JOURNAL OF PERSONALITY ASSESSMENT, 1988, 52(1), 142-164

Copyright GI 1988, Lawrence Erlbaum Associates, Inc.

The Defense Mechanism Inventory: A

Review of Research and Discussion of
the Scales

Phebe Cramer
Williams College

The current status of the Defense Mechanism Inventory (DMI) is assessed through
a review of the published research. Despite some psychometric problems and
questions of scale interpretation, the defense scales are found to be meaningfully
related to cognitive, personality, pathological, and demographic variables. A n
argument is presented for the continued use of the individual scales.

Since its appearance 19 years ago, the Defense Mechanism Inventory (DMI;
Gleser & Ihilevich, 1969; Ihilevich & Gleser, 1986) has been used as a person-
ality measure in some 40 published investigations. Despite some psychometric
problems, its design-more projective than, for example, Haan's (1965) MMPI-
based scales, and more objective than Schafer's (1954) approach to scoring
defenses on the Rorschach-enhanced its appeal to clinical researchers. Al-
though it is with clinical populations that the majority of DM1 research has been
carried out, it has also been adopted as a measure of defense change in the
experimental laboratory. Considering the importance of defenses for under-
standing personality and the relative paucity of defense measures available in
research, a review of the DM1 seems timely.
The DM1 is an objective, paper-and-pencil test that measures the relative
strength of five defense clusters. The inventory consists of 10 stories describing
conflict situations. Each story is followed by four questions requesting informa-
tion about: the subject's actual behavior in such a situation, impulsive fantasy
response, thoughts, and affect. For each of these four questions, five different
response alternatives representing five defense mechanism clusters are provided.
For each question, subjects are asked to select the response that is most
representative of their own reaction (scored 2) and the response that is least
representative of their reaction (scored 0). The remaining three alternatives are
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 143

scored 1. Scores for each defense mechanism are summed over the 10 stories,
with a maximum possible score of 80.
The five defense clusters (scales), as defined by Gleser and Ihilevich (1969)are:
Turning Against the Self (TAS), Turning Against the Object ('TAO-including
identification with the aggressor and displacement), Projection (PRO), Reversal
(REV-including negation, denial, reaction formation, and repression), and
Principalization (PEW-including intellectualization, isolation, and rationaliza-
tion).
It is the purpose of this article to review the published information regarding
the reliability and validity of the DMI, and to review what has been learned
about the relationship of the DM1 scales to other psychological, demographic,
clinical, and experimental variables. In every case, where a correlation is cited or
a difference is noted, the statistic is significant at the .05 level or better. When
mention is made of no correlation or no difference, the statistic obtained is not
significant at the .05 level. Finally, the psychological meaningfulness of each
scale is discussed, by considering the extent to which the research findings fit
with the definition of the defense(s) that each scale purporte to measure.

RELIABILITY

Table 1 summarizes the findings of six studies in which the reliability of the five
defense scales was assessed. The results are fairly consistent. With one exception,
the retest and the interitem reliability measures both yield coefficients with
similar values of about .78. The lower retest reliability, obtained in the study by
Rohsenow, Erikson, and O'Leary (1978), may be the result of an intervening
therapy experience, inasmuch as therapy has been shown to be related to
defense change in this kind of alcoholic population (O'Leary, Donovan, &
Kasner, 1975).
The findings are also consistent in showing that TAO is the most reliable
scale, whereas PRO is less reliable. Also, when a sex comparison has been made,
the Dl41 scales have been somewhat more reliable for women.

Content Validity

There are two recurring problems regarding the content validity of thle DM1
scales, both of which were identified by Gleser and Ihilevich (11969). The first
problem stems from the nonindependence of the scales. The second problem
concerns the conceptual status of Turning Against the Object.
Gleser and Ihilevich (1969) established content validity by having clinicians
 TABLE 1
Reliability of the Dh4I Scales

Reliability Measure Sample Interval Statistic Reliability

Test-retest
Gleser and Ihilevich (1969) 12 male and female counselors 1 week Pearson r M = .84
Range = .85 (PRO)
to .93 (TAO)
11 male and female psychology 3 weeks Pearson r M = .76
graduate students Range = .69 (PRN)
to .87 (TAO)
Weissman et al. (1971) 94 male and female upper-division 17 days Pearson r Male M = .66
college students Female M = .76
Range = .48 (PRO, Male)
to .87 (TAO, Female)
Woodrow (1973) 27 adults (ages 21 to 55) 2-4 weeks Pearson r M = .78
Range = .66 to .88
Rohsenow et al. (1978) 83 male alcoholics 8 weeks; inpa- Pearson r M = .59
tient therapy Range = .50 (TAS)
to .70 (TAO)
Inter-item
Juni (1982) 95 male and 252 female college Cronbach's coef- Male M = .68
students ficient alpha Female M = .76
Range = .47 (PRO, Male)
to .80 (TAO, Female)
and .81 (REV, Female)
Vickers and Hervig (1981) 131 Marinea recruits Cronbach's coef- M = .85
ficient alpha Range = .77 (PRN)
to .92 (TAO)

"Indicates modified procedure: oral administration, all responses rated 1 through 7.

