The use of defenses and physician health care costs: are physician health care costs lower in persons with more adaptive defense profiles?
BACKGROUND
The objective of the present study was to determine if persons who use more adaptive defenses have lower physician health care costs compared to those who use less adaptive defenses.


METHODS
We randomly selected 667 persons from the 1995 population-based Nova Scotia Health Survey who completed a videotaped structured interview. Each interview was rated for typical defense use by the Defense-Q. We obtained physician health care costs for 3 months before and after the interview, as well as medical diagnoses and measures of psychological functioning.


RESULTS
A more adaptive defense profile significantly predicted lower future physician health care costs. These results were found when controlling for other psychosocial variables, before and after controlling for previous physician health care costs, and when testing only within a physically healthy subsample. Results of secondary analyses showed that a more adaptive defense profile was positively related to a number of psychosocial variables, such as nurse's rating of competence, lack of depressive symptoms, and days at work.


CONCLUSIONS
The adaptiveness of a person's defense use in managing affect is important in predicting physician health care costs as well as psychosocial functioning.
MacGregor
Michael William
MW
Department of Psychology, University of Saskatchewan, Saskatoon, Sask., Canada. micael.macgregor@usask.ca
Davidson
Karina W
KW
Rowan
Paul
P
Barksdale
Cheryl
C
MacLean
David
D
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000175:diagnosis / Q000191:economics / Q000523:psychology; D005251:Fees, Medical / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009674:Nova Scotia; D010552:Personality Assessment / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D012017:Referral and Consultation / Q000191:economics* / Q000706:statistics & numerical data; D012803:Sick Role; D012917:Social Adjustment