Abstract : Standardized and clinical evaluation of defense mechanisms: a critical review of 6 quantitative tools

Background: The defense mechanisms (DM) concept goes back to the foundation of psychoanalysis and is one of its theoretical cornerstones. Recently, with the introduction of this notion in an experimental item of categorical classification, DMs have become a new field in research and scientific communication. The increasing number of studies taking DMs into account matches the development of clinical evaluation scales that are easier to use than projective tests. To our knowledge, there is no comparative analysis of these tools.

Objective: We aimed first to describe the operating mode and metrological qualities of the most recent scales and then to highlight the benefits and limitations of these clinical evaluation tools. Finally, this article aims to help clinicians choose a tool that is most convenient for their protocol.

Method: We introduce the following tools through a literature review: Defense Mechanism Inventory, Defense Mechanism Profile, Defense Style Questionnaire (DSQ), Defense Mechanism Rating Scale, Life Style Index, and Response Evaluation Measure.

Conclusion: Using clinical scales includes many limitations associated with the DM concept. Nevertheless, their feasibility and validity warrant their use. The DSQ stands out for its many qualities, but the other tools specificities are yet to be considered in regard to the chosen protocols.