Abstract
The psychodynamic concept of defense mechanisms is nowadays considered by professionals with various theoretical orientations of great importance in the understanding of human development and psychological functioning. More than half century of empirical research has demonstrated the impact of defensive functioning in psychological well-being, personality organization and treatment process-outcome. Despite the availability of a large number of measures for their evaluation, only a few instruments assess the whole hierarchy of defenses, based on the Defense Mechanisms Rating Scales (DMRS), which arguably offers an observer-rated gold standard of assessment. The present article illustrates the theoretical and methodological background of the DMRS-Q, the Q-sort version of the DMRS for clinical use. Starting from the definition and function of the 30 defense mechanisms included in the hierarchy, we extracted 150 items that captured a full range of defensive manifestations according to the DMRS theory. The DMRS-Q set is described in this paper with reference to the DMRS manual. Directions are also provided for using the DMRS-Q online software for the free and unlimited coding of defense mechanisms. After each coding, the DMRS-Q software provides a report including qualitative and quantitative scores reflecting the individual’s defensive functioning. Qualitative scores are displayed as the Defensive Profile Narratives (DPN), while quantitative scores are reported as Overall Defensive Functioning (ODF), defensive categories, defense levels, and individual defense mechanisms. Syntax for the scoring is displayed in the results and a clinical vignette of a psychotherapy session coded with the DMRS-Q is provided. The DMRS-Q is an easy-to-use, free, computerized measure that can help clinicians in monitoring changes in defense mechanisms, addressing therapeutic intervention, fostering symptoms decreasing and therapeutic alliance. Moreover, the DMRS-Q might be a valid tool for teaching the hierarchy of defense mechanisms and increase the observer-rated assessment of this construct in several research fields.
Highlights
The psychodynamic concept of defense mechanisms, defined as automatic psychological mechanisms that mediate the individual’s reaction to emotional conflicts and to internal or external stressors (American Psychiatric Association, 2013; Perry, 2014), has been extensively studied since its first appearance in Freud’s psychoanalytic theory (Freud, 1894)
While the Defense Mechanisms Rating Scales (DMRS) is necessary for some types of research, we developed the DMRS-Q to meet the needs of a quicker, more user-friendly computerized tool for the assessment of defense mechanisms in clinical setting (Di Giuseppe et al, 2020b,c)
The DMRS-Q software automatically lists these items and indicates the defense level and individual defense mechanism associated with each item
Summary
The psychodynamic concept of defense mechanisms, defined as automatic psychological mechanisms that mediate the individual’s reaction to emotional conflicts and to internal or external stressors (American Psychiatric Association, 2013; Perry, 2014), has been extensively studied since its first appearance in Freud’s psychoanalytic theory (Freud, 1894). The main contribution to the gold-standard approach to the study of defense mechanisms has been provided by the theory of defensive adaptiveness and the hierarchical organization of defense mechanisms proposed by Vaillant (1971, 1992) and operationalized by Perry (1990). In his extensive and valuable work, Vaillant described excellent clinical vignettes of defenses as they operate in real life – both in momentary examples, and those that recur over time – and integrated findings from several longitudinal studies demonstrating the evolution of defense mechanisms over the life cycle. We describe theoretical background, coding procedure, scoring system and results interpretation of the DMRS-Q, a computerized observerrated Q-sort for the assessment of defense mechanisms in clinical setting
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