 E V E W OF THE DEFENSE MECHANISM INVENTORY 145

rate the 240 DM1 alternatives for the defense represented. The agreement
between ratings and the DM1 scoring key was reasonably good for TAS, REV,
and PRN. However, there was noticeable overlap between the PRO and TAO
alternatives. Furthermore, 30% of the TAO alternatives and 19% of the PRO
alternatives were rated as not representing any defense.
These findings were replicated by Blacha and Fancher (1977), whose data
were used by Juni (1982) to show that agreement between the raters and the
scoring keys improved considerably when TAO and PRO alternatives were
combined into a single category. A similar improvement occurred when the
REV and PRN alternatives were combined.
Additional evidence for the nonindependence of the DM1 scales is seen in the
consistently positive intercorrelations found between scores on TAO and PRO
(M r =: .45) and on REV and PRN (M r = .48; Gleser & Ihilevich, 1969; Gleser
& Sacks, 1973; Gur & Gur, 1975). Even higher correlations between TAO and
PRO (r = .88) and between REV and PRN (r = "78)were found by Vickers and
Hervig (1981) who used a modified procedure of oral presentation in which
subjects were asked to rate each response alternative on a 7-point scale.
The intercorrelations among the response alternatives were also clearly
demonstrated in a large, replicated factor analytic study by Woodrow (1973).
Using a modification of the DMI, in which nearly 1,000 subjects rated each
alternative for their likelihood of responding in that way, Woodrow found that
items from TAO and PRO loaded on one factor; items from REV and PRN
loaded on a second factor; and items from TAS, plus female subject sex, loaded
on a third factor.
These consistent findings of scale interrelationshipshave led to the suggestion
that the DM1 scales represent a single defense cor~tinuum.This continuum may
be conceptualized as representing externalizing versus internalizing deferses, as
supported by Juni's (1982) finding that raters categorized 89% of the TAO plus
PRO alternatives as "externalizing" and 93% of the REV plus PEW alternatives
as "internalizing."' Alternatively, Juni (1982), Juni and Masling (1980), and
Wilson (1982) proposed that the DMI defenses constitute a single contnnuum
relating to the expression of aggression, in which the defenses at. one end
facilitatie the expression of aggression (TAO &PRO), whereas those at the other
end inhibit acting out (PRN, REV, & TAS). Juni and Masling (1980) demon-
strated that a composite defense score representing this continuum [(TAO +
PRO) -- (PRN + REV +TAS)] correlated somewhat better than any
individual defense score with subjects' manifestation of an aggressive response to
aggressive provocation. It may be questioned, however, whether this increase in
predictive value exceeds that which would be expected to occur statistically as

'It is also supported by studies of male subjects in which TAO and PRO were associated with
empirical measures of externality, while internality was associated with REV and PRN (Gur Cx Gur,
1975; Rohsenow et al., 1978).
the result of a 5-fold increase in the number of items constituting the defense
score (Spearman-Brown correction).
To summarize: There is consistent evidence, based on both raters' judgments
and subjects' performance, that there is item overlap among the scales. One
interpretation of these findings is that the items have poor content validity. An
alternative interpretation, however, is that the defense clusters do, in fact,
overlap in reality. For example, a defensive reaction may involve both projec-
tion and displacement (part of TAO), as in some animal phobias. Whether or
not it makes sense to maintain five separate scales on the DM1 would seem to
depend on whether, in any important circumstances, they manifest different
predictive relationships. This issue is addressed later.
A second problem with the content validity of the DM1 is seen in the finding
that more than 30% of the alternatives keyed as TAO were rated as not
representing any defense, At the basis of this problem is the conceptual status of
Turning Against the Object. From one point of view, the overt expression of
aggression toward another might be considered to indicate the absence of
defense, However, Hilgard (1949) pointed out that the direct expression of
hostility is defensive when the object of the hostility is considerably removed
from the object of the original conflict. In the case of the DM1 alternatives, the
~roblemis not that they fail to represent the content of Turning Against the
Object, but rather that Turning Against the Object is a defense only within
certain contexts.

Concurrent Validity

Attempts to establish concurrent validity have been hampered by a lack of other

comparable standardized defense measures to use as a criterion. However, there
are seven investigations that report on the relationship of the DM1 scales to
eight defense measures. The majority of these studies have been carried out with
pathological populations.
The relationship of the DM1 scores to the MMPI defensive scales-L (Lie
score), K (Defensiveness; "fake goodn), and F (Validity score)-and to Byme's
(1963) Repression-Sensitization scale has been reported by Gleser and Ihilevich
(1969)in their study of 160 psychiatric outpatients and by Rohsenow et al. (1978)
in a study of 83 male alcoholics. Gleser and Ihilevich (1969) also reported on the
relationship between the DM1 and Haan's (1965) MMPI-derived defense scales.'
The relationship of the DM1 to Joffee and Naditch's (1977) defense scales3
derived from the California Psychological Inventory (CPI; Gough, 1956) and to

*~efensesmeasured include Denial, Projection, Intellectualizing, Regression, Displacement,

Repression, and Primitive defense.
3~efensesmeasured include Denial, Projection, Intellectualization, Regression, Displacement,
Repression, Primitive defense, Isolation, Reaction formation, and Rationalization.
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 147

