[Interplay between defenses and coping during the course of illness--a study of Crohn disease patients]

The psychological coping concept and the psychoanalytic theory of defense are the two most important models for assessing coping with chronic illness. Their interplay has hardly been investigated so far. A "layer model" is proposed to describe the connections between defense and coping. This model is empirically tested by applying a path analysis (latent trait model) to patients suffering from Crohn's disease during the course of the illness. The layer model can be verified, but is valid only during the acute phase of the illness. The results convincingly show that the relationship between defense and coping can only be described as a dynamic interplay that changes in the course of the disease process.