., ’ . ». OVERDUE FINES: 1., _ , 25¢ per day per item 3:: {6%}; 1: RETURNING LIBRARY MATERIAL§: {- «laud/'1' ‘1} Place in book return to mm W [I won charge from circulation recor COPING AND DEFENSIVE EGO FUNCTIONING IN PERSONS SEEKING AND NOT SEEKING PSYCHOTHERAPY By Paul B. Jacobsen A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Psychology 1980 K. 9/ éflév ABSTRACT COPING AND DEFENSIVE EGO FUNCTIONING IN PERSONS SEEKING AND NOT SEEKING PSYCHOTHERAPY By Paul B. Jacobsen The Haan-Kroeber model of the ego specifies that, in addition to the traditional defense mechanisms, the ego also possesses a parallel gfoup of coping processes. The most recent effort to operationalize this model has been the development of a set of 26 scales based on items from the California Psychological Inventory. The set is comprised of 10 coping scales, 10 defense scales, 4 factor scales, and 2 summary scales. In an effort to determine their validity, the scales were administered to 22 students (8 males, 14 females) applying for personal counseling at a university counseling service and a comparison group of 46 students (21 males, 25 females) from introductory psychology classes who indicated they had no experiences with and no interests in receiving any form of psychotherapy. A general hypothesis was offered stating that the applicant group would manifest greater use of defense processes and less use of coping processes than the Paul B. Jacobsen no-therapy group. Seventeen additional predictions were made as to each group's performance on the individual scales. The data were analyzed using an analysis of variance design with repeated measures on one factor. Results did not confirm the main hypothesis. Two unex- pected significant interactions (p:§.01) indicated that greater relative use of a specific c0ping or defense pro- cess and of a specific pair of coping and defense processes paired under a generic process did differentiate the groups. With regard to the individual scale comparisons, five hypotheses were confirmed, and five others were in the predicted direction but failed to reach significance. The no-therapy group scored significantly higher than the applicant group on the coping scales of Sublimation (p;S.05) and Substitution (pLSHOS) and on the defense scale of Denial (pJS.Ol). The applicants scored significantly higher on the defense scale of Doubt (p:S.05) and on the factor scale of Primitive Defense (pii.05). The results were interpreted as offering only limited support for the validity of the revised ego scales and for the usefulness of the Haan-Kroeber model. Relating ego process functioning more directly to behavior was suggested as one way of providing a clearer evaluation of validity. In addition, exploring different methods of assessing ego functioning and developing a more economical model were identified as a few needed refinements in this area. Dedicated to my parents ii ACKNOWLEDGMENTS I would like to acknowledge a few of the many peOple whose contributions enabled me to conduct this research project. First of all, I want to thank my chairman, Dr. Albert Rabin, who introduced me to the topic of ego assessment. It was in one of what are always lively exchanges of ideas with him that I first saw the outline of the present study. Because of his continued guidance and encouragement, I was able to translate those early ideas into this Master's thesis. Dr. Albert Aniskiewicz and Dr. Alton Kirk were instru- mental in helping me secure permission to collect data at the MSU Counseling Center and in develOping workable data collection procedures. Ms. Maxine Hire of the Mental Health Office at Olin Health Center deserves special thanks for the actual work of securing and testing sub- jects in one of the samples under study. Dr. Lawrence Messé guided me through the intricacies of the computer analysis of the data. For this, and for his critical evaluation of my work, I am deeply grateful. Finally, I want to thank Ms. Marcia Israeloff whose contributions were too numerous and unique to ever be enumerated. iii TABLE OF CONTENTS Page LIST OF TABLES . . . . . . . . . . . . . . . . . . vi INTRODUCTION . . . . . . . . . . . . . . . . . . . l The Haan-Kroeber Model . . . . . . . . . . . . . 3 Measurement of Haan-Kroeber Ego Processes. . . . 8 Research Using Ratings of Haan-Kroeber Ego Processes. . . . . . . . . . . . . . . . . . . . 23 Research Using the Original Ego Scales . . . . . 28 Research Using the Revised Ego Scales. . . . . . 32 Summary and Integration of the Relevant Literature . . . . . . . . . . . . . . . . . . . 34 Outline of the Present Study . . . . . . . . . . 38 HYPOTHESES . . . . . . . . . . . . . . . . . . . . 43 Overall Configuration. . . . . . . . . . . . . . 43 Cognitive Functions. . . . . . . . . . . . . . . 43 Reflexive-intraceptive Functions . . . . . . . . 44 Affective-impulse Regulations. . . . . . . . . . 45 Attention-focusing Functions . . . . . . . . . . 46 Factorial Dimensions . . . . . . . . . . . . . . 47 METHOD . . . . . . . . . . . . . . . . . . . . . . 48 Applicant Sample . . . . . . . . . . . . . . . . 48 No-therapy Sample . . . . . . . . . . . . . . . 49 Safeguards . . . . . . . . . . . . . . . . . . . 50 Scoring. . . . . . . . . . . . . . . . . . . . . 51 Data Analysis. .p. . . . . . . . . . . . . . . . 51 iv Page RESULTS. . . . . . . . . . . . . . . . . . . . . 53 Demographic Characteristics. . . . . . . . . . 53 Overall Configuration. . . . . . . . . . . . . 54 Cognitive Functions. . . . . . . . . . . . . . 61 Reflexive-intraceptive Functions . . . . . . . 61 Affective-impulse Regulations. . . . . . . . . 63 Attention-focusing Functions . . . . . . . . . 64 Factorial Dimensions . . . . . . . . . . . . . 64 Summary. . . . . . . . . . . . . . . . . . . . 65 DISCUSSION . . . . . . . . . . . . . . . . . . . 66 APPENDIX . . . . . . . . . . . . . . . . . . . . 75 REFERENCES . . . . . . . . . . . . . . . . . . . 83 Table CXDVO‘LJ'I LIST OF TABLES Taxonomy of Ego Processes. Reliability of Original Scales of Coping and Defense. . . . . . Correlations Between Original Doubt and Denial Scales and MMPI Scales. Validity Coefficients of the Revised Ego Scales . . . . . . . . . . . . . . Factor Analysis of Ego Processes Summary of Demographic Data. Individual Scale Comparisons Summary of Analysis of Variance. vi Page 14 16 19 20 55 58 6O INTRODUCTION Empirical work in the assessment of ego functions is grounded in Sigmund Freud's theoretical ideas concerning the defensive operations of the ego (Freud, 1922/1955, 1926/1959) and in the further elaboration and development of these ideas by Anna Freud (1937). Their discussion of defensive Operations coincided with and, in part, contri- buted to a major shift in psychoanalytic theory from an earlier focus on the id determinants of behavior to the role of the ego in both normal and pathological functioning. The defensive operations of the ego refer, in the classical sense, to the ego's mechanisms for defending itself against painful or unendurable ideas and affects emanating from the id. The ego mechanisms are used for the express pur- pose of restricting the development of anxiety and "pain" and for transforming the original nature of the id instincts. These