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Defense Style Questionnaire

Chapter · January 2017

DOI: 10.1007/978-3-319-28099-8_22-1

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Georgios D Floros
Aristotle University of Thessaloniki
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D
Defense Style Questionnaire
Georgios D. Floros
2nd Department of Psychiatry, Aristotle
University of Thessaloniki, Thessaloniki, Greece
Synonyms
DSQ
Definition
Defense styles are empirically validated clusters
of psychological defense mechanisms, measured
with the Defense Style Questionnaire (DSQ). The
DSQ is a paper-pen, self-report questionnaire,
with two versions containing either 88 or
40 items. Each item is a statement that the subject
scores according to the degree of agreement to its
content on a Likert-type interval scale, with scores
ranging from one (total disagreement) to nine (full
agreement).
Introduction
The concept of character defenses hails from the
early days of psychoanalysis; according to Anna
Freud, they form “the ways and means by which
the ego wards off displeasure and anxiety, and
exercises control over impulsive behavior, affects
# Springer International Publishing AG 2017
V. Zeigler-Hill, T.K. Shackelford (eds.), Encyclopedia of Personality and Individual Differences,
DOI 10.1007/978-3-319-28099-8_22-1
and instinctive urges” (Freud 2011). Although
defenses have been defined and differentiated for
some time, their unconscious nature made their
empirical measurement difficult. To this end, the
Defense Style Questionnaire (DSQ) was devel-
oped to assess defense styles (Bond et al. 1983).
The defense style concept has its roots in the
hierarchical model of Vaillant, which is based on
an immaturity-maturity continuum and strives to
examine ego function in operational rather than in
theoretical terms (Vaillant et al. 1986). A defense
style is defined as an empirically validated cluster
of perceived defense mechanisms, ranked on a
developmental continuum so as to describe in
succinct terms the subject’s ability to adapt in
challenging situations by mobilizing its full
potential in a mature manner, rather than falling
back to immature behavior. Defense styles can be
approximated by assessing overt behavior, in con-
trast to individual defenses, rendering them a use-
ful concept in both research and clinical settings.
As stated by the DSQ authors, “although it would
be impossible to conclude anything about isolated
defense mechanisms we hoped that we could
approximate the measure of groups of defense
mechanisms that we call defense styles.”
(Editor’s note: since examining defenses would
require a lengthy clinical investigation of psycho-
logical processes as they occur). Identifying a
defense style essentially provides information on
the patient’s ways of coping with challenging
situations, and thus this line of thought equates
defense mechanisms with coping strategies.
2 Defense Style Questionnaire
Hence the term “defense mechanism” in this
respect refers to both the unconscious intrapsy-
chic process and corresponding overt behavior.
The main premise is that the examinees can accu-
rately comment on their behavior from a distance
or at least acknowledge related comments made
by others.
Defense Styles and Mechanisms
Individual defenses are classified according to
Bond in four defense styles, and an overall defen-
sive functioning score can be calculated for each
style:
Maladaptive style
Characterized by the employment of imma-
ture defense mechanisms (e.g., withdrawal,
acting out, inhibition, passive-aggressiveness,
projection, projective identification, somatiza-
tion, consumption, fantasy, help rejecting,
complaining, and regression).
Image distorting style
Characterized by the presence of primitive
defense mechanisms like splitting, omnipo-
tence, and primitive idealization. It is typically
associated with both borderline and narcissistic
personality disorders.
Self-sacrificing style
This grouping includes more mature
defense mechanisms whose aim is social
acceptance and inclusion as a solution to ego
struggles (e.g., pseudoaltruism, repression,
reaction formation).
Adaptive style
This style includes mature defense mecha-
nisms that channel drives to age-appropriate
interests and goals (e.g., sublimation, task-
orientation, anticipation, humor, suppression,
