The International Journal of the Addictions, 13(3), 403-414, 1978

The Defense Mechanism

Inventory and Alcoholics
Damaris J. Rohsenow, Ph.D
Alcoholism and Drug Abuse Institute

Richard C . Erickson, Ph.D.

Michael R. O’Leary, Ph.D.

Department of Psychiatry and Behavioral Sciences

University of Washington
Seattle, Washington 98195
and
Seattle VA Hospital
Seattle, Washington 98 108

Abstract
The utility of the Defense Mechanism Inventory (DMI) with
alcoholic patients was evaluated by reviewing previous research
and presenting new data concerning the test characteristics and
the relationships between the DMI and various demographic,
cognitive, and personality variables. In general, the defense
mechanisms of projection and turning against others was as-
sociated with greater anxiety, depression, and psychopathology.
Utilization of the mechanisms of intellectualization and denial

403

Copyright 01978 by Marcel Dekker, Inc. All Rights Reserved. Neither this work nor any
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104 ROHSENOW. ERICKSON, AND O ' L E A R Y

were related to lower levels of psychopathology. The construct

validity of' the DMI was questioned in view of the results
obtained, and the utility of the measure for the prediction of
treatment response of alcoholics was discussed.

Understanding the defensive style of an alcoholic patient is an impor-

tant step in designing an effective treatment program. A reliable and valid
instrument for assessing the patient's defensive style would be a valuable
clinical tool. One instrument recently developed by Gleser and Ihilevich
(1969) is the Defense Mechanism Inventory (DMI), constructed in order
to operationalize and assess five clusters of defense mechanisms:

1 . T//rxir?gcigclrrinst object (TAO) involves attacking the real or per-

ceived source of external frustration.
2. Projection (PRO)involves justifying aggressive behavior by first
making unsupported negative attributions to the object.
3. Prfr7cipciIiration (PRN) involves defenses such as intellec-
tualization, isolation, and rationalization.
4. T~rrningugahst self' (TAS) involves directing aggression against
oneself.
5 . Rcvcisal ( R E V ) involves reacting positively or neutrally to events
normally producing negative reactions and includes denial, repression.
negation, and reaction formation.

The DMI consists of 10 stories about conflict areas. For each story, Ss
are asked what their reactions would be. Five choices are provided, one
corresponding to each defense cluster, and respondents are asked to
indicate the ones most and least representative of their reactions.
This paper reviews research and presents new data on the reliability
and validity of the DMI in order to assess the value of the DMI for
clinicians in alcoholism treatment programs.

METHOD
We administered the DMI as part of a larger battery to male alcoholic
inpatients a week and a half after admission and after 8 weeks of
treatment. None showed residuals of acute intoxication or had a primary
diagnosis of psychiatric disorder or organic brain syndrome.
THE DEFENSE MECHANISM INVENTORY AND ALCOHOLICS 405

TEST CHARACTERISTICS
Reliability

Table 1 shows the test-retest reliability correlations for the original

small samples and our larger sample. We found considerably lower
reliability than Gleser and Ihilevich (1969) noted. Whether the differences
should be attributed to treatment effects, sample size, or differing pop-
ulations is not evident. Additional reliability studies with adequately large
and representative samples need to be performed.

Normative Data

The DMI has been administered to a variety of populations. The mean

scores for the five subscales are listed in Table 2 according to type of
samples employed. In comparing scores of different samples in this table,
it should be kept in mind that the samples differ in size, age, education,
and geographic locale.