Coping Operations Preference Enquiry (COPE) defense measures4 (a Funda-

mental Interpersonal Relations Orientation awareness scale; Schutz, 1962) was
studied by Vickers and Hervig (1981) in a sample of 99 male Marine recruits
being discharged as unsuitable for the service.
Only one study made use of clinical ratings as a criterion measure for defense
use. Schueler, Herron, Poland, and Schultz (1982) rated 80 schizophrenic
inpatients for their manifestation of avoidance of others, turning against the
object, projection, and turning against the self, and compared these ratings with
DM1 scores.
Two studies investigated the use of the DM1 in normal college populations.
Massomg, Dickson, Ritzler, and Layne (1982a) related the DM1 scores of 40
underg~aduatesto their scores on the Blacky Defense Preference Inquiry (Blum,
1950);~ Evans (1979) related the DM1 scores of 113 undergraduates to the Denial
subscale of the Marlowe-Crowne Social Desirability scale (Crowne & Marlowe,
1960).
Table 2 summarizes the DM1 concurrent validity data from these studies.
Significant relationships between identically named or theoretically related
variablles are reported. When the relationship was significant for one sex but not
the other, this is indicated. Studies that include only male subjects are foot-
noted.
REV is the only DM1 scale to show consistently the expected relationships
with the criterion measures: It is consistently related to Denial, Primitive
defense, Repression, and Avoidance. PRN does not correlate with any of the
criterion scales that measure its components, with the exception of the (COPE
Isolation scale. At the same time, PRN does correlate with measures of Denial,
Primitive defense, Regression, and Repression-all of which are lower level
defenses and, theoretically,would not be expected to relate to PRN. Overall, the
data do not support the validity of PRN.
In considering the validity data for TAO, it should be noted that only one
study (Schueler et al., 1982) directly measured this variable, using the Phillips
Symptom Checklist6 (Phillips & Rabinovitch, 1958) measure of Turning
Against Others. The failure of TAO to correlate with this criterion variable may
be related to the fact that this population of schizophrenic patients obtained
extremely high scores on the REV scale, thereby precluding high scores on other
scales. The data also show a consistent negative correlation between TAO and
Repression and between TAO and Denial with some evidence for a positive

4Defenses measured include Denial, Projection, Intellectualization, Regression, and Turning

Against th~eSelf.
5Defenscsmeasured include Avoidance, Projection, Intellectualization,Regression, and Reaction
Formation.
6Defenses measured include Turning Against the Object, Turning Against the Self, and i4void-
ance of Others.
 TABLE 2
Relationship Between DM1 Scales a n d Other Defense Measuresa
- -

Criterion Measure PRN TAO PRO TAS

MMPI
Gleser and Ihilevich
(1969) +w/L - w/L (males)
+w/K (males) +w/K (females) - w/K(males) -w/K females)
- w/F - w/F (females) +w/F (females) +w/F (females)
Rohsenow et al.
(1878)b

Hpan MMPI-based
Gleser and lhilevich
(1969) +w/Denial +w/Denial - w/Denial 0 w/Projection + w/Repression (males)
+w/Primitive defense +w/Primitive defense -w/Repression -w/Repression (females)
0 w/Intellectualizing 0 w/Displacement
Joffee and Naditch
(1977)
CPI-based
Vickers and Hervig
(198Qb

COPE
Vickers & Hervig
(1981)~ 0 w/Turning against self +w/Projection 0 w n u r n i n g against self
Repression-Sensitization
Ihilevich and Gleser
(1971) +w/Repression (males) -w/Repression (males) - w/Repression (males) -w/Repression (males)
Rohsenow et al.
(197Wb 0 w/Repression +w/Repression - w/Repression 0 w/Repression 0 w/Repression
Phillips Symptom Check
List
Schueler et al.
(1982) +w/Avoidance of 0 w/Tuming against +w/Projection/Turning +w/Turning against
others/Turning against object/ against self self/Projection
object Avoidance of Others
Blacky Defense Preference
Inquiry
Massong et al.
(1982a) - w/Regression 0 w/Intellecutalization
Marlow-Crowne Social
Desirability Scale: Denial
Evans
(1979) +
w/Denial (females) 0 - w/Denial (females) -w/Denial (females) +w/Denial (females)
0 w/Denial (males) 0 w/Deniai (males) +w/Denial (males)
-w/Denial (males)
- - - -

"+ W/ = positive correlation with; - w/ = negative correlation with; 0 w/ = no correlation with. b ~ a m p l eincluded only males.
150 CRAMER

correlation with Displacement and Regression. Taken together, these findings

provide some support for the TAO scale.
The findings for PRO are mixed. In two studies (Gleser & Ihilevich, 1969;
Massong et al., 1982a), there was no relationship between the DM1 PRO
measure and the criterion measure of Projection. In two other studies (Schueler
et al., 1982; Vickers & Hervig, 1981), there was a positive correlation between
PRO and three criterion measures. It is perhaps significant that two of these
successful correlations included only men in their subject sample.
Finally, the findings for TAS are quite inconsistent. The only clear support
for TAS comes from the study that used staff ratings for the criterion variable
(Schueler et al., 1982). The only other study to measure turning against the self
directly (Vickers & Hervig, 1981)showed no relationship to TAS. There is some
evidence that the relationship between the TAS scale and other measures of
defense (e.g., Repression, Projection, and Denial) is modified by subjects' sex.
Overall, there appears to be ample validity support for REV, none for PRN,
and moderate support for PRO, TAO, and TAS. It is possible that sex may be
an important mediating variable in TAS and PRO. Furthermore, although REV
and PRN generally show the same pattern of intercorrelations with criterion
variables, as do TAO and PRO, there are some meaningful exceptions.

THE RELATIONSHIP BETWEEN DM1 SCALES AND

COGNITIVE MEASURES

Investigations of the relationship between the DM1 and measures of cognitive

functioning have focused on two areas: field dependence-independence and
memory constriction. In both areas, the findings are generally consistent and
theoretically meaningful.