transformations provide some measure of gratifica- tion in the outside world, but only through distorted, less anxiety-evoking expressions of the original impulses. The ego mechanisms of defense are thought to play a key role in the development of neurotic symptoms since they provide only partial, incomplete solutions for the 2 conflicts between id impulses, and ego and superego restrictions. Anna Freud (1937) has identified ten defense mechanisms: regression, repression, reaction formation, isolation, undoing, projection, introjection, turning against the self, reversal, and sublimation. She cautions, however, that this does not constitute an ex- haustive list and that other defenses await identification. Working from this traditional definition, several researchers have developed empirical methods for measuring defense mechanisms. In the field of projective techniques, Holt and Havel (1960) created a scoring system for the Rorschach that determines the presence and nature of de- fensive attempts to contain drive dominated responses. Blum (1956) developed the Defense Preference Inquiry (DPI), given in conjunction with the Blacky Pictures (Blum, 1949), where subjects rank various descriptions in terms of how well they reflect the main character's feelings or actions; each description is an operational definition of a defense mechanism. Objective methods for assessing defenses have also been developed. Gleser and Ihilevich (1969) con- structed the Defense Mechanism Inventory (DMI), which assesses relative preferences among five clusters of defenses identified by the authors: turning against object, projection, principalization, turning against self, and reversal. Scores are obtained by having subjects indicate, in a multiple-choice format, how they would 3 respond to various stories involving interpersonal con- flicts. Byrne has created (Byrne, 1961) and revised (Byrne, Barry & Nelson, 1963) an MMPI-based Repression- Sensitization (R-S) Scale, on the assumption that defenses can be placed on a one-dimensional continuum. High R-S Scale scores indicate preference for sensitizing responses and refer to the use of approach defenses such as isolation and intellectualization; low scores indicate preference for repressing responses and refer to the use of avoidance defenses such as repression and denial. The Haan-Kroeber Model The line of empirical investigation in this field that will be explored in greater detail includes one of the few major elaborations of the original theory of ego mechanisms of defense. The ego psychologists, notably Hartmann, have emphasized that the ego is capable of adaptive, healthy behavior as well as maladaptive, defen- sive behavior. Hartmann (1958) posited a conflict-free ego sphere in which ego functions, independent of conflict and instinctual vicissitudes, develop as part of the maturational process. 'The major focus of Hartmann's work was on the sources of adaptive ego behavior and, consequently, he offered few detailed descriptions of 4 the non-defensive ego functions. Sublimation and neutral- ization are the only specific ego processes identified by Hartmann (1955/1964) that are related to adaptive func- tioning. Haan (1963, 1977) and Kroeber (1963) have attempted to fill this gap concerning adaptive ego pro- cesses. They posit that, in addition to defense mechanisms, the ego possesses a parallel group of coping mechanisms. Haan (1977) has conceptualized the ego as a col- lection of mental processes. Working with the traditional defense mechanisms described by Anna Freud (1937), Haan (1963) and Kroeber (1963) derived ten generic ego pro- cesses by identifying in the use of each defense an underlying psychological function. In the Haan-Kroeber model, these underlying psychological functions, referred to as generic processes, are hypothesized to be capable of two possible modes of expression. One mode is defensive functioning, and each generic process can be manifested as a defense mechanism, now referred to as a defense process. The other mode is c0ping, and the ten generic processes can also be manifested as coping processes; Haan (1963) and Kroeber (1963) have identified a c0ping process for each of the generic processes (see Table 1). An example will illustrate the development of this model. From the defense mechanism of denial, which involves a negation of experienced reality, an underlying 5 cognitive capacity for selective awareness is identified and conceptualized as a generic ego process. In addition to being manifested as the defense process of denial, the generic process of selective awareness can also, according to theory, be expressed in a coping mode. Concentration is identified as the coping expression of selective aware- ness and the counterpart to the defense process of denial. In terms of analyzing behavior, one would predict that when selective awareness of the environment is being used for defensive purposes it will be manifested as denial, when being used more adaptively it will be manifested as concentration. The ten coping processes share certain common properties that permit them to be distinguished from the ten defense processes. At the most general level, all the coping processes reflect healthy, adaptive mental functioning, whereas the defense processes reflect a more neurotic and less adaptive style of functioning. According to Haan (1977), c0ping implies purpose; choice, flexible shifts in behavior, and adherence to intersubjective reality and logic on the part of the user; it also allows and enhances appropriate affective reactions to interpersonal situations. Defensiveness, on the other hand, is compelled, negating, and rigid; it involves distortions of intersubjective reality and logic, allows only covert impulse and affective .Aaamav can: scum .ouoz camocsm .cofiuouwachmuoqon cowmmoudom sowmmoudusm unflmuumom .oH cofiuocuouao «fineness cowuwsuow cowuomoa acuusuwumnsm :oHumahowmawuH .m cowuod=ooooua o>wuoomm< ucosoumHamwn cowumawansm coamuo>aa .m unawumaamou wadsaaauo>wuuouw< cowuoxwm .coHuumuumwo deacon coflumuucoocou mmocoumsm o>wuooaom .m oaofiuuaaw madmauomuaoHucouu< cofiumucoQBOOoo cowaouuwom owoucowmmouwom cofimuo>ou cage .0 Hmcowmaaoo sowuoonoum hnumaam >uw>wuamcom .m cofiumuwafinoeau unaoo huwawwnam mo oucmuoaoe omcoamou poamaoo .q mcoHuucam o>wuaoowuucwao>wmeuox cowumasnmmcou sawumuaHuGOwuoa mwmzamc< Hmoawoa :oHuouaHonahm vcoumumoz .m mamwmoHoo: .mvmamm memos weauaamauooaaoucH auHHMSuooHHoucH ucoenoouon .m Emwuouocoo cOMuMHomH zuH>Huoonno :oHumcwawuomHo .H maofiuocnm o>fiuficwou cofiumucoammum oncomon wcwaoo mono: mommoooum owuocou mommoooum owm mo xaocoxmh H mqmHuounno oamfiom mam: Manama mam: mamamm mam: mHmEmh mam: masowoo o>wuaawum q uouumm OwCQw Ga Uflhau ODHU m m HOuowh N heuomm, mafiaou m>wmmuuaxm mcwaou voaaouucoo H HOuomm mwcuvmoq MOuomm m mommmooum owm mo mwmmec< u0uomm m m4m<fi 21 the highest positive loadings were on regression ego and empathy, and the highest negative loadings were on re- pression and reaction formation. With the females, only three coping processes had high positive loadings (empathy, suppression, and regression ego) and, again, there was an absence of large negative defense loadings. This factor was