BRIEF REPORTS
A Study of the Face Validity of the 40 Item Version of the
Defense Style Questionnaire (DSQ-40)
Henri Chabrol, MD, PhD,* Amélie Rousseau, PhD,* Rachel Rodgers, MA,* Stacey Callahan, PhD,*
Gérard Pirlot, MD, PhD,† and Henri Sztulman, MD, PhD*
Abstract: There are few studies examining the face validity of the
40-item version of the Defense Style Questionnaire (DSQ-40).
Moreover, the existing studies have provided conflicting results. The
present study provides an in-depth examination of the face validity
of the DSQ-40. Eight clinicians independently attributed each item
of the DSQ-40 to a defense mechanism. The defense mechanisms
listed in the DSM-IV Defensive Functioning Scale and their defini-
tions were provided as a guide, along with the definition of those
defense mechanisms investigated by the DSQ that are not included.
It was further specified that the raters could attribute the items to
defense mechanisms other than those listed or coping mechanisms.
Twelve items out of 40 (30%) were attributed to the defense
mechanisms they were supposed to investigate by fewer than four
out of the eight raters. This result suggests that a substantial part of
the DSQ-40 is lacking in face validity.
Key Words: DSQ-40, defense mechanisms, face validity.
(J Nerv Ment Dis 2005;193: 756-758)
T he 40-item version of the Defense Style Questionnaire
(DSQ-40; Andrews et al., 1993) is currently the most
frequently used self-report measure for defense mechanisms.
The DSQ-40 derives from a previous 88-item version (Bond
et al., 1983) that was first relabeled in terms of DSM-III-R
defenses (Andrews et al., 1989). Despite elements in favor of
the fidelity and validity of the different versions of the DSQ,
they share the same limitations as other self-report measures
of defense mechanisms (Davidson and McGregor, 1998).
To our knowledge, there are only three studies of the
face validity of the items composing the DSQ-40. The first
study evaluated the face validity of the version proposed by
Andrews et al. (1989) by assessing the degree of agreement
among three analytically oriented clinicians as to which
defense each item represented. Agreement was found for
74% of the items, and the items with insufficient face validity
*Université de Toulouse-Le Mirail, Toulouse, France; and †Université de
Paris X-Nanterre, Nanterre, France.
Send reprint requests to Henri Chabrol, MD, UFR de Psychologie, Université
de Toulouse-Le Mirail, 5 allées Antonio Machado, 31058 Toulouse
Cedex 9, France.
Copyright © 2005 by Lippincott Williams & Wilkins
ISSN: 0022-3018/05/19311-0756
DOI: 10.1097/01.nmd.0000185869.07322.ed
756 The Journal of Nervous and Mental Disease • Volume 193, Number 11, November 2005
were not explicitly mentioned; these results appear to be
significantly limited. A second study was conducted on the
revised version proposed by Andrews et al. (1993). The
authors provided no information as to the procedure of
the assessment of the face validity. They stated, however, that
“even in this present revision, there are still some items for
which a perfect consensus was not reached. Some items with
good face validity were discarded and others with less than
ideal face validity were included. It must be remembered,
however, that the allocation of such items to a particular
defense was made on other criteria assessing construct and
criterion related validity” (p. 248). Again, the items with low
face validity were not explicitly stated.
Bonsack et al. (1998), who translated and validated the
88-item French version, went on to publish the first face
validity study to be conducted independently of the DSQ
authors: five independent experts with previous experience of
psychotherapy or research attributed each item to one of the
24 defense mechanisms. When available, the DSM-IV defi-
nitions were used (American Psychiatric Association, 1994).
Two items alone did not achieve a consensus and had to be
reformulated (nos. 7 and 77). Therefore, face validity ap-
peared to be excellent. Most of the DSQ-40 items originate in
the 88-item version. Only three items are new: one for autistic
fantasy and two for rationalization. Items 7 and 77 from the
88-item version were not included in the DSQ-40. Thus, there
is a discrepancy in the estimation of the face validity of DSQ
items in the three studies.
The present study provides a detailed examination of
DSQ-40 face validity.