Field Dependence-Independence

The rationale for hypothesizing a relationship between defense preference and

the cognitive style of field dependence-independence is based on the conception
of certain defenses, such as denial and repression, being less differentiated (more
primitive) and more global, whereas other defenses, such as projection and
hostility-turned-outward, are more articulated and involve more separation of
self from surround. The use of more global defenses are expected to relate to field
dependence; more articulated defenses are associated with field independence.
The results of four studies support this hypothesis. Regardless of the measure
of field dependence used-Rod and Frame Test, Figure Drawing, Autokinetic
effect, Embedded Figure Test, Group Embedded Figure Test-the choice of
REV and TAS as defenses were associated with field dependence. This has been
demonstrated most clearly for men (Bogo, Winget, & Gleser, 1970; Donovan,
Hague, & O'Leary, 1975; Ihilevich & Gleser, 1971; Rohsenow et al., 1978) but
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 151

has also been found in one sample of women (Ihilevich & Gleser, 1971). On the
other hand, both TAO and PRO are consistently found to be associated with
field independence (Bogo et al., 1970; Donovan et al., 1975; Ihilevich & Gleser,
1971; Rohsenow et al., 1978). Most studies have found PRN to be unrelated to
the field dependence variable. Only one study (Shevrin, Smokler, &Wolf, 1979)
failed to find any relationship between field de~endence-independence and
DM1 variables.
On first consideration, these relationships between DM1 scales and field
dependence might appear to be spuriously mediated by sex because (as is
documented later) women typically score higher on REV and TAS, as well as on
field dependence, whereas men typically score higher on TAO and PRO, as well
as on field independence. Two lines of evidence negate this possibility. First,
when men and women were equated for preferred defense strength, they did not
differ in field dependence-independence (Ihilevich & Gleser, 1971). Second, the
relationship between defense preference and field dependence-independence
holds within one sex: men who are high on REV and TAS are field dependent;
men who are high on TAO and PRO are field independent @onovan et al.,
1975; Rohsenow et al., 1978).These findings raise the interesting possibility that
field dependence is defense-mediated rather than sex-linked.

Memory Constriction
The rationale for hypothesizing a relationship between defense preference and
memory is based on the assumption that defenses, such as repression and denial,
function by restricting the range of memories or perceptions toward which
attention may be deployed-especially if the recognition of these events would
arouse anxiety. One would, then, expect to find a special relationship between
REV and memory unavailability not found with the other defense clusters.
Such a relationship was demonstrated by Schill and Bekker (1976). In a
word-association study, those subjects who avoided giving sexual associations to
double entendre stimuli were found to have high scores on REV and PRN,
whereas subjects who gave more sexual associations scored high on TAO and
PRO. It was also demonstrated in Gleser and Ihilevich's (1969) analysis of
Cohen's (1969) dream recall data: Subjects who were identified as having low
dream recall scored high on REV and low on TAO, as compared with high
recallers. This conclusion differed from that in Cohen's (1969) report of the
original study, perhaps because Cohen's subject groups were based on defense
scores rather than on dream recall.

CLINICAL MEASURES

Investigations of the relationship between the DM1 and measures of pathology

are of two types: those in which pathology is determined from responses to
questionnaires and those in which pathology is based on clinical diagnoses.
Questionnaire Pathology

The results of correlating DM1 scores with MMPI scale scores in two large
samples (Gleser & Ihilevich, 1969; Rohsenow et al., 1978) were consistent in
showing that the choice of either T A O or TAS was positively related to a
number of pathological MMPI scores. Of special note is the finding in both
studies of a positive relationship between TAS and Depression, and a negative
relationship between TAS and Barron's MMPI-derived Ego Strength scale
(Barron, 1953). The two studies were consistent also in showing that the choice
of PRN or REV was negatively related to pathological MMPI scores. PRO was
unrelated to any MMPI scales in Gleser and Ihilevich's sample, and, in both
samples, failed to correlate with Paranoia. The relationship between DM1 scores
and MMPI scales differed for men and women in ways not easily summarized or
interpreted, a result also noted by Shevrin et al. (1979).
The relationship between DM1 scores and acknowledgment of various psy-
chological symptoms was investigated by Frank, McLaughlin, and Crusco
(1984). For both male and female college students, TAS was positively related to
symptom distress, whereas PRN and REV were negatively associated with
symptom distress. Among women only, T A O and PRO were positively related
to symptom distress and were better predictors of distress than was their
(masculine) sex-role orientation.
In a study of mood level (Clum & Clum, 1973a, 1973b), DM1 scores were
found to be related, for men only, to scores on the Wessman-Risks mood scale
(Wessman & Ricks, 1966). As in the previously discussed studies, T A O was
positively related to dysphoria (anger and depression) and negatively related to
euphoria (energy level, freedom, and receptivity). The reverse relationships were
found for PRN and REV.
As is discussed later, these results should be interpreted in conjunction with
the findings for both sexes that REV and PRN correlate positively with the
MMPI Lie scale and with Marlowe-Crowne Social Desirability scores (Evans,
1979; Richert & Ketterling, 1978; Wilson, 1982), whereas T A O was negatively
correlated with Social Desirability. However, TAS was positively correlated
with S ~ c i aDesirability
l in women, but negatively correlated in men, whereas
PRO was positively related to Social Desirability in men, but negatively corre-
lated in women.

Clinically Diagnosed Pathology

Alcoholics. A study by Aldridge (reported in Gleser & Ihilevich, 1969)

suggested differences in defense choice between male alcoholics and a normative
sample. However, when an alcoholic group was matched with a nonalcoholic,
hospital control group for sex, age, educational level, race, and social class,
Donovan, Rohsenow, Schau, and O'Leary (1977) found no differences in
 REVIEW OF THE DEFENSE MECHANISM INVENTORY' 153

defense choice. Rohsenow et al. (1978) also found that the pattern of relation-
ships between alcoholics' DM1 scores and other psychological measures was
essentially similar to that of nonalcoholic populations.

