Observer-rated measures of defense mechanisms

Observer-rated measures of defense mechanisms are the direct lineal descendants of Freud's clinical proposition that an observer can reasonably infer defensive operations in an individual of which the individual himself or herself is unaware. Assessment methods of defenses have used both projective testing and clinical interview data. Recent Rorschach test methods have focused on borderline and neurotic-level defenses used to discriminate diagnostic groups and predict other aspects of functioning. A TAT method has demonstrated some evidence for age progression in the development of defensive functioning and for regression in defensive functioning following psychological stress. While interrater reliability is generally good, the methods are limited by the availability of the testing situation and the need to demonstrate generalization to external situations. Following the early introduction of systematic methods by Haan and Vaillant, a number of methods use clinical interview data to assess specific defenses and overall defensive functioning. These methods identify defenses either as qualitative categories, rank-ordered scores by Q-sort, or actual counts of each instance a defense is used. Summary scores are generally of good reliability, with wider variation for individual defenses. There is wide variation on Graining required, ease of use, and levels of validation. A review of some correlates of each method suggests that the instruments have a robust potential for use in fundamental and applied clinical research. While each method has some clear applications, the quantitative clinical interview methods appear best adapted to microanalytic process research on issues of defensive change in treatment.