Can Defense Mechanisms Aid in our Differentiation of Borderline and Antisocial Personalities?

160 Pages·2008·0.72 MB·English

Running head: DEFENSE MECHANISMS

Can Defense Mechanisms Aid in our Differentiation
of Borderline and Antisocial Personalities?
Michelle Presniak

A dissertation submitted to the College of Graduate Studies and Research,
in partial fulfillment of the requirements for the degree of
Doctor of Philosophy in Clinical Psychology,
University of Saskatchewan, SK

© Michelle D. Presniak, August, 2008. All rights reserved.
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PERMISSION TO USE

In presenting this thesis/dissertation in partial fulfillment of the requirements for a Postgraduate
degree from the University of Saskatchewan, I agree that the Libraries of this University may
make it freely available for inspection. I further agree that permission for copying of this
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the professor or professors who supervised my thesis/dissertation work or, in their absence, by
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University of Saskatchewan
Saskatoon, Saskatchewan S7N 5A5
Canada

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University of Saskatchewan
107 Administration Place
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Abstract
Goal: The aim of the current studies was to evaluate the ability of individual defenses to
differentiate Antisocial (APD) and Borderline (BPD) personalities. Because multiple defense
measures were utilized, Study 1 was dedicated to evaluating the convergent validity between the
measures used: Defense Style Questionnaire (DSQ), Defense-Q, and Defense Mechanism
Manual (DMM). Studies 2, 3, and 4, then evaluated the ability of the defenses to differentiate
APD and BPD groups. Method: In Study 1, participants completed all defense measures and
correlations were conducted between the individual defenses. In Studies 2, 3, and 4, groups of
nonclinical participants were divided into APD and BPD groups based on scores from the
Personality Assessment Inventory. They also completed the DSQ (Studies 2, 3, & 4), the
Defense-Q (Study 3), and/or the DMM (Study 4).The groups were then examined for differences
on defenses using MANOVA and DFA analyses. Results: Results from Study 1 revealed no
significant correlations between the measures for any of the individual defenses. In Studies 2, 3,
and 4, DSQ and Defense-Q results revealed that defenses were able to differentiate the APD and
BPD groups, but the DMM results did not replicate these findings. Univariate analyses showed
that many defenses differed between the groups (e.g., Acting Out, Denial, and Turning Against
Self), while others showed no differences (e.g., Idealization). Conclusion: The results were
discussed in relation to previous theory and research. The findings provided support for many
theoretical expectations. For example, the results supported: Kernberg (1984) who posited both
groups would use primitive defenses (e.g., Splitting, Denial); Perry and Cooper (1986) who
posited BPD groups would internalize negative views towards the self; and Gacono and Meloy
(1988) who believed Denial was characteristic of APD. Overall, the results suggested that APD
and BPD groups demonstrated differences in defense use.
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Acknowledgements

I would like to thank many people for helping me during my doctoral work. I first would
like to thank my supervisor, Michael MacGregor for opening my eyes to the world of
psychology, as well as opening many doors for me. Second, I would like to thank my advisory
committee members; Brian Chartier, Peter Grant, Lynn Corbett, & Teresa Paslawski. I have had
an exceptional committee who has generously given me their time and encouragement
throughout my work. I would also like to offer a special thanks to Brian Chartier for offering
many questions at the beginning of my work and for providing tremendous support and
encouragement towards the end of my work. You have helped me develop into a more
meticulous and confident researcher and clinician. I would also like to thank my external
examiner, Martin Drapeau, for sharing his time and feedback with me.
Thank you to everyone who has played a role in conducted my research. Numerous
people were needed to collect, transcribe, code, and enter data for my project. Without all of their
efforts, this project would not have been possible. Additionally, financial support through
SSHRC’s Canadian Graduate Scholarship has allowed me to devote time to my research and
studies that wouldn’t have been otherwise possible.
I would also like to thank my family. You have supported me throughout my years in
university. Furthermore, you have always made me feel as though I could accomplish any goal
no matter how little or large.
Finally and most of all, I would like to thank Trevor Olson for his love and support. I am
grateful for his encouragement and for teaching me that I could be the best researcher possible.
You spent a great deal of time with me contemplating ideas and sharing insights that supported
and expanded my work. Without your guidance and encouragement, I may never have found my
love for research or the rigour necessary to conduct great research. Furthermore, you led me to
discover that I am responsible for my own knowledge, which is a gift that goes beyond my
doctoral work. With your love, encouragement, and support, I have developed into a better
researcher, clinician, and person.
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Table of Contents
PREAMBLE
Permission To Use ………………………………………………………………...i
Abstract ………………………………………………………………………..ii
Acknowledgements ……………………………………………………………….iii
Table of Contents ……………………………………………………………….iv
List of Appendices ……………………………………………………………….ix
List of Tables ………………………………………………………………………..x
List of Abbreviations ……………………………………………………………….xi

