Defense styles and borderline personality disorder

Seventy-eight borderline and 72 nonborderline personality' disordered patients were compared on scores on the Defense Style Questionnaire (DSQ). The borderline group reported using maladaptive and image-distorting defense styles more often and adaptive defense styles less often than the nonborderline group. These findings empirically validated clinical observations and theory. It is striking that, not only did the borderline group use more splitting and acting out. but they underused the defenses of suppression, sublimation, and humor. This suggests that borderlines' deficit in mastering anxiety, painful emotion, and threatening impulse is related to an underutilization of adaptive defenses and not only an overreliance on the characteristic image-distorting defenses.