An empirical study of the DSM-IV Defensive Functioning Scale in personality disordered patients.

The inclusion of the Defensive Functioning Scale (DFS) in the DSM-IV provides clinicians with the opportunity to incorporate psychodynamic information into their descriptive diagnoses. The DFS contains 27 specific defenses covering six levels of defensive functioning ranging from psychotic to normal. This study undertook an initial empirical evaluation of the DFS. A sample of 100 clinicians completed a questionnaire containing both the personality disorder (PD) symptoms and the DFS defenses of PD patients known to them, DFS ratings were not related to clinician orientation. Patient gender was related to only one defense level, with women being assigned significantly more action level defenses than men. Multiple regression analyses revealed unique and meaningful patterns of association between the defense levels and PD symptoms. Additionally, the DFS ratings provided unique information regarding level of impairment and treatment success. These results provide initial empirical support for the clinical application and relevance of the proposed DFS system.

A Rorschach exploration of the DSM-IV Borderline Personality Disorder.

Rorschach data has been useful in identifying the DSM Borderline Personality Disorder (BPD) and has potential for improving our understanding of this disorder. Recently, the DSM-IV BPD has been shown to be composed of 3 primary or core factors: Factor I-unstable self-other images. Factor II-deficits in affect and thought modulation, and Factor III-impulsive self-damaging actions. In a sample of outpatients with personality disorders. we explored the relationships among 6 psychoanalytically derived Rorschach scales (primitive aggression, oral dependency, self-other differentiation, splitting, devaluation, and projective identification), and the core BPD features. Significant correlations were found between 5 of the Rorschach variables and BPD total scores. Correlations between these 5 variables and the BPD core features showed that oral dependency needs were negatively associated with all 3 BPD core features, whereas the defenses of devaluation and splitting were positively associated with these core features. The clinical implications of these findings are reviewed.