"The role of psychological defenses in moderating between trauma and post-traumatic symptoms among Palestinian men"

Raija-Leena Punamaki, Katri Kanninen, Samir Qouta, Eyad El-Sarraj; International Journal of Psychology, 2002, 37 (5), 286-296.

Psychological defenses are conceptualized as protective processes that help individuals to maintain their integrity in the face of threat and danger. Accordingly, their role in defending trauma victims from post-traumatic symptoms was examined. The sample considered of 128 Palestinian male political ex-prisoners who had reported various degrees of torture and ill-treatment. The first aim was to analyze the dimensionality and distribution of different defense mechanisms. The second was to examine which defenses would moderate the association between the reported torture and ill-treatment and the post-traumatic symptoms (PTSD). Third, the direct association between reported torture and ill-treatment and defenses and between the defenses and symptoms were explored. Defense mechanisms were assessed by a 40-item version of the Defense Style Questionnaire (DSQ), and Post-traumatic symptoms by the Harvard Trauma Questionnaire (HTQ), and experiences of torture and ill-treatment by a sale developed for that purpose. The results show, first, that men used predominantly mature defenses such as anticipation, sublimation, suppression, and rationalization, but also relatively frequently somatization and dissociation, which are characteristic responses among trauma victims. Second, the principal component analysis revealed four defense dimensions, differentiated by the level of maturity and the approach to reality: the mature reality-distorting consciousness-limiting, the immature reality-escaping, and the immature reality-distorting defense. Third, against our hypothesis, the moderating analyses indicated that the reported torture and ill-treatment were relatively more associated with vigilance, avoidance, and intrusion symptoms if men used consciousness-limiting defenses. Yet as expected, the mature reality-based defenses did not show a protective effect. Furthermore, a high level of reported torture and ill-treatment was associated with a low level of the mature reality-based defenses but not with a high level of immature defenses. Last, similarly to earlier studies, the immature reality-distorting and immature reality-escaping defenses associated directly with high, and mature reality-based defenses with low, levels of PTS-symptoms.