METHODS
Eight clinicians with previous experience in psychody-
namic therapies, clinical research in psychodynamic psycho-
pathology, or both independently attributed each item of the
DSQ-40 to a defense mechanism. The clinicians were not
familiar with the DSQ-40 and were unaware that these were
DSQ items. The defense mechanisms listed in the DSM-IV
Defensive Functioning Scale and their definitions were pro-
vided as a guide, along with the definition of those defense
mechanisms investigated by the DSQ that are not included. It
was further specified that the raters could attribute the items
to defense mechanisms other than those listed or to coping
strategies.
The Journal of Nervous and Mental Disease • Volume 193, Number 11, November 2005 Face-Validity of the DSQ

TABLE 1. DSQ-40 Items With a Low Face Validity, Defenses They Are Supposed to Explore, and
Proportion of Raters Agreeing With This Attribution
Defense Supposed Frequency of
Items to be Explored Attribution
Doctors never really understand what is wrong with me Displacement 0/8
I’ve special talents that allow me to go through life with no problems Dissociation 0/8
I am a very inhibited person Devaluation 0/8
I pride myself on my ability to cut people down to size Devaluation 0/8
If I were in a crisis, I would seek out another person who had the same problem Pseudo-altruism 1/8
I ignore danger as if I was Superman Dissociation 1/8
When I’m depressed or anxious, eating makes me feel better Displacement 1/8
I am sure I get raw deal from life Projection 2/8
After I fight for my rights, I tend to apologize for my assertiveness Undoing 2/8
People tend to mistreat me Projection 3/8
I’m often told that I don’t show my feelings Isolation 3/8
No matter how much I complain, I never get a satisfactory response Passive aggression 3/8

RESULTS
Twelve items out of 40 (30%) of this version of the
DSQ were attributed to the defense mechanisms they were
supposed to investigate by fewer than four out of the eight
raters: 0/8 for four items, 1/8 for three items, 2/8 for two
items, and 3/8 for three items. These items that appear to have
unsatisfactory face validity can be found in Table 1.
The items supposed to explore devaluation, “I am a
very inhibited person” and “I pride myself on my ability to
cut people down to size,” were mainly attributed to a deficit
in self-assertion for the former and to omnipotence for the
latter. The items considered to investigate displacement,
“Doctors never really understand what is wrong with me” and
“When I’m depressed or anxious, eating makes me feel
better,” were mainly ascribed to somatization in the case of
the former and to acting out or a form of avoidant coping for
the latter. The items, “I ignore danger as if I were Superman”
and “I’ve special talents that allow me to go through life with
no problems,” expected to explore dissociation, were princi-
pally considered to express denial for the former and omnip-
otence for the latter. The items presumed to investigate
projection, “I am sure I get raw deal from life” and “People
tend to mistreat me,” were principally attributed to a negative
view of the world revealing depressive cognitions. The item,
“If I were in a crisis, I would seek out another person who had
the same problem,” supposed to explore pseudo-altruism, was
mainly ascribed to affiliation, which is one of the defenses of
the high adaptive level of the DSM-IV Defensive Functioning
Scale. The item, “I’m often told that I don’t show my
feelings,” considered to investigate isolation, and the item,
“After I fight for my rights, I tend to apologize for my
assertiveness,” supposed to evaluate undoing, were mainly
attributed to a deficit in self-assertion, which is included in
the DSM-IV highly adaptive level. The item, “No matter how
much I complain, I never get a satisfactory response,” ex-
pected to investigate passive aggression, was attributed to
regression, to the DSM-IV help-rejecting complaining, to a
lack of self-assertion, or to a lack of a form of problem-
focused coping, information-seeking.
The mean frequency with which the other items were
correctly attributed to the defense mechanisms they were
supposed to investigate was 6.9/8. The face validity of the
other items can therefore be considered satisfactory.
DISCUSSION
In our study, the face validity of almost a third of
DSQ-40 items appears to be unsatisfactory. The majority of
an independent sample of eight raters agreed with the original
labeling of 70% of the items. This level of agreement is
consistent with the study by Andrews et al. (1989) in which
an independent panel of three raters agreed to 74% of the
original labeling.