Subscale lntercorrelations

Does the DMI consist of five separate defense measures? Gleser and
Ihilevich (1969) found that TAO and PRO are highly correlated, P R N and

Table 1
Test-Retest Reliability Studies

Test-retest
Sample N Interval correlations

Gleser and Counselors 12 I week (T- Ranged from ,235

Ihilevich (1969) group ex- (PRO) to .93
perience) (TAO). Average
correlation .89
Psychology 11 3 months Ranged from .69
graduate (psychology (PRN) to 3 7
students course) (TAO). Average
correlation .76
Rohsenow et al. Male alcoholic 83 8 weeks (in- TAO .70; PRO 3 8 ;
inpatients patient PRN .60; TAS
treatment) .50; REV .55.
Mean correlation
.59
 Table 2
Mean DMI Scores According to Subject Sample

TAO PRO PRN TAS REV Age Eaucation n Sample

Gleser and Ihilevich (1969) 40.9 39.6 45.3 37.5 36.6 226 Male undergraduates
Gleser and Sacks (1973) 40.3 39.3 45.7 37.2 37.5 40 Male undergraduates
Bog0 et al. (1970) 39.6 37.5 47.5 36.7 38.6 45 Male undergraduates
Donovan et a]. (1977) 32.9 40.0 46.5 37.3 43.2 49.9 13.9 38 Male general adults (matched controls)
Gleser and Ihilevich (1969) 39.4 38.4 48.4 34.4 39.6 23.0 13.8 43 Male general adults
Gleser and Ihilevich (1969) 36.8 36.2 45.6 39.6 41.9 32.6 12.3 124 Male psychiatric outpatients
Gleser and Ihilevich (1969) 44.2 42.3 41.3 40.7 31.6 28.7 12.8 12 Male psychiatric outpatients
Gleser and Ihilevich (1969) 38.8 35.7 44.3 40.5 40.6 26.0 13.2 11 Male psychiatric waiting list
Sugarman et a]. (1975) 37.2 36.8 46.4 36.4 43.2 44.1 108 Male alcoholic private inpatients
O’Leary et al. (1977) 35.8 38.1 45.2 37.1 43.7 46.9 12.0 247 Male alcoholic VA inpatients
Gleser and Ihilevich (1969) 38.9 36.9 45.5 44.0 35.1 180 Female undergraduates
Gleser and Sacks (1973) 32.5 35.9 37.4 44.7 39.4 45 Female undergraduates
Bog0 et al. (1970) 34.9 35.6 45.9 44.5 38.4 52 Female undergraduates
Gleser and Ihilevich (1969) 34.8 36.9 47.3 41.9 39.2 28.7 13.4 71 Female general adults
GIeser and Ihilevich (1969) 33.8 35.4 45.5 44.2 41.1 31.6 12.1 110 Female psychiatric outpatients
Gleser and Ihilevich (1969) 39.3 39.3 44.4 42.9 34.1 29.4 12.4 14 Female psychiatric outpatients
Gleser and Ihilevich (1969) 30.8 32.5 48.0 46.2 42.5 26.1 11.7 I1 Female psychiatric waiting list
Sugarman et a]. (1975) 32.4 35.0 46.8 42.6 43.3 42.0 56 Female alcoholic private inpatients
THE DEFENSE MECHANISM INVENTORY AND ALCOHOLICS 407

Table 3
D M I Intercorrelations for 247 Male Alcoholics'

TAO PRO PRN TAS

PRO .52**
PRN -.61** -.54**
TAS --.32** -.28** -.13*
REV -.78** -.67** .38** .03
a Mean age = 49.6, mean education = 12.0.
* p < .05.
* * p < .0005.

REV are highly correlated, and both TAO and PRO are highly negatively
correlated with both P R N and REV. TAS was less highly negatively
correlated with TAO, PRO, and PRN and independent of REV. Gleser
and Sacks (1973) found a similar pattern with their two normal samples.
We administered the DMI to 247 male alcoholics. The intercorrelations
(Table 3) support previous results.
A factor analysis would be helpful in clarifying whether the DMI
consists of five separate defense measures or only three. In reading the
definitions of the defense scales, TAO and PRO appear remarkably
similar, as do P R N and REV. Both TAO and PRO involve expression of
aggression against an external object, and both PRN and REV involve not
responding with negative affect to the object. There appears to be little
predictive or conceptual value in separating TAO from PRO, and P R N
from REV.

