Change in Defense Mechanisms During a Brief Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder

Defense mechanisms (DMs) are strategies used by the individuals to protect the ego. Therefore, compulsive behaviors in obsessive-compulsive disorder (OCD) can be recognized as DMs. We analyzed how DMs changed in a brief cognitive behavioral therapy (CBT) for OCD. This was a quasi-experimental study with 92 OCD patients (aged 18-60 years). We used the Mini International Neuropsychiatric Interview to confirm OCD diagnosis, and we assessed the DMs with the Defense Style Questionnaire at three time points. Through a latent change score modeling, we found that the mature mechanism presented a constant change during the therapy. This mechanism increased in average 0.37 points at each measured moment of CBT, showing a linear trajectory. Neurotic and immature mechanisms showed no significant changes during therapy. The increased use of the mature mechanism can be an indicator of improvement in OCD treatment, showing that patients intensified their more adaptive responses to conflicts.