What explanation is there for the fact that the 12 items
with unsatisfactory face validity in our study were attributed
to the defense mechanisms they were supposed to investigate
in the study reported by Bonsack et al. (1998)? One possible
explanation relates to the different procedures: in the study
published by Bonsack et al., the raters attributed the 88 DSQ
items to the 24 defense mechanisms they were supposed to
investigate, of which a list was provided. In our study, the
raters had a wider and therefore more complex choice since
they were told that they could attribute each item to a defense
mechanism among those on the list comprising more than just
the previous 24 or a coping mechanism of their choice. This
procedure would appear more exacting and satisfactory.
However, the most relevant explanation is the inaccuracy of
the relabeling that occurred for the study by Andrew et al.
(1989). If we compare the current study’s ratings with the
original labeling of the DSQ-88, there is good face validity
concurrence: our ratings are consistent with the original
labeling for eight out of the 12 DSQ-40 items with dubious
face validity. For example, the most inadequate relabeling
was for the item, “I am a very inhibited person,” which was
simply designed for inhibition in the DSQ-88. “Doctors never
really understand what is wrong with me” and “No matter
how much I complain, I never get a satisfactory response”
were originally designed to measure help-rejecting complain-
ing. “I pride myself on my ability to cut people down to size,”

© 2005 Lippincott Williams & Wilkins 757

Chabrol et al. The Journal of Nervous and Mental Disease • Volume 193, Number 11, November 2005
“I ignore danger as if I were Superman,” and “I’ve special
talents that allow me to go through life with no problems”
were all designed for omnipotence/devaluation. Because the
DSM-III-R subcommittee on defense mechanisms decided to
add some coping mechanisms to the glossary, coping items
were added to the DSQ-88 at its revision. Thus, “If I were in
a crisis, I would seek out another person who had the same
problem” was designed for affiliation, and “When I’m de-
pressed or anxious, eating makes me feel better” was de-
signed to tap consumption as a maladaptive coping style. It
seems that the Australian group was so focused on develop-
ing a balanced (two items per defense mechanism) DSQ-40
that face validity was killed in about one third of the items.
In the current study on DSQ-40, among the 12 items
with dubious face validity, seven were mainly attributed by
the raters to other mental operations than defense mecha-
nisms: five of them were attributed to coping mechanisms and
two to depressive cognitive distortions. This result is in
keeping with the difficulty self-report questionnaires have in
differentiating defense mechanisms from coping strategies
(Davidson and McGregor, 1998).
Among the five items attributed to other defense mech-
anisms, four shifted from the DSM-IV neurotic level to the
DSM-IV immature level: two from displacement to somati-
zation and acting out, two from dissociation to omnipotence
and denial. The possible misattribution of these items may
blur the differences between the immature and intermediate/
neurotic factor. It may explain why displacement and disso-
ciation were included in the immature factor extracted by
exploratory factorial analysis in the study by Andrews et al.
(1993) although they are usually considered to belong to the
neurotic/intermediate/mental inhibition (compromise forma-
tion) level (e.g., American Psychiatric Association, 1994).
If this lack of face validity were to be confirmed, it
might help to explain the previously reported limitations of
the DSQ concerning insufficient internal consistency of one
or all of the three of the mature, neurotic, and immature
dimensions (e.g., Andrews et al., 1993; Chabrol and Brandi-
bas, 2000), the unstable factor structure (e.g., Rutherford et
al., 1998; Spinhoven et al., 1995; Trijsburg et al., 2000;
Wastell, 1999), or the low correlation with other instru-
ments measuring defense mechanisms (Hersoug et al., 2002;
Hibbard and Porcelli, 1998; Melhman and Slane, 1994).
758
CONCLUSION
This study suggests a lack of validity of a substantial
portion of DSQ-40 items, whereas the face validity of the
major portion of DSQ-40 items appeared to be excellent.
Further studies of the face validity seem necessary. If these
results were to be corroborated, they would indicate the need
to find more appropriate items to replace items lacking in face
validity. Another suggestion is to prefer DSQ-88 for the
assessment of defense mechanisms, given its much better
face validity.
ACKNOWLEDGMENTS
The authors thank Geneviève Peresson, MD, Fréd-
érique Teissèdre, PhD, and Sonia Sowa, MA, for their con-
tribution to the study.
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© 2005 Lippincott Williams & Wilkins