Schauenburg Henning, Willenborg Verena, Sammet Isa, Ehrenthal Johannes C
Department of Psychosomatic and General Clinical Medicine, University of Heidelberg, Germany.
Psychol Psychother. 2007 Sep;80(Pt 3):355-66. doi: 10.1348/147608306X146068.
The psychoanalytically informed construct of 'defence mechanisms' is of central importance for the understanding of the dynamics of inner conflicts and the onset of neurotic symptoms. Objective and valid assessment of 'defence' is difficult. There are a number of observer rating instruments but only few self-report questionnaires. The German version of the 'Defence Style Questionnaire - DSQ 40' (Andrews, Singh, & Bond, 1993) was examined with regard to its factorial and content validity, and its sensitivity to change during inpatient psychotherapy. One hundred and fifty-five patients with mixed diagnoses were administered the DSQ 40 and the SCL-90-R before and after 3 months of inpatient psychotherapy. Diagnoses were mostly affective and anxiety disorders as well as eating disorders, and there was a high comorbidity of personality disorders. After deletion of some items due to insufficient pairwise item-intercorrelation or false classification to a defence mechanism by experienced clinicians, we found three stable factors of defence (maladaptive, intermediate-neurotic and adaptive) consistent with the previous research. After 3 months of therapy, a decrease in maladaptive mechanisms and an increase in adaptive patterns were found, while neurotic mechanisms did not change on average. Our shortened version of the DSQ 40 was shown to be a valid instrument for the assessment of defence mechanisms and change in these mechanisms after psychotherapy. Our design did not permit an assessment of whether or not the change in defence mechanisms was due to the therapeutic treatment.
从精神分析角度构建的“防御机制”概念，对于理解内心冲突的动态过程以及神经症症状的发作至关重要。对“防御”进行客观有效的评估颇具难度。虽有一些观察者评定工具，但自我报告问卷却寥寥无几。我们对《防御方式问卷 - DSQ 40》的德文版（Andrews、Singh和Bond，1993年）进行了析因效度和内容效度检验，以及其在住院心理治疗期间对变化的敏感性检验。155名混合诊断的患者在住院心理治疗3个月前后分别接受了DSQ 40和SCL - 90 - R测试。诊断结果大多为情感障碍、焦虑障碍以及饮食失调，且人格障碍的共病率较高。在因成对项目间相关性不足或经经验丰富的临床医生误分类至某一防御机制而删除部分项目后，我们发现了与先前研究一致的三个稳定防御因素（适应不良、中度神经症和适应性）。治疗3个月后，发现适应不良机制减少，适应性模式增加，而神经症机制平均未发生变化。我们缩短版的DSQ 40被证明是评估防御机制以及心理治疗后这些机制变化的有效工具。我们的设计无法评估防御机制的变化是否归因于治疗。