labelled expressive coping since it was thought to reflect an emphasis on intrapersonal and interpersonal accuracy as well as a heightened flexibility and creativity. Factor three for males consisted of positive loadings on seven defense processes, with the highest loading on intellectualization, followed by rationalization, pro- jection, and isolation. The pattern was similar for females, with positive loadings on seven defense processes,although here the highest loading was on regression, followed by intellectualization and rationalization. This factor was labelled structured defense since, according to Joffe and Naditch, it described a sophisticated and well-integrated pattern of self-protection. The sex difference, regression having greater relative importance for women than for men, was thought to reflect the predominant male sex-role stereo- type: regression being-a more acceptable means of defense for women than for men. The last factor for males consisted of positive loadings on the defense processes of doubt and regression and negative loadings on the coping processes of concentration 22 and sublimation. For females, the last factor was char- acterized by positive loadings on the defense processes of reaction formation, denial, and repression and a negative loading on the coping process of tolerance of ambiguity. Although the last male and female factors share no major loadings on the same ego processes, Joffe and Naditch believed they both reflected thin, disorganized and poorly integrated pattern of defense in contract with the previous factor labelled structured defense. Following Haan (1963), this factor was labelled primitive defense. Scales were constructed for each factor using CPI items and the scale construction procedures previously described. The cross-validity coefficients for the factor scales were generally poorer than for the scales constructed on the basis of individual ratings. According to Joffe and Naditch, this suggests that the data reduction involved in factor analysis overgeneralizes the ego processes and that important distinctions are preserved by the individual scales. No internal consistency measures of reliability have been published for the new ego scales, although Joffe and Naditch (1977) reported test-retest reliability co- efficients based on a different sample of subjects. The median reliability for males was .71 and for females .70. Generally, the scales with lower cross-validities also had less than average reliability coefficients. Joffe and 23 Naditch (1977) generated preliminary data on validity by correlating the newly created ego scales with the established scales of the CPI and the MMPI. The coping scales tended to be positively related and the defense scales tended to be negatively related with the standard CPI scales. The same pattern held for the scales based on factor scores and summed scores. There were exceptions, though: intellectualization, which is theoretically a more sophisticated defense, was positively correlated with the CPI scales for both men and women. As expected, the two MMPI-based coping scales had large negative correlations with most of the standard MMPI scales. Research Using Ratings of Haan-Kroeber Ego Processes Research employing ego ratings can be classified into three groups: studies relating ego processes to longi- tudinal variables, studies examining current behavioral and personality correlates of ego processes, and studies using ego processes to categorize responses to stressful situa- tions. Six published reports using ratings of ego processes are longitudinal in nature, using data from two ongoing projects at the University of California at Berkeley-- the Oakland Growth Study (OGS) and the California Guidance Study (CGS). 24 Haan (1963) found a relation between current ego process ratings and past intellectual functioning. Ratings of coping processes, especially the cognitive functions, tended to correlate positively with Stanford-Binet IQ scores obtained 20 years earlier}, defense, with the notable ex- ception of intellectualization, tended to correlate nega— tively with IQ. Kuypers (1974) observed a Similar positive relationship between coping and intelligence, but found no negative relation between defense and intelligence. Other longitudinal investigations were focused on the relationships between social class, social mobility, and ego functioning. Haan (1964a) found that membership in a higher status group as an adult was associated with higher scores on controlled coping processes (objectivity, intellectuality, suppression) and summed coping, and that certain primitive defenses (denial, regression) were negatively related to higher adult social status. Kuypers (1974) also found positive relationships between higher social status and coping, as well as negative relations with fragmentation. Results reported by Haan (1964a), comparing ego processes to social mobility, supported the general hypothesis that coping was related to gains in social status over time, while downward social mobility was related to the use of more primitive defenses. Weinstock (1967b) found that higher childhood social 25 class was positively related to the use of more elaborate defenses (intellectualization, projection) 30 years later; adult reliance on a more primitive defense (denial) was negatively related to higher childhood social class. Haan (1974) undertook a study to determine the antecedents of adult ego functioning. Reliance on coping in adulthood was found to be preceded by a reorganization of ego processes with consequent changes in personality functioning during adolescence; this reorganization in- cluded a period marked by temporary disorganization in the personality structure. The "copers" generally passed through periods of inner and outer conflict during ado- 1esence, accompanied by a working through of the disorgani- zation, usually through dependence on cognitive functions. Subjects relying on defensive functions as adults had veered away from reorganization during adolescence. As part of the same study, subjects were rated by experienced clinicians, using Q-sort techniques, in terms of optimal personality adjustment. Only 50 percent of the males and 30 percent of the females identified as "copers" were classified as being optimally adjusted; all the persons identified as "defenders" were characterized as less than optimally adjusted. In a similar study, Weinstock (1967a) investigated the relationship between family environment and development of coping and defense processes. He found that, in line with theory, reliance on primitive 26 defenses (repression, denial) as an adult was more related to early family environment than to the environment at adolescence; on the other hand, the more differentiated defenses (isolation, displacement, projection) were more related to the adolescent family environment. Weinstock concluded that the individual's level of cognitive func- tioning at the time of family difficulties played an important part in determining which ego processes became part of the adult character structure. A second group of ego studies employing ego ratings related ego functioning to current behavioral and person- ality correlates. Haan (1964b), in an elaboration of a pilot study conducted by Kroeber (1963), reported relation- ships between coping and test-taking attitudes on the Rorschach. Elaboration of good F responses1 and affective and intellectual enjoyment of the test situation all had postive relationships with coping, especially the expressive coping processes. Kuypers (1972) studied the relation between internal-external locus of control (Rotter, 1966) and ego functioning in old age. Internal locus of control was positively related to higher scores on the coping processes and negatively related to higher scores on the defense and fragmentation processes. In one of the most 1A good F (F+) response indicates that not only has the subject perceived the inkblot (or part of it) as suggesting the form of an object, but, in addition, the specific nature of the form perceived reflects the presence of accurate and consensually validated perception. 27 wide-ranging studies using ego ratings, Haan, Stroud, and Holstein (1973) investigated the relationships between the level of moral development (Kohlberg, 1969), level of ego development (Loevinger, Wessler, & Redmore, 1970), and the use of c0ping, defense, and fragmentation pro- cesses (Haan, 1963, 1969) in a sample of "hippies" from the San Francisco Bay Area. Results indicated that higher levels of moral development were accompanied by increased use of cognitive coping processes, but were relatively independent of the defense dimension. Level of ego develOp- ment was found to be independent of the coping dimension; however, higher levels of ego development were related to greater use of intellectualization and projection, which is explained by the authors as the "successful" use of defense. Three studies have used the Haan-Kroeber model as a scheme for coding responses to experimentally induced stressors. Hunter and Goodstein (1967) administered a difficult symbolic reasoning test to college students classified eigher high or low on the Barron Ego Strength (Es) Scale (Barron, 1953); afterwards, subjects were asked to explain their "poor" test performance. As predicted, high Es subjects made greater use of the c0ping process of logical analysis than low Es subjects. Low Es sub- jects were also judged to be generally more defensive in their responses. However, contrary to one hypothesis, 28 high Es subjects made greater use of the defense process of rationalization than low Es subjects. Using a similar paradigm, Margolis (1970) first classified students as either high or low on Es; subjects then role-played with a confederate, each of four roles designed to induce varying levels of stress. Results showed that high Es subjects used significantly more coping responses across situations than low Es subjects. Folkins (1970) used the c0ping, defense, and framenta— tion dimensions to study the relationships between antici- pation time and psychological stress reactions. Subjects were threatened with electric shock at the beginning of time intervals ranging from 5 seconds to 20 minutes. Results showed that ego functioning could be described as a function of anticipation time. Shorter intervals were characterized by greater use of coping processes, while longer intervals were associated with greater use of defense and fragmentation processes. A cluster analysis of the ego ratings was also performed; three separate clusters were identified, which resembled the dimensions of coping, defense, and fragmentation. Research Using the Original Ego Scales Several investigations were conducted using the original coping and defense scales published by Haan (1965). 29‘ Most of these studies examined the validity of only a few selected scales; no study reported results for the entire array. Naditch, Gargan, and Michael (1975) examined the relationships between the Denial scale (Haan, 1965), locus of control (Rotter, 1966), and self—reports of anxiety and depression in a sample of 547 males in Army basic training. Negative correlations were observed between denial and anxiety (—.40), depression (-.29), and external locus of control (-.30). The first two findings partially replicated previously observed relationships between use of denial and disavowal of psychological distress (Haan, 1965). The negative relationship between denial and external locus of control was seen as showing that deniers may also disavow any suggestion of manipulation or control from external sources. In a series of studies, Naditch (1974, 1975a, 1975b) and Naditch and Fenwick (1977) examined the relationships between ego functioning and experiences with illicit drugs. Using a sample of 483 self—reported drug users, Naditch (1974) found that high scores on the Regression scale (Haan, 1965) were associated with LSD/mescaline usage, marijuana usage, and acute adverse reactions to both LSD/ mescaline and marijuana. In addition, regression was negatively correlated with a measure of personal adjustment. These results were interpreted as supporting a hypothesis 30 that regressive individuals take drugs in an attempt to uq.' handle personal problems, and that this motivation in- creases the-likelihood of having an adverse reaction. :; Naditch (1975a, 1975b) reports two further analyses of these data. Regression continued to show strong inde- pendent associations with drug usage and adverse reactions when considered in multiple regression equations which included motives for use (Naditch, 1975a). Regression also had the same relationships with the dependent vari- ables when other ego processes were included in the regression equations (Naditch, 1975b). One other defense process (repression) was positively associated with adverse drug reactions; two defenses (intellectualization, denial) were negatively associated with adverse drug reactions. A high score on Summed Coping was related to avoiding acute adverse reactions to LSD/mescaline alone. Using a sample of subjects from the previous study identified as LSD users, Naditch and Fenwick (1977) examined the relationship between ego functioning and reports of LSD flashbacks. Results showed that subjects who experi- enced flashbacks had higher scores on the Summed Coping, Tolerance of Ambiguity, and Intellectualization scales. Flashbackers were characterized as using more primitive defenses and as having less coping capacity. Only Repression and severity of acute adverse reactions made 31 significant contributions when several variables were included in multiple regression equations for predicting flashbacks. Thelen and Varble (1970) attempted to use the coping and defense scales to differentiate college students seeking psychotherapy from no-therapy controls. Results were analyzed for each sex separately and were reported for all the scales developed by Haan (1965) except Con- trolled Coping, Summed Coping, and Primitive Defense. It was hypothesized that the controls would score higher on the coping scales and lower on the defense scales. Results were generally favorable; for the coping dimen- sion, Suppression and Concentration differentiated groups of both sexes in the predicted direction and Objectivity did so for males only. However, one coping scale (Logi- cal Analysis) yielded