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An Empirical Study of the Relationship Between Diagnosis and Defense Style

Michael Peter Bond, MD; Jacqueline Sagala Vaillant, MD
Arch Gen Psychiatry. 1986;43(3):285-288. doi:10.1001/archpsyc.1986.01800030103012.
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• The relationship between DSM-III diagnosis and defense style was studied in a sample of 74 psychiatric patients. The subjects completed a self-administered questionnaire composed of 81 statements about behaviors, thoughts, and feelings, which were designed to reflect various unconscious defense mechanisms. Factor analysis yielded four defense styles ranging on a continuum from primitive to mature. Patients' defense styles were compared with their diagnoses on axes I, II, and IV of DSM-III. Significant relationships were found between defense style and only one diagnosis, major affective disorder. The fact that DSM-III diagnosis could not predict defense style suggests that diagnosis and defense style are two independent dimensions. If this can be confirmed by further, more adequate studies, a sixth axis reflecting psychodynamic formulation would provide additional information necessary for therapeutic planning.


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