THE D M I A N D DEMOGRAPHIC A N D
COGNITIVE VARIABLES
In order to assess the validity of the DMI, it is important to examine
research that investigates its relationships to demographic, cognitive, and
personality variables.

Demographic Variables

Gleser and Ihilevich (1969) found that TAO decreases and P R N and
REV increase with increased age. Also, women consistently score higher
on TAS and lower on TAO than men (Table 2). Using our sample of male
alcoholics, we found (Table 4) TAO and PRO decrease, REV increases,
408 ROHSENOW. ERICKSON, AND 0’LEAR.Y

Table 4
Correlations between the DMl and Demographic and Cognitive Variables“

TAO PRO PRN TAS REV n

- -
Age -.22 (.001) -.15 (.02) .12 (.06) -.01 .27 (.001) 245
Education .I1 .06 .21 (.OOl) -.23 (.001) -.I7 ( . O l ) 236
Shipley:
Verbal . I 7 (.02) .07 . I 4 (.04) - . I 7 (.02) -.23 (.001) 218
Shipley :
Abstract .20 (.005) .14 (.05) .09 -.21 (.005) -.25 (.OOl) 218
Group
Em bedded
Figures Test
(Oltman et
al., 1971) .I9 (.005) . I 7 (.01) .06 -.14(.03) -.27 (.OOl) 2143
-
a F3gures in parentheses refer to significance levels.

PRN tends to increase, and TAS appears to be unrelated to age. We found

increased education associated with higher PRN and lower TAS and
REV. but unrelated to TAO and PRO.

Cognitive Variables

Witkin predicted field dependence would be associated with defenses

believed to involve less differentiation such as denial, repression, and
hostility-turned-inward, while field independence would be related to
defenses assumed to reflect greater differentiation, such as isolation,
projection, and hostility-turned-outward (Witkin et al., 1962). The studies
(Bogo et al.. 1970: Donovan et a]., 1975; Ihilevich and Gleser, 19’71)
largely support this: field dependence as measured by the Embedded
Figures Test, the Figure Drawing Test, the R o d and Frame Test, and the
Group Embedded Figures Test is associated with TAS and R E V while
field independence is associated with TAO and PRO. P RN generally
shows n o significant relationship to field articulation. Results with our
sample of alcoholics were consistent (Table 4).
For our alcoholic males, greater intelligence (Shipley Institute of
Living Scale; Shipley, 1940) was associated with less REV and TAS and
more TAO (Table 4).

THE D M I AND PERSONALITY VARIABLES

Previous investigators have correlated the DMI with the MMPI.
Gleser and Ihilevich (1969) found significant correlations for 67 male and
T H E DEFENSE MECHANISM INVENTORY AND ALCOHOLICS 409

93 female psychiatric outpatients, suggesting that REV and PR N tended

to be associated with healthier appearing MMPI profiles, and PRO, TAO,
and TAS with more disturbance on the MMPI.
Ihilevich and Gleser (1971) found that male psychiatric patients who
use TAO, PRO, or TAS have more sensitizing scores on the Repression-
Sensitization Scale than those who use REV. N o relationship was found
for the female patients. In a study using Haan’s (1965) defense scales,
Denial correlated positively with REV and PRN, and negatively with
TAO; Doubt correlated positively with TAS and negatively with PRN;
Repression correlated positively with REV and negatively with TAO; and
Primitive Defense correlated positively with P R N and REV (Gleser and
Ihilevich, 1969). Clum and Clum (1973) found that men who scored high
on REV and PRN were less depressed and angry and had more energy
than men high on TAO. N o relationships were found for women.
Only two DMI studies have studied whether alcoholics and non-
alcoholics differ. Aldridge et al. (1967) found a sample of alcoholics to be
high on TAS and REV and low on TAO relative to normals. However,
Donovan et al. (1977) failed to find differences when they employed
matched controls, a procedure not used by Aldridge et al.
We administered a variety of personality and psychopathology scales
to our sample of alcoholics. Our findings are presented in Tables 5 and 6
and will be grouped for discussion below according to major areas of
interest for construct validity
Measures of Defensive Style

The MMPI’s K and L scales (sophisticated and naive defensiveness,

respectively) correlated negatively with PRO and TAO and positively with
PRN and REV, while TAS was unrelated. Repressors (CR-S) use more
P R N while sensitizers tend to use more TAO. Assertiveness was unrelated
to the DMI. Three MMPI scales suggesting somatization, Hs, Hy, and Lb
(low back pain), also did not correlate with the DMI. Our findings are
consistent with Gleser and Ihilevich’s (1969) findings for a psychiatric
population.
The bulk of our correlations with locus of control did not reach
significance, but those which did were consistent with each other. TAO
was associated with external locus of control on the I-E. PRO was
associated with externality on the I-E, 01 (control over internal forces),
and OE (control over external events). P R N was related to internality on
the I-E, 01, OE, and FE (control by external events). REV was correlated
with internality on the I-E. TAS was unrelated to locus of control.
 Table 5
Correlations between the DMl and Other Personality Variables”

TAO PRO PRN TAS REV n

Controlled Repression-Sensitization
Scale (CR-S ; Handal, 1973) .I9 (.06) .I 1 -.I9 (.05) - .04 -,13 108
Rathus Assertiveness Scale
(RAS; Rathus, 1973) .07 .I 1 - .01 -.I7 (.07) - .05 119
Internal-External Locus of
Control (I-E; Rotter, 1966) .I6 (.02) .I7 (.01) -.I4 (.04) .01 -.I7 (.01) 247
Experienced Control: (EC;
Tiffany et al., 1969)
FI subscale .09 - .02 -.08 .06 - .04 92
01 subscale p.20 (.06) -.29 (.01) .40 (.001) -.I1 .I7 92
OE subscale -.I2 -.22 (.04) .32 (.005) -.I9 (.07) .I6 93
FE subscale .I4 -.04 -.30 (.005) .07 .09 92
Activity Preference Questionnaire
(APQ; Lykken and Katzenmeyer,
1968):
Physical -.I1 --.I4 (.05) - .04 .I4 (.06) .I6 (.03) I86
Social .05 .05 -.I9 (.02) .I5 (.04) - .04 185
Cornell Index (Weider et al., 1949) .24 (.006) .23 (.008) -.50 (.001) .28 (.OOl) -,21 (.02) 130
Beck Depression Inventory
(BDI ; Beck, 1967) .20 (.02) .I4 -.22 (.01) .25 (.003) -.31 (.001) 140
a Figures in parentheses refer to significance levels.
T H E DEFENSE MECHANISM INVENTORY AND ALCOHOLICS 41 1

Table 6
Correlations between the DMI and MMPI"

TAO PRO PRN TAS REV

L -.36 (.001) -.19 (.005) .19 (.005) .10 .31 (.001)
F .I7 .13 (.07) -.20 (.005) . I 3 (.06) -.18 (.01)
K -.26 (.001) -.23 (.001) .30 (.001) - .07 .24 (.001)
Hs -.02 - .07 - .03 .06 .05
D .08 .15 (.03) -.20 (.005) .20 (.005) -.16 (.02)
HY - .03 -.I1 (.lo) .04 .09 .03
Pd .32 f.001) .23 (.001) -.20 (.005) .07 - .39 (.001)
Mf .17 (.01) .02 .oo .06 -.25 (.001)
Pa .I6 (.02) .08 -.lo .08 -.18 (.01)
Pt .15 (.04) .10 -.24 (.001) .17 (.01) -. I5 (.03)
sc .18 (.01) .12 (.09) -.20 (.005) .ll P . 1 9 (.01)
Ma .27 (.001) .05 -.04 -.21 (.005) -.18 (.01)
Si .I9 (.005) .23 (.001) -.35 (.001) .18 (.01) -.I8 (.01)
At .26 (.001) .22 (.001) -.31 (.001) .I3 (.06) -.27 (.001)
Lb .02 - .04 .05 - .05 .oo
So-r -.24 (.001) -.18 (.01) .31 (.001) -.14(.04) .22 (.001)
DY .25 (.001) .23 (.001) -.37 (.001) . I 7 (.02) -.25 (.001)
Es - .04 - .06 .21 (.005) -.15 (.03) .02

a Figures in parentheses refer to significance levels. N = 219.

Psychopathology

Anxiety. PRN and REV are associated with less anxiety on the
Manifest Anxiety Scale (At) and the Pt scale of the MMPI, while PRO,
TAO, and TAS are associated with more anxiety. The results for the
APQ's social anxiety scale supported the above findings for P R N and
TAS, but interestingly, REV was associated with greater physical anxiety
and PRO was associated with less.
Depression. TAO is correlated with more depression as measured by
the BDI and PRO with more depression on the D scale of the MMPI. TAS
is positively correlated and P R N and REV negatively correlated with
depression on both measures.
Other Measures. TAO, PRO, and TAS were found to be associated
with increased psychopathology on the Cornell Index while P R N and
REV were associated with lower scores. TAO, PRO, and TAS are
associated with more psychopathology on the MMPI, and REV and P R N
with healthier profiles.
312 ROHSENOW, ERICKSON. AND O ' L E A R Y

DMI A N D PSYCHOTHERAPY
Very little work has been done on the relationship of DMI scores to
treatment. Gleser and Ihilevich (1969) found that patients who had been
receiving individual psychotherapy were lower on REV and higher on
PRO than waiting list controls. Hague et al. (1976) examined the
relationship between pretreatment DMI scores to dropping out or com-
pleting a 2-month alcoholism treatment program and found no re-
lationship. O'Leary et al. (1975) found that alcoholics who completed a K-
year treatment program scored higher on REV than those who dropped
out, patients who were rehospitalized during the year had lower REV and
higher TAO scores than those not rehospitalized, but pretreatment DMI
scores were unrelated to later employment. These findings are consistent
w i t h the results shown earlier in this paper that REV appears related to
better and TAO to poorer reported psychological adjustment; Gleser and
Ihilcvich's results above show the reverse.

CONCLUSIONS
The general picture drawn from the foregoing research is that higher
scores on TAO, PRO, and TAS, and lower scores on,PRN and REV. arle
associated with increased psychopathology, anxiety, depression, and
external control. The only contradictory note is that intelligence and field
independence are associated with higher scores on TAO and lower scores
on REV. There are several possible interpretations of these results. It may
be that the DMI actually measures the defenses that Gleser and Ihilevich
( 1 969) intended and that defenses that imply conflict with self or others
lead to self-reported poorer adjustment, while defenses that involve not
responding with negative affect result in better psychosocial health.
However. these results may indicate that the DMI does not have good
construct validity. Rather than assessing the intended defenses, the DMI
may actually measure willingness to report behaviors which are indicative
of better or poorer psychosocial functioning, or it may measure an active
as opposed to passive interaction style. The function of defenses is to
reduce anxiety, yet TAO,PRO, and TAS certainly do not protect the:
individual against anxiety, depression, or perceived helplessness. The
D M I does appear to have utility for the clinician, however. A mental
health professional can predict an alcoholic's general adjustment as
reflected by other personality tests, as well as probable attrition from
T H E DEFENSE MECHANISM INVENTORY AND ALCOHOLICS 413

treatment or rehospitalization, by knowing the scores on the DMI.

However, it is obvious that further research with the DMI needs to be
done.