Psychiatric patients. Gleser and Ihilevich (1969) reported on a sample of

psychiatric outpatients, presumably in the neurotic-character disorder range. It
was found that for men only, TAS and REV were higher than in a nonpatient
sample, whereas TAO and PRO were lower. Within a sample of schizophrenics,
Schueler et al. (1982) found that patients diagnosed as reactive schizophrenic
scored higher on PRO and TAS than did those diagnosed as process schizophre-
nic, who, in turn, scored extremely high on REV (M = 50-k).
In an interesting study by Scholz (1973), 35 patients hospitalized for :suicide
attempts were matched with 35 nonsuicidal patients. The finding that TAS was
higher in the suicidal than in nonsuicidal patients provides support for the
validity of the TAS scale. In addition, those suicidal patients who vacillated
between being dependent versus hostile toward others scored higher on TAO
and PRO; those who maintained a symbiotic, undifferentiated relationship with
others scored higher on REV, whereas those who were unaccepting of them-
selves and sought approval from others were found to score higher on PRN.
These results make theoretical sense and provide support for DM1 validity.

Physical distress in women. In a study of 50 young adult women, Greenberg

and Fisher (1984) assessed the degree of menstrual discomfort relative to other
body problems they experienced, and related this distress to DM1 scale scores.
Women who scored high on TAO or PRO reported greater discomfort; scores
on PRN and REV were negatively correlated with distress.
The postoperative behavior of women recovering from major surgery was
related to modified DM1 scores by Wilson (1982). High scores on TAO andl PRO
were correlated with spending more time in bed, requesting more injections for
pain, and initiating more posthospital contact with the physicians. High scores
on REV and TAS showed the opposite relationships. In addition, preoperative
fear was correlated positively with TAO and negatively with REV.

RELATIONSHIP BETWEEN THE DMI AND SUBJECT

VARIABLES

Sex

A comparison of the performance of men and women on the DM1 has been
made in 12 different investigations with 14 different subject samples (Bogo et al.,
1970; Cramer, 1979; Cramer & Carter, 1978; Dudley, 1978; Frank et al., 1984;
Gleser & Ihilevich, 1969; Gleser & Sacks, 1973; Massong et al., 1982b; Morelli
& Andrews, 1982; Schueler et al., 1982; Sugerman, Sheldon, & Roth, 1975;
Weissman, Ritter, & Gordon, 1971). In 11 of the subject groups, men scored
higher on TAO than women, and women scored higher on TAS than men. The
exceptions to these results occurred in subject samples that were unique in some
way-for example, rural Southern Baptists (Dudley, 1978), schizophrenic
inpatients (Schueler et al., 1982), or early adolescents (Cramer, 1979). The only
sample in which the TAO-TAS sex difference was not found (nor any other sex
difference), and for whom no unique feature is apparent, is that of Morelli and
Andrews (1982) with students from a New Jersey State College.
In nine samples studied, men scored higher on PRO than women. Of the six
samples that did not show this sex-related difference, four were adult without
college educations and/or pathological groups (Gleser & Ihilevich, 1969;
Schueler et al., 1982; Sugerman et al., 1975).
Finally, there is weak evidence for women scoring higher than men on REV
or PRN in a few samples (Bogo et al., 1970; Cramer, 1979; Cramer & Carter,
1978; Frank et al., 1984; Gleser & Sacks, 1973; Weissman et al., 1971).

Sexual Orientation

Five studies show a relationship between defense choice and sexual orientation
as assessed by the MMM Mf scale (Gleser & Ihilevich, 1969; Rohsenow et al.,
1978), by Bem's Sex Role Inventory (Evans, 1982), by the PRF-Andro scale
(Frank et al., 1984), and by May's fantasy measure (Cramer & Carter, 1978).
The results are consistent in showing that for both men and women the choice
of TAS was associated with a feminine orientation. In both men and women, 4
of the 5 studies also found REV to be associated with a feminine orientation and
TAO to be associated with a masculine orientation. For men, the choice of PRO
was associated with a masculine orientation, and one study (Frank et al., 1984)
found PRN to be associated with an androgynous orientation.

Age, Education, and Birth Order

The findings are consistent regarding the relationship between defense choice
and age: PRN and REV are positively related to age, whereas TAO and PRO are
negatively related. This was found to be true within the narrower range of early
adulthood (Gleser & Ihilevich, 1969) as well as over the broader range, through
late adulthood (Donovan, Hague, & O'Leary, 1975; Rohsenow et al., 1978;
Wilson, 1982). Only one study reports the relationship between defense choice
and education unconfounded by age (Rohsenow et al., 1978): PRN correlated
positively with years of education, REV and TAS correlated negatively, and
both TAO and PRO were unrelated. Dudley (1978) reported that first-borns
chose TAO less often than later-borns.
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 155

