Spinhoven P, Kooiman C G
Department of Psychiatry, Leiden University, The Netherlands.
J Nerv Ment Dis. 1997 Feb;185(2):87-94. doi: 10.1097/00005053-199702000-00004.
The aim of the present study was threefold: (a) to investigate whether anxiety or depressive disorders are related to the use of specific defenses; (b) to evaluate which defenses are associated with self-report measures for anxiety and depression; and (c) to assess whether the association between defenses and anxiety or depression is gender specific. Subjects were 483 consecutive psychiatric outpatients with the following DSM-III-R diagnoses: (a) V-code or no psychiatric diagnosis (N = 71) (controls); (b) one or two anxiety diagnoses (N = 116), among which 47 patients with a single diagnosis of panic disorder; (c) one or two depressive disorder diagnoses (N = 93), among which 35 patients with a single diagnosis of dysthymia and 51 with a single diagnosis of major depression; and (d) 203 otherwise. Defense use was measured with the Defense Style Questionnaire-36 and level of anxiety and depression with the Symptom Checklist-90. Compared to controls, anxiety and depressive disorder patients scored higher for the immature defense style. Moreover, anxiety disorder patients obtained significantly higher scores for the neurotic defense style than both depressive disorder patients and controls. Panic patients made more use of the defense mechanisms of somatization, devaluation, and idealization, and dysthymic patients of somatization, devaluation, and isolation. Both anxiety and depression scores were positively related to the immature and neurotic, and negatively to the mature defense style. Anxiety was predominantly related to somatization and depression to projection. No evidence for a gender specific association between defense and anxiety or depression was found. It is concluded that the observed differences in defense between groups may be a consequence of the nature of the psychiatric disorder irrespective of gender. Prospective studies of persons at risk are needed to evaluate whether specific defenses are predictive of anxiety or depressive disorders and/or symptoms.
（a）调查焦虑或抑郁障碍是否与特定防御机制的使用有关；（b）评估哪些防御机制与焦虑和抑郁的自我报告测量相关；（c）评估防御机制与焦虑或抑郁之间的关联是否存在性别差异。研究对象为483名连续就诊的精神科门诊患者，他们有以下DSM-III-R诊断：（a）V编码或无精神科诊断（N = 71）（对照组）；（b）一种或两种焦虑诊断（N = 116），其中47例为单一惊恐障碍诊断患者；（c）一种或两种抑郁障碍诊断（N = 93），其中35例为单一心境恶劣诊断患者，51例为单一重度抑郁诊断患者；（d）203例其他情况。使用防御方式问卷-36测量防御机制的使用情况，使用症状自评量表-90测量焦虑和抑郁水平。与对照组相比，焦虑和抑郁障碍患者在不成熟防御方式上得分更高。此外，焦虑障碍患者在神经症防御方式上的得分显著高于抑郁障碍患者和对照组。惊恐障碍患者更多地使用躯体化、贬低和理想化防御机制，心境恶劣患者更多地使用躯体化、贬低和隔离防御机制。焦虑和抑郁得分均与不成熟和神经症防御方式呈正相关，与成熟防御方式呈负相关。焦虑主要与躯体化相关，抑郁主要与投射相关。未发现防御与焦虑或抑郁之间存在性别差异的证据。结论是，观察到的不同组之间防御的差异可能是精神障碍性质的结果，与性别无关。需要对有风险的人群进行前瞻性研究，以评估特定防御机制是否能预测焦虑或抑郁障碍和/或症状。