results in the opposite direction for both sexes, with the therapy group outscoring the controls. In general, the control group outscored the therapy group on processes related to controlled coping rather than expressive coping. For the defense dimension, Displacement and Projection differentiated groups of both sexes in the predicted direction, and Doubt did so for males only. However, Denial produced results in the opposite direction for both sexes, with the control group outscoring the therapy group. This last result is I... 2‘ - (11-..): ‘I‘I' 32 consistent with previously noted negative relationships between the Denial scale and indices of psychological distress (Haan, 1965; Naditch, Gargan, & Michael, 1975). Help-seeking behavior usually involves the acceptance and admission of psychological difficulties, both of which are incompatible with the use of denial. Research Using the Revised Ego Scales To the best of my knowledge, there are only two 'studies that have used the revised scales of coping and defense (Joffe & Naditch, 1977). Joffe and Bast (1978) examined the relations between ego functioning and accommo- dation to blindness defined in terms of employment status and travel mobility. The subjects (101 blind men) were divided into three groups: congenitally totally/partially blind subjects (Group 1), congenitally partially sighted subjects (Group 2), and acquired totally/partially blind subjects (Group 3). Results were reported for all 26 ego scales: 20 process scales, 4 factor scales, and 2 summary scales. Joffe and Bast (1978) report that among subjects in Group 2 there were significant differences in ego functioning on the basis of employment status, with employed congenitally partially sighted subjects scoring higher on four coping scales and lower on five defense scales. On one defense scale (Intellecutalization) 33 employed subjects outscored unemployed subjects. Among subjects in Group 3, employed subjects scored higher on three c0ping scales and lower on six defense scales than unemployed subjects. Subjects with a high degree of travel mobility in Group 3 scored higher on nine coping scales and lower on six defense scales than less mobile subjects. More mobile subjects also scored higher on three defense scales (Intellectualization, Rationalization, and Structured Defense). In a similar study, Joffe (1977) examined the relations between intelligence, ego functioning, and accommodation to epilepsy defined in terms of employment status. The subjects, 132 men and 82 women suffering from epileptic seizures, were administered the Wechsler- Bellevue Intelligence Test and the 26 ego scales (Joffe & Naditch, 1977). Among the males, those who were employed scored higher on IQ and five coping scales (Objectivity, Concentration, Regression Ego, Sublimation, and Substitu- tion) and lower on four defense scales (Rationalization, Projection, Regression, and Summed Defense). Females who were employed scored higher than unemployed females on IQ and one coping scale (Sublimation) and lower on five defense scales (Doubt, Regression, Displacement, Summed Defense, and Structured Defense). Regression equations developed to predict employment status indicated that 34 coping and IQ exerted direct positive effects on employ- ment, while defense exerted a direct negative effect. Coping and defense also affected employment status in- directly through their impact on IQ. Taken together, these two studies suggest that coping ego functions play an important role in accommo- dation to physical disabilities and, with certain excep- tions, defensive functioning, through its reality-dis- torting effects, hinders successful readjustment into society. Summary and Integration of the Relevant Literature In order to integrate the evidence which has been presented, it is first necessary to restate the original theoretical basis for organizing ego processes into the two independent dimensions of coping and defending. The distinction is based on the assumption that employment of coping processes (which reflects a more differentiated, purposive mode of personality functioning) can be expected to lead to more adaptive and rewarding experiences for the individual than can use of defense processes. The theorized behavioral differences between coping and de- fensive functioning are subtle ones, since Haan (1977) has generally eschewed directly identifying coping with 35 health and defense with neurosis. Instead, it is argued that the flexible, reality-oriented system of functioning characteristic of coping increases the likelihood of productive, life-enhancing experiences occurring, where- as the rigid, reality distorting system of functioning characteristic of defense reduces the likelihood of an in- dividual profiting from experience and makes maladaptation more likely. The empirical evidence is not unequivocal, but it strongly supports many of the theoretical distinctions made between coping and defense. COping has been found to be positively related to higher intellectual functioning (Haan, 1963; Kuypers, 1974), higher adult social status (Haan, 1964a; Kuypers, 1974), upward social mobility (Haan, 1964a), affective and intellectual enjoyment of the Rorschach test situation (Haan, 1964b); CPI measures of nonpathological functioning (Haan, 1965); higher ego strength (Hunter & Goodstein, 1967; Margolis, 1970), internal locus of control (Kuypers, 1972), higher levels of moral development (Haan et al., 1973), and accommo- dation to physical disabilities (Joffe, 1977; Joffe & Bast, 1978). Negative relationships have been reported with help-seeking behavior (Thelen & Varble, 1970), acute adverse drug reactions (Naditch, 1975b), and reports of LSD flashbacks in drug users (Naditch & Fenwick, 1977). 36 Defense, on the other hand, has been shown to be negatively associated with higher levels of intellectual functioning (Haan, 1963), and personal adjustment (Naditch, 1974), and to be positively related to lower adult social status and downward social mobility (Haan, 1964a), lower ego strength (Hunter & Goodstein, 1967), external locus of control (Kuypers, 1972), help-seeking behavior (Thelen & Varble, 1970), less than optimal personality functioning (Haan, 1974), acute adverse drug reactions (Naditch, 1974, 1975b), LSD flashback experiences (Naditch & Fenwick, 1977), and difficulties accommodating to chronic physical dis-‘ abilities (Joffe, 1977; Joffe & Bast, 1978). It should be noted, however, that not all results fit this general pattern. In some cases, use of defenses was not associated with self-defeating behavior or psycho- pathology: intellectualization was found to be positively related to IQ (Haan, 1963) and negatively related to reports of acute adverse drug reactions (Naditch, 1975b); blind subjects with travel mobility were observed to rely on intellectualization and rationalization in addition to several coping processes (Joffe & Bast, 1978); and intellectualization and projection were found to be positively associated with higher levels of ego develOp- ment (Haan et al., 1973). As Morrissey (1977) has pointed out, these findings, in combination with the 37 fact that the summed defense variable has consistently failed to