HISTORY OF DEFENSE MECHANISM THEORY ..…………………………..…..1
Sigmund Freud …………………………………………………………..……1
Structural Models ……………………………………………………......2
Defense Mechanisms ……………………………………………………......3
Anna Freud ……………………………………………………………………......4
CURRENT CONCEPTUALIZATION AND ASSESSMENT
OF DEFENSE MECHANISMS ...……………………………….……..5
Conceptualization ………………………………………………………………..5
Definition of Defense Mechanisms ………………………………………..5
Role of Defense Mechanisms in Lifespan development ………………..7
Maturity of Defenses ………………………………………………………..8
The Assessment of Defense Mechanisms .……………………………………...10
Self-report Measures ………………………………………………………10
Observer-report Measures ………………………………………………11
Projective Measures ………………………………………………………13
EMPIRICAL EXAMINATION OF DEFENSE MECHANISMS
IN LIFESPAN DEVELOPMENT ……………………………………....14
Maturity of Defenses (Chronological and Hierarchical Organization) ………14
Defenses and Psychosocial Functioning ………………………………………16
Sex Differences in Defense Use ………………………………………………17
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THEORETICAL AND EMPIRICAL ROLE OF DEFENSE MECHANISMS IN THE
DEVELOPMENT OF PSYCHOPATHOLOGY ………………………18
Defenses and Clinical Disorders ………………………………………………18
Theoretical Role of Defense Mechanisms in the
Development of Clinical Disorders ...…………………………….19
Empirical Evidence for the Role of Defense
Mechanisms in Clinical Disorders ………………………………20
Defenses and Personality Psychopathology ………………………………………21
Theoretical Role of Defense Mechanisms
in Personality Psychopathology ………………………………22
Empirical Evidence for the Role of Defense
Mechanisms and Personality Psychopathology ………………23
THEORETICAL AND EMPIRICAL ROLE OF DEFENSE MECHANISMS IN
DIFFERENTIATING BPD AND APD ………………………………………………24
Defense Mechanisms and BPD ………………………………………………24
Borderline Personality Disorder ………………………………………24
Theoretical Role of Defense Mechanisms in BPD ………………………25
Empirical Evidence of the Role of Defense Mechanisms in BPD ………27
Defense Mechanisms and APD ………………………………………………29
Antisocial Personality Disorder ………………………………………29
Theoretical Role of Defense Mechanisms in APD ………………………30
Empirical Evidence of the Role of Defense Mechanisms in APD ………31
Differentiating BPD and APD Based on Defense Mechanisms ………………32
Theoretical Differences in Defense Use between BPD and APD ............33
Empirical Differences in Defense Use between BPD and APD ………34
PROPOSED RESEARCH STUDIES ………………………………………………36
Summary of Research Findings ………………………………………………36
Goal of Current Studies ………………………………………………………38
Research Questions and Hypotheses ………………………………………………39
STUDY 1 ………………………………………………………………………………41
Method ………………………………………………………………………41
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Participants ………………………………………………………………41
Measures ………………………………………………………………48
Procedure ………………………………………………………………48
Data Analysis ………………………………………………………………48
Results ………………………………………………………………………49
Testing Assumptions ………………………………………………………49
Coder Reliability ………………………………………………………50
Correlations ………………………………………………………………50
Study 1 Discussion ………………………………………………………………51
Convergent Validity Between Individual Defenses ………………………51
Convergent Validity Between Defense Styles ………………………………54
Conclusions and Implications for Research ………………………………56
STUDY 2 ………………………………………………………………………………59
Method ………………………………………………………………………59
