline personality disorder (BPD) and antisocial personality disorder (APD) could be differentiated based on defense mechanisms as measured by observer (Defense-Q; MacGregor, Olson, Presniak, & Davidson, 2008) and self-report (Defense Style Questionnaire; Andrews, Singh, & Bond, 1993) measures. We conducted 2 studies whereby nonclinical participants were divided into borderline and antisocial groups based on scores from the Personality Assessment Inventory (Morey, 1991). Multivariate analysis of variance results revealed significant overall group differences in defense use. Univariate analyses further showed group differences on several individual defenses (e.g., acting out, denial, and turning against self). Together, the findings suggest that in BPD, the defenses may emphasize interpersonal dependency and a tendency to direct aggression toward the self; whereas in APD, the defenses may emphasize egocentricity, interpersonal exploitation, and a tendency to direct aggression toward others. Overall, this study demonstrates important differences in defense use between borderline and antisocial personality groups across both observer and self-report measures.

Defense Mechanisms and Self-Reported Violence Toward Partners and Strangers

We examined the relationship between defense mechanisms and self-reported violence toward partners and toward strangers in a sample of college student men. Fifty men completed the Thematic Apperception Test (TAT; Murray, 1943) and the Conflict Tactics Scale (CTS; Straus, 1979), a self-report measure of strategies (including violence) for resolving conflicts with partners and strangers. The TAT responses were coded for defense mechanisms with the Defense Mechanisms Manual (Cramer, 1991b). The relative use of identification was negatively correlated (r = -.49, p <.001), and the relative use of projection was positively correlated (r =.49, p <.001) with the most extreme CTS report of violence toward partners. The relative use of identification was negatively correlated with the most extreme CTS report of violence toward strangers (r = -.34, p <.05). The relative use of denial was positively correlated with the most extreme CTS report of violence toward strangers (r =.32, p <.05).

Defense mechanisms in adolescent conduct disorder and adjustment reaction

The use of defense mechanisms by male and female adolescents with a diagnosis of conduct disorder was compared with the defense use of adolescents with a diagnosis of adjustment reaction. Because conduct disorder has been shown to be associated with a developmental lag in several areas of psychological functioning, we expected that these adolescents would show immaturity in the use of defenses. This expectation was confirmed. As compared with adjustment reaction, conduct disordered youths were more likely to use the immature defense of denial and less likely to use the mature defense of identification.

Defense mechanisms and psychological adjustment in childhood

The association between maturity of defense use and psychological functioning was assessed in a group of 95 elementary school children. Defense mechanisms were measured using a valid and reliable storytelling task, and psychological adjustment was assessed through a combination of parent and self-report questionnaires. Correlational analyses indicated that children who relied on the developmentally immature defense of denial reported higher levels of self-rated social anxiety and depression and received higher ratings of parent-reported internalizing and externalizing behavior problems. However, children who made use of the developmentally mature defense of identification exhibited higher scores on perceived competence in social, academic, conduct, athletic, and global domains. Significantly, there was no relationship between children's use of denial and their level of perceived competence or between children's use of identification and their degree of maladjustment.

A critique of Lilienfeld et al.'s (2000) "The scientific status of projective techniques"

Lilienfeld, Wood, and Garb (2000) published a largely negative critique of the validity and reliability of projective methods, concentrating on the Comprehensive System for the Rorschach (Exner, 1993), 3 systems for coding the Thematic Apperception Test (TAT; Murray, 1943) cards, and human figure drawings. This article is an effort to document and correct what I perceive as errors of omission and commission in the Lilienfeld et al. article. When projective measures are viewed in the light of these corrections, the evidence for the validity and clinical usefulness of the Rorschach and TAT methods is more robust than Lilienfeld et al. represented.

Defense mechanisms and physiological reactivity to stress

The relation between the use of defense mechanisms and autonomic nervous system reactivity, under conditions of laboratory stress, was studied in 78 men and women. Both diastolic blood pressure (DBP) and skin conductance level (SCL) were monitored during exposure to ten stress tasks; concurrently, the use of three defense mechanisms was assessed by coding Thematic Apperception Test stories. Autonomic reactivity was found to be related to defenses; the nature of that relation differed across the defenses. DBP, typically found to be associated with cognitive work, was higher in those individuals who used more Identification, a defense that requires greater cognitive activity. The use of Projection, on the other hand, was associated with lower DBP. In addition, the use of Identification showed a tendency to be associated with lower SCL.

Object relations and defense mechanisms of a psychopathic serial sexual homicide perpetrator: a TAT analysis

The case of a 24-year-old African American man who committed serial sexual homicide and who met criteria (Hare, 1991) for psychopathy is presented. His Thematic Apperception Test (Murray, 1943) responses were used to code key aspects of personality organization--object relations and defense mechanisms--via the Social Cognition and Object Relations Scale (Westen, Lohr, Silk, & Kerber, 1989) and the Defense Mechanisms Manual (Cramer, 1991), respectively. Severe object relations pathology and a reliance on the defense mechanism of immature projection and immature denial are noted. Findings are relatively consistent with previous psychodynamic Rorschach studies of psychopathic sexual homicide perpetrators (Gacono, Meloy, & Bridges, 2000; Meloy, Gacono, & Kenney, 1994).