Abstract
DSM-IV-TR describes psychological defense mechanisms as “automatic psychological processes that protect the individual against anxiety and from the awareness of internal or external dangers or stressors.” These defense mechanisms are stable, unconscious processes universally used by people to protect the psyche from anxiety (Davidson and MacGregor 1998; Cramer 2009). Self-esteem is concerned with a person’s self-evaluation and attitude toward self, and indeed everyone is motivated to maintain a high level of self-esteem (James 1890; Pyszczynski et al. 2004). Both defense mechanisms and level of self-esteem have been established as important factors in an individual’s functioning (Pyszczynski et al. 2004; Zeigler-Hill, Chadha, and Osterman 2008; Zeigler-Hill 2011; Cramer 2008; Bowins 2004; Segal, Coolidge, and Mizuno 2007; Davidson and MacGregor 1998; Orth et al. 2009; Sowislo and Orth 2013). Several studies have looked at this more specifically, examining relationships between self-esteem stability and defense mechanisms (Zeigler-Hill, Chadha, and Osterman 2008; Myers and Zeigler-Hill 2011) and defense mechanisms in clinical populations or healthy samples (Sarisoy et al. 2014; Segal, Coolidge, and Mizuno 2007). Further, defense styles and self-esteem have often been studied in tandem, but not as directly related to each other (Sarisoy et al. 2014), a gap the current study will fill. Nor have self-esteem and defense style been studied in a population of cognitive complainers, who are an important population to examine due to their self-reported problems in cognitive functioning and increased risk for depression (Hohman, Beason-Held, and Resnick 2011; Singh-Manoux et al. 2014). The present study examined the relationship between defense style and self-esteem in a population of patients with cognitive complaints. The researchers hypothesized that the use of more immature defense styles would predict lower self-esteem, while the use of more mature defense styles would predict higher self-esteem. Given the small amount of literature on neurotic defenses related to self-esteem, it was considered an exploratory factor in this study.
Method
One hundred eighty-one subjects were administered the Defense Style Questionnaire–40 (DSQ-40; Andrews, Singh, and Bond 1993) and the Minnesota Multiphasic Personality Inventory–2
Results
Demographics for this population and mean scores are presented in Table 1. A hierarchical linear regression analysis revealed a positive relationship between immature defense styles and total LSE score, as well as neurotic defense styles and total LSE score. Conversely, there was a negative relationship between mature defense styles and total LSE score. When analyzing with the factors of the LSE, self-doubt and submissiveness, both immature and neurotic were positively related, excluding neurotic defenses and self-doubt, where the relationship approached significance (p = .05). Mature defenses were negatively related to both self-doubt and submissiveness. Summaries of the regression analyses are displayed in Table 2.
Discussion
The results are consistent with our hypotheses, indicating that more use of mature defense styles is related to higher self-esteem, and more use of immature defense styles is related to lower self-esteem. The neurotic defense style seemed to be similar to the immature defense style in its relationship to self-esteem, except on the self-doubt factor, where it was approaching significance. Interestingly, the relationship for mature and immature defenses remains consistent with both factors of the LSE, showing that defense styles relate not only to self-esteem as a broad construct but also to the more specific constructs that make up self-esteem. Previous studies have identified low self-esteem as a risk factor for depression (Orth et al. 2009; Sowislo and Orth 2013). In addition, cognitive complainers are at higher risk for depression, especially as they age (Hohman, Beason-Held, and Resnick 2011; Singh-Manoux et al. 2014). The fact that this population is presenting at a clinic is indicative of the potential need for psychotherapy for both their cognitive complaints and any comorbid psychopathology. If these cognitive complainers participate in psychotherapy, the clinician should be aware of the relationship between their individual defense styles and self-esteem, as it may affect the outcome of psychotherapy. If a clinician can alter the defense styles used, and/or the level of self-esteem, it may predict a more positive outcome for the client.
Our study examined the relationship between defense styles and self-esteem only in a sample of cognitive complainers. Future studies might look at other populations to examine if the relationship is generalizable across groups. In addition, future studies might examine the effect of treatment on the relationship between defense mechanisms and self-esteem so that we may understand how best to treat individuals presenting with cognitive complaints.