Participants ………………………………………………………………59
Measures ………………………………………………………………59
Procedure ………………………………………………………………62
Data Analysis ………………………………………………………………62
Results ………………………………………………………………………63
Testing Assumptions ……………………………...……………………….63
MANOVA Results ………………………………………………………63
DFA Results ………………………………………………………………64
Correlation Results ………………………………………………………64
Study 2 Discussion ………………………………………………………………65
Can Defenses Separate APD and BPD groups? ………………………65
Specific Defenses and Their Ability to Separate groups ………………66
Conclusions ………………………………………………………………69
STUDY 3 ………………………………………………………………………………70
Method ………………………………………………………………………70
Participants ………………………………………………………………70
Measures ………………………………………………………………70
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Procedure ………………………………………………………………70
Data Analysis ………………………………………………………………70
Results ………………………………………………………………………………71
Testing Assumptions ………………………………………………………71
DSQ Results ………………………………………………………………71
Defense-Q Results ………………………………………………………72
Study 3 Discussion ………………………………………………………………73
Can Defenses Separate APD and BPD groups? ………………………73
Specific Defenses and Their Ability to Separate groups ………………74
Conclusions ………………………………………………………………77
STUDY 4 ………………………………………………………………………………78
Method ……………………………………………………………………………...78
Participants ………………………………………………………………78
Measures ……………………………………………………….……...78
Procedure …………………………………………………….………...78
Data Analysis ………………………………………………………………78
Results ………………………………………………………………………78
Testing Assumptions ………………………………………………………78
DSQ Results ………………………………………………………………79
DMM Results ………………………………………………………………80
Study 4 Discussion ………………………………………………………………80
Can Defenses Separate APD and BPD groups? ………………………81
Specific Defenses and Their Ability to Separate groups ………………82
Conclusions ………………………………………………………………84
GENERAL DISCUSSION ………………………………………………………………85
Can Defenses Differentiate Between APD and BPD Groups? ………………85
DSQ and Defense-Q contributions ………………………………………86
DMM contribution ………………………………………………………86
Specific Defenses and Their Ability to Separate the APD and BPD Groups ………88
1. Splitting ………………………………………………………………88
2. Devaluation, TAO, and TAS ………………………………………91
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3. Idealization ………………………………………………………………92
4. Grandiosity ………………………………………………………………94
5. Projection ………………………………………………………………96
6. Denial ………………………………………………………98
7. Rationalization ……………………………………………………..100
8. Intellectualization ……………………………………………………..101
9. Acting Out and Passive Aggression ……………………………..102
Conclusion ……………………………………………………………..104
Implications ……………………………………………………………………..104
Theoretical and Empirical Implications ……………………………..104
Clinical Implications ……………………………………………………..107
Methodological Contributions ……………………………………..108
Strengths and Limitations ……………………………………………………..109
Strengths ……………………………………………………………..109
Limitations ……………………………………………………………..110
Future Research …………………………………………...………………...111
Conclusions ……………………………………………………………………..112
References ……………………………………………………………………………..114
Appendices ……………………………………………………………………………..125
Tables ……………………………………………………………………………………..128
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List of Appendices
Appendix A. Defense Q Scoring Sheet ………………………………………………125
Appendix B. Defense Mechanism Manual Defense Scales and Categories ………………126