REFERENCES

ALDRIDGE. R.G.. BAXTER. G.I.. NOPZIGER, L.M., ROGGENBUCK. A.L.,

SHIMANSKY, R.L.. and WOLTHUIS, D.J. De/ense Mi4ranism.s of an Alcoholic
Population as Coinpared to a Nornial Populalion. Unpublished Master’s Thesis. Mich-
igan State University, 1967. Cited in Gleser and Ihilevich, 1969, below.
BECK, A.T. Depression: Clinical. Experimenlal, and Theoretical Aspects. New York: Harper
& Row, 1967.
BOGO, N., WINGET, C., and GLESER, G.C. Ego defenses and perceptual styles. Percept.
Mot. Skil1.s 30: 599-605, 1970.
CLUM, G.A., and CLUM, J. Choice of defense mechanisms and their relationship to mood
level. Psycho/. Rep. 32: 507-510, 1973.
DONOVAN, D.M.. HAGUE, W.H., and O’LEARY, M.R. Perceptual differentiation and
defense mechanisms in alcoholics. J . Clin. Psychol. 31 .: 356-359, 1975.
DONOVAN, D.M., ROHSENOW, D.J., SCHAU, E.J., and O’LEARY, M.R. Defensive
style in alcoholics and nonalcoholics. J . Stud. Alcohol 38: 465-470. 1977.
GLESER, G.C., and IHILEVICH, D. An objective instrument for measuring defense
mechanisms. J . Consult. Clin. Psychoi. 33: 51 -60, 1969.
GLESER, G.C., and SACKS, M . Ego defenses and reaction to stress: A validation study of
the Defense Mechanisms Inventory. J . Consult. Clin. Psychol. 40: 181-187, 1973.
HA AN, N . Coping and defense mechanisms related to personality inventories. J . Consufr.
Psycho/. 29: 373--378, 1965.
HAGUE, W.H., DONOVAN, D.M.. and O’LEARY, M.R. Personality characteristics
related to treatment decisions among inpatient alcoholics: A non-relationship. J . Cfin.
Psychol. 32: 476-479, 1976
HANDAL, P.J. Development of social desirability and acquiescence: Controlled repression
sensitization scale and some preliminary validity data. J . Cfin. Psychol. 29: 486-487,
1973.
IHILEVICH, D., and GLESER, G.C. Relationship of defense mechanisms to field
dependence-independence. J . Abnorm. Psycho/. 77: 296-302, 1971.
LYKKEN, D.T., and KATZENMEYER, C.G. Manua1,for the Activity Preference Ques-
rronnuiw ( A P Q ) . Minneapolis: University of Minnesota reports from the research
laboratories (Report No. PR-68-3), 1968.
O’LEARY, M.R., ROHSENOW, D.J., SCHAU, E.J., and DONOVAN, D.M. Defensive
style and treatment outcome among men alcoholics. J . Stud. Alcohol 38: 1036-1040,
1977.
OLTMAN, P.K., RASKIN, E., and WTTKIN, H.A. Group Embedded figure.^ Test. Palo
Alto. California: Consulting Psychologists Press. 1971.
RATHUS, S.A. A 30-item schedule for assessing assertive behavior. Behav. Ther. 4:
398-406, 1973.
ROTTER, J .B. Generalized expectancies for internal vs. external control of reinforcement.
Psyrhol. Monogr. 80(Whole No. 609): 1-28, 1966.
314 ROHSENOW. ERICKSON. AND O'LEARY

SHIPLEY. W C. . S / ~ i ~ / ~ ~ ~ - H uRetrrut
~ / f o , . d.S~~a/<,,
Mrtluul of' D i r r c t i o ~ at7d
~ , ~ .S(,orirrg Ki.1..
Hartford, Connecticut: Hartford Retreat, 1940.
S U G A R M AN. A..4.. SHELDON, J.B., and ROTH, C. Defense mechanisms in men a d
w m e i i alcoholics. J . Stud. Alcohol 36: 422-424, 1975.
TIFFANY. D.W.. SHONTZ, F.C., and WOLL, S.B. A model of control. J . Grii. Psj,c,/fol.
81: 67FX2. 1969.
K E I D E R . A , . WOLFF, H.G., BRODMAN. K., MITTELMANN, B.. and WECHSLER.
D. Comd/ Ii&.v Mwmd. New York: Psychological Corporation, 1949.