differentiate items in personality inventories (Haan, 1965; Joffe & Naditch, 1977), suggest that a global conceptualization of defense as maladaptive functioning is misleading. Specific defenses may be facilitative for certain persons and certain situations. Furthermore, results such as these are not in— consistent with the distinctions made between coping and defense at the beginning of this section. Coping and defense were not considered synonymous with healthy and neurotic functioning; instead, they were offered as labels for what were conceived to be two independent dimensions of personality functioning. The model does not predict a strict pattern of relationships with other personality variables, but only that in the long run greater reliance on coping processes, rather than defense processes, will be associated with more success in adapting to the intel- lectual, social, and emotional demands of everyday life. The empirical evidence, especially the longitudinal data, generally supports this prediction. However, other non- longitudinal evidence suggests that c0ping and defense are more directly related to an underlying continuum of healthy versus maladaptive functioning; the correlations between coping and measures of adaptive and non-pathologi- cal functioning (Haan, 1965; Hunter & Goodstein, 1967; 38 Margolis, 1970; Kuypers, 1972), and between defense and measures of maladaptive and pathological functioning (Hunter & Goodstein, 1967; Naditch, 1974, 1975b) support this assertion. The distinctions made by Haan (1977) between coping and defense are more relevant when dis- cussing long-term effects of reliance on either coping or defense processes; with regard to short-term effects and current personality correlates, the distinction is more simply explained as one between healthy, adaptive functioning and more neurotic, maladaptive functioning. Outline of the Present Study Having decided to work with the Haan-Kroeber model, an early consideration was the selection of a measuring instrument. Scales were determined to have several distinct advantages over the rating method. First, scales were deemed easier to administer and score since they did not involve any training of interviewers and judges. Secondly, scales also appeared more economical, incurring none of the expense of recording numerous hours of inter- views. In terms of research planning, these considerations meant that a larger number of subjects could be tested using the scales rather than interviews and, consequently, a more complex design could be constructed. 39 Within the context of the development of measures of ego processes, scales also represented a methodological advance over interviews. Since the interview method has never been based on a standardized interview or on formal rating criteria, the raw material from which ratings are made and the means by which ratings are arrived at has differed appreciably from study to study. These methodologi- cal difficulties account, in part, for the large variations in interrater reliability achieved by different experi- menters, as well as the inconsistent pattern of results that have been reported. The use of the scales has intro— duced standardization into the field of ego process assess- ment, permitting for the first time the direct comparison of measurements of ego processes from different research projects. In comparing the two scale methods in existence, the revised scales developed by Joffe and Naditch (1977) were judged superior to the original scales for the obvious reason that they were constructed using more advanced statistical methods. However, having only recently been created, the revised scales have not been adequately validated as experimental measures of coping and defending. Secondly, their usefulness for populations other than those on which they were created has also not been proven. These factors determined the general orientation of the 40 present study. Having selected the revised ego scales as the best available measuring instrument, the state of the art dictated that determining their validity should be a primary consideration. Along these lines, the design utilized by Thelen and Varble (1970) seemed particularly appropriate since it allowed for a test of the entire ego process model, rather than tests of only a limited number of scales as reported in most studies. This design also allowed a test of theoretical assumptions concerning the distinctions between the coping and defense dimensions. In the Thelen and Varble (1970) study the coping and defense scores of applicants for psychotherapy and of a no-therapy comparison group were compared, and a global hypothesis was offered which predicted that the applicants would score higher on the defense scales and lower on the coping scales than the no-therapy group. The present study also compared coping and defense scores of applicants for psychotherapy and a no-therapy group. However, numerous differences in methodology preclude considering the present study a simple repli- cation of the earlier study. One major difference is that the present study used the revised coping and defense scales (Joffe & Naditch, 1977), whereas Thelen and Varble (1970) used the original scales (Haan, 1965); therefore, the results of the two studies are not directly comparable. 41 Secondly, the present study made use of analysis of variance techniques for a more clear-cut test of the global hypothesis described above. Another new feature of the present study was that, in addition to the global hypothesis, predictions about differences between the two groups on specific coping and defense scales were also offered. A final methodological difference concerns criteria used to select subjects for a no-therapy comparison group. The difference between subjects in an applicant group and in a no-therapy group is not, strictly speaking, level of psychopathology (which may, of course, be a correlate of self-referral for psychotherapy), but the decision to seek professional help for personal and/or social problems. Implicit in this decision is a personal awareness of psychological distress and the recognition of the need for outside help. Help-seeking behavior involves acknowl- edging one has been experiencing difficulties in inter- personal relations and/or in meeting the demands of every- day life. The question then is: what constitutes an appropriate no-therapy comparison group? For Thelen and Varble (1970), the only criterion was that subjects had not received personal counseling or psychotherapy within the previous two years. This, however, does not exclude persons who would like to receive psychotherapy, or can 42 recognize how psychotherapy would benefit them, but have never made the necessary arrangements. It is questionable whether such persons belong in a no-therapy comparison group. The present study screened out these individuals from the comparison group, as well as former mental patients, persons consulting clergy, and persons who reported ever receiving personal counseling, psychotherapy, or out- patient psychiatric treatment. HYPOTHESES Overall’Configuration 1) The applicant group will generally be characterized by greater use of defense processes