title: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Defensive Functioning Scale: a validity study.
abstract: OBJECTIVE
  We assess the convergent and predictive validity of the Defensive Functioning Scale (DFS) with measures of life events, including childhood abuse and adult partner victimization; dimensions of psychopathology, including axis I (depressive) and axis II (borderline personality disorder) symptoms; and quality of object relations.
  
  
  METHODS
  One hundred and ten women from a university-based urban primary care clinic completed a research interview from which defense mechanisms were assessed. The quality of object relations was also assessed from interview data. The women completed self-report measures assessing depression, borderline personality disorder symptoms, childhood physical and sexual abuse, and adult partner physical and sexual victimization.
  
  
  RESULTS
  Inter-rater reliability of the scoring of the DFS levels was good. High adaptive defenses were positively correlated with the quality of object relations and pathological defenses were positively correlated with childhood and adult victimization and symptom measures. Although major image distorting defenses were infrequently used, they were robustly correlated with all study variables. In a stepwise multiple regression analysis, major image distorting defenses, depressive symptoms, and minor image distorting defenses significantly predict childhood victimization, accounting for 37% of the variance. In a second stepwise multiple regression analysis, borderline personality disorder symptoms and disavowal defenses combined to significantly predict adult victimization, accounting for 16% of the variance.
  
  
  CONCLUSIONS
  The DFS demonstrates good convergent validity with axis I and axis II symptoms, as well as with measures of childhood and adult victimization and object relations. The DFS levels add nonredundant information to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition beyond axis I and axis II.
authors.affiliation: Department of Family Medicine & Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA. jporcer@med.wayne.edu
authors.forename: John H
authors.initials: JH
authors.lastname: Porcerelli
authors.forename: Rosemary
authors.initials: R
authors.lastname: Cogan
authors.forename: Tsveti
authors.initials: T
authors.lastname: Markova
authors.forename: Kristen
authors.initials: K
authors.lastname: Miller
authors.forename: Lavonda
authors.initials: L
authors.lastname: Mickens
mesh_terms: D000223:Adaptation, Psychological; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D019548:Crime Victims / Q000523:psychology*; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008016:Life Change Events; D009769:Object Attachment; D010555:Personality Inventory; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires