[Defense mechanisms and the prediction of PTSD]

The purpose of this study was to assess mental defense mechanisms, characteristics of trauma and life events predicting the development of posttraumatic stress disorder. Victims of traumatic events were recruited from a general university hospital. 23 participants were examined with a semi structured clinical interview, according to DSM IV criteria. All of them were assessed with the Social Readjustment Scale (Holmes et al., 1967), with the Traumatic Disorder Inventory Scale (Steinitz et al., 1992) and completed the Impact of Event Scale of Horowitz. All the subjects completed the Defense Style Questionnaire-40 (DSQ-40). The different mechanisms were ranked in three categories: mature, neurotic, and immature. Finally, we compared defense scores, trauma scores and life events scores between PTSD subjects and non PTSD subjects. 8 subjects were diagnosed as having PTSD compared to 15 not considered to have PTSD. Being alone during exposure significantly enhances the risk for the development of PTSD. Among PTSD subjects only reaction formation, a neurotic defense, was employed significantly more often than in those without PTSD. These findings suggest that mental defense mechanisms may be indicative of a risk for the development of PTSD after event exposure. Using DSQ-40, mature and immature defenses didn't differ, although reaction formation played a role, particularly in regard to traumatic memories and perseverative thoughts.