and less use of c0ping processes than the no-therapy group. Defensiveness, which reflects a rigid and reality distorting mode of personality functioning, will be more characteristic of persons seeking help for personal and/ or social problems than of a no-therapy comparison group. Similarly, coping will be less characteristic of the help- seeking group and more characteristic of the no-therapy group. Cognitive Functions Compared to the no-therapy group, the applicant group will make greater use of the following cognitive defense processes: 2) isolation 3) rationalization 43 44 No differences are expected for intellectualiza- tion, since use of this defense is almost universal among college students. Both groups should show similar use of the coping processes of objectivity, intellectuality, and logical analysis. The real differences between these groups of college students will not appear as a deficit in cognitive coping processes in the applicant group, but' in the applicants' greater use of the two defense pro- cesses of isolation and rationalization. Reflexive-intraceptive Functions Compared to the no-therapy group, the applicant group will rely more on the following reflexive-intra- ceptive defense processes: 4) doubt 5) projection 6) regression The no-therapy group will have a greater preference than the applicant group for the following reflexive- intraceptive coping processes: 7) regression ego 8) tolerance of ambiguity 9) empathy A sex difference may be evident for the use of regression since a factor analysis of the ego scales 45 (Joffe & Naditch, 1977) suggested regression was a more acceptable mode of behavior for females than for males. Doubt, in particular, should be elevated for the appli- cant group, since self—referral for or an agreement to seek psychotherapy usually involves admission of psycho- logical distress. Previous results (Haan, 1965; Thelen & Varble, 1970) showed a strong relationship between the Doubt scale and self-reports of psychological distress. Unlike the cognitive sector, the coping reflexive-intra- ceptive functions should differentiate the groups (the no-therapy group outscoring the applicant group), since use of these processes is not necessarily elicited by the college experience. Affective-impulse Regulations Compared to the no-therapy group, the applicant group will make greater use of the following affective- impulse defense processes: 10) displacement ll) reaction formation 12) repression The no-therapy group will rely more than the appli- cant group on the following affective-impulse coping processes: 46 13) sublimation l4) substitution 15) suppression A preference for defensive, rather than coping affective-impulse regulations should be evident in a group of persons seeking help for personal and/or social problems at a university counseling service since diffi- culties in interpersonal relations frequently involve maladaptive modes of affective~expression. Attention-focusing,Functions 16) The no-therapy group will make greater use of the defense process of denial. Previous research has consistently showed negative relationships between the use of denial and indices of psychological distress (Haan, 1965; Thelen & Varble, 1970; Naditch, Gargan, & Michael, 1975). Help-seeking, which is assumed to involve acknowledgement of problems in living, will largely preclude the use of denial as a defense. No differences are expected for the use of concentration, which is an important part of successful college performance. 47 Factorial Dimensions 17) The no-therapy group will have a greater preference for the factorial dimension of expressive c0ping. 18) The applicant group will have a greater preference for the factorial dimension of primitive defense. Expressive coping is expected to differentiate the groups because the reflexive-intraceptive coping processes have high loadings on.this factor. Primitive defense is also expected to differentiate the groups because it reflects a thin, disorganized, and poorly integrated pattern of de- fense; persons in psychological distress are presumed to be suffering because of the failure of the defenses to bind anxiety. Controlled coping, on which the cognitive and affective-impulse regulating coping processes have high loadings, is not expected to differentiate the groups, since few differences in coping functioning are expected in the cognitive sector. Structured defense, characterized by high loadings on the defensive cognitive functions, reflects a sophisticated pattern of defensive functioning; because of the high loading of intellectualization on this factor, significant differences between the two groups are not expected here either. METHOD Two samples of college students were used in the experiment: an applicant group consisting of 8 male and 14 female students applying for personal/social counseling and a group of 33 male and 36 female students enrolled in introductory psychology classes from which subjects for the no-therapy comparison group were selected. The students in each group were recruited and tested separately. Applicant Sample Persons requesting personal/social counseling at branches of the Michigan State University Counseling Center were given an information sheet (see Appendix) for the Ego Research Project (official title of the study) along with the standard intake material all applicants complete. Anyone requesting more information or indicating interest in participating was subsequently given an informed consent form (see Appendix). Applicants were asked to participate only if they had not received any counseling 48 49 or psychotherapy within the past two years. Persons giving their informed consent were administered the Cali- fornia Psychological Inventory (Gough, 1957) individually at their convenience at Counseling Center locations. The CPI contains 480 items that are endorsed either true or false by the respondent. In addition to completing the CPI, subjects in the applicant group were also asked to supply a limited amount of demographic data (see Appendix). All securing of informed consent and testing was done by the staff of the Counseling Center, and the experimenter did not have direct contact with any of these subjects. All applicants were tested no later than following their second session with a therapist. No-therapy,Sample To secure subjects for the no-therapy sample, notices were posted in introductory psychology classes at Michigan State University. Volunteers were given additional course credit in return for their participation. In a group administration each student completed the California Psychological Inventory (Gough, 1957), a demographic data sheet (see Appendix), and a questionnaire designed to screen subjects for the no-therapy comparison group (see Appendix). These last two instruments were 50 constructed by the experimenter. The screening form contains items relating to experiences with and attitudes toward psychiatric treatment, personal counseling, psycho- therapy, and vocational guidance. This information was used to select subjects for the no-therapy comparison group. Twenty-one males and 25 females indicated they had no experiences with or any strong interests in receiving any of