REACTIONS TO EXPERIMENTAL INTERVENTION

Predicting the Response to Intervention

The DM1 has been used to predict subjects' responses to interventions involving
induced failure, self-appraisal, and psychotherapy.
In three studies (Gleser &Sacks, 1973;Juni & Masling, 1980; Klusman, 1982),
subjects were rated for affect and expression of hostility following an induced
failure experience, and their opinion toward psychological experiments was
elicited. Despite the use of different interventions, the results were consistent.
Subjects with high scores on TAS reacted to failure by turning hostility inward,
experiencing negative affect and anxiety. High scores on REV and PRN were
associated with low rated hostility and positive affect; high scores on TAO and
PRO were associated with high hostility. However, men who scored high on
TAO expressed this hostility directly, but men who scored high on PRO
expressed hostility indirectly or turned it inward. Subjects who scored high on
TAO and PRO also expressed negative opinions regarding the value of psycho-
logical experiments, whereas subjects who scored high on TAS, REV, and PRN
expressed positive opinions.
In addition, Gleser and Sacks (1973) related defense scores to subjects'
estimates of their own ability following failure. High scorers on PRN made the
most accurate self-estimates. Men who scored high on TAS and REV reacted to
failure by lowering their self-estimate;men who scored high on TAO reacted by
increasing their self-estimate. That these results are, in fact, due to the failure
manipulation is supported through a study by Kipper and Ginot (1979). Subjects
were asked to rate their performance in a neutral-that is, no failure, no
success-setting; those who had high scores on TAS undervalued themselves, as
before. However, subjects who scored high on REV, in the absence of negative
feedback, overvalued themselves, as did those who scored high on PRO.
Two studies made use of DM1 scores to predict therapy outcatme. O'Leary,
Rohsenow, Schau, and Donovan (1977), in a study of 54 male alcoholics, found
that the capacity to complete 1 year of treatment was associated with high
pretherapy scores on REV, whereas low REV and high TAO scores were
associated with rehospitalization. However, a second study with alcoholics
(Hague, Donovan, & O'Leary, 1976), found no relationship between DM1
scores and therapy outcome measured over a 2-month period.

Measuring Intervention Effectiveness

Juni and Yanishevsky (1983) measured change in DM1 scores as a result of a

failure experience. Male subjects who experienced failure between the two
halves of the test showed greater variability in TAS scores. Also, their scores on
REV increased but those on TAO decreased. Scores for female subjects were not
affected.
Two studies used the DM1 to determine changes in defense scores following a
therapeutic intervention (Gleser & Ihilevich, 1969; O'Leary et al., 1977). Both
found a decrease in the choice of REV and an increase in the use of externalizing
defenses (PRO and TAO, respectively).
A study by Dudley (1978) suggested that the results just mentioned were
unlikely to be due to a1'fake good" attempt, for when his subjects were instructed
to respond to the DM1 in order to create a favorable impression, the result was
to increase scores on REV and on PEW, and to decrease scores on PRO and
TAO.

CONCLUSION

Two issues are addressed in this final section. First, the heuristic value of
maintaining five separate DM1 scales is considered. Second, the findings re-
viewed in this article are used to evaluate the theoretical meaningfulness of each
scale.
Although there is overlap between the REV and PEW scales and between the
TAO and PRO scales, such nonindependence may be theoretically justified, as
discussed earlier. Beyond this, there is considerable evidence that the scales are
assessing separate dimensions, and thus, should be individually maintained. For
example, REV is positively related to Denial, field dependence, low dream recall,
few postoperative complaints, and successful therapy, whereas PRN is unrelated
to these variables. On the other hand, PRN is positively related to number of
years of education and to accurate self-appraisal, whereas REV is negatively
related to education and is associated with inaccurate self-evaluation. Among
suicidal patients, REV is associated with dependent, symbiotic relationships
with others, whereas PRN is associated with using achievement as a way to gain
approval from others. Finally, extremely high REV scores are associated with
severe psychopathology.
Similar distinctive patterns of relationships exist for TAO and PRO. TAO,
but not PRO, is positively related to Regression and Dysphoria and negatively
related to Repression, Denial, and Social Desirability. O n the other hand, PRO,
but not TAO, is ~ o s i t i v erelated
l~ to Projection, and self-overvaluation. More-
over, TAO is negatively associated with Social Desirability, whereas PRO is
~ o s i t i v e lassociated
~ for men and negatively for women. Finally, TAO is
positively associated with directing hostility outwards, but PRO is associated
with either the indirect expression of hostility or with directing hostility
inwards.
A similarly convincing case may be made for the importance of maintaining
the TAS scale, contrary to the suggestion of Juni and Masling (1980). TAS is
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 157

associated positively with Depression, negatively with Ego-Strength, positively

with undervaluation of self, positively with suicide attempts, and, in women,
positively with low dominance and Social Desirability. In men, TAS i.i nega-
tively related to Social Desirability. Consistently, women score higher than men
on TAS. Taken together, these results show TAS to be reliably related to
affective pathology and a culturally stereotyped female role-a finding that
tempts speculation regarding the origins of depression in women.
These findings indicate the usefulness of the individual D M scales insofar as
they predict unique relationships with other psychological variables. In the
following section, what it is that the five DM1 scales are measuring is discussed.
This issue is addressed by reviewing the theoretical definition of each scale and
considering the extent to which the research findings are consistent with the
theoretical meaning of the defense.
The REVersal scale is described as measuring negation, denial, repression,
and reaction formation. Because these are immature defenses that function by
limiting awareness, we expect that REV is related to other indications of
psycholiogical immaturity and cognitive restriction. Several studies provide
these expected results: The relationship between REV and educational level is
negative, but, is positive with field dependence, the tendency to overvalue one's
own performance, and a feminine orientation-the latter finding perhaps
reflecting a cultural stereotype of "femininen that includes a component of
childlike immaturity. REV is also associated with the avoidance of sexual
responses and reduced dream recall.
Due to the limiting of awareness and the psychological immaturity, we expect
that the use of REV in adults is associated with psychopathology, as was found
for male outpatients and chronic schizophrenics. Because we believe that
psychotherapy fosters psychological growth and broadens awareness, the
finding of decreased REV following therapy is also expected. Finally, we expect
that REV correlates with other scales defined as measuring the same defenses.
REV is found consistently to be correlated with other scales of Denial, and is
occasionally related to other measures of immature defenses (primitive defense,
repression, regression, and avoidance).In all these ways, the KEV scale is related
to other psychological indexes in ways that are expected.
On the ~ t h e rhand, there are a number of unexpected and proble~matic
results. The first of these is that REV is positively correlated with age, but we
expect a decrease in the use of immature defenses with age. Possible explanations
include the restriction of populations studied to adults only or cohort effects, as
suggested earlier. Other problematic findings come from studies in which REV
is associated with apparent psychological and physical health: Subjects with
high REV scores report feeling more energetic, less dysphoric, having fewer
psychological symptoms, less menstrual distress, and make fewer requests for
postoperative attention, They also report less upset following experiences of
failure, From these results, it would appear that REV is a "successful" defense,
 contributing to positive psychological functioning. Such an interpretation,
however, is at odds with the theoretical expectations and empirical findings just
described.
The apparent contradiction may be cleared up by focusing on the defense
itself. People who use REVersal or denial as a defense do so not only on a test of
defense mechanisms. It may be that, by its very nature, the use of this defense
precludes recognizing or admitting to the existence of pathology, pain, or
discomfort on self-report measures.
There is, in fact, consistent evidence that people who score high on REV also
respond to other measures in a way they believe to be socially desirable, even
though this may distort reality, and scores on REV are increased under
"fake-good" instructions. From this point of view, it appears that the REV scale
does, in fact, do a good job in measuring the immature defenses it purports to
measure.
The PRiNcipalization scale is described as measuring intellectualization,
isolation, and rationalization. Insofar as these are higher level defenses that
attempt to control conflict or anxiety through cognitive maneuvers and the use
of one's intellect, we expect this scale to be related to other indications of
intellectual maturity and to the positive evaluation of intellectual activity.
Some of the findings with the F'RN scale are expected. PRN is positively
correlated with age and education, and is positively related to an internal locus
of control. After a failure experience, subjects who score high on PRN are more
likely to express a positive opinion about the value of psychological experiments
and to make an accurate estimate of their own performance. Among suicidal
patients, those who score high on PRN used their intellectual capabilities as a
way to elicit approval from others.
As a more mature defense, it is expected that PRN is related to measures of
social desirability, as was found. For the same reason, the negative correlations
obtained between PRN and measures of psychopathology are expected.
However, as in the discussion of REV, these last findings are probtmatic in
that PRN also correlates positively with the MMPI Lie scale and "Fake Good"
scale, As with REV, it is possible that persons who score high on PRN also use
that defense to prevent the acknowledgment of psychological difficulties.
On the other hand, there are several unexpected findings that seriously
question whether PRN does measure the intellectual defenses by which it is
defined. It does not relate to any of the measures of cognitive functioning, but a
positive relationship with field independence, dream recall, and nonavoidance
of sexual responses is expected. Nor does it relate to other scales designed to
measure intellectualizing. Instead, PRN correlated positively with measures of
lower level, immature defenses: denial, primitive defense, and regression.
Thus the conceptual status of PRN is unclear. The research evidence is about
equally divided between those findings that are consistent with the definition of
PRN as an "intellectual" defense and those that are inconsistent. It appears that
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 159

PRN may be measuring the subjects' tendency to value intellectuality rather

than the proclivity to use intellectual defenses.
The Turning Against the Object scale involves the expression of aggression
outward and includes the defenses of identification with the aggressor and
diplacement. We thus expect TAO to be positively related to other measures of
anger and hostility and to an antagonistic external orientation. Critical to the
definition of TAO as a defense, however, is the assumption that the aggression
is being directed toward a person other than the one for whom it is intended-
generally, a person of weaker or lower status-or that the expression of aggres-
sion masks or is an attempt to relieve the experience of anxiety (cf. Moustakas,
1959).
Several lines of evidence converge to show a relationship between TAlO and
other measures of aggression or antagonistic hostility. Patients who scoretd high
on TAO were observed to vacillate between dependency and hostility toward
others, and to make more requests for medication and physician contact but
report less relief. Also, observations following a failure experience found a lhigher
incidence of hostility among individuals high on TAO. In addition to these
observational data, individuals high on TAO report that they feel more angry
and less receptive toward others.
The finding that men and women with a masculine orientation reliably score
higher on TAO is consistent with the masculine stereotype, as is the finding that
mildly disturbed men score lower on TAO than do "normal" men, whereas
mildly disturbed women score higher. At the same time, the expectation that
the overt expression of aggression will meet with social disapproval is confirmed
by the negative correlation of TAO with measures of social desirability and with
instructions to "fake good."
There is very little evidence to support the assumption that TAO measures
defensive aggression. One study found TAO to correlate positively with a
measure of displacement (although PRO and T14S also correlated with this
measure), but another study found no relationship with displacement. Better
support comes from an induced failure experiment, in which subjects high on
TAO were more likely to devalue others and to criticize psychological experi-
ments following failure. Beyond these two studies, confirming evidence for
defensive aggression is not available.
There is, however, considerable information relating TAO to lack of inhibi-
tion or control. High scores on TAO were related to the tendency to give siexual
associations to double entendre stimuli, to the ability to recall dreams, and to an
external locus of control, but negatively related to the use of defenses such as
denial or repression. The finding that older individuals and, within a family,
first borns are less likely to use TAO is evidence for a negative relationship
between control and TAO. It also seems likely that the relationship between
TAO and the pathological scales on the M W I is mediated by lack of control, as
is the relationship between high TAO scores and the need for rehospitalization,
160 CRAMER