affiliation).
Psychometric Properties
The standard edition DSQ is a self-report inven-
tory comprising of 88 items, scored on a 9-point
Likert-type scale. It has been extensively
translated and validated for other languages.
There is also a shorter, 40-item version, validated
for three defense styles (mature, neurotic, imma-
ture) and employed widely. The standard 88-item
version has demonstrated good reliability and
validity across all languages, with Cronbach
alphas ranging from 0.65 for the adaptive defense
style to a high of 0.85 for the maladaptive defense
style, while factor analysis typically reproduces
the four-factor structure. Concurrent validity with
other paper-pen instruments that measure charac-
ter traits or pathology is also high. Defense styles
assessed with the 88-item version have correlated
to the expected directions with results from the
Defense Mechanism Rating Scale (DMRS), in
which clinical judges rate videotaped interviews
(Bond et al. 1989). However, there have been
reported limitations of the short version of the
DSQ. For example, following a review of
published papers including their own study,
Chabrol and colleagues found poor face validity
for 12 out of 40 items and concluded that using the
88-item version may be the best research practice
(Chabrol et al. 2005). It is unclear whether this
conclusion applies to clinical use of the DSQ-40
as well. Efforts to validate a 60-item version have
not been shown to produce a reliable scale
(Thygesen et al. 2008).
Applications
DSQ has been employed in a wide variety of
clinical contexts, including the treatment of eat-
ing, anxiety, depressive, and personality disor-
ders, addiction, trauma, and alexithymia; it has
also been used to assess the relationship of
defense styles with psychopathology and change,
while guiding psychotherapeutic treatment (Bond
2004). The DSQ has also been used to test
whether specific defense styles could predict sur-
vival in cancer or if they are associated with
adherence to medication, treatment modality pref-
erences, psychiatric complications, disease activ-
ity, and quality of life in chronic somatic disease.
It is noteworthy that there was no clear relation-
ship detected between defense style and clinical
Defense Style Questionnaire
diagnosis (Bond 1992); hence, the DSQ cannot be
employed to conclusively assist in this respect.
Conclusion
The grouping of defense mechanisms on an adap-
tive hierarchy has enabled us to indirectly mea-
sure these intrapsychic processes in a valid and
reproducible way. The DSQ, in its 88-item ver-
sion, has been shown to be a reliable research
instrument that may assist both the researcher
and the clinician working with patients who pre-
sent with character pathology in a variety of
settings.
References
Bond, M. (1992). An empirical study of defensive styles:
The Defense Style Questionnaire. In Ego mechanisms
of defense: A guide for clinicians and researchers
(pp. 127–158). Washington, DC: American Psychiatric
Association.
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Bond, M. (2004). Empirical studies of defense style: Rela-
tionships with psychopathology and change. Harvard
Review of Psychiatry, 12(5), 263–278.
Bond, M., Gardner, S. T., Christian, J., & Sigal, J. J. (1983).
Empirical study of self-rated defense styles. Archives of
General Psychiatry, 40(3), 333.
Bond, M., Christopher, J., Gautier, M., Goldenberg, M.,
Oppenheimer, J., & Simand, J. (1989). Validating the
self-report of defense styles. Journal of Personality
Disorders, 3(2), 101–112.
Chabrol, H., Rousseau, A., Rodgers, R., Callahan, S.,
Pirlot, G., & Sztulman, H. (2005). A study of the face
validity of the 40 item version of the Defense Style
Questionnaire (DSQ-40). The Journal of Nervous and
Mental Disease, 193(11), 756–758.
Freud, A. (2011). The ego and the mechanisms of defence.
London: Karnac Books.
Thygesen, K. L., Drapeau, M., Trijsburg, R. W., Lecours,
S., & De Roten, Y. (2008). Assessing defense styles:
Factor structure and psychometric properties of the new
Defense Style Questionnaire 60 (DSQ-60). Interna-
tional Journal of Psychology and Psychological Ther-
apy, 8(2), 171–181.
Vaillant, G. E., Bond, M., & Vaillant, C. O. (1986). An
empirically validated hierarchy of defense mecha-
nisms. Archives of General Psychiatry, 43(8), 786–794.