these forms of treatment (except possibly vocational guidance), and also indicated they had never received suggestions from friends or relatives that they receive professional help.for personal and/or social problems. These 46 subjects constituted the no-therapy comparison group, and their CPI responses were used in the data analysis. CPI data for all other persons in this group were not utilized. Safeguards To safeguard confidentiality and anonymity, all subjects were identified by a subject number on all research records. Subjects' names appeared only on the completed informed consent forms, which were stored separately. The experimenter was the only person with access to the data, and results for any individual record were not made available to the subjects or to anyone else. 51 Scoring The CPI data were computer scored for the 26 revised ego scales developed by Joffe and Naditch (1977). Raw scales scores were computed using the appropriate male or female form of each scale. In most cases, the two versions of a scale for an ego process contained different numbers of items. In order to analyze the data for both sexes together, the raw scale scores were con- verted into t-scores. This was accomplished by summing across the applicant and no-therapy groups for each sex separately, and then finding the mean and standard devia- tion for both versions of every scale. All the reported data analyses and group means are of t-scores. Data Analysis The data were arranged in a four factor analysis of variance design with repeated measures on one factor (Winer, 1971). This design, in terms of the statistical tests it provides, is analogous to the profile analysis technique developed by Block, Levine, and McNemar (1953). The four independent variables were: applicant status (A), sex (B), caping vs. defense dimension (C), and generic process (D). Repeated observations were made on the last 52 factor (D), since each generic process is manifested in both a coping and defense mode. The dependent variable was the scale score derived by transforming all the raw scores for each scale into comparable t-scores. Compu- tations were made using a version of the BALANOVA computer program. RESULTS Demographic Characteristics The demographic data are presented in Table 6. Summarizing the results, the applicant group was slightly older than the no-therapy group; the median age was 20.6 for the applicants and 19.3 for the no-therapy group. This age difference is reflected in the fact that the applicant group was farther ahead in their secondary education and consisted of relatively fewer persons who had never been married. Parents' marital status was roughly equivalent for the two groups: 81 percent of the no-therapy group and 68 percent of the applicants were members of intact families. The no-therapy sub- jects, through self-report, indicated they came from more affluent families. Sixty-one percent of the no-therapy subjects and 36 percent of the applicants stated that their parents' incomes exceeded $30,000 per year. Finally, the applicants reported higher grade point averages than the no-therapy subjects: 11 percent of the no-therapy sub- jects and 36 percent of the applicants reported their G.P.A. was between 3.5 and 4.0. 53 54 Overall Configuration Hypothesis 1: In terms of the experimental design, Hypothesis 1 was tested in two different ways. First, it translates into a prediction that the applicant group will score higher on the Summed Defense scale, while the no-therapy group will score higher on the Summed Coping scale. Secondly, it translates into a prediction there will be a significant interaction between applicant status and coping vs. defense (AxC interaction). There were no significant differences between the groups on either Summed Defense or Summed Coping (see Table 7). Results were in the predicted direction for the Summed Defense scale, where the applicant group out- scored the no-therapy group. On the Summed Coping scale, however, results were not in the predicted direction; the applicant group scored higher on Summed Coping than the no-therapy group. The second test also did not lead to direct con- firmation of this hypothesis. Inspection of the summary analysis of variance table (Table 8) shows that the AxC (applicant status x coping vs. defense) interaction was not significant. However, two other interactions were significant: the AxD (applicant status x generic process) interaction and the AxCxD (applicant status x coping vs. 55 TABLE 6 Summary of Demographic Data Percentage of each group8 No-therapy Applicant Marital status Single 98 82 Married 2 9 Divorced 9 Year in School Freshman 50 18 Sophomore 33 18 Junior 13 27.5 Senior 2 27.5 Graduate student 9 Grade Point Average 3.5-4.0 11 36 3.0-3.49 26 14 2.5-2.99 33 36 2.0-2.49 23 14 below 2.0 7 Parents' marital status Married 81 68 Separated 4.5 Divorced 3 23 Father deceased 2 4.5 Mother deceased 2 Not available 2 56 Percentage of each group3 No-therapy Applicant Parents' annual income Above $30,000 61 36 $25,000-29,999 11 14 $20,000-24,999 15 18 $15,000-19,999 4 4.5 $10,000-14,999 7 14 $5,000-9,999 4.5 Below $5,000 4.5 Not available 2 4.5 aNo-therapy group, n=46; applicant group, n=22. 57 defense x generic process) interaction. Greater reliance on coping as opposed to defense processes did not vary according to whether a subject was a member of either the applicant group or the no-therapy group. Applicant status was related to greater preference for certain generic processes, as well as to greater reliance on a specific c0ping or defense process within the pair derived from a generic process. The interaction between applicant status, coping vs. defense, and generic process (AxCxD interaction) was examined individually for each of the ten generic pro- cesses. In effect, this meant looking at the AxC (appli- cant status x coping vs. defense) interaction at each level of D (generic process). This procedure was carried out to determine whether the hypothesized relationship between applicant status and coping vs. defense (that the no- therapy group would rely more on coping processes and the applicants would rely more on defense processes) existed for any of the coping and defense processes paired under a generic process. None of the comparisons reached signif- icance, and only one pair of coping/defense processes yielded the expected interaction pattern: the paired pro- cesses of sublimation and displacement. The no-therapy group scored higher on the coping scale of Sublimation, while the applicant group scored higher on the defense scale of Displacement. TABLE 7 Individual Scale Comparisons Summed Coping Summed Defense Coping Defense Coping Defense Coping Defense fl __-._— Meana roup No-t erapy, pplicant F Ratio Summary Scales 49. 49. Cognitive Functions Objectivity 49. Intellectuality 49. Logical Analysis 49. Isolation 51. Intellectualization 50. Rationalization 49. Reflexive-intraceptive Functions Tolerance of Ambiguity 48. Empathy 48. Regression Ego 50. Doubt 48. Projection 50. Regression 49. Affective-impulse Regplations Sublimation 51. Substitution 51. Suppression 49. Displacement 49. Reaction Formation 50. 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