in a psychiatric patient group. Two other problematic findings-that TAO

increased following psychotherapy and was positively related to preoperative
fear-may also reflect less inhibition on the part of these subjects in acknowl-
edging their feelings.
On balance, there is very little evidence available that supports the TAO scale
as a measure of defense. It is noteworthy, however, that this scale consistently
shows the highest level of reliability.
The PROjection scale is described as measuring the classical defense of
projection in which the subject's own unacceptable thoughts or feelings are
placed onto someone else in the environment, who then becomes an object of
suspicion. It is expected that this scale is related to other measures indicating an
external, but wary, orientation-an inability to express negative feelings directly
and a tendency to blame others for one's own shortcomings. There is some
evidence to support these expectations: PRO is positively related to field
independence and an external locus of control. Moreover, after an experimental
failure, subjects high in PRO tend to devalue the experiment and to express their
hostility in an indirect or inward manner, in contrast to TAO subjects, who
express hostility directly. In a problem-solving situation, high PRO subjects tend
to overvalue themselves, perhaps through projecting inadequacy outward.
The use of projection may give the individual a reason or justification to feel
angry at the object of the projection. This expectation is consistent with the
finding of a greater number of postoperative complaints and requests made by
women who scored high on PRO, and by the greater degree of hostile depen-
dency expressed by suicidal patients who scored high in PRO. Not surprisingly,
PRO decreases with "fake good" instructions and with age (presumably an
indication of increased maturity).
Because of its external orientation often invoIving the (indirect) expression of
aggression, it is expected that PRO may be more characteristic of men and would
be associated with a masculine orientation, as was found. For this same reason,
the finding that men with psychological difficulties are less likely than 'cnormal"
men to use PRO is expected, as well as the finding of a positive association
between PRO and psychological symptoms in women.
In fact, there is considerable difficulty in trying to understand the relationship
between PRO and indications of psychopathology. Theoretically, projection is
one of the characteristic defenses of paranoia, yet scores on PRO were not
correlated with those on the MMPI Paranoia scale. Also, PRO has been found
to correlate positively with, and to be unrelated to, the other MMPI scales.
Similarly, PRO has been found to have both a positive and a negative correla-
tion with Denial and a negative or no relation with Repression. Even with other
scales purporting to measure projection, the evidence is inconsistent: Sometimes
the correlation is positive; other times, the two measures are unrelated. Further,
the increase found in PRO scores after psychotherapy are difficult to fit with the
conception of projection as a defense associated with psychopathology.
 REVIEW OF THE DEFENSE MECHANISM INVENTORY 161

As suggested earlier, some of the inconsistent results may reflect the observa-
tion that high PRO scores have different correlates in men than in women. Of
the three studies in which PRO correlated positively with other measures of
projection, two of the samples were entirely men. The sex-related differences
were also seen in the relationships between PRO and denial, and with Social
Desirability. In both cases, the correlation is positive for men but negative for
women. A second explanation of the inconsistent results is found nn the
noticeably lower reliability of the PRO scale, especially among college-age males.
The Turning Against Self scale is described as measuring the tendency to deal
with conflict by turning against oneself. It is thus expected to be related to the
internalization of external problems, affective dysphoria, the inhibition of the
overt expression of aggression, and a lower self-esteem.
The research reviewed provides support for these expectations. TAS is
~ositivelyrelated to depression, suicide attempts, low Ego Strength, aind an
undervaluation of self-worth-findings consistent with the theoretical position
that depression results from aggression turned inward that attacks and destroys
the self rather than an external object. Moreover, following a failure experience,
subjects high on TAS were noted to turn hostility inward and to express positive
opinions about the experiment. Although TAS is positively related to reported
psychological symptoms and field dependence, women who scored high on TAS
were less likely to voice complaints or request help in connection with physical
distress. The expected inhibition of overt aggression is also seen in the findings
that high TAS is associated with low assertiveness in men and low dominance in
women.
As wilth TAO and PRO, TAS is a sex-linked defense, occurring more often in
women and in those with a feminine orientation. It would be expected, as was
found, that TAS would be positively correlated with Social Desirability for
women, but negatively related for men. The undesirability of TAS for men was
also found in the higher TAS scores among those receiving therapy.
Some of the evidence regarding TAS is inconsistent. TAS correlates with
denial in both a positive (women) and a negative (men) direction, possibly
explained by the social desirability finding. Also, TAS relates to Repression
positively, negatively, or not at all. Likewise, it has been found to be both related
and not related to other measures of turning against the self.
There are also some unexpected findings. Although TAS is related to scores
on the MMPI Depression scale, it failed to correlate with indications of
depression or low energy level on the Wessman-Ricks mood scale. Also prob-
lematic are the positive correlations found for TAS with Projection and with
Displacement, both of which are externalizing defenses. As this occurred in an
all-male sample, it may again highlight the different meaning ofthe scale for men
and women. In a mixed-sex sample using a more projective test, TAS was
negatively related to Projection.
In sum: The DM1 has made it possible for clinical researchers to investigate, in
a systematic way, one of the most important aspects of the normal and
pathological personality. Despite the fixed choice format and the scoring
restrictions, the individual scales have proven quite sensitive to rather subtle
nuances of clinical behavior, especially in real life or "miniature" situations
(Santostefano, 1962). The failure to find correlations with other similarly named
scales may reflect inadequacies in those scales. The best empirical support was
found for the REV and TAS scales; it is somewhat less clear what PRN and PRO
are measuring. TAO clearly measures the tendency to direct aggression out-
wards, but lacks support for being a measure of defense.

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Phebe Cramer
Department of Psychology
Williams College
Williamstown, MA 02167

Received November 7, 1986

Revised April 23, 1987