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J Nerv Ment Dis. 2009 Oct;197(10):736-41. doi: 10.1097/NMD.0b013e3181b977f7.

Defense mechanisms and Major Depressive Disorder in African American women.

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Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA.


This study explored differences in defense use between a group of predominantly African American women diagnosed with Major Depressive Disorder (MDD; n = 20) and a healthy control sample (n = 20), both from a primary care medical clinic. Patients completed the Patient Health Questionnaire to assess DSM-IV diagnoses and underwent video-recorded interviews, which were assessed for defenses using the Defensive Functioning Scale from the DSM-IV. Groups were compared for differences in overall defensive functioning, defense levels, and individual defenses using independent samples t tests. Results showed that the MDD group scored higher on mental inhibition, minor image distorting, and major image distorting defense levels as well as the individual defenses devaluation, dissociation, and isolation. The control group scored higher on the overall defensive functioning and the individual defense anticipation. The results also showed a trend toward the MDD group scoring higher on the disavowal defense level and the individual defense splitting.

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