title: Defensive Functioning Among Women With Breast Cancer and Matched Community Controls.
abstract: OBJECTIVE
  The general theory of defense mechanisms posits that stress is associated with using defenses lower on the hierarchy of defensive adaptation. Some have observed that individuals with cancer use certain defenses, such as repression, denial, and immature defenses. This cross-sectional study examined four hypotheses about defensive functioning in a sample of women who are mothers with a recent history of breast cancer (BC), compared to a matched sample of healthy mothers in the community.
  
  
  METHODS
  We rated defenses from interview transcripts about interpersonal vignettes, using the Defense Mechanism Rating Scales quantitative method. Measures of symptoms and functioning were also gathered.
  
  
  RESULTS
  The BC group displayed lower (z = 5.39, df = 1,231, p < .0001) overall defensive functioning than controls: 5.32 [95% CI: 5.13 to 5.51] versus 5.63 [95% CI: 5.50 to 5.76], which is equivalent to a medium effect size (0.62). Compared to controls, the BC group displayed more denial, idealization, displacement, isolation of affect, and splitting of others' images; conversely, they used less altruism, anticipation, intellectualization, and undoing. Controls used a mixture of high adaptive (35.5%), neurotic (43.0%), and immature defenses (21.4%). In contrast, the BC group used fewer high adaptive (30.7%) and neurotic (38.8%) and more immature defenses (30.5%). Both groups scored in relatively healthy ranges on other measures. Correlations with other measures supported the hierarchy of defense adaptiveness.
  
  
  CONCLUSIONS
  The relationships among stress, defensive functioning, and adaptation were largely as predicted. Future studies should examine defenses in the process of seeking care, diagnosis, and treatment response for breast cancer.
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Perry
authors.forename: Jesse
authors.initials: J
authors.lastname: Metzger
authors.forename: John J
authors.initials: JJ
authors.lastname: Sigal
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology