DEFENSE MECHANISMS OF STRANGER
VIOLENT COLLEGE STUDENT MEN
by
MYEONG WOO KIM, B.S., B.A., M.A.
A DISSERTATION
IN
PSYCHOLOGY
Submitted to the Graduate Faculty of Texas Tech University in Partial Fulfillment of the Requirements for the Degree of
DOCTOR OF PFnLOSOPHY
Approved T3
njo> f -'i
Copyright 2001, Myeong W. Kun ACKNOWLEDGEMENTS
I would like to give special thanks to Dr. Rosemary Cogan, who has assumed many roles as we worked together for this project. She has been a great teacher, an msightful researcher, a supportive mentor, and a caring advisor. She has helped me grow as a mature person, a professional researcher, and an intuitive therapist. I am forever mdebted to her. It is a pleasure, honor, and privilege to know and conduct this study with her.
I also would hke to thank Dr. Catherine Epkms, Dr. Richard McGlyim, Dr. Robert
Morgan, and Dr. John Porcerelli, for makmg this project possible. Theu- suggestions, feedback, support, patience, and guidance have enhanced the quaUty of this research. I would like to express my appreciation to my colleague, Stacy Carter, who assisted me in scoring the TAT responses.
I owe a great deal of love, support, encouragement, and motivation to my wife,
Jung-A. I owe a large debt of "play-time" to my children, Ian and Ina. Lastly, I would like to deeply thank my mother who has beheved in my abiUty to achieve my goals. TABLE OF CONTENTS
ACKNOWLEDGEMENTS ii
ABSTRACT v
LIST OF TABLES vii
CHAPTER
I. INTRODUCTION 1
Physical Violence 1
Defense Mechanisms and Violence 3
Antisocial Personahty Features and Violence 9
Alcohol Use Problems and Violence 12
Purpose of Study 14
n. METHODOLOGY 15
Participants 15
Measures 15
Procedures 21
Statistical Analyses 22
m. RESULTS 24
Inter-Rater ReUabiUty 24
Differences Between the Two Groups 24
Cortelations Between the DMM, the DSQ-40, and the MMPI-2 Scales 26
IV. DISCUSSION 31
Differences Between the Two Groups 31
ui Lunitations and Future Research 36
REFERENCES 39
APPENDICES
A. EXTENDED LITERATURE REVIEW 59
B. THE MODIFIED PARTNER VIOLENCE SCREEN (PVS) 110
C. THE DEFENSIVE STYLE QUESTIONNAIRE-40 (DSQ-40) Ill
IV ABSTRACT
Physical violence is a significant heahh problem m the United States (Potter &
Mercy, 1997). Arrest rates for physical violence m the United States reach a peak among older adolescents and young adults, whose offenses represented more than 50% of the nonfatal crimes of violence (U.S. Department of Justice, 1992, 2001). Adolescent males are four times more hkely to be mvolved m a physical fight resultuig in injury than female counterparts (U.S. Department of Justice, 1992). College age men are at an age when violence reaches a peak (U.S. Department of Justice, 2001) and many college men report violence toward strangers (Dromgoole & Cogan, 1995; Ballinger, 2001). Attempts to understand college student men who are violent toward strangers have been siuprismgly limited. The purpose of this study is to investigate several characteristics of college men who are violent toward strangers.
Defense mechanisms, antisocial personahty features, and alcohol use problems of thirty men who reported no violence within the past year and 30 men who reported violence toward strangers within the past year were compared. Defense mechanisms were identified based on responses to the Defensive Style Questionnaire-40 (DSQ-40;
Andrews, Smgh, & Bond; 1993) and six Thematic Apperception Test (TAT; Murray,
1943) cards scored with the Defense Mechanisms Manual (DMM; Cramer, 1991a). Two tramed graduate students, bUnd to the group membership of the participant, independently scored the DMM (Cramer, 1991a). After mter-rater rehabihty was computed, the two raters discussed and resolved scoring differences. The mutually agreed scores were used for statistical analyses. Antisocial features and alcohol use problems were assessed based on responses to three scales (Pd, ASP, and MAC-R) of the
Miruiesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher et al., 1989).
The mter-rater rehabihty of the two coders' scores was adequate. Between group differences were evaluated with the multivariate analysis of variance and any significant main effects were followed by analysis of variance tests. It was found that student men who were violent toward strangers were more hkely than non-violent student men to use primitive defense mechanisms, have antisocial features, and have an indication of alcohol related problems.
VI LIST OF TABLES
1. Average Scores ofthe DMM and the DSQ-40 Scales 28
2. Average Scores ofthe DMM, the DSQ-40, and the MMPI-2 Scales of Men with VaUd MMPI-2 Scales 29
3. Cortelations between the DMM, the DSQ-40, and the MMPI-2 Scales of All Participants (N=60, Upper Quadrant) and Participants (N=49, Lower Quadrant) with Valid MMPI-2 Profiles 30
vu CHAPTER I
INTRODUCTION
Physical Violence
Physical violence is a significant health problem m the United States (Potter &
Mercy, 1997). Arrest rates for physical violence in the United States reach a peak among older adolescents and young aduUs, whose offenses represented more than 50% ofthe nonfatal crimes of violence (U.S. Department of Justice, 1992,2001). Adolescent males are four tunes more likely to be involved m a physical fight resuhmg m mjury than female counterparts (U.S. Department of Justice, 1992). The Centers for Disease Control and Prevention (1994b) found that 31.5% of adolescent males have carried a weapon
(e.g., gun, knife, or club) at least once during the past month for self-protection or for use in a fight, compared to relatively low 8.1% of adolescent females. Male adolescents were more hkely than female adolescents to carry a weapon and physically fight (Orpinas,
Basen-Engquist, Grunbaum, & Parcel, 1995). Men were 1.6 to 3 times more Ukely than women to be victims of aggravated assault or violence by strangers while women were 7 to 21 tunes more likely than men to be victuns of violence by intimates or rape/sexual attack (U.S. Department of Justice, 2001).
Violence is prevalent m men of college age. In a community sample, Harwell and
Spence (2000) found that 5% of men who participated m a telephone survey reported having experienced physical violence m the previous year. Compared to a community sample, a much higher prevalence rate of violence was found hi a college sample.
Dromgoole and Cogan (1995) mvestigated prevalence rates of three subtypes of physical
1 violence m a sample of single, college men who had been ui a relationship with partner
withm the previous year. Ofthe 312 college men, 39% reported perpetrating violence m
the previous year. Ofthe violent men, 57.8% were violent toward strangers and not
partners, 11.8% were violent toward partners and not strangers, and 30.5% were violent
toward both strangers and partners (Dromgoole & Cogan, 1995). BaUinger (2001)
recently found that among 1,064 college student men, 45% were violent. Ofthe violent
men, 56% were violent toward strangers and not partners, 20% were violent toward partners and not strangers, and 24% were violent toward both strangers and partners
(Ballmger, 2001). Desphe the relatively high prevalence of stranger violence, attempts to understand men who are violent toward strangers have been surprisuigly limited.
Ofthe few research findings, violent crimes toward strangers are usually committed by men against other men (Fagan & Wexler, 1987; U.S. Department of
Justice, 1987). People who perpetrate violence toward strangers are typically young
(Lunentani, 1985; U.S. Department of Justice, 1996; Werner & Wolfgang, 1985). People who are arrested for violence toward strangers are often nonwhite (Petersiha,
Greenwood, & Lavin, 1978) and with insufficient interpersonal skills (Cocozza &.
Hartstone, 1978). Men who are violent toward both strangers and their partners are more
Ukely than men who are violent toward partners to have a more positive attitude toward the use of violence, break the law, have lower occupational status, have gambled, and have been involved m extra-famiUal relationships (Shields, McCall, & Hanneke, 1988).
Men who are violent toward strangers are more likely to have alcohol problems than men who are violent toward partners, suggestmg that men who are violent toward strangers are hkely to drink and be involved m fights with strangers (Cogan, Porcerelli, &
Dromgoole, 2001; Shields et al., 1988).
Given that college age men are at an age when violence reaches a peak (U.S.
Department of Justice, 2001) and that many college men report stranger violence
(Dromgoole & Cogan, 1995), research findmgs warrant the understanding why some
college men are violent toward strangers while others are not is of considerable importance. Three areas of hterature may be usefiil m differentiatmg between violent and
non-violent college men: coping mechanisms (defense mechanisms), antisocial personality features, and alcohol use problems.
Defense Mechanisms and Violence
Several investigators have suggested that the concept of defense mechanism might be a useful tool to understand psychodynamics of violence. Adolescents are m the period of transition (e.g., leaving for college), beguming to loosen emotional ties with the parents and to develop a sense of who they are (Cramer, 1995, 1997b; Erikson, 1968;
Marcia, 1980). While separatuig from parents and gaining autonomy, adolescents may experience msecurity, alienation, anxiety, stress, confusion, rejection, and disappointment
(Bios, 1962; Erikson, 1968; Marcia, 1980). They consequently experience a decrease m self-esteem that was once supported by "narcissistic gratification" derived from parental love and unconditional positive regard (Cramer, 1995, 1997b). To reduce these unpleasant feeUngs and compensate for the decrease in self-esteem, adolescents may develop narcissistic defenses (e.g., creating a grandiose, false self) commonly found in adolescence (Bios,. 1962; Cramer, 1995). Another way of protectmg self-esteem m
3 adolescence may be violence, in which feeUngs of stress and inadequacy are turned uito
feehngs of being strong and powerfiil. Pezza and Bellotti (1995) sunilarly pomted out
that college students tended to utilize interpersonal violence as a means to acquire power,
privilege, and protection.
Cognitive psychologists have found that antisocial/violent children and
adolescents tend to show cognitive distortions or errors that are similar to the
consequences of defense mechanisms (e.g., denial, projection). Crick and Dodge (1994)
found that aggressive children tended to have deficiencies m one or more of a series of
sequential cognitive processes (e.g., encoding, interpretation, clarification of goals, response access or construction, response evaluation and decision, and behavior enactment). Gibbs, Potter, and Goldstem (1995) suggested that antisocial youths tend to have cognitive distortions such as self-centeredness, minimizing/mislabeling, assuming the worst, or blamuig others. Barriga and Gibbs (1996) found that adolescent boys vvho were incarcerated for violent crimes were more likely than a control group of high school students to show cognitive distortions such as minimizing/mislabeling, misattributing one's act to another person, and assuming the worst. These cognitive deficiencies or distortions are consistent with consequences of denial (e.g., not perceivmg the presence of a disruptive internal psychological unpulse or a disturbing external event, m order to protect the self from excessive anxiety) and projection (e.g., attributing unacceptable internal psychological impulses to others external to oneself).
Nevertheless, only a few researchers to date have mvestigated a relationship between defense mechanisms and violence. In a sample of 60 psychiatric mpatients,
Apter et al. (1989) found that violent inpatients were more Ukely to use denial,
4 projection, and displacement defenses, and less hkely to use repression and reaction
formation defenses, compared to non-violent patients. Pfeffer, Plutchik, Mizurchi, and
Lipkins (1987) found that aggressive children were more likely than non-aggressive
children to use a projection defense. In a sample of high school students, Feldman and
Gowen (1994) found that mature defense mechanisms were positively related to Seeking
Social Support and Compromise factors derived from the Conflict Tactics Scale (CTS;
Straus, 1979).
Defense mechanisms were proposed by Sigmund Freud (1926/59) as ways m
which one part ofthe mind keeps distressing ideas out of awareness m an effort to reduce
unpleasant affects such as anxiety, depression, and guilt. Sigmund Freud (1923/1961)
proposed that the ego is an organizer and synthesizer of a variety of mental processes
such as regulating instinctual drives, adapting to external reaUty, and maintaining psychic
equilibrium between the mtemal and external demands. Smce Sigmund Freud originated
the concept of defense mechanisms, many psychodynamic theorists have expressed this
idea m a variety of different ways (Bennett & Hohnes, 1975; Cooper, 1998; Cramer,
1991a; Fenichel, 1945; Greenberg & MitcheU, 1983; Kohut, 1984; Modell, 1984;
Rothbaum, Weisz, & Snyder, 1982; Schachter, 1987). Theorists and researchers have described specific subtypes of defense mechanisms (e.g., regression, repression, reaction formation, projection, denial m fantasy, denial m word and act, altruism, spUtting, projective identification, actmg out, humor) (Cramer, 1987; Freud, 1926/1959,
1936/1966; Kemberg, 1967; Klein, 1973; Vaillant, 1976). Researchers have approached the measurement of defense mechanisms through both projective (e.g., Cramer, 1987) and self-report measures (e.g.. Bond, Gardner, Christian, & Sigal, 1983). Defenses have
5 been studied ui terms of a developmental hierarchy and relationships between defense
mechanisms and psychopathology/personality characteristics.
The TAT (Murray, 1943) has been frequently used m assessing the defense
mechanisms. Many researchers suggested that the TAT (Murray, 1943) is usefiil for
assessing unconscious mental processes such as defense mechanisms because the TAT
task intrudes into a person's private world and reveals his or her rejected unpulses and
wishes (Schafer, 1967). The TAT (Murtay, 1943) task requu-es a person to respond to
unfamihar stimuU and an examiner, causmg anxiety in the person. Consequently, the
person is likely to manifest defenses she or he uses in real Ufe situations during the TAT
task (Cramer, 1987). Unstructured verbal responses to the TAT cards allow mvestigators
to observe unconsciously operatmg defense mechanisms that can not be dkectly observed
(PorcereUi, Thomas, Hibbard, & Cogan, 1998). In addition, the way of communicatmg to another person such as in the TAT task serves in both asserting one's feeUngs, needs, and desu-es and defensively disguismg one's feeUngs and thoughts (Cooper, 1998).
Cramer (1991a) developed the Defense Mechanism Manual (DMM), a TAT scoring system designed to assess three defenses (denial, projection, and identification), rangmg from unmature to mature. Denial is defined as a mental process of ignoring, denying, negatmg, reversing, or distorting the unpleasant/noxious uitemal/extemal stimuH to reduce anxiety (Cramer, 1987). Projection is defined as a mental process of attributing unacceptable mtemal drives, needs, and unpulses to others external to oneself as a way of reducing anxiety (Cramer, 1987). Identification is a mental process of forming enduring internal mental representations of oneself by takmg others' certam qualities mto one's own, in order to obtain a sense of security and self-esteem (Cramer,
1987).
Self-report measures have also been used to assess defense mechanisms. Bond et
al. (1983) suggest that a self-report questionnau-e can also assess an unconscious process
such as defense mechanisms because (a) people may at times become aware of theu-
defensive styles agamst unacceptable unpulses, especially when theu- defenses
temporarily fail, (b) others often tell them defense mechanisms they use, and (c) people
can comment on theu" primary styles of dealmg with conflicts. Based on these
assumptions. Bond et al. (1983) developed a self-report measure, the Defense Style
Questionnau-e (DSQ), to assess possible "conscious derivatives" of defense mechanisms
(e.g., reaction formation, passive-aggression). Several versions ofthe DSQ (Andrews,
PoUock, & Stewart, 1989; Andrews, Smgh, & Bond, 1993; Bond, 1986, Bond et al.,
1983) have been developed to assess defensive styles.
A developmental hierarchy of defenses has been studied by several mvestigators, using projective measures (e.g., Cramer & Gaul, 1988; Hibbard & Porcerelli, 1998;
PorcereUi et al., 1998) or usmg both projective and self-report measures (Cramer, 1997b,
1998, 1999; Cramer, Blatt, & Ford, 1988; Cramer & Block, 1998). Inmiature and simple defenses (e.g., denial) have been found to be most predomuiant in early chUdhood (e.g., a developmental period characterized by lack of ego control and resiUency) and graduaUy decrease after this period (Brody, Rozek, & Muten, 1985; Cramer, 1987, 1991b; Cramer
& Block, 1998; Cramer & Gaul, 1988; Smith & Rossman, 1986). The mtermediate defenses (e.g., projection) emerge during late chUdhood and become fiiUy operative during early adolescence (Cramer, 1987, 1997a; Smith & Danielson, 1977; Tero &
7 ConneU, 1984). Most mature and complex defenses (e.g., identification, sublimation)
have been found to slowly develop and reach a peak in late adolescence and young
adulthood (Bios, 1979; Cramer, 1987, 1991a, 1995; Vaillant, 1976).
Several mvestigators have shown that defense mechanisms are related to various psychological characteristics, providmg empirical evidence for the defense mechanisms.
SpecificaUy, people tended to protect self-esteem by not remembering failures (denial;
Crary, 1966). People took much longer to recognize non-threatening words compared to threatening ones (denial; Lipp, Kolstoe, James, & RandaU, 1968). Non-depressed people recaUed adjectives that were favorable to the self more than non-favorable ones (denial;
Kuiper & Derry, 1982). Denial was positively related to anaclitic personaUty (e.g., other- focused, infantile personaUty) (Blatt & Shichman, 1983). An age-mappropriate defense mechanism (e.g., denial) in adulthood was positively related to psychological upset in childhood (Cramer & Block, 1998). Heterosexual males who were told that they had homosexual characteristics tended to later describe other males as having such characteristics (projection; Bramel, 1963). Persons with defensive projection tended to perceive others as having bad traits when the persons received negative feedback on those bad trarts (Newman, Duff, & Baumeister, 1997). Projection was related to paranoid traits (Berman & McCann, 1995) and obsessive-compulsive personaUty features (PoUock
& Andrews, 1989). Actmg-out was related to antisocial traits (Berman & McCann, 1995) and obsessive personaUty features (Pollock & Andrews, 1989). Displacement and devaluation were related to social phobia (PoUock & Andrews, 1989). Reaction formation was related to histrionic personaUty features (Rubuio, Saya, & Pezzarossa,
1992). Immature defense mechanisms (e.g., denial, projection) were related to
8 psychopathology (Spinhoven, Hendrikus, & Abraham, 1995; VaiUant, 1986), anxiety disorders (Andrews et al., 1993), trait anxiety (Muris & Merckelbach, 1994), and fear
(Muris & Merckelbach, 1995). Mature defense mechanisms (e.g., identification) were positively related to ego adaptation and maturity (Bond et al., 1983). Mature defenses were negatively related to anxiety disorders (Andrews et al., 1989; Spmhoven et al.,
1995).
In sum, these research findings generaUy uidicate that those who rely on unmature defense mechanisms (e.g., denial, projection) tend to have difficulty m resolvuig conflicts and to be more vuhierable to stress whereas those who utiUze mature defense mechanisms (e.g., identification, subUmation) tend to deal with conflicts in an adaptive way (Berman & McCann, 1995). These resuUs are consistent with Freud
(1936/1966) who proposed that specific defenses might be closely related to particular forms of emotional disturbances and MiUon (1986a, 1986b) who suggested that individuals with a certam personaUty disorder might be linked to one primary defense mechanism. Nevertheless, only a few mvestigators have exammed a relationship between defense mechanisms and overaU psychological health (Berman &. McCann,
1995).
Antisocial Personality Features and Violence
Studies regarding a relationship between violence and diagnostic features of
Antisocial PersonaUty Disorder (ASPD) have produced mixed results. Many researchers have found that violence is related to unpulsivity in children and adolescents (Dykeman,
Daehlm, Doyle, & Flamer, 1996; Farrington, 1989; Rodney, Tachia, & Rodney, 1999),
9 UTitability m coUege students (Caprara, Renzi, D'Imperio, & TravagUa, 1983),
uresponsibiUty in partner violent men (Hanson, Cadsky, Harris, & LaLonde, 1997), guilt
in men charged with violent crimes (Aromaki, Lmdman, & Eriksson, 1999), and lack of
empathy m adolescent murders (MiUer & Looney, 1974; Zenoff& Zients, 1979).
However, other researchers have reported that violence is not related to unpulse control
m juvenile offenders (Caputo, Frick, & Brodsky, 1999) and unpulsivity m male offenders
who were in psychiatric treatment (Wang & Diamond, 1999). MUler and Eisenberg
(1988) reviewed studies conducted on a relationship between violence and empathy, and
concluded that the results were inconsistent depending on the measures used to assess
empathy.
Studies regarding a relationship between violence and ASPD have generaUy
found consistent results. Many researchers have found that violence is related to the
ASPD m community samples (Bland & Om, 1986a, 1986b) and m violent male offenders
(Aromaki et al., 1999; Blackburn & Coid, 1999; ComeU, MUler, & Benedek, 1988).
Eronen, Angermeyer, and Schulze (1998) conducted an extensive review and suggested
that men with a diagnosis of ASPD were at least three tunes more Ukely than men
without a diagnosis of ASPD to commit violent crimes, and cross-vaUdated the strong
relationship between violence and ASPD in prison, clinical, and community samples.
The Mumesota Multiphasic PersonaUty Inventory (MMPI) has often been used to investigate a relationship between violence and antisocial personaUty features, yielding mixed results depending on the MMPI profiles or scales used to measure antisocial personaUty features, the type and severity of violence, and the nature of sample. Ofthe
MMPI scales, the Pd (Psychopathic Deviate) and the ASP (Antisocial Personality
10 Practices Content) scales have been developed and used to measure antisocial personaUty
features. Many researchers have found that the Pd scale was one ofthe high points
related to violence in adolescent murders (ComeU et al., 1988), m partner violent men
who were m treatment (Else, Wonderiich, Beaty, Chrisite, & Staton, 1993), m male
offenders mcarcerated for violent crimes (HoUand, Beckett, & Levi, 1981; KaUchman,
1988; Persons & Marks, 1971; VaUlant, Gristey, Pottier, & Kosmyna, 1999), and m sex
offenders (Moncrieff & Pearson, 1979). However, other researchers have found no
relationship (Katz & Marquette, 1996; Kemph, Braley, & Ciotola, 1998) or a negative
relationship (Chick, Loy, & White, 1984) between violence and the Pd scale.
In addition to the Pd scale, the ASP scale has been used to assess antisocial personaUty features. Several mvestigators have found that the ASP scale is positively related to psychopathology (LUienfeld, 1996), antisocial personaUty disorder (Smith,
Hilsenroth, Castlebury, & Durham, 1999), dishonesty (LiUenfeld, 1996), and the Pd scale
(Butcher et al., 1990). LUienfeld (1996) reported that the ASP scale was more sensitive than the Pd in differentiating between individuals with antisocial features and individuals v^thout the features. Despite the empuical evidence ofthe vaUdity ofthe ASP scale, no researchers to date have investigated a relationship between violence and antisocial personaUty features employmg the ASP scale.
Given the mixed results, the various types of violence, the lack of studies m a community sample, and the paucity of studies that employed the ASP scale, it should be helpfiil to conduct a comparative study examining the relationship between narrowly defined violence (e.g., stranger violence) and antisocial personaUty features m a coUege sample utilizing more than a scale.
11 Alcohol Use Problems and Violence
Alcohol use problems have been found to be related to violence m representative
samples of adolescents and aduUs (Bland & Om, 1986a; Komro et al., 1999; Orpmas et
al., 1995; Scott, Schafer, & Greenfield, 1997; WeUs, Graham, & West, 2000), m college
populations (Cogan et al., 2001; Wechsler, Lee, & Gledhill-Hoyt, 2001), m criminal
samples (ComeU et al., 1988; Gudjonsson & Sigurdson, 2000; Martm, 2000; Toombs,
Benda, & Corwyn, 2000; White, Ackerman, & Caraveo, 2001), and m cUnical samples
(Hastings & Hamberger, 1988; Klassen & O'Connor, 1988; Soyka, 1994).
As iUustrated above, the field is in general agreement that violence is related to
alcohol use problems. However, the curtent Uterature review reveals that the relationship
between alcohol use problems and violence is not simple and straightforward, but varies
as a flmction of many mediatmg factors such as the severity ofthe alcohol use problems
(Komro et al.; 1999), a relationship between perpetrators and victuns (Graham, WeUs, &
West, 1997), and the physical avaUabiUty of alcohol (Scriber, MacKinnon, & Dwyer,
1995).
The relationship between alcohol use problems and violence is also Ukely to be mediated by the nature of samples. The prevalence rates of Alcohol Dependence and
Alcohol Abuse m a commimity sample are estimated at 5% to 8% (Diagnostic Statistical
Manual-4th Edhion: American Psychiatric Association, 1994). In a coUege population,
Walters (2000) and Wechsler, DowdaU, Maenuer, GledhUl-Hoyt, and Lee (1998) found that about 40% reported havmg engaged in bmge drinkmg (e.g., 5 or more drinks m a row m the past two weeks). Walters (2000) reported that about 80% of coUege students who belong to fraternities or sororities reported to have heavily been drinking alcohol.
12 The relatively high prevalence rate of binge drinking in coUege students suggests that alcohol use problems are more Ukely to be related to violence in a coUege population compared to a general population. Furthermore, Scott et al. (1997) found that alcohol use problems were not related to either perpetration or victimization of "general" violence among women, suggestmg that the strong relationship between alcohol use problems and violence is only tme for men.
Alcohol use problems have been found with partner violence (Bland & Om,
1986a; Eberie, 1982; Hastmgs & Hamberger, 1988). However, most studies regardmg a relationship between alcohol use problems and partner violence did not differentiate between men who were violent only toward partners and men who were violent to both partners and other people. Although the type of violence mediates a relationship between alcohol use problems and violence, only a few researchers have mvestigated the relationship between alcohol use problems and a more distinctively classified pattem of violence. Shields et al. (1988) reported that both non-family violent men and generaUy violent men were more Ukely than family-violent men to have alcohol problems, suggesting famUy-only violence is not related to alcohol use problems. Sunilar to Shields et al. (1988), Cogan et al. (2001) found that stranger violent men and generaUy violent men were more Ukely than partner violent men and nonviolent men to have alcohol use problems whereas partner violent men were not more Ukely than nonviolent men to have alcohol use problems.
Nevertheless, not many investigators have examined the relationship between nartowly defined violence and alcohol use problems in a community sample. Given that violence is heterogeneous, most prevalent m young aduUs, and causmg serious problems
13 in a coUege population, it should be helpful to conduct a comparative study mvestigating a relationship between stranger violence and alcohol use problems m a coUege population.
Purpose of Study
As pointed out above, defense mechanisms, antisocial personaUty features, and alcohol use may contribute to understanding the psychological characteristics of stranger violence. Nevertheless, no researcher to date has examined defense mechanisms, antisocial personality features, and alcohol use of coUege student men who are violent toward strangers. The purpose of this project is to luiderstand several aspects of psychodynamics of stranger violence. It is expected that coUege student men who are violent toward strangers are more likely than non-violent college student men to use primitive defense mechanisms (e.g., denial, projection) rather than mature defense mechanism (e.g., identification). It is also expected that coUege student men who are violent toward strangers wiU have more antisocial features and more often wiU have an indication of alcohol related problems compared to non-violent coUege student men.
This knowledge wUl be usefiil for cUnicians and counselors m developmg prevention and mtervention programs for stranger perpetrators.
14 CHAPTER II
METHODOLOGY
Participants
Participants were recmhed from a large group of mtroductory psychology students who participated in a mass-survey project that mcluded a variety of self-report measures. Based on theu- responses to the Modified Partner Violence Screen (PVS:
Feldhaus et al., 1997) administered during the mass survey, 30 men who reported no violence m the past year and 30 men who reported stranger violence (but no violence toward partners, fiiends or famUy) m the past year were recmhed. Only those students who were wilUng to be contacted by phone for a foUow-up study were soUched. Students were selected who were between 18 and 21 years of age. The two groups were matched for age and ethnicity. Student participation in the mass survey and this project was voluntary and was one of several avaUable altematives for earning class credit.
Measures
The Modified Partner Violence Screen (PVS)
The current study used the following question to screen for violence: "Have you hit, kicked, punched, or otherwise hurt someone within the past year?" (Feldhaus et al.,
1997). As part ofthe question, each participant was asked to answer "no" or "yes" to four categories: stranger, fiiend or someone you know, partner or ex-partner, and someone in your family (see Appendix B). This item was derived from the PVS
(Feldhaus et al., 1997), which is a 3-hem self-report measure of violence based on the
15 severe violence hems ofthe Conflict Tactics Scale (CTS; Straus, 1979). ReUability and vahdity ofthe modified PVS have not been directly mvestigated with stranger violence.
Ofthe three items, a physical violence item alone ("Have you been hit, kicked, punched, or otherwise hurt by someone wdthin the past year? If so, by whom?") was more sensitive and specific than the other two items m detecting partner violence (Feldhaus et al., 1997).
When compared with two empuicaUy weU-vaUdated measures of partner violence, the
Index of Spouse Abuse (ISA; Hudson & Mcintosh, 1981) and the CTS (Straus, 1979) as criterion standards, the item showed good senshivity, specificity, positive predictive value, and negative predictive value (Feldhaus et al., 1997).
The Thematic Apperception Test (TAT)
In the present study, six cards (1,2, 3BM, 4, 6BM, and 13MF) from the TAT
(Murray, 1943) were used. These cards were chosen because they have been often used by other researchers (e.g., Cogan & PorcerelU, 1996; Cramer, 1995, 1998; Cramer &
Block, 1998; Hibbard & PorcereUi, 1998; Westen, 1991) and represent work and famUy relationships. FoUowmg standard TAT instmctions, for each TAT picture presented, each participant was asked to teU a story about the pictiare. The TAT (Murray, 1943) has been shown to be a reliable and vaUd measure on which to base assessment of achievement motivation (Atkuison, 1958), power motivation (Wmter, 1973), castration anxiety (Schwartz, 1955, 1991), social cognition and object relations (Cogan &
Porcerelli, 1996; Westen, 1991; Westen, Lohr, SUk, Gold, & Kerber, 1990), and defense mechanisms (Cramer, 1991a, 1995, 1998; Cramer & Block, 1998, Hibbard et al., 1994;
16 Hibbard & Porcerelli, 1998). Stories told for the TAT cards were scored with the
Defense Mechanism Manual for the TAT (Cramer, 1991a).
The Defense Mechanism Manual for the TAT (DJVCVn
The DMM (Cramer, 1991a) provided a procedure for scoring three types of
defenses (denial, projection, and identification) from TAT responses. For each defense,
Cramer (1991a) identified seven different scoring categories and each was identified and
summed for each defense. Scoring categories for denial (Cramer, 1991a) mclude: (1)
Omission of major characteristics of objects, (2) Misperception, (3) Reversal, (4)
Negation, (5) Denial of reaUty, (6) Overly maximizing the positive or minimizmg the negative, and (7) Unexpected goodness.
Scoring categories for projection (Cramer, 1991a) mclude: (1) Attribution of aggressive/hostUe feeUngs or intentions to a character, (2) Addhions of ominous people, ghosts, anunals, objects, or quaUties, (3) Concem for protection against extemal threat,
(4) Themes of pursuh, entrapment, and escape, (5) Apprehensiveness of death, injury, or assault, (6) Magical or circumstantial thmking, and (7) Bizarre or very unusual story or theme.
Scoring categories for identification (Cramer, 1991a) mclude: (1) Emulation of skiUs, (2) Emulation of characteristics, (3) Regulation of motives or behavior, (4) Self- esteem through affiUation, (5) Work: delay of gratification, (6) Role differentiation, and
(7) MoraUsm.
ReUabUity ofthe DMM (Cramer, 1991a) has been considered m several research lines. The spUt-half reliabiUty coefficient for the defense mechanism scores is adequate,
17 rangmg from .52 to .84 (Cramer, 1991a). Inter-rater reliabUities for defense measures by
different samples, pictures, and raters range from .40 to 1.0 (Cramer, 1991a, 1991b, 1995,
1997a; Hibbard et al., 1994; Hibbard & PorcereUi, 1998; PorcereUi et al., 1998).
Numerous researchers have provided evidence ofthe criterion-related vaUdity, constioict vaUdity, and convergent and discriminant validhy ofthe DMM (Cramer,
1991a) scoring system. Defense scores measured by the DMM (Cramer, 1991a) were significantly cortelated with mdependent clmical judgments (Cramer, 1991a), identhy crises (Cramer, 1995, 1997b, 1998), and specific personaUty syndromes (Cramer, 1999;
Cramer et al., 1988; Cramer & Blatt, 1990; Hibbard et al., 1994; Hibbard & PorcerelU,
1998). The DMM (Cramer, 1991a) scores changed foUowmg naturaUy occurring stress
(DoUinger & Cramer, 1990), experimentally mduced anger (Cramer, 1991b), a threat to gender identity (Cramer, 1998), and approxunately 15 months of psychoanalyticaUy oriented mtensive psychotherapy (Cramer & Blatt, 1990). In both cross-sectional
(Cramer, 1991a; Hibbard & PorcereUi, 1998; PorcerelU et al., 1998) and longitudmal studies (Cramer, 1997a), DMM (Cramer, 1991a) scores also changed as a function of age
(e.g., more mature defenses are shown by adolescents than by younger chUdren), consistent Avith the developmental theory of defenses (Cramer, 1997a; Erikson, 1968;
Freud, 1936/1966; VaiUant, 1971). Inter-correlations between the three defense scores of the DMM (Cramer, 1991a; PorcerelU et al., 1998) range from -.01 to .37, suggestmg that they are primarily measuring three different characteristics of defense, further demonstrating the vaUdity ofthe DMM (Cramer, 1991a).
18 The Defensive Style Ouestionnaire-40 (DSO-40)
The DSQ-40 (Andrews et al., 1993) is a 40-item, self-report questioimaire,
designed to measure 20 different defensive styles. For each statement (e.g., 'Teople say I tend to ignore unpleasant facts as if they didn't exist." "People tend to mistreat me." "I
am able to keep a problem out of my mind untU I have time to deal with h."), participants
are asked to mdicate their degree of agreement or disagreement on a 9-pomt scale (1 =
strong disagreement, 9 = strong agreement) (see Appendix C).
Test-retest rehabihty ofthe questionnaire has been reported as adequate, ranging from .38 (suppression scale) to .80 (displacement scale) (Andrews et al., 1993;
Kneepkens & Oakley, 1996; Watson & Smha, 1997). Intemal consistency coefficients for unmature, neurotic, and mature factors were .68, .58, and .80, respectively (Andrews
et al., 1993). Profile and discriminant analyses revealed that the questionnaire was able to significantly discriminate anxiety patients from normal controls, child-abusing parents from normal controls, and chUd-abusmg parents from anxiety patients (Andrews et al.,
1993). FoUowing psychotherapy, patients with major depression showed significant changes m theu- DSQ-40 scores (Kneepkens & Oakley, 1996). Principal component factor analysis revealed a three-factor solution: immature, neurotic, and mature factors
(Andrews et al., 1993). The three-factor solution has been cross-culturaUy vaUdated
(Watson & Smha, 1997). In this study, three factors (unmature, neurotic, and mature defenses) ofthe DSQ-40 (Andrews et al., 1993) were used for statistical analyses.
19 The Minnesota Multiphasic Personality Inventorv-2 CMMPI-2'>
The MMPI-2 (Butcher et al., 1989) is a 567-hem self-report measure of
personality and psychopathology. The curtent study used three scales ofthe MMPI-2
(Butcher et al., 1989): the clinical scale Psychopathic Deviate (Pd), the content scale
Antisocial Practices (ASP), and the supplementary scale MacAndrew Alcoholism scale-
revised (MAC-R). These scales have been used to identify persons with antisocial
features (e.g., faUure to conform to social norms or laws, aggressiveness, uresponsibUity,
lack of remorse, unpulsivity, and excessive use of alcohol and/or dmgs) (Graham, 1993).
Individuals with high scores on the Pd scale tend to have difficulty conforming to the
values and rules of society, "engage m asocial or antisocial" behaviors such as lying and
steaUng, act impulsively, be hostUe and aggressive, be perceived as narcissistic and
selfish, and show lack of deep emotional response such as remorse and guUt (Graham,
1993). Individuals whh high scores on the ASP tend to have trouble Avith the law, resent
authority, display anger and hostiUty, abuse dmgs, and be dishonest and inconsiderate of
others (Graham, 1993). Individuals with high scores on the MAC-R tend to have alcohol/substance abuse problems, "behavior problems in school or with the law," risk- taking behavior, and/or self-confident (Graham, 1993).
Test-retest reUabUity coefficients for the Pd, ASP, and MAC-R scales are .81
(Butcher et al, 1989), .81 (Butcher et al., 1990), and .82 (Moreland, 1985b), respectively.
Intemal consistency coefficients for the Pd, ASP, and MAC-R scales are reported at .60
(Butcher et al., 1989), .78 (Butcher et al., 1990), and .56 (Butcher et al., 1989), respectively. The vaUdity of these scales has been reported as appropriate. Persons with high scores on the Pd scale were described as "antisocial" by theu- partners, psychiatrists,
20 and psychologists (Graham, 1988). The ASP scale was positively related to the Pd scale
(Butcher et al., 1990). Persons with antisocial personaUty diagnosis tend to have
relatively higher scores on the MAC-R scale whether or not they have alcohol or dmg
problems (Wolf, Schubert, Patterson, Grande, & Pendleton, 1990; Zager & Megargee,
1981).
Procedures
As part of a mass survey of students enroUed in an introductory psychology
course, aU participants completed the modified PVS (Feldhaus et al., 1997) and other
self-report measures. Based on theu- responses to the modified PVS (Feldhaus et al.,
1997), non-violent men and stranger violent men were identified. Thirty men from each
group were randomly selected. Only those who were willing to be called by telephone to
be asked to participate m research were contacted by phone and were sunply told that this
was a convenient way of recmiting research participants. The investigator, blind to the group membership ofthe participant, made an experimental appomtment with each participant. Upon arriving in the experimental room, each participant was asked to read and sign a consent form. FoUowing the standard TAT (Murray, 1943) procedure, each participant was asked to teU a story about each of six TAT pictures (1,2, 3BM, 4, 6BM, and 13MF). A total of 360 stories (60 participants X 6 cards) were audio-taped and subsequently transcribed verbatim. After the TAT administration, each participant was asked to respond to three self-report measures, the DSQ-40 (Andrews et al., 1993), the
MMPI-2 (Butcher et al., 1989), and a brief demographic measure. Completmg the TAT administration and the three self-report measures requu-ed one and a half to two hours.
21 After the curtent investigator and another rater were successfliUy tramed m the DMM
(Cramer, 1991a) scoring system for stories told about the six TAT cards, the v^rritten
responses to the TAT pictures were independently scored by the two raters. After inter-
rater reUabUity was computed, two raters discussed and resolved scoring differences.
The mutually agreed scores were used for statistical analyses. Both the DSQ-40
(Andrews et al., 1993) and the MMPI-2 (Butcher et al., 1989) were hand-scored.
Statistical Analyses
Prior to data analyses intended for specific research questions, inter-rater
reUabUity was computed to assess the reUabUity ofthe DMM (Cramer, 1991a) scoring
system for stories told for the TAT cards. A multivariate analysis of variance was
conducted for each ofthe DMM, the DSQ-40, and the MMPI measures. To identify Xhe
differences between non-violent and stranger violent groups, five multivariate analyses of
variance (MANOVA) were conducted on the subscales ofthe DMM, the DSQ-40, and
the MMPI-2. The first MANOVA was conducted to test for group differences in defense mechanisms measured by the DMM, a projective test. The second MANOVA was conducted to test for group differences in the defense mechanisms excluding mdividuals with invalid MMPI-2 profiles. Dependent variables were the three DMM subscales (e.g., denial, projection, and identification). The thurd MANOVA was conducted to test for group differences in defensive styles measured by the DSQ-40, a self-report test. The fourth MANOVA was conducted to test for group differences m the defensive styles excludmg mdividuals with invaUd MMPI-2 profiles. Dependent variables were the three
DSQ-40 subscales (e.g., unmature, neurotic, and mature). The fifth MANOVA was
22 conducted to test for group differences in antisocial personaUty features. Dependent variables were the three subscales (e.g., Pd, ASP, and MAC-R) ofthe MMPI-2. If there was a significant multivariate effect, follow-up analyses of variance tests were carried out for each ofthe dependent variables m order to assess possible subscale differences between the groups. In addhion, cortelations between the DMM, DSQ-40, and MMPI-2 subscales were computed for both the participants included the ones with invaUd MMPI-
2 profiles and the participants excluded the ones with the invaUd MMPI-2 profiles.
23 CHAPTER m
RESULTS
Inter-Rater ReUabUity
The curtent investigator and an advanced female student in a doctoral program in
cUnical psychology coded the DMM (Cramer, 1991a). The inter-rater reUabUity ofthe
two coders' scores was adequate with Pearson product moment cortelations of .64
(denial), .82 (projection), .79 (identification), and .81 (the combmation of denial,
projection, and identification). Total scores for denial, projection, and identification for
participants ranged from 0 to 9, from 1 to 14, and from 2 to 22, respectively. The resuhs
are consistent with previous findings (e.g., Cramer, 1991a; Hibbard & PocereUi, 1998;
PorcereUi et al., 1998), which demonstrated the adequate mter-rater reUabUities.
Differences Between the Two Groups
The DMM Scales
A multivariate analysis of variance (MANOVA) was conducted to compare the
differences between coUege student men who were violent toward strangers and coUege
student men who were not violent m denial, projection, and identification scores. There was a significant multivariate effect, HoteUing-Lawley Trace = . 17, F(3,56) = 3.1, p =
.03. FoUow-up analysis of variance tests were carried out for denial, projection, and identification scores. The denial scores ofthe stranger violent men were significantly higher than tiie scores ofthe non-violent men, F(l,58) = 7.72, p = .007 (see Table 1).
Neither the projection nor the identification scores of men in the two groups differed
24 significantly. The projection scores ofthe stranger violent men were not significantly different from the scores ofthe non-violent men, F(l,58) = .05, p = .83. The identification scores ofthe stranger violent men were not significantly different from the scores ofthe non-violent men, F(l,58) = .72, p = .40.
After the scores of 8 stranger violent men and 3 non-violent men were excluded from the analysis because their MMPI-2 profiles were invaUd based on L > 79, F > 90, and K > 70 (Butcher et al., 1989), another MANOVA was conducted to compare the differences between coUege student men who were violent toward strangers and college student men who were not violent in denial, projection, and identification scores.
Although the probabUity of finding a large effect size (e.g., d = .8) was reduced from .87 to .80 as a resuh of a smaUer sample size, the results ofthe second MANOVA were consistent with the resuhs ofthe first MANOVA (see Table 2).
The DSO-40 Scales
A multivariate analysis of variance (MANOVA) was conducted to compare the differences between the stranger violent and non-violent men hi uimiature, neurotic, and mature scores. There was no significant multivariate effect, HoteUing-Lawley Trace =
.002, F(3,56) = .34, p = .80 (see Table 1). Another MANOVA was conducted to compare the differences between the stranger violent men and non-violent men in unmature, neurotic, and mature scores after participants who produced mvalid MMPI-2 profiles based on L > 79, F > 90, and K > 70 (Butcher et al., 1989) were excluded from the analysis. There was no significant multivariate effect, HoteUmg-Lawley Trace = .002,
F(3,56) = .36, p = .78 (see Table 2).
25 The MMPI-2 Scales
A multivariate analysis of variance was conducted to compare the differences between the stranger violent and the non-violent men in Pd, MAC-R, and ASP scores.
The scores of 8 stranger violent men and 3 non-violent men were excluded from the analysis because theu- MMPI-2 profiles were invalid based on L > 79, F > 90, and K > 70
(Butcher et al., 1989). There was a significant muhivariate effect, HoteUuig-Lawley
Trace = .37, F(3,45) = 5.59, p = .002. Follow-up analysis of variance tests were carried out for Pd, ASP, and MAC-R scales. The Pd scores ofthe stranger violent men did not differ from the scores ofthe non-violent men, F(l,47) = 1.82, p = . 18 (see Table 2). The
ASP scores ofthe stranger violent men were significantly higher than the scores ofthe non-violent men, F(l,47) = 12.93, p = .0008. The MAC-R scores ofthe stranger violent men were significantiy higher than the scores ofthe non-violent men, F(l,47) = 8.75, p =
.005.
Cortelations Between the DMM. the DSO-40. and the MMPI-2 Scales
Pearson product moment correlations between Denial, Projection, Identification,
Immature, Neurotic, Mature, Pd, MAC-R, and ASP variables were computed. None of the DMM scales was significantiy correlated with each other (see Table 3). In contrast, the DSQ-40 Neurotic scale was positively related to both the DSQ-40 Immature and
Mature scales. Furthermore, the MMPI-2 ASP scale was positively cortelated with both the MMPI-2 Pd and MAC-R scales. Except the positive cortelation between the DMM
Projection scale with the DSQ-40 Immature scale and the negative cortelation between the DMM Projection scale with the DSQ-40 Mature scale, no significant correlations
26 were found between the DMM and the DSQ-40 scales. Except the positive cortelation between the DMM Projection scale and the MMPI-2 Pd scale, no significant correlations between the DMM and the MMPI-2 scales were found. The cortelations between the
DMM, the DSQ-40, and the MMPI-2 subscales were consistent with the cortelations computed for the participants excluding the ones whh the mvalid MMPI-2 profiles.
27 Table 1
Average Scores ofthe DMM and the DSQ-40 Scales.
Stranger Violent Men Non-violent Men (N=30) (N=30)
M SD M SD DMM Scales
Denial** 3.8 1.7 2.5 2.0
Projection 3.3 1.7 3.4 1.8
Identification 10.3 3.7 11.2 4.5
DSQ-40 Scales
Immature 4.0 1.1 3.8 0.8
Neurotic 4.9 1.3 4.8 1.3
Mature 5.8 1.2 5.7 1.3
*E<.05 **E<.01
28 Table 2
Average Scores ofthe DMM, the DSQ-40, and the MMPI-2 Scales of Men with VaUd MMPI-2 Profiles.
Stranger Violent Men Non-violent Men (N=22) (N=27)
M SD M SD DMM Scales
Denial* 3.8 1.9 2.6 2.0
Projection 3.0 1.5 3.2 1.6
Identification 9.5 3.5 11.1 4.6
DSQ-40 Scales
Immature 4.0 1.1 3.7 0.7
Neurotic 4.9 1.2 4.8 1.3
Mature 5.8 1.3 5.7 1.3
MMPI-2 Scales
Pd 45.9 9.5 42.2 9.3
ASP** 61.9 9.8 53.0 7.4
MAC-R** 59.2 7.7 52.1 8.8
* E < .05 **2<.01
29 Table 3
Correlations between the DMM, the DSQ-40, and the MMPI-2 Scales of AU Participants (N=60, Upper Quadrant) and Participants (N=49, Lower C^adrant) with VaUd MMPI-2 Profiles.
DMM DSQ-40 MMPI-2
DEN PRO IDE LMM NEU MAT PDS ASP MAC
DEN 1.0- -.09 .14 -.02 -.02 .07 .01 .13 .14 1.0 -.05 .12 .02 -.07 .08 .08 .27 .21
PRO -.09 1.0 .11 .60** .10 .18 54** .14 .07 -.05 1.0 .03 45** -.03 -.32* .35* .06 -.07
IDE .14 .11 1.0 .06 .15 .22 .18 -.04 -.21 .12 .03 I.O 0.0 .12 .22 .14 -.04 -.26
IMM -.02 .60** .06 1.0 .27* .03 39** 43** .37* .02 .45** 0.0 1.0 .13 -.02 .24 44** .27
NEU -.02 .10 .15 .27* 1.0 47** .13 .03 .19 -.07 -.03 .12 .13 1.0 47** .13 .04 .10
MAT .07 -.18 .22 .03 47** 1.0 -.08 0.0 .11 .08 -.32* .22 -.02 47** 1.0 -.08 .12 .17
PDS .01 .54** .18 .39* 13 -.08 1.0 48** .22 .08 .35* .14 .24 13 -.08 1.0 .48** .11
ASP .13 .14 -.04 .43** 03 0.0 .48** 1.0 .48** .27 .06 -.04 44** 04 .12 .48** 1.0 .38*
MAC .14 .07 .21 .37* 19 .11 .22 .48** 1.0 .21 -.07 -.26 .27 10 .17 .11 .38* 1.0
*E<.05 **p<.001
Note: DEN = Denial, PRO = Projection, IDE = Identification, IMM = Immature, NEU= Neurotic, MAT = Mature, PDS = Psychopathic Deviate Scale, ASP = Antisocial Practices Scale, MAC = MacAndrew AlcohoUsm Scale-Revised.
30 CHAPTER rV
DISCUSSION
Differences Between the Two Groups
In this study, h was predicted that college student men who were violent toward
strangers would be more Ukely than coUege student men who were non-violent to use
primitive defense mechanisms (e.g., denial, projection) rather than mature defense
mechanism (e.g., identification). The coUege student men who were violent toward
strangers were more Ukely than the coUege student men who were non-violent to use
denial measured by the DMM. However, the coUege student men who were violent
toward strangers did not differ from the coUege student men who were non-violent m
usmg projection and identification defenses measured by the DMM (Cramer, 1991a).
Furthermore, the two groups did not differ on unmature, neurotic, and mature defenses
measvu-ed by the DSQ-40 (Andrews et al., 1993). The resuUs unveUed some
psychological characteristics of coUege student men who were violent toward strangers.
Fust, the results suggest that the coUege student men who were violent toward
strangers may have problems in managmg painfiil or imdesirable affects. Consistent with the definitions of denial proposed by Aima Freud (1936/1966) and Cramer (1991a), the coUege student men who were violent toward strangers may be more likely than the coUege student men who were non-violent to deny the presence of a dismptive mtemal psychological impulse or a disturbmg extemal event that would cause psychological pam or discomfort if recognized. As suggested by the DMM (Cramer, 1991a), the coUege student men who were violent toward strangers may have an unconscious attitude such as
31 '^ust ignore the problem and it wUl go away." The greater use of denial by the coUege student men who were violent toward strangers may lead them to misperceive the meaning of events, distort neutral stimuU as threats or chaUenges, mmimize or maximize the consequence of their behaviors, and have unreaUstic expectations such as "violence does not cause harm to victims," "I can get away with violence," or "violence pays off'
(Barriga & Gibbs, 1996; Crick & Dodge, 1994). Consequently, they may respond to strangers in aggressive or violent behaviors.
Second, based on the developmental hierarchies of defense mechanisms proposed
(e.g., Anna Freud, 1936/1966) and empuically validated by several researchers (Brody et al., 1985; Cramer, 1987, 1995, 1997a; Cramer & Block, 1998; Smith & Rossman, 1986;
VaUlant, 1971, 1976), the greater use of denial (e.g., most unmature, the simplest, and most predominant m early chUdhood) by the coUege student men who were violent toward strangers suggests that they may not have fiiUy developed the ego that can regulate uistinctual drives, adapt to extemal reaUty, and mamtaui psychic equiUbrium between the intemal and external demands. The current resuhs also suggest that the
DMM (Cramer, 1991a) is a usefijl tool to distmguish the two groups, givmg support to the past research (e.g., Berman & McCann, 1995; Cramer, 1991a; Cramer & Block,
1998) that showed evidence for the discriminant vaUdity ofthe DMM (Cramer, 1991a).
Thu-d, the curtent resuhs raise a question of why there was no difference between the two groups m projection and identification measured by the DMM (Cramer, 1991a).
The resuhs suggest that the coUege student men who were violent toward strangers are able to use the higher level of defense but may faU back on denial at tunes. In addition, there was no difference between the two groups on the DSQ-40 (Andrews et al., 1993),
32 castmg some doubt about whether or not a self-report measure can assess an unconscious process such as defense mechanisms as suggested by Bond et al. (1983), Andrew et al.
(1993), and Cramer (2001). It is Ukely that the coUege stiident men who were violent toward strangers were somewhat able to disavow theu- denial defense mechanisms m self- report tests (e.g., DSQ-40), but they would not be able to mask their use of denial during the DMM (Cramer, 1991a) because of rts projective nature. This explanation is consistent with Porcerelli et al. (1998) who suggested that unstmctured verbal responses to the TAT cards help researchers observe imconsciously operating defense mechanisms.
It was expected that the coUege student men who were violent toward strangers would have more antisocial features, compared to the non-violent coUege student men.
Although the content analysis ofthe ASP hems revealed that none ofthe ASP hems referred to violence, it was found that the coUege men who reported stranger violence scored higher than the non-violent college student men on the ASP. The resuh suggests that the coUege student men who were violent toward strangers are more likely than the non-violent coUeges student men to have trouble with the law, resent authority, engage m asocial or antisocial behaviors, display anger and hostiUty, abuse dmgs, and be dishonest and inconsiderate of others (Graham, 1993). The resuh is sunUar to many other studies, which have found that violence is related to antisocial features (e.g., Aromaki et al.,
1999; Caprara et al., 1983; Dykeman et al., 1996; Farrington, 1989; Hanson et al., 1997;
Rodney et al., 1999) and antisocial personaUty disorder (e.g., Blackburn & Coid, 1999;
Bland & Om, 1986a, 1986b; ComeU et al., 1988; Eronen et al., 1998). The resuh fiirther suggests that the ASP scale may be used to screen for stranger violence.
33 Consistent with Butcher et al. (1990) who demonstrated a positive relationship
between the Pd and the ASP and Graham (1993) who reported that individuals with high
scores on the Pd scale tended to have antisocial features, it was found that the Pd scale
was positively correlated with the ASP scale. As pomted out, the current study found a
positive relationship between the ASP scale and stranger violence. Nevertheless, the
curtent study did not find a significant difference between the stranger violent college
student men and non-violent men on the Pd scale. The resuh is uiconsistent with other
researchers (e.g.. Else et al., 1993; HoUand et al., 1981; Persons & Marks, 1971; VaUlant
et al., 1999) who have found a significant relationship between violence and the Pd. The
inconsistent resuhs may be due to the fact that the current study mvestigated a more
nartowly defined type of violence (e.g., stranger violence), a less severe form of violence
(e.g., not homicide), and a different measure (e.g., ASP) compared to other studies.
Alternatively, the ASP may be more sensitive than the Pd in assessing antisocial features
(LiUenfeld, 1996) and stranger violence.
It was expected that the coUege student men who were violent toward strangers would more often have an indication of alcohol related problems, compared to the non violent college student men. The coUege student men who were violent toward strangers scored higher than the non-violent coUege student men on the MAC-R. The result suggests that the coUege student men who were violent toward strangers are more likely than the non-violent coUege student men to have alcohol/dmg abuse problems, behavior problems m school, or risk-takmg behavior (Graham, 1993). The resuh is sunilar to other studies (e.g.. Bland & Om, 1986a; Cogan et al., 2001; Komro et al., 1999; Orpmas et al..
34 1995; Wechsler et al. 2001; WeUs et al., 2000), which found a positive relationship
between violence and alcohol use problems.
The curtent shady found that the DSQ-40 Neurotic scale was positively cortelated
with both tiie DSQ-40 Immature and Mature scales. The resuh raises some doubt about
the constmct validity ofthe measure. In contrast, none ofthe DMM scales was
cortelated to each other, providing evidence for the constmct validity ofthe measure. No
significant relationship between the DMM and DSQ-40 scales except the poshive
relationship between the DMM Projection scale and the DSQ-40 Immature scale suggests
that the two measures may be measuring somewhat different constmcts.
The probabiUty of rejecting a false nuU hypothesis (e.g., power) reduces as a
sample size decreases. Nevertheless, aU the significant differences and resuhs discussed
earUer did not change even after aU the statistical analyses were repeated for group
differences excludmg participants with mvaUd MMPI-2 profiles. This suggests the robustness ofthe current findings.
In sum, the curtent results uidicate that the coUege student men who were violent toward strangers are more Ukely than the non-violent coUege student men to cope with anxiety or stress by denying and mmunizing rather than actively solvuig problems.
Another way of copmg with the emotionaUy disturbmg situations may be violently actmg out toward strangers by which the feeUngs of anxiety, stress, and msecurity are transformed mto feelings of bemg powerful and strong. In order to just ignore the stressful reaUty, the coUege student men who were violent toward strangers may at times go to drink and become mvolved m an altercation leadmg to assaultmg a stranger. It has been suggested that drinking alcohol seems to mcrease male violence by reducmg an
35 abUity to accurately evaluate the negative consequences of violent acts (Steele & Josephs,
1990) and transforming an unconscious "mascuUne ideal" or "power fantasies" mto a
sense of "pride" and "control" (Graham et al, 2000). Due to these characteristics, the
stranger violent college men are more lUcely than the non-violent college student men to be described as "antisocial."
Lunitations and Future Research
This study has some Umitations. First, a Umited sample was used m that aU participants were male coUege students so that the generalizabUity ofthe current results is
Umited. Second, this research should collect additional non-test data (e.g., VaiUant's
clmical mterview of defense) on the type of most dommant defense mechanisms as weU as the degree of antisocial features and alcohol/dmg problems.
Desphe the limitations noted above, this study does make several significant contributions toward the understanding of stranger violence m coUege student men. This was the first study to estabUsh that stranger-violent coUege student men score higher than non-violent coUege student men on the DMM denial (Cramer, 1991a). This study also provided evidence for the reUabUity and vaUdity ofthe DMM (Cramer, 1991a).
The clmical unpUcations ofthe ciurent findmgs are important. Fu-st, the poshive relationship between stranger violence and denial defense suggests that restmcturing cognitive distortions or deficiencies (e.g., mmunizmg or mislabeUng) may be necessary component of prevention and intervention programs for stranger perpetrators. Second, cUnicians should not solely rely on a self-report measure m assessing stianger violence.
Thu-d, cUnicians should assess and specify the degree to which stranger violent men
36 predommantly rely on a denial defense mechanism because the denial defense can be
served as measures for diagnosis, change process, and treatment outcome. In fact,
Cramer (2000b), the DSM-IV (APA, 1994), and VaUlant (1994) suggested that the
predominant defense mechanisms individuals have been employing should be assessed as
a part of clinical diagnoses and understanding psychopathology. Fourth, whUe working
v^th stranger violent men, cUnicians should be aware that the therapeutic alUance might
be mptured by the denial defense stranger violent men often use, suggesting that
cUnicians must be careful about confrontmg the use of denial defense. It may be
necessary to mandate (e.g., legal system) treatment for stranger violence. Lastly, the
positive relationship between stranger violence and alcohol use problems suggests that
cUnicians should pay attention to the alcohol use problems in unplementmg treatment for
stranger perpetrators.
Certainly, further research is required in order to repUcate or generaUze the
current results. SpecificaUy, this study needs to be repUcated by emplojing larger and
more homogeneous samples of stranger violent and non-violent coUege student men.
Future research is caUed for unproving the generaUzabiUty ofthe current findmgs. It is
possible that the curtent resuhs may be obtained from children or coUege student women.
It is also possible that such populations may not differ m denial but in projection or
identification. Furthermore, h vnil be interestmg to mvestigate how various subtypes of
violence (e.g., partner violence or general violence) are related to different kinds of
defense mechanisms. Given that the college student men who were violent toward
strangers were more Ukely than the non-violent coUege student men to employ an unmatiire defense mechanism, h wiU be also mterestuig to see a relationship between
37 stranger violence and academic performance. AddhionaUy, it is suggested that fiirther research take mto account other possible attributes such as degree of psychological distress, history of child abuse, and family stmcture (e.g., intact or broken) as possible confounding variables. Overall, the curtent study was the first study that empiricaUy mvestigated the relationship between stranger violence and defense mechanisms in a coUege sample, contributing to improve understanding the psychological characteristics of coUege student men who were violent toward strangers.
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58 APPENDIX A
EXTENDED LITERATURE REVIEW
Prevalence of Violence
The incidence of physical violence is high (Lore & Schultz, 1993) and constitutes
a significant problem in the United States (Potter & Mercy, 1997). During the period
between 1988 and 1994, the juvenile arrest rate for violent crimes m the United States
mcreased by more than 50 percent, compared to the relatively stable rate ofthe period
between 1975 and 1988 (Snyder, Sickmund, & Poe-Yamagata, 1996). Homicide rates of
adolescents and yoimg aduks between ages of 14 and 24 have significantly mcreased
during the same tune period, and became the number-two cause of death in 1992, vehicle
accidents bemg the number-one cause of death (Lore & Schultz, 1993). Arrest rates for
aggravated assauhs in the United States doubled among adolescents during the period
between 1980 and 1996 (U. S. Department of Commerce, 1998).
The Federal Bureau of Investigation has gathered information about violent
crimes (e.g., homicide, forcible rape, robbery, aggravated assault) reported to local law
enforcement agencies, and found that the crime uidex rate had decreased and reached the lowest level m 1999 smce 1992 (Federal Bureau of Investigation, 2000). Accorduig to the National Crime Victimization Survey (NCVS) of approximately 80,000 persons per year aged 12 and older that has been conducted since 1973, violent crime rates have steadily decUned since 1994, and reached the lowest level hi 2000 (U.S. Department of
Justice, 2001). The decreases m violent crimes m the United States since 1994 was primarily attributable to a decUne in the sunple assauh (e.g., "attack vyithout a weapon
59 resuhing in no injury or minor injury" such as bmises or black eyes) rather than
aggravated assault (e.g., "attack or attempted attack with a weapon," "attack without a
weapon" but resulting ui serious mjury) or robbery (U.S. Department of Justice, 2001).
Desphe the decreased rates of violent crime since early 1990s, significant risk
factors associated with violence have not changed. Male gender, persons aged 16 to 24
years, bemg a student or unemployed, low income, never havmg been married, and heavy
drinkmg/substance abuse have been associated with a higher UkeUhood of being mvolved
ui violence. Men were less Ukely than women to be victuns of rape or sexual assauh, but
men were 159% more likely than women to be victuns of aggravated assauh (U.S.
Department of Justice, 2001). Men were three tunes more Ukely than women to be
victuns of violence by strangers while women were more Ukely than men to be victims of
violence by people known to them or relatives (U.S. Department of Justice, 2001).
During the period between 1996 and 2000, persons aged 16 to 24 years have been more
Ukely than other age groups to be victuns of aggravated assauh (U. S. Department of
Justice, 2001). The percentage of male victims between ages of 20 and 24 of violent
crimes by strangers has not been changed from 1996 (71.8%) to 1999 (68.4%) (U.S.
Department of Justice, 2000a).
Kandel-Englander (1992) mterviewed 2,291 men from a nationaUy representative
sample, and found that 15% of them had assauhed a spouse, a non-family member, or both. Potter, Sacks, Kresnow, and Mercy (1999) asked 5,238 respondents if they had mvolved in violence in the preceding 12 months, and found that 8% ofthe U.S. population experienced nonfatal physical assault in 1994. Five percent of men and 3% of women who responded to a telephone survey conducted m Montana m 1998 reported that
60 they experienced physical violence in the previous year (HarweU & Spence, 2000). The
prevalence rate of violence is consistent with another survey data coUected from a
community sample of Pennsylvania in 1994 by Forjuoh, Kinnane, Coben, Dearwater, and
Songer (1997). Compared to the prevalence rates of violence m the general population,
other researchers found relatively higher prevalence rates of violence in coUege age
population. Accorduig to Luckey (1999), 30% of 961 coUege students living on campus
reported bemg the victim of at least one form of violence (e.g., assauh, robbery, or
courtship violence). Thuty-nme percent of 312 coUege men, who had been m a romantic
relationship withm the previous year, reported that they perpetrated violence toward theu
partners in the past year (Dromgoole & Cogan, 1995).
The U.S. Department of Justice (2001) fiirther provides an enormous amount of
data that are very usefiil to understand constant trends of violent crimes for the past nine
years. In sum, during the period between 1996 and 2000, the less a household uicome
was, the more likely the household was to become the victim of violent crimes. Never-
married persons were more Ukely than divorced/separated, married, or widowed persons to be victims of violent crimes. Alcohol and substance abuse are significant risk factors.
In 1999, an estunated 48% of victuns of assauh reported that they were uncertain of whether or not perpetrators were under the influence of alcohol or dmgs, and an estunated 30% of victims of assauh reported that perpetrators were under the mfluence of either alcohol or dmgs. In a community sample, Scott, Schafer, and Greenfield (1997) found that young age (18 to 34), male, and alcohol misuse were significant risk factors for both perpetrating physical violence and bemg the victun ofthe violence. Violence resuhs m a significant problem in work. In 1999, an estimated 66% of victims of violent
61 crimes had economic loss more than $99.00, and an estimated 80% of victims of violent
crimes had to be absent from work more than a day. Another distinctive pattem of
violence is that less than 50% of victuns of violent crimes reported to poUce. Roark
(1987) suggested that violence has been under-reported because victims tend to feel
fearful, embarrassed, skeptical (e.g., "nothing can or wUl be done"), and self-critical (e.g.,
"I caused the violence").
Given the prevalence rates and severity of physical violence in young adult males,
it should be helpfiil to investigate various characteristics associated with violence in order
to unprove understanding of violence. The foUowmg sections are focused on age, sex
differences, antisocial personality features, alcohol use problems, and defense
mechanisms.
Age
Physical violence is most prevalent m adolescents and young aduhs (U.S.
Department of Justice, 2001). Victuns of violent crimes (e.g., assauh) per 1,000 persons
between ages of 12 and 24 were 173.8 in contrast to 74 victims of violent crimes per
1,000 persons older than 24 (U.S. Department of Justice, 2001). Since the mception of the Crimmal Victunization Survey ui 1973, youths between ages of 16 and 24 were more
Ukely than other age groups to be victuns of aggravated assauhs (U.S. Department of
Justice, 2001). Although violent crimes steadUy decreased smce tiie early 1990s and reached the lowest level in 2000 (U.S. Department of Justice, 2001; Federal Bureau of
Investigation, 2000), victunization rates of violent crimes m young aduhs between ages
62 of 20 and 24 were very stable during the period between 1997 and 1999 (U.S.
Department of Justice, 2000b).
Age is a significant risk factor for committmg violence m adolescents and young adults. Kemph, Braley, and Ciotola (1998) found that adolescent and young aduh males ages of between 14 and 24 who committed violent crimes were significantly younger than youths who committed non-violent crimes, regardless of whether or not they have diagnoses of psychopathology. Age has been found to be an uiconsistent risk marker for violence in relatively old aduhs (older than early 20s) who have been married or are m treatment for partner violence m several studies. HotaUng and Sugarman (1986) analyzed over 400 empuical data reported m 52 studies in which men who were violent toward thek partners were compared with a non-violent group m various characteristics
(e.g., age), and identified consistent risk, inconsistent risk, consistent non-risk, and inconclusive risk markers of husband-to-vyife violence. Of 16 studies m which the association between age and partner violence was investigated, 8 studies found a non significant relationship, 7 studies found a negative relationship, and one study found a mixed or curvilinear relationship.
Several researchers proposed various factors mediathig the relationship between young age and violence. They include onset of violence, cognitive development, physical maturation, separation from parents, and environmental stress. The childhood- onset of violence predicts the severity and persistence of violence. Hmshaw, Lahey, and
Hart (1993) and Rutter (1997) suggested that those who displayed aggression m early chUdhood were more aggressive m adulthood, and displayed more serious violence m the aduh years than those with adolescent-onset violence. Moffitt (1993) proposed two
63 developmental pathways of antisocial behavior (ASB), life-course persistent and
adolescence-lunited. Moffitt (1993) hypothesized that the cWldhood-onset ASB begms
with emergence of Oppositional Defiant Disorder symptoms (e.g., angry, defiant, irritable
behaviors) in early childhood, progresses to Conduct Disorder symptoms (e.g., fightmg,
lymg) m late chUdhood, and then to more serious ASBs (e.g., uiterpersonal violence,
dmg) m adolescence and adulthood (Hmshaw et al., 1993). Rutter (1997) suggested that
early onset ASB was largely determmed by genetic components (e.g., mattention,
hyperactivity, famUy pathology) and is Ukely to persist to aduhhood. In contrast,
adolescence-onset ASB is mamly determmed by envu-onmental factors (e.g., violent
peers), and is unlUcely to persist mto aduh Ufe.
HoUand, Beckett, and Levi (1981) found a significant relationship (r = -.213)
between the number of violent convictions and mtelUgence, suggestmg that the relationship between age and violence is mediated by cognitive development.
The relationship between violence and watching violence on TV is controversial, and varies as a flmction of resiUent or protective factors (e.g., mtelUgence, parentmg). Dorr and Kovaric (1980) proposed that chUdren were more Ukely to be uifluenced by negative effects of viewing violence on TV because they had not fuUy developed cognitive abUities to view the violence on TV as "unreaUstic," compared to older chUdren with greater cognitive abiUties.
Pezza and BeUotti (1995) reviewed Uterature on the developmental issues related to violence, and explained why violence is prevalent in adolescents and young adults.
Adolescents are in a period of undergoing a developmental shift or transition from
"concrete" to "abstract" persons while deaUng with various Ufe tasks and social/
64 uiterpersonal chaUenges (Pezza & BeUotti, 1995). "Concrete" persons tend to rely on
absolute categories in making judgments and understanding others/events, have a
dualistic worid-view (e.g., bad or good), have intolerance of ambiguity and people with
different backgrounds, immaturely manage emotional stress, have few aheraative
response choices and views, and quickly resort to a last response choice (e.g., violence) m
deaUng with social and uiterpersonal chaUenges unposed on them (Pezza 8c BeUotti,
1995). "Abstract" persons tend to have a relativistic worid-view, have a great flexibUity
m solvmg problems and resolvuig conflicts, and have numerous response choices (Pezza
& BeUotti, 1995). They suggested that those who did not successfiiUy complete the
developmental transition from concreteness to abstractness are more Ukely than
"abstract" persons to display violent behaviors (Pezza & BeUotti, 1995). Sunilarly,
Roark (1987) suggested that young aduhs (e.g., coUege students) are at risk for bemg victims or perpetrators of violence because they are no longer under dkect supervision of parents (e.g., attendmg coUege bemg away from old support systems) whUe they are at an age when theu- identities, competence, and autonomy are not fliUy developed, their sexual unpulses are strong, and their peers are also "experimentuig with new freedoms."
Sex Differences m Violence
The relationship between violence and gender is mixed, and varies as a function of other variables such as t5^e of violence, participant characteristics, and recruitment sources. In a sample of 2,075 high school students, Orpmas, Basen-Engquist, Gmnbaum, and Parcel (1995) reported that male adolescents had significantly higher rates of carrying weapons and physical fights compared to corresponding female adolescents. In
65 community-based samples of couples m the close relationship, men were equaUy or less
Ukely than women to perpetrate or uiitiate partner violence (Bland & Om, 1986a; Capaldi
& Owen, 2001; Foshee, 1996; Kwong, Bartholomew, & Dutton, 1999). Men are less
Ukely than women to be victuns of a sexual attack (U.S. Department of Justice, 2001).
Criminological reports uidicate that men are more Ukely than women to be mvolved ui
overaU violence in a way that leads to the attention ofthe legal system. Men are seven
tunes more lUcely than women to have antisocial personaUty disorder (ASP) (Clomger,
Bayon, & Przybeck, 1997). Accorduig to Violent Victimization Rates of Selected
Demographic Categories, 1993-2000 (U.S. Department of Justice, 2001), men were
approximately 40% to 50% more Ukely than women to be victuns of overaU violent
crimes during the period between 1993 and 2000. The FBI's Uniform Crime Reporting
revealed that men were three tunes more likely than women to be victims of homicide in
1999 (Federal Bureau of Investigation, 2000). Men were more Ukely than women to be victims of violence perpetrated by strangers, and less likely to be victims of violence perpetrated by mtimates and other relatives (U.S. Department of Justice, 2001). In the general population, men are significantly more than women to have experienced physical violence m the previous year (Forjuoh et al., 1997; HarweU & Spence, 2000). Adolescent male residents ofthe Job Corps program reported having perpetrated more physical violence agamst strangers and fiiends compared to female residents (Langhuuichsen-
RohUng & Neidig, 1995).
66 Defense Mechanisms and Violence
The human mmd often operates to delude or deceive hself not to experience
pamfiil affects and thoughts (Cramer, 1991a). Freud's classical instinct theory suggests
that there is a mental stmcture called "ego" that fimctions to protect the person's mmd
from being dismpted or disorganized by ideas associated with excessive negative affects
such as anxiety, depression, and guUt, resulting from intra-psychic conflicts (A. Freud,
1936/1966). Since then, many psychodynamic theorists have expressed this idea in many
different ways. Fenichel (1945) suggests that the human mind operates to protect itself
agamst negative affects such as anxiety, shame, and guUt. Rothbaum, Weisz, and Snyder
(1982) proposed that people defend themselves agamst feelings of disappomtment,
poweriessness, or failure by (a) lowering expectations that can not be fulfilled
C'predictive control"), (b) associatmg Avith a powerful agent such as luck or chance
("iUusory or vicarious control"), or (c) uiterpretmg negative events or outcomes m a
manner that is meaningful, understandable, and acceptable to them ("mterpretive
control"). Greenberg and MitcheU (1983) pomted out that the human mind tends to
operate to protect itself against the negative impUcations of interpersonal relationships.
ModeU (1984) proposed that the human mind defends hself against the significant
empathic faUures of important caretakers by beUevmg that they are self-sufficient.
Schachter (1987) pointed out that people often forgot traumatic events in order to defend themselves from pamful memories associated with the traumatic events. Cooper (1998) defuied a defense mechanism as a mental operation to protect self-esteem. In fact,
Bennett and Hohnes (1975) demonstrated that a mental operation such as denial or redefinition was effective m copuig with anxiety and stress resultuig from a threat to self-
67 esteem (e.g., personal failure). Vaillant (2000) stated, 'There are involuntary mental
mechanisms that distort our perception of mtemal and extemal reality to reduce
subjective distress." These mental mechanisms or processes, operatmg to protect the
human mmd against unpleasant affects and thoughts, have been caUed defense
mechanisms (Cramer, 1991a).
Psychodynamic theorists and other researchers have suggested that the concept of
defense mechanisms is central to the underlymg mechanisms of violence. Bios (1962)
suggested that adolescents often develop a grandiose, false self to defend the self agamst
a decrease m self-esteem. Bios (1962) proposed that adolescents were hi the critical
period of overcoming a major developmental task of beginning to separate from their
parents and developing a new relationship with other people as aduhs. WhUe separating from parents and gaining independence, adolescents may feel msecure, rejected, confused, and anxious because they stiU have wishes and needs to be dependent on/unconditionaUy loved by theu- parents, especiaUy when they had problems with separation and individuation during early development e early development (Bios, 1962;
Cramer, 1997b; Erikson, 1968). In tum, they may develop "narcissistic defenses" such as creatuig a grandiose, false self in order to cope with the unpleasant feelmgs and a decrease m seff-esteem. Another way of protecting self-esteem and reducing unpleasant feelings is to display violent behaviors ui which feelings of anxiety, stress, and msecurity are transformed mto feeUngs of bemg powerful and strong. Toch (1969) and Pezza and
BeUotti (1995) also suggested that people tend to display violence hi order to protect self- esteem and as a means of obtaining protection. Cram (1979) proposed that violence could be understood as a defense mechanism that mdividuals manifest as a means to
68 avoid experiencmg unpleasant thought and feeUngs. MiUer and Looney (1974) suggested
tiie utility of considering defense mechanisms (e.g., identification) m understanding the
psychodynamics of violence. They reported that adolescents who committed homicide
tended to perceive theu victims as "a fiustratmg object" rather than "a person whh whom
they can identify or empathize."
Cognitive psychologists have found that violent children and adolescents tend to
show cognitive distortions and errors in cognitive processes that are sinular to denial or
projection of defense mechanisms. Crick and Dodge (1994) proposed that aggressive
behaviors resuked from one or more of a series of sequential cognitive processes, which
mclude encoding, interpretation, clarification of goals, response access or constmction,
response evaluation and decision, and behavior enactment. According to an extensive
review conducted by Crick and Dodge (1994), aggressive chUdren were more Ukely than non-aggressive chUdren to encode and mterpret neutral stunuli as hostUe (e.g., projection), minimize theu" abUity to act pro-sociaUy, and mmimize the negative consequences (e.g., causing harm to victuns, beuig rejected by peers) of aggressive behaviors. SunUarly, Gibbs, Potter, and Goldstein (1995) suggested that violent youths were Ukely to have cogrutive errors such as minimizing (e.g., denial) and blaming others
(e.g., projection). Barriga and Gibbs (1996) found that 55 adolescent boys mcarcerated for violent crimes (e.g., assault, murder) scored higher than a control group of 52 adolescent boys who were attendmg a pubUc high school on the How I Think questionnau-e (HIT; Gibbs et al., 1995), which measures cognitive distortions such as minimizing/mislabeUng (e.g., describmg violent behaviors as causing no real harm,
"referring to others with a beUtthng or dehumanizmg label), blaming others (e.g.,
69 misattributing one's act to another person), and assummg the worst (e.g., "gratiikously
attributing hostUe mtentions to others"). Dutton (1988) conducted an extensive review of
the Uteratiire on male-to-female partner violence and proposed that some partner violent
men were violent toward tiiek partners m order to defend themselves agamst a
misperceived sense of loss of control and the subsequent feeUngs of emotional
vulnerabiUty. The men who were violent toward theu- partners due to feeUng of
emotional vuherabUity fek guUt and uneasiness over thek assauhive behaviors. In order
to reduce these unpleasant feeUngs, they may rely on cognitive distortions such as
attributing thek acts to thek partners (e.g., she provoked me) and minknizkig the
frequency, severity, and consequences of thek violent behaviors. In a sample of sex
offenders who were ki treatment. Hartley (1998) quaUtatively analyzed cUnical interview
data and reported that sex offenders had cognitive distortions such as mkiimizing
responsibUity or cuIpabUity for the abuse (e.g., "I only did what she would let me do").
Nevertheless, only a few researchers to date have mvestigated a relationship
between defense mechanisms and violence. What foUows is a review ofthe Uterature
regarding reUabiUty and vaUdity of defense measures, assessment methods (self-report
vs. projective tests), and empkical evidence for a developmental hierarchy of defense
mechanisms.
ReUabiUty and VaUdity of Defense Mechanism Measures
Cramer (1991a) has extensively written about various defense measures. The frequently used defense measures mclude (a) Haan's MMPI based Defense Scales
(HMDS; Haan, 1965), (b) Defense Mechanisms Inventory (DM1; Gleser & IhUevich,
70 1969), (c) Defense Style Questionnake-40 (DSQ-40, Andrews, Singh, & Bond, 1993), and (d) VaUlant's (1971) cUnical interview method, and the Defense Mechanism Manual
(DMM; Cramer, 1991a). The following sections described each of these measures in terms of reUabUity and vaUdky.
Haan's Mmnesota Muhiphasic Personality Inventory (MMPI) based Defense
Scales (HMDS; Haan, 1965). The HMDS (Haan, 1965) is a self-report defense measure that was developed by extractkig kems from the MMPI (Hathaway & McKinley, 1943) to assess ten defenses (denial, projection, primitive defense, doubt, reaction formation, regression, displacement, repression, rationaUzation, and kiteUectualization). The kems were selected based on experienced clkiicians' judgment ofthe appropriateness of each kem for the ten defenses. SpUt-haff reUabiUties ranged from .54 to .81 (Cramer, 1991a).
The Denial HMDS (Haan, 1965) scale was negatively cortelated with cUnical MMPI scales (e.g.. Anxiety, Depression, F scales), suggesting that the denial scale may be assessing mdividuals' characteristics of presentkig themselves m a poshive Ught without any difficulties (Cramer, 1991a; Haan, 1965). In contrast, the Projection HMDS (Haan,
1965) scale was poskively related to the clmical MMPI scales (Cramer, 1991a).
Furthermore, the denial HMDS (Haan, 1965) scale was poskively cortelated with the
Social DeskabiUty MMPI scale whereas the Projection HMDS (Haan, 1965) scale was negatively correlated with the Social DeskabUity MMPI scale (Cramer, 1991a).
Defense Mechanisms laventory (DMI; Gleser & IhUevich, 1969). The DMI
(Gleser & IhUevich, 1969) is a paper-and-pencU test that assesses the relative kitensity of usmg five defense clusters, which mclude Tumkig Agamst Self (TAS; self-punitive defense), Tumkig Agamst the Object (TAO; resolvuig conflict through displaymg
71 aggression toward extemal threats). Projection (PRO; justifykig aggressive behaviors by
attributing tiie behaviors to extemal objects). Reversal (REV; responduig to a frustratkig
object ki a positive rather than negative mamier) and Principahzation (PRN; rationaUzkig
or inteUectualizing conflicts to repress them). The uiventory consists of 12 stories
describmg six different conflictiial sitiiations (2 stories for each sihiation). Each story
asks respondents to reply to four questions regarding the respondent's actual behaviors m such a conflictkig sittiation, knpulsive fantasies, thoughts, and feelings. Each question
has five options conrespondkig to the five different defensive clusters. The respondents
are asked to mark a plus (scored 2) for the option that is most representative of their
reaction and a mkius (scored 0) for the option that is least representative of thek reaction
(scored 0). The unmarked responses are scored one. Scores for each defensive cluster
are obtained by summing scores across aU stories and aU categories, resulting ki scores for each defensive cluster that range from 0 to 80. Test-retest and inter-kem reUabUities have been reported as adequate, ranging from .47 (PRO) to .93 (TAO) (Cramer, 1991a,
1998; Davidson 8c MacGregor, 1998; Gleser & IhUevich, 1969; Juni, 1982; Weissman,
Ritter, & Gordon, 1971). VaUdity ofthe DMI (Gleser & IhUevich, 1969) has been extensively examined. When three psychologists and seven social workers were asked to assign a defense to each ofthe 240 DMI (Gleser & IhUevich, 1969) responses, there was acceptable agreement (more than 60%) between clinicians' ratkigs and the DMI (Gleser
& IhUevich, 1969) scoring key for TAS, REV, and PRN. However, 33% of tiie TAO kems and 19% ofthe PRO were rated as not assessing any ofthe five defense clusters
(Blacha 8c Fancher, 1977; Cramer, 1991a; Gleser & IhUevich, 1969;). Furthermore, 14% of responses identified as PRO defenses were actuaUy TAO defenses. The correlation
72 between PRO and TAO was reported as high (r = .45) (Cramer, 1988) and these two
scales were loaded on the same factor (Woodrow, 1973), leading to questions about the
validity of DMI (Gleser & IhUevich, 1969).
Defense Style Ouestionnaire-40 (DSQ-40; Andrews et al., 1993). The DSQ-40
(Andrew et al., 1993) is a 40-item, self-report questionnaire, designed to assess 20
different defensive styles. The DSQ-40 (Andrews et al., 1993) kicludes kems such as
'Teople say I tend to ignore unpleasant facts as they did not exist" and 'Teople tend to
mistreat me." The DSQ-40 (Andrews et al., 1993) has evolved from DSQ-81 (Bond,
Gardner, Christian, & Sigal, 1983), DSQ-88 (Bond, 1986), DSQ-72 (Andrews, Pollack,
& Stewart, 1989), and DSQ-36 (Andrews et al., 1989). The 40 kems ofthe DSQ-40
(Andrews et al., 1993) were selected from the various versions of DSQ based on
cUnician's ratings ofthe appropriateness of each item, factor analyses, and kem-to-total
defense score cortelations (Andrews et al., 1993). Intemal consistency coefficients
ranged from -.01 (devaluation scale) to .89 (autistic fantasy scale) (Andrews et al., 1993).
Four weeks test-retest reUabiUties ranged from .38 (suppression scale) to .80
(displacement scale) (Andrews et al, 1993). Factor analysis revealed a three-factor
solution; immature, neurotic, and mature (Andrews et al., 1993; Watson & Smha, 1997).
Intemal consistency coefficients for immature, neurotic, and mature factors were .68, .58,
and .80, respectively (Andrews et al., 1993). Test-retest cortelations for unmature,
neurotic, and mature factors were .75, .78, and .85, respectively (Andrews et al., 1993).
Patients with major depression obtakied dramatic changes ki thek DSQ-40 scores right after psychotherapy (Kneepkens & Oakley, 1996).
73 Defense Mechanisms Manual (DMM; Cramer, 1991a). The DMM is a reUable
and stmctured approach to assessmg defense mechanisms (Cramer, 1991a, 1991b, 1995;
Hibbard, Farmer, Wells, DifiUipo, Barty, Konnan, & Sloan, 1994, Hibbard & PorcereUi,
1998) that employs a projective Thematic Apperception Test (TAT; Murray, 1943). The
DMM (Cramer, 1991a) is a procedure for scoring three types of defenses (denial,
projection, and identification) from the TAT responses. Raters score the TAT responses
for seven different scoring categories for each defense (see Cramer, 1991a). The idea of
usmg stories told for tiie TAT cards to assess defenses had been suggested by Bush,
Hatcher, and Mayman (1969) and Shapko and Rosenwald (1975). ReUabUity and
vahdity ofthe DMM have been demonstrated by many researchers (Cramer, 1991a,
1991b, 1995, 1997a, 1998; Cramer & Blatt, 1990; Cramer & Gaul, 1998; Hibbard et al.,
1994; Hibbard & PorcereUi, 1998).
Assessment Methods; Self-Report versus Projective
The foUovying paragraphs describe advantages and disadvantages of different methods of measuring defense mechanisms. The assessment measures of defense mechanisms are generally divided into two categories; self-report vs. projective tests. The frequently used self-report defense measures include (a) Haan's MMPI based Defense
Scales (HMDS; Haan, 1965), (b) Defense Mechanisms Inventory (DMI; Gleser &
IhUevich, 1969), (c) Defense Style Questionnake-40 (DSQ-40, Andrew et al., 1993), and
(d) VaUlant's (1971) cUiucal interview method. The Defense Mechanism Manual
(DMM; Cramer, 1991a) is a projective test that employs TAT (Murray, 1943) cards to assess defense mechaiusms.
74 Davidson and MacGregor (1998) suggested that self-report defense measures
have some advantages. The kems used to elicit responses are objective and
straightforward, and therefore may have the same meaning to aU respondents. The
elicited responses by self-report questionnaires are unambiguous and objective so that
they can be easUy scored and quantified without rater bias. Furthermore, VaiUant (1986)
suggested that self-report measures could minimize assessment time, cost, and problems
related to inter-rater reUabiUty. However, these self-report defense measures have
several problems in assessing defense mechanisms. Fkst, Bond et al. (1983) suggested
that individuals are very capable of reportkig the use of certam behaviors vyithout bemg
aware of thek defensive purpose. Given that defense mechanisms are defined as a mental
process that operates outside ofthe awareness, k may be inappropriate to ask respondents
to consciously report thek own defenses (Cramer, 1998; Davidson & MacGregor, 1998).
Second, respondents may over-report behaviors which can seem to be sociaUy desirable,
such as "denying" negative behaviors, and may under-report sociaUy undesirable
defensive behaviors such as "projection" (Cramer, 1998), as demonstrated by Haan
(1965) who found a positive correlation between the HMDS (Haan, 1965) denial scale and the Social DeskabUity MMPI (Hathaway & McKkUey, 1943) scale, and a negative correlation between the HMDS Projection scale and the Social DeskabUity MMPI scale.
Colvki, Block, and Funder (1995) proposed that all the self-report measures contakikig self-evaluation components tended to be positively biased due to respondents' self- enhanckig tendencies. Third, high kiter-correlations between scales of each of these self- report measiu-es mdicate that these measures may not assess distmctive defense mechanisms (Cramer, 1998; Davidson & MacGregor, 1998). Fourth, inter-correlations
75 for the self-report measures of sknUarly named defenses are extremely low (Cramer,
1998). For example, Davidson and MacGregor (1998) reported that the DSQ (Andrews
et al., 1993) did not show convergent or discrimkiant vaUdity wkh DM (Gleser &
IhUevich, 1969). Fkth, single self-report measure may not be sufficient for capturing
such complex constmcts of defense mechanisms that operate in various dknensions,
contexts, and skuations (Davidson & MacGregor, 1998). Sixth, k is not clear whether the
self-report measures assess defense mechanisms that operate intra-psychically or
kiterpersonaUy Baumeister, Dale, & Sommer, 1998).
Based on the assumption that defense mechanisms can be kiferred from
"extensive samples of verbal behaviors," cUnical interviews have been used to assess defense mechanisms (Cramer, 1991a; Davidson & MacGregor, 1998). Analyzkig episodes of behavior that seemed to reflect the use of defense mechanisms, VaiUant
(1971) identified 18 defenses (e.g., denial, projection, reaction formation, subUmation) from cUnical interview data, and further classified the 18 defenses into four levels; psychotic (e.g., denial), unmature (e.g., projection), neurotic (e.g., repression), and mature (e.g., sublimation). The "psychotic" level defenses are often reported in adults' dream/fantasy and are "common in healthy individuals before age 5" (VaiUant, 1986).
The "immature" level defenses are often found in "healthy individuals" whose age ranges from 3 to 15, in mdividuals with personality disorders, and in individuals ki treatment
(VaiUant, 1986; VaiUant & Drake, 1985). The "neurotic" defenses are often found in
"heahhy kidividuals" whose age ranges from 3 to 90, and ki mdividuals with neurotic disorders (VaiUant, 1986). The "mature" defenses are often employed by healthy mdividuals whose age ranges from 12 to 90 (VaiUant, 1986). Inter-rater reUabUities for
76 the 18 separate defenses ranged from .01 (dissociation) to 44 (kitellectiaaUzation)
(VaiUant, 1976). VaUlant (1986) reported that immature defenses (e.g., projection, actmg out) were negatively related to high ego development measured by the 36-kem Sentence
Completion Test (SC; Loevmger, Wessler, & Redmore, 1970) whUe mature defenses
(e.g., subUmation, altmism) were poskively related to the high ego development.
The cUnical mterview method seems more promismg than paper-pencU tests in assessmg defense mechanisms. The advantages of cUnical interview approach include the closeness ofthe data to the kkids of observation made in actual cUnical practice, the richness of data, and the opportunity to detect unconscious processes reveaUng during the kiteraction between kiterviewers and kiterviewees (VaUlant, 1986). Nevertheless, the cUnical assessment of defenses may suffer from several problems. First, the approach may be too subjective, and inter-rater reUabiUties for each defense may not be satisfactory (VaUlant, Bond, & VaUlant., 1986). ReUable identification of defenses may be hindered by kiterviewers' styles, theoretical orientations, and methods of observation
(VaUlant, 1986). Second, each kiterviewer or rater may need respondents' biographical, medical, and psychiatric kiformation in order to reUably assess thek defenses, and such prior knowledge may bias cUnical judgments of defenses (Davidson & MacGregor, 1998;
VaUlant et al., 1986). Thkd, this approach requkes tkne and cost for developmg reUable ratings and training interviewers (VaUlant, 1986).
The projective defense measure, the Defense Mechanisms Manual (DMM;
Cramer, 1991a), appears to have more advantages than disadvantages. Although the
DMM requkes tkne and cost for ttakikig raters and at tknes raters must make judgment about "borderUne" responses, the approach has more advantages than other defense
77 measures and methods (e.g., paper-pencU test, cUnical interview). Fkst, the DMM
(Cramer, 1991a) is not subjective. More than one rater can score TAT (Murray, 1943) responses, and then defenses that are mutually identified by all the raters can be summed for scores for each defense. Second, the DMM aUows researchers to obtaki unguarded sample of thought processes, and therefore increases the possibility of identifying kidividual's idiographic defensive mechanisms (Cramer, 1991a). Thkd, the eUcited responses may not be Iknited to a specific defense operating in a situation or context because each TAT card may evoke various defenses that are associated with various situations or contexts (Cramer, 1991a, 1998). Fourth, respondents are unUkely to under- report knmature defenses (e.g., denial) and over-report mature defenses (e.g., identification) ki an effort to fake good or bad.
Empkical Evidence for a Developmental Hierarchy of Defense Mechanisms
Using the various measures and methods for the assessment of defense mechanisms described above, many mvestigators have provided evidence for the vaUdity of defense mechanism measures, shovykig that specific defense mechanisms are Ikiked to particular forms of emotional disturbances, psychological characteristics, and personaUty disorders. Some researchers (e.g.. Bond et al., 1983) preferred self-report measures and others (e.g., Cramer, 1987) reUed on projective tests. The foUowkig paragraphs are focused on studies regardmg various subtypes of defense mechanisms, classification of defense mechanisms, and studies providmg empirical evidence of a developmental and hierarchical model of defense mechanisms.
78 Many researchers (e.g.. Crammer, 1987; Freud, 1926/1959, 1936/1966; Kemberg,
1967; VaUlant, 1976) have described a large number of defense mechanisms (e.g., denial in fantasy, denial in word and act, projection, projective identification, identification).
To defme a few, denial is defined as a mental process of denykig, ignoring, negatmg, or minimizing wishes, needs, or extemal events causing unpleasant feeUngs as a way of reducmg the unpleasant affects (Cramer, 1991a). Projection is defined as a mental process of attributing unacceptable intemal drives, needs, and knpulses to others in order to reduce unpleasant feeUngs (Cramer, 1991a). Identification is defined as a mental process of formkig enduring mtemal mental representations of oneself by taking on others' characteristics as one's own, in order to obtaki a sense of security and self-esteem
(Cramer, 1991a).
The numerous defense mechanisms have been classified into developmentaUy and/or hierarchically different categories. Freud (1936/1966) proposed a developmental/ chronological classification of defense mechanisms. That is, different defense mechanisms (e.g., repression) may emerge in different stages of psychosexual development (e.g., phaUic stage). As cognitive capacity (Piaget, 1952) and moral reasorung (Kohlberg, 1969) develop, the quaUtatively different defense mechanisms emerge at chronologicaUy different stages of development (Cramer, 1991a, 2000b;
VaUlant, 1971). MUler and Swanson (1960) hierarchicaUy ranked defense mechanisms based on the four dimensions kicludkig simpUcity, generaUty, the extent to which reality is distorted, and the degree to which the use of defense mechanisms creates social difficulties. For example, denial is representative of defense mechanisms that are the simplest, most generaUzed, most distortkig, and creating most social difficulties because
79 the defense can be as simple as "faUing asleep," can be used to ignore ahnost anything,
and creates serious social difficulties by ignoring/denying what is happenkig Cramer
(1987, 1991a). Other researchers (Cramer & Block, 1998; Smith & Rossman, 1986)
classified defense mechanisms based on both the developmental and hierarchical models.
They suggested that "simple and immature" defense mechanisms tend to emerge ki early
chUdhood when the ego is not fliUy consolidated and stable and then gradually disappear
after childhood, whereas "complex and mature" defense mecharusms tend to develop ki
late adolescence and become most dominant ki young aduhhood (Bios, 1979; Cramer,
1987, 1991a, 1995; Cramer & Gaul, 1998; VaiUant, 1976). VaiUant (1971) classified
defense mechanisms as "knmature," "neurotic," and "mature." Of various defense
mechanisms, denial, projection, and identification have been most studied because they
serve as anchor points for (a) sknple and immature defenses (e.g., denial) operating most predominantly in early chUdhood, (b) mtermediate defenses (e.g., projection) emerging during late chUdhood and fliUy operating ki early adolescence, and (c) complex and mature defenses (e.g., identification) kicreasing graduaUy from early chUdhood untU they reach a peak ki late adolescence and adulthood (Cramer, 1991a, 1998).
Several researchers have provided evidence for the developmental hierarchy of defense mechanisms by showkig that quaUtatively different defenses are characteristics ofdifferent periods of development (Cramer, 1987, 1991a, 1998). Cramer (1987) recmked a sample of 320 students, representkig four age groups mcludmg Primary
(rangmg from 4 to 7 years). Intermediate (ranging from 8 to 11 years). Early Adolescence
(9* or 10*^ graders), and Late Adolescence (11*^ or 12* graders). AU participants were shown two TAT (Murray, 1943) cards (1, 17BM), and thek TAT responses were scored
80 based on the prelknkiary DMM (Cramer, 1987). Cramer (1987) found that the lowest
level of dense mechanism (denial) was most frequently used ki the Primary group but
decreasingly used ki other groups whereas the highest level of defense mechanism
(identification) was minimaUy used ki the Primary group but mcreasingly used ki the
other two groups. The intermediate level of defense mechanism (projection) was more
frequently used m the Intermediate and Early Adolescence groups compared to the
Primary and Late Adolescence groups. Cramer (1997a) showed that from early (6 years
and 6 months) to middle (9 years and 5 months) chUdhood there was a gradual decrease
in the use of denial, a sharp increase in the use of projection, and a gradual increase ki the
use of identification, accordmg to their scores on the DMM (Cramer, 1991a). In thek
cross-sectional study, PorcereUi, Thomas, Hibbard, and Cogan (1998) recmited a sample
of 148 students ki the 2nd, 5th, 8th, 11th grades, and coUege freshmen. The participants were admkiistered TAT (Murray, 1943) cards (1, 2, 6GF, 8BM, 9GF, 17BM), and thek responses to the TAT (Murray, 1943) cards were scored based on the DMM (Cramer,
1991a). Consistent with Cramer's (1987, 1997a, 1997b) findmgs, PorcereUi et al. (1998) recmited a sample of 148 chUdren, adolescents, and college students and compared thek scores on the DMM (Cramer, 1991a). They found that knmature defenses (denial, projection) graduaUy decreased as a function of grade whUe a mature defense graduaUy mcreased as a flmction of grade. In a coUege sample, Hibbard and PorcereUi (1998) found that identification was more frequently used compared to projection and denial defenses, denial being the least frequently used defense.
81 Other investigators have also provided evidence for the developmental hierarchy
of defense mechanisms, showkig that different levels of defense mechanisms are related
to different levels of ego development (Haan, Stroud, & Holstein, 1973), psychosocial
development (VaUlant & Drake, 1985), emotional disturbance (Cramer & Gaul, 1988),
and identity status (Cramer, 1998). In a sample of 58 "hippies" who were recmked in a
community, Haan et al. (1973) identified 30 different ego processes (e.g., denial,
projection, kitellectualizing) based on a psychiatric interview and six ego development
stages (e.g.. Impulse Ridden, Opportunist, Conformist, Conscientious, Autonomous, and
Integrated) assessed by the 36-kem Sentence Completion Test (SC; Loevmger et al.,
1970). They found that mdividuals m the high ego development stage (e.g.. Integrated)
were more Ukely than kidividuals ki the low ego development stage (e.g.. Impulse
Ridden) to use ego defenses (e.g., projection), providmg no evidence for the
developmental hierarchy of defense mechanisms. They cautioned that the results would
be unreUable and misleadkig due to the "kiappropriate" sample characteristics such as
dmg use and "ambivalent" cooperation. VaiUant and Drake (1985) found that knmature
defenses (e.g., denial) were positively related to Erikson's (1950) lower levels of
psychosocial development whereas mature defenses (e.g., identification, sublknation)
were positively related to Erikson's (1950) higher levels of psychosocial development.
Cramer (1997b) mvestigated a relationship between the use of defense mechanisms
measured by the DMM (Cramer, 1991a) and identity crisis measured by the Q-sort prototype for Ego Identity Status (Q-EIS; MaUory, 1989). In thek cross-sectional study of chUdren ofdifferent ages, Cramer and Gaul (1988) mtroduced experimental manipulations to produce either feeUngs of faUure or feeUngs of success and admkiistered
82 two TAT cards (6BM, 7GF). ChUdren in the failure group were more Ukely than
children m the success group to use knmature defense mechanisms (e.g., denial,
projection). Children in the success group were more lUcely than children in the faUure
group to use a mature defense mechanism (e.g., identification). Cramer (1997b) found
that both experiencing an identity crisis without commitment to one's beliefs and goals
(Moratorium; Marcia, 1966) and shovying no kiterest in the identky exploration and the
commitment (Diffiision; Marcia, 1966) were positively correlated with knmatiare
defenses (e.g., denial and projection), but firmly committmg to one's beUefs and goals
without active exploration of one's own identity (Foreclosure; Marcia, 1966) was
negatively associated vyith knmature defenses. Cramer (1995, 1997b) fijrther found that commitment to one's beUefs and goals after having experienced a crisis (Identity
Achieved; Marcia, 1966) was not related to any use of defense mechanisms. These results indicate that those who have not achieved identity tend to rely on inunature defenses (e.g., denial and projection) rather than mature defenses (e.g., identification), suggesting that the developmental hierarchy of defense mechanisms corresponds to
Marcia's (1966) model of hierarchical identity development.
Other researchers have demonstrated the validity of a hierarchy of defenses by shovying that different levels of defense mechanisms are related to different types of personaUty disorders. Berman and McCann (1995) mvestigated a relationship between particular defense mechanisms and specific personaUty disorders in a sample of 130 psychiatric inpatients and outpatients, and reported a general trend that "higher level" defenses assessed by the PRN and REV DMI (Gleser & IhUevich, 1969) scales were negatively related to eight MUlon CUnical Multiaxial Inventory-II (MCMI-II; MUlon,
83 1987) scales (e.g., passive-aggressive, borderikie, avoidant) whUe "lower level" defenses
assessed by TAO, PRO, and TAS DMI (Gleser 8c IhUevich, 1969) scales were positively
related to eleven MCMI-H scales (e.g., passive-aggressive, borderUne, avoidant). In a
sample of 55 mpatients diagnosed with various Axis I disorders (without acute psychotic
state, dementia, and/or intoxication), Devens and Erickson (1998) found that knmatiire
defense styles measured by the Immature DSQ (Andrews et al, 1989) scale were
predictive of personality disorders (e.g., borderikie, histrionic) assessed by the Stmctural
Interview for the DSM-FV PersonaUty disorders (SIDP-IV; Pfohl, Blum, & Zknmerman,
1994). Cramer (1999) analyzed data obtained from 91 aduhs who had participated ki a
longitudmal study smce the age 3, and reported a general trend that denial and projection
defenses measured by the DMM (Cramer, 1991a) were poskively related to borderUne,
psychopathic, narcissistic, and histrionic personaUty features identified by four
independent raters based on the CaUfomia Aduk Q-Sort (CAQ; Block, 1978) whUe
identification defense measured by the DMM (Cramer, 1991a) was not related to the
personaUty prototypes assessed by the CAQ (Block, 1978).
Studies regarding a relationship between different levels of defense mechanisms
and psychopathology have also produced evidence for the developmental hierarchy of defense mechanisms. In a general sample of 99 adults, Haan (1965) found a negative relationship between denial measured by cUiucal ratings and clinical symptoms assessed by the A (Anxiety) and D (Depression) MMPI scales. Haan (1965) concluded that the resuh did not mdicate a positive relationship between denial and the absence of cUnical symptoms, but that people who were characterized by denial sknply "denied" thek cUnical symptoms on the MMPI. The kiterpretation was consistent wkh a positive
84 relationship between denial and the L (Lie) MMPI scale. Cramer, Blatt, and Ford (1988)
divided a sample of 90 inpatients with various psychiatric diagnoses into two groups of
patients with Anaclitic personality organization (e.g., preservkig interpersonal
relationships neglecting the development ofthe self) and patients with Introjective
personaUty organization (e.g., protecting a poskive self-identity neglecting the
development of uiterpersonal relationships). In the AnacUtic group, denial measured by
the DMM (Cramer, 1991a) was positively correlated wkh cUnical symptoms (e.g.,
Bizarte-Disorganized) measured by the Strauss-Harder CUnical Symptom Scales (S-H
CSS; Strauss & Harder, 1981) while identification measured by the DMM (Cramer,
1991a) was negatively correlated vyith clmical symptoms (e.g.. Psychotic) assessed by the
S-H CSS. In the Introjective group, none of defenses was sigiuficantly related to cUnical
symptoms assessed by the S-H CSS. Pollock and Andrews (1989) compared the defense
scores measured by the DSQ (Andrews et al., 1989) of 119 patients vyith anxiety
disorders with defense scores of 204 control participants in a general population, and found a general trend that patients with anxiety disorders scored higher than a control group on knmature/neurotic defenses, and lower on mature defenses. In a general sample of 30 aduhs, Muris and Merckelbach (1994) found that the knmature and neurotic defenses measured by the DSQ (Andrews et al., 1989) were positively related to trait anxiety, worry, and physical symptoms assessed by self-report measures while mature defense measured by the DSQ was not related to these anxiety symptoms. In a sample of
356 normal aduhs, Mvuis and Merckelbach (1996) found that projection measured by the
DSQ (Andrews et al., 1989) was positively related to psychopathology measured by the
Symptom CheckUst 90-R (SCL-90-R; Derogatis, 1977) and Eysenck PersonaUty
85 Questionnaire (EPQ; Eysenck & Eysenck, 1975). Erickson, Feldman, and Steiner (1996) reported that an immature defense style measured by the DSQ (Andrews et al., 1989) was negatively related to general adjustment rated by two mdependent psychiatrists based on the DSM-III-R Global Assessment of Functioning Scale whUe a mature defense style was poskively related to general adjustment. Spmhoven, van Gaalen, and Abraham (1995) found that patients vyith a psychiatric diagnosis (e.g., an anxiety disorder, an affective disorder) scored higher than patients with no psychiatric diagnosis (e.g., no or a V-code) and medical students in a control group on the Immature and Neurotic defense scales of the DSQ (Andrews et al., 1989) and scored lower on the Mature DSQ scale. It should be noted that cUnical groups were not matched vyith the control group for education and kiteUigence. In a sample of 483 psychiatric patients, they also found that both Immature and Neurotic DSQ scales were positively related to clinical symptoms assessed by the
SCL-90-R (Derogatis, 1977) whUe Mature DSQ scale was negatively correlated vyith clinical symptoms measured by the SCL90.
Antisocial Personality
Antisocial PersonaUty Disorder (ASPD) is defined by the Diagnostic and
Statistical Manual-Fourth Edkion (DSM-FV. American Psychiatric Association, 1994) as mamfestkig three ofthe following features smce age 15 years; faUure to conform to social norms (e.g., artest), decekfijlness (e.g., lying), knpulsivity (e.g., failure to plan ahead), irritabiUty (e.g., physical fights), reckless disregard for safety of self and other, consistent kresponsibUity, and lack of remorse. The estknated prevalence rate of
Antisocial Personality Disorder (ASPD) in community samples is 3% m males and 1% in
86 females (DSM-FV: APA, 1994). The prevalence rates ofthe ASPD in samples from
cUnical and forensic settings are much higher than the base rates (DSM-IV; APA, 1994).
Psychopathy (e.g., egocentricity, grandiosity, cold-hearted, and lacking ki empathy,
remorse, anxiety, and guih) has often been used as defimng features of ASPD (Hare,
1991; Walsh, 1999).
Many diagnostic features of antisocial personaUty disorder (ASPD) have been
studied to understand violence. They include impulsivity, kritabiUty, lack of empathy,
disregard for human Ike, irresponsibUity, and lack of guUt and remorse. Shidies
concerning a relationship between diagnostic features of ASPD and violence have
reached differing conclusions, dependmg on which antisocial feature was investigated
and the nature of sample. Farrington (1989) conducted a longitudinal study to mvestigate
a relationship between impulsivity and aggression ki chUdren ages between 8 and 10, and
found that impulsivity predicted 45% ofthe variance ki aggression displayed 2 years later
and 37% ofthe variance 8 years later. From a sample of 280 students grades 5 to 10,
Dykeman, Daehlin, Doyle, and Flamer (1996) reported that knpulsivity, empathy, and locus of control accounted for 23% ofthe variance in school violence, knpulsivity alone accountkig for a half of the prediction (23%) of school violence. Those who had a trait of impulsivity or dyscontrol were more Ukely to display violence than other persons. In a sample of 1,874 African-American male college students, Rodney, Tachia, and Rodney
(1999) reported that 2.4% ofthe students were classified as violent based on thek responses to a self-report measure of past violent behaviors (e.g., use of weapons, interpersonal violence, arrests) and about 25% ofthe violent men were identified as knpulsive based on thek scores on a self-report measure assessing impulsivity, lack of
87 patience, and loss of control, suggestmg that knpulsivity is cortelated with violence. It
has been suggested that impulsive individuals are more Ukely to have an kiabiUty to delay
gratmcation (Soubrie & Bizot, 1990). Gray, Owen, Davis, and Tsahas (1983) proposed
that knpulsive kidividuals had a stronger behavioral activation system (BAS) than
behavioral inhibkion system (BIS), and therefore were more Ukely than non-knpulsive
mdividuals to display aggressive behavior. However, in a sample of 69 juvenUe
offenders ages between 13 and 18, Caputo, Frick, and Brodsky (1999) found that 17
violent offenders did not differ from 29 non-violent offenders and 23 sex offenders on
knpulse control measured by the PCL-R (Hare, 1991) for children. In a sample of 385
mcarcerated male offenders receivmg kipatient psychiatric treatment, Wang and
Diamond (1999) found that physical violence was not related to knpulsivity.
In a sample of 120 male and female coUege students, Caprara, Renzi, D'Imperio,
and TravagUa (1983) found that mdividuals who scored high on a scale that measures
kritabUity (defined as a stable tendency to react offensively to even mkiknal provocation) were more lUcely than those who scored low on the scale to display violent behaviors
(e.g., deUvering an electrical shock to an experimental confederate). Zenoff and Zients
(1979) compared seven adolescents who murdered strangers or distant acquakitances in the context of a robbery or for no apparent reason with six adolescents who murdered acquakitances diuing interpersonal disputes. Those who murdered strangers had less empathy and more disregard for human Ufe than did those who murdered acquaintances.
MUler and Looney (1974) suggested that adolescent murderers tend to perceive the victim as a "fiiistratmg object" rather than "a person with whom they can identify or empathize." MiUer and Eisenberg (1988) conducted a meta-analysis on studies
88 mvestigating the relationship between empathy and aggression, and reported that the
resuhs are mixed depending on the measures used to assess empathy.
Hanson, Cadsky, Harris, and LaLonde (1997) investigated characteristics
associated with physical violence against female partners in a sample of 997 men who
were recmited from a community or a forensic outpatient clinic. Both moderately and
severely abusive men were more likely than non-abusive men to have conduct disorder
symptoms (e.g., property damage) and antisocial personaUty disorder featiires (e.g.,
kresponsibUity). It should be noted that the resuhs might be confounded by the fact that
the partner violent men are very Ukely to have included men who were violent toward
both partners and non-partners. Persons (1968) proposed that mdividuals wkh less guUt
were more Ukely than mdividuals vyith more guih to display violent behaviors. In fact, of
28 violent male offenders, none reported any guilt or remorse vyith regard to their violent
crimes (Aromaki, Lindman, & Eriksson, 1999).
Studies regarding a relationship between a diagnosis of Antisocial PersonaUty
Disorder (ASPD) and violence have generaUy yielded relatively consistent resuhs across
various samples. ComeU, MUler, and Benedek (1988) reported that 14 of 18 adolescents
who committed a homicide in the context of other crimes (e.g., robbery) met the
diagnostic criteria for either ASPD or Conduct disorder. In a sample of 1,149 male prison inmates, CoUins, Schlenger, and Jordan (1988) reported that 28.7% met the diagnostic criteria for ASPD. Aromaki et al (1999) found that 23 of 28 violent male offenders met the cUnical diagnostic criteria of ASPD defined by the Diagnostic
Statistical Manual-Thkd Edition-Revised (DSM-ni-R. American Psychiatric Association,
1987) whereas none ofthe control group (e.g., 16 of 20 men who were recmked from
89 coffee shops, restaurants, or on the street) met the diagnostic criteria for ASPD. In a
sample of 164 violent male offenders, Blackburn and Coid (1999) reported that 62% of
them met the diagnostic criteria for ASPD defined by the DSM-IH-R (American
Psychiatric Association, 1987). Cluster analysis revealed six diagnostic patterns such as
antisocial-narcissistic, paranoid-antisocial, borderiine-antisocial-passive-aggressive,
borderikie, compulsive-borderiine, and schizoid (Blackbum & Coid, 1999). Although the
resiUts showed that violent offenders had multiple features of personality disorders rather
than a single personality trait, antisocial features were most prevalent in violent offenders
(Blackbum & Coid, 1999). In a community sample of 1,620 residents who had been in
close relationships. Bland and Om (1986a) reported that 19.7% of them had physicaUy
abused thek partners (e.g., hit or throw things), 56.1% of those who had abused thek
partners had a Ufetime psychiatric diagnosis, and 60.6% of those vyith a diagnosis of
ASPD had perpetrated partner violence. Bland and Om (1986b) also conducted
diagnostic interviews of a representative sample of 1200 adult residents in the city of
Edmonton, Alberta in an attempt to investigate a relationship between violence (e.g., partner violence, chUd abuse, aduk fights, or fights with weapons) and psychiatric disorders, and reported that 47.8% of those wkh a diagnosis of ASPD committed violent behaviors. High prevalence rates (80 to 92.9%) of violence were found among those who had a diagnosis of ASPD with alcohol abuse and/or recurtent depression (Bland & Om,
1986b). Accordmg to an extensive review by Eronen, Angermeyer, and Schulze (1998), people vyith a diagnosis of ASPD and/or substance abuse disorder were 3 to 11 tknes more Ukely than people without the diagnose(s) to commit violent crimes (e.g..
90 homicide), and the strong relationship was consistent across prison, clkiical, and
community populations.
In addition to the diagnostic featiire or a diagnosis of antisocial personaUty
disorder (ASPD), tiie Mmnesota Muhiphasic Personality Inventory (MMPI) has often
been used to identify personality characteristics of people who are violent, yielding
mixed resuhs dependmg on the MMPI profiles or scales used to assess antisocial
personality features, type of violence, severity of violence, and characteristics of violent
samples recmked. The Psychopathic Deviate (Pd) scale ofthe MMPI has often been
used to assess antisocial personaUty featiires. Individuals with high scores on the Pd
scale tend to have difficulty conformkig to the values and mles of society, "engage ki
asocial or antisocial" behaviors such as lying and stealing, act impulsively, be hostUe and aggressive, be perceived as narcissistic and selfish, and show lack of deep emotional response such as remorse and guUt (Graham, 1993). Test-retest reUabUity and mtemal consistency coefficients for the Pd scale were .81 and .60, respectively (Butcher,
Dahlstrom, Graham, TeUegen, & Kaemmer, 1989). Persons vyith high scores on the Pd scale were described as "antisocial" by thek partners, psychiatrists, and psychologists
(Graham, 1988). Those with a diagnosis of ASPD obtakied significantly higher scores than a non-clkucal control group on the Pd scale (Smith, HUseiu-oth, Castlebury, &
Durham, 1999).
In several MMPI studies, the relationship between violence and the Pd scale has been studied, produckig mixed resuks. ComeU et al (1988) demonstrated that the Pd scale was one ofthe high pokits related to violence. Adolescent males who committed a homicide ki the context of other crimes showed the highest elevation on the Pd scale
91 compared to other MMPI clkiical scales (ComeU et al, 1988). Ingram, Marchioni, HUl,
Caraveo-Ramos, and McNeU (1985) found that male offenders mcarcerated for violent
crimes scored higher than incarcerated offenders who committed non-violent crimes on
tiie Pd scale. VaiUant, Gristey, Pottier, and Kosmyna (1999) compared 18 violent male
offenders (e.g., charged with assault) with 18 non-violent male offenders (e.g., charged
with theft) and 17 coUege student men on various measures, and found that violent
offenders scored higher than non-violent and control groups. KaUchman (1988) reported
that men charged with murdering thek partners were best described by the elevation on
the Pd scale. In a sample of women who were incarcerated for assaultmg significant
others or strangers, EdwaU, VUlenueva, HoUgan, Buchanan, and Campbell (1989) found
that female mmates who assauhed significant others were best described by the elevation
on the Pd scale. Else, WonderUch, Beaty, Christie, and Staton (1993) reported that 21
men who were violent toward thek partners and were in treatment obtained significantly
higher scores on the Pd scale than did a control group which did not differ from the
partner violent group on age, education, socioeconomic status, and kiteUigence.
In contrast, other researchers found an inverse or no relationship between the Pd
scale and violence. In 390 aduk male offenders, HoUand et al. (1981) found that violent offenders (e.g., homicide or aggravated assauh) scored lower than non-violent (e.g., burglary) group on the Pd scale. In a sample of 193 male offenders begiiuiing substance abuse treatment. Chick, Loy, and White (1984) also found that violent offenders (e.g., homicide, assault) had lower scores on the Pd and Ma scales, and higher scores on the F scale than did those who are potentiaUy bodUy violent (e.g., carrykig weapons), materially violent (e.g., property destmction), or non-violent (e.g., neither Uiterpersonal
92 nor property violence). Mack (1969) found no significant difference between mukiple
offenders and first offenders on any ofthe validky and clmical scales, ComeU et al.
(1988) analyzed MMPI profiles of 54 adolescents charged vyith homicide or larceny, and
found that 36 adolescents who committed homicide did not differ from 18 adolescents
who committed larceny (e.g., theft) on any ofthe MMPI validity and cUnical scales,
suggesting that serious violence (e.g., murder) is not related to the severity of
psychopathology as measured by the MMPI. Katz and Marquette (1996) reported that
adolescent and young aduk male inmates who committed violent crimes (e.g., homicide)
did not differ from mmates charged wkh non-violent crimes or a control group (high
school juniors and seniors) on any ofthe MMPI-A vaUdity and clinical scales (mcludmg
a Pd scale). Kemph et al. (1998) compared MMPI scores of eight adolescents and young
aduhs (ages rangmg from 16 to 24) who committed violent crimes (e.g., aggravated
battery) and eight mmates who committed non-violent crimes (e.g., grand theft). No
significant differences between the two groups were found on any of the 13 MMPI
scales, repUcatkig the findings of ComeU et al. (1988) and Katz and Marquette (1996) m
a prison population vyith less severe violence than homicide. Katz and Marquette (1996)
suggested that violence was unlikely to be associated vyith personaUty traits or
psychopathology assessed by the MMPI in a prison population. Nesca (1998) did not find significant differences between men incarcerated for assaulting a stranger (e.g., more than one stranger assault and no more than one kitknate assault) and men mcarcerated for assaultmg an inmate (e.g., more than one partner assauh and no more than one stranger assault) on the Pd scale. Interestingly, female inmates who committed homicide agamst a
93 significant other showed a tendency to elevate on the scale 0 (Social Introversion) rather
than the Pd scale.
In other MMPI studies, a relationship between violence and high pokits on the
MMPI profile has been mvestigated. Moncrieff and Pearson (1979) obtained MMPI
profiles of sex offenders in an attempt to identify personality traits that may differentiate
assaultive and nonassaultive offenders, and reported that assauhive sex offenders
produced a 4-8-9 (Pd-Schizophrenia-Ma) profile, whereas non-assaukive sex offenders
generated an 8-2-4 (Schizophrenia-Depression-Pd) profile, suggestmg the utiUty of Pd
scale in discrimkiatmg the two groups. Persons and Marks (1971) found that a 4-3 (Pd-
Hysteria) MMPI profile was strongly associated with violence (e.g., murder, assauh) ki a
prison population. They reported that 66.7% of mmates with 4-3 (Pd-Hysteria) MMPI
profile were mcarcerated for violent crimes and 85.4% of them had a history of violent
offenses. The percentage of violent crimes conunitted by those mmates vyith 4-3 (Pd-
Hysteria) MMPI profile was approxunately two tknes ofthe institutional base rate
(33.3%) of violent offenses and the rates of violent crimes committed by those vyith 4-2
(Pd-Depression), 4-8 (Pd-Schizophrenia), or 4-9 (Pd-Ma) MMPI profiles. Davis and
Sines (1971) cross-validated the association between the 4-3 (Pd-Hysteria) profile and violence ki both hospkal and prison settings. Bauer and Clark (1976) reported that crimkials vyith mukiple offenses obtakied higher scores on the Pd and Ma MMPI scales, compared to criminals vyith only one offense. KaUchman (1988) reported that men charged with murdering strangers were Ukely to have a 4-3 (Pd-Hysteria) profUe.
HoUand et al. (1981) investigated a relationship between violence and a combination of the Pd, Hypomania (Ma), and F scales proposed by Huesmann, Leflcowitz, and Eton
94 (1978) as an index of measuring aggression. In 390 adult male offenders, the number of violent convictions was positively correlated wkh a combination ofthe Pd, Ma, and F scales, suggesting a predictive power ofthe kidex for violent crimes. Further analysis revealed that nekher the Ma nor the F scale discriminated violent (e.g., homicide, aggravated assault) and non-violent (e.g., burglary) groups, whereas the Pd scale was able to discriminate the two groups.
As suggested by many researchers (Cogan, PorcerelU, & Dromgoole, 2001;
HoUand et al., 1981; Megargee, 1970; Nesca, 1998), the inconsistent findings may be due to the possibUity that inter-group differences were obscured or confounded by variables such as type of violence (e.g., too broadly defined violent groups), severity of violence, kiteUigence, age, gender, psychopathology, and settings. Altematively, the Pd scale may not be actuaUy related to violence.
In addition to the Pd scale, the Antisocial Practice Content Scale (ASP) ofthe
MMPI has also been used to assess antisocial personality features and behaviors.
Individuals with high scores on the ASP tend to have trouble vyith the law, resent authority, display anger and hostUity, abuse dmgs, and be dishonest and inconsiderate of others (Graham, 1993; Smith et al, 1999). Test-retest reUabUity and intemal consistency coefficient have been reported as .81 and .78, respectively (Butcher, Graham, WiUiams,
& Ben-Porath, 199). LUienfeld (1996) and Smith et al. (1999) pomted out that only a few researchers have mvestigated the convergent and discriminant vaUdity of tiie ASP scale.
The ASP scale was poskively related to the Pd scale (Butcher et al., 1990). In a normal population (coUege students), LUienfeld (1996) found that the ASP scale was negatively associated wkh honesty and poskively wkh psychopathy. LUienfeld (1996) fiirther
95 reported that the ASP scale was more related to psychopathy and antisocial behavior than
was the Pd scale. Smith et al. (1999) found that outpatients at a university based clkiic with a diagnosis of ASPD obtained significantly higher scores on the ASP scale,
compared to those with a Histrionic PersonaUty Disorder, those with other personality
disorders (except Borderiine and Narcissistic Personality disorders), or a non-clinical
control group (coUege students). In a sample of male and female mmates, Megargee,
Mercer, and CarboneU (1999) found that the ASP scale was one ofthe most elevated
scales (e.g., Pd, MAC-R), fiirther providing evidence for the vaUdity ofthe ASP scale.
Although a few studies have been carried out, empirical evidence ofthe vahdity ofthe
ASP is limited and no researchers to date have investigated a relationship between violence and antisocial personality feature employing the ASP.
Several other measures have been employed to explore a relationship between violence and antisocial personality features, kicluding the Millon CUnical Multiaxial
Inventory, Hare Psychopathy CheckUst-Revised, PersonaUty Assessment Inventory, and the Rorschach. Hastings and Hamberger (1988) compared MUlon CUnical Muhiaxial
Inventory (MCMI; MiUon, 1983) scores of partner violent men who attended a domestic violence program and partner non-violent men who were recmked from various places such as a family therapy cUnic. Partner violent men were less "conforming" compared to partner non-violent men, regardless of whether or not the partner violent men had alcohol problems. In a non-cUnical sample of partner violent men, Hamberger and Hastings
(1991) did not find significant differences on the MCMI scores between partner violent men and a control group. Regardmg the uiconsistent findmgs, Hamberger and Hastmgs
(1991) cautioned that the resuks obtakied from men who are violent toward thek partners
96 and are in treatment should not be generalized to men who are violent toward thek
partners and not in ti-eatment. Gondolf (1999) found that 19 % of a sample of 828 men
who were court-referted or voluntarily participated in a batterer program in four different
cities had elevations on the antisocial scale ofthe MiUon CUnical Muhiaxial Inventory-m
(MCMI-ni; MiUon, 1994). Gondolf (1999) compared his resuks with findmgs obtained
by other researchers, and reported that the prevalence rate of antisocial personaUty ki his
sample (men participating ki a batter program) was almost equal to the rate found ki a
psychiatric sample, and was almost three tunes less likely than the rates reported among
Canadian batterers and dmg abusers,
VaUlant et al, (1999) compared 18 violent male offenders (e,g,, charged with assault) with 18 non-violent male offenders (e,g,, charged vyith theft) and 18 college students ki a control group on various measures, and found that the violent offenders obtakied higher scores than did the non-violent men and the coUege students on the Hare
Psychopathy CheckUst-Revised (PCL-R; Hare, 1991), Walsh (1999) investigated a relationship between violence and psychopathy, which has been used as defining features of ASPD, Walsh (1999) divided a sample of 128 incarcerated offenders mto psychopathic and non-psychopathic groups based on thek scores on the PCL-R, and found that psychopathic offenders (30 or greater on the PCL-R) were more likely than non-psychopathic offenders to have committed violent crimes (e,g,, murder, assauh, or rape), with psychopathic and non-psychopathic offenders committmg an average of 5,8 and 3,4 violent crimes, respectively. Walsh (1999) further conducted qualkative analyses ofthe PCL-R responses, and reported that psychopathic offenders were more Ukely than non-psychopathic offenders to deny thek violent behaviors, and less Ukely to have
97 empathy and remorse, Wang and Diamond (1999) found a strong relationship between
physical aggression and antisocial personality style (e,g,, antisocial behavior, stimulus
seeking egocentricity) assessed by the PersonaUty Assessment Inventory (PAI: Morey,
1991),
The Rorschach test has also been used to identify psychological characteristics
(e,g,, antisocial or psychopathic featiires) of various types of violent people, Solway,
Richardson, Hays, and Elion (1981) found that people who murdered strangers or distant
acquakitances in the course of robbery were "psychopathic-Uke" and were less Ukely to
produce "popular" responses and total human contents on the Rorschach, compared to
people who murdered relatives or acquaintances, Greco and ComeU (1992) divided a
sample of 55 adolescent boys who committed homicide mto two groups; crime group vs,
conflict group. Adolescents ki the crime group were those 'Svho committed a homicide
ki the course of other crimes such as a robbery or burglary," Adolescents ki the conflict
group were those "who committed a homicide in the course of an interpersonal conflict
vyith the victim." Relative to the conflict group and non-violent control group, the
adolescent crime group obtained significantly higher scores on the OveraU H (Human)
and Poor form H (Human) scales ofthe Differentiation measure, which was developed by
Blatt, Brenneis, Schimek, and GUck (1976) to assess object differentiation based on the
Rorschach human responses, and Victkn scale, which was developed by Hoh (1975) to assess aggressive contents of Rorschach responses. They concluded that the crime group youths might have committed a homicide because they had a "pervasive deficit ki thek conception of others," and therefore "thek aggressive feeUngs were not kihibited by a reaUstic perception of others as complex, differentiated human beings" (Greco & ComeU,
98 1992). In contrast, the conflict group youths had a relatively weU-developed concept of
otiiers, but they might have committed homicide because they had a "poor coping
strategy for dealing with an extremely stressfiil relationship rather than a generalized
kiabiUty to take tiie perspective of others and empathize wkh them" (Greco & ComeU,
1992).
Given the uiconsistent findings, heterogeneous nature of violence, lack of studies
in a community sample, and paucity of stiidies employed the valid ASP scale, k should
be helpful to conduct a comparative study kivestigatkig the relationship between a
specific type of violence and antisocial personality features in a conununity sample
utiUzing more than a scale.
Alcohol Use
Studies regardmg a relationship between violence and alcohol use have yielded
relatively consistent results. Violence has generaUy been found to be associated vyith
alcohol use. The degree to which violence is related to alcohol use varies as a function of the alcohol use problems, the nature ofthe sample, mediating variables, and the tj^je of violence investigated. The foUowmg sections describe studies involving each of these factors, as weU as different explanations proposed for why violence is associated with alcohol use,
A relationship between violence and alcohol use is mediated by the heterogeneity of alcohol use problems. Alcohol use problems vary on several dimensions such as severity, type, and co-morbid psychopathology. In a representative sample of 923 adolescents, Komro et al, (1999) found that adolescents who reported binge drinkmg
99 (e.g., 5 or more drinks in a row ki the past two weeks) were more likely than adolescents
who did not report bmge drinking to report physical violence (e.g., hit or beat up
someone), suggesting that the relationship between violence and alcohol use is mediated
by the severity ofthe alcohol use problems. Finn et al. (1997) reviewed the Uterature on
alcohol, and suggested three types of alcohol use problems. The first type is a relatively
less severe subtype of alcohol use problems with high levels of psychological adjustment
(e.g., no violence) and low levels of psychopathology. The second subtype of alcohol use
problems is characterized by mood disorders (e.g., depression, anxiety). Individuals with
the second subtype are Ukely to drink alcohol as a response to thek negative moods. The thkd subtype is a relatively severe subtype of alcohol use problems that is characterized by an early onset, conduct problems, antisocial behaviors, substance abuse, novelty
seekkig behaviors, and difficulty inhibitmg or regulatkig behaviors. The thkd subtype of alcohol use problems is more Ukely than the other two subtypes to be related to violence.
In a community sample of 1,620 residents who had been ki a close relationship. Bland and Om (1986a) found that those with Ufetime diagnoses of Alcohol Abuse/Dependence vyith Major Depression Episode (MDE) and/or Antisocial Personality Disorder (APSD) were 2.4 times more Ukely than those with a Ufetkne diagnosis of Alcohol Abuse/
Dependence without MDE and/or ASPD to have been mvolved ki partner violence (e.g., hit or throw things at vyife, husband, partner).
The extent to which violence is related to alcohol use varies depending on the type of samples studied. A relationship between violence and alcohol use problems has been demonstrated in community samples. The prevalence rates of Alcohol Dependence and Alcohol Abuse ki a community sample are estknated at 8% and 5%, respectively
100 (Diagnostic Statistical Manual-4th Edkion; American Psychiatric Association, 1994). In
a sample of 2,075 adolescent giris and boys, Orpinas et al. (1995) found that those who
had carried a weapon and were mvolved ki a physical fight were 19 times more Ukely to
drink frequentiy than those who had not carried a weapon or fought. In a representative
sample of 1,150 adult men and women, Scott et al. (1997) found that 11.5% and 16.6%
reported havmg perpetrated a physical assauh (e.g., beat up, hit, or attack), and havmg
been a victim of a physical attack since age 12, respectively. Thkty percent of
perpetrators reported drinking alcohol when they were assauhkig someone, and 26% of victims reported drinkmg when they were attacked. The resuks indicate a strong relationship between alcohol use and perpetration/victimization ofthe "general" violence.
Further analysis revealed that the strong association was tme for only men, suggesting that alcohol does not play a significant role in perpetiation and victimization of violence among women. They also found that perpetrators were 19 times more likely to drink at the time of attack when thek victims were also drinking compared to when the victims were not drinkkig, suggesting that violence is more Ukely to occur when both perpetrators and victims were drinking compared to when either perpetrators or victims were drmking. In a representative sample of residents ki Ontario, WeUs, Graham, and West
(2000) found that 67.9% of perpetrators and/or victkns of physical aggression (e.g., grabbed, shoved, pushed, or hit) reported drinking in the most recent incident of violence.
Drinkers were more Ukely than non-drinkers to report bekig mvolved ki physical aggression (WeUs et al., 2000).
Regardmg partner violence ki a community sample, Eberie (1982) found that men who hit thek partners and were high m alcohol use (e.g., "a lot of alcohol used") were
101 more lUcely than men who hit their partners and did not drink alcohol use to report a high
level and frequency of injury in partner violence. Eberie (1982) also found that among
men who were violent toward their partners, those who have been drinking alcohol were
more likely than those who have not been drinkkig alcohol to physically abuse their
partners who have been drinking alcohol. The resuks were based on reports from 390
women who reported being physically abused by thek partners. Bland and Om (1986a)
reported that 19.7% of 1,620 community men and women who had been ki a close
relationship had physically abused thek partners (e.g., hit or throw things) and 32.9% of
the abusers had a Ufetkne diagnosis of Alcohol Abuse or Dependence. HotaUng and
Sugarman (1986) reviewed 52 studies, in which men who were violent toward their
partners were compared vyith a non-violent group ki various characteristics (e.g., alcohol
abuse), and identified consistent risk, kiconsistent risk, consistent non-risk, and
inconclusive risk markers of husband-to-vyife violence. Of 9 studies ki which the
association between partner violence and alcohol use was investigated, 7 studies found a
positive relationship and 2 studies found a non-significant relationship, suggesting that
alcohol use is a consistent risk marker for partner violence. Schumacher, Feldbau-Kohn,
Slep, and Heyman (2001) reviewed studies on risk and protective factors for partner violent men, and reported that alcohol/dmg abuse, depression, hostUity, and state/trak anger were the perpetrator factors. None ofthe studies described above differentiated between men who were violent only toward partners and men who were violent to both partners and other people. However, Shields, McCaU, and Hanneke (1988) recmked 85 violent men who had been ki a close relationship and classified them into "famUy only,"
"non-famUy," or "generally" violent men based on their responses to questions about 16
102 violent behaviors (e.g., violent toward a partner) in order to mvestigate group differences
on many variables (e.g., severity of violence). They found that "generally" and "non-
family" violent husbands were more likely than "famUy only" violent husbands to have
sought tteatment for alcohol/dmg problems, fiirther clarifying the relationship between
violence and alcohol problems by types of violence.
The association between violence and alcohol use problems has also been studied
in coUege populations. Although college admkiistrators have adopted some forms of on-
campus alcohol/substance abuse education and mtervention programs, alcohol misuse is
still prevalent among coUege students, causing serious problems (Bishop, 2000; Walters,
2000). About 40% of coUege students reported having engaged ki heavy drinking (e.g.,
five or more drinks in a row ki the past 2 weeks) (Wakers, 2000; Wechsler, DowdaU,
Maenuer, GledhUl-Hoyt, & Lee, 1998). About 80% of coUege students who belong to
fraternities or sororities reported having engaged in binge drinking in the previous two weeks (Walters, 2000). Heavy episodic drinkers reported having significantly more academic, social, and heakh-related problems than did non-heavy drinkers (Wechsler,
Lee, & GledhiU-Hoyt, 2001). Binge drinking was associated vyith serious problems such as kijuries from physical fights, property destmction, and intermption of study (Wechsler et al., 2001). Turrisi, Wiersma, and Hughs (2000) mvestigated the relationships between bkige-drinking beUefs and consequences ofthe bmge drinking, and found a significant positive relationship between the beUef that drinking can enhance social behaviors and the consequence of getting into a physical fight after drinking. Getting into a physical fight after drinkmg was negatively related to the beUef that alcohol can resuh ki negative affect (e.g., kritabUity) (Turrisi et al, 2000).
103 A relationship between violence and alcohol use problems has been found ki
criminal samples. ComeU et al. (1988) reported that 15 out 18 adolescents who
committed a homicide in the context of interpersonal conflicts met the diagnostic criteria
defined by the DSM-HI-R (APA, 1987) for Substance Abuse. In a sample of 594 male
inmates placed in a boot camp, Toombs, Benda, and Corwyn (2000) found that self-
reported alcohol consumption was one ofthe good predictors (e.g., carry a weapon, peer
association) of violent crimes (e.g., attack causmg injury). Martm (2001) reported that
about 41% of violent offenders, 33% of property offenders, and 25% of substance abuse
offenders had been drinking at the tune ofthe offenses they were charged. White,
Ackerman, and Caraveo (2001) reported that 60.9% of 115 iiunates were poskive for
alcohol use problems assessed by the Michigan Alcohol Screening Test (MAST), and
those with alcohol use problems were three tknes more Ukely than those without alcohol
use problems to report a physical violence toward their partners during the year before
their mcarcerations.
Other studies have also found a relationship between violence and alcohol use in clmical samples. In a sample of 125 male batterers who had participated ki a domestic abasement violence program, 47 had a history of alcohol use problems (Hastings &
Hamberger, 1988). Klassen and O'Coimor (1988) conducted a prospective study to identify predictors for violence in a sample of 239 violent male mpatients, and reported that alcohol abuse was a good predictor for subsequent violent arrests. In a sample of
192 patients vyith a Ufetime diagnosis of schizophreiua, Soyka (1994) reported that those wkh a Ufetime dual diagnosis of schizophrenia and alcohol dependency were three times
104 more likely than a simple diagnosis of schizophrenia to have been convicted for violent
crimes.
A relationship between violence and alcohol use problems is mediated by many
factors. Graham, Wells, and West (1997) found that the UkeUhood of violence was very
high when both perpetrators and victuns were intoxicated because other people ki the
setting contributed to the escalation of violence through the dynamic interaction process
(e.g., an kitoxicated perpetrator's kiabiUty to accurately perceive the other's comment,
mtention, or look is ahnost doubled when the other was also kitoxicated). Other
researchers (e.g., Scribner, MacKinnon, & Dwyer, 1995) proposed that the effects of
alcohol on violence were mediated by the physical avaUabUity of alcohol. The density of
alcohol outlets was positively associated vyith violent assauhs reported to the poUce of 74
cities m Los Angeles County (Scribner et al., 1995). CoUege students at schools that did
not ban alcohol were more Ukely to be negatively affected by alcohol use of other
students (e.g., being insulted, awakened, vandalized, or sexually/ physicaUy attacked), compared to coUege students at schools that banned alcohol on campuses (Wechsler et al., 2001). Wechsler et al. (2001) reported that students at schools that did not ban alcohol on campuses were more likely get hurt or kijured, compared to students at schools that banned alcohol on campuses.
Many researchers have proposed explanations regardmg why alcohol use problems are related to violence. Lang, Goeckner, Adesso, and Marlatt (1975) suggested that those who had observed violence ki dmnken people were Ukely to commit violent behaviors after drinking because they had developed false beUefs or expectancy such as
"alcohol leads to violence" and "violence after drinkmg is relatively less accountable."
105 Steele and Josephs (1990) suggested that those who were intoxicated were likely to
commit an act of violence because alcohol consumption reduced abiUty to engage in
kiferential/judgmental thoughts such as negative consequences of violent acts. Regarding
violence toward strangers, Gudjonsson and Sigurdsson (2000) suggested that violent
offenders might drink m a bar or discotheque and become mvolved in an altercation
resuking ki attackmg a stranger. Graham, West, and WeUs (2000) analyzed descriptions
of 105 violent incidents that naturaUy occurred in bars, and suggested that alcohol
mcreased male violence by transformkig an unconscious "masculine ideal" or "power
fantasies" into an inappropriate sense of mastery, control, or pride. Based on her review
of studies conducted on the effects of alcohol on violence, Martm (2001) suggested that
alcohol was Ukely to nartow perceptual fields, knpair cognitive flinctionmg, prevent
driiUcers from examining kitemaVextemal cues/values and exploring akemative inhibkory responses, and consequently resuh in violent behaviors. Martm (2001) also proposed that alcohol appeared to intensify the level of aggression by reducing anxiety about the consequences of violent behaviors or by reducing knpulse control
The relationship between violence and alcohol use varies dependmg on the type of violence. In fact, categorizing violent individuals into homogeneous subgroups is very useful for several reasons. Fkst, it helps improve understandkig of psychological characteristics that are specific to distkict subgroups of violence. Second, such understanding helps clarify the confusion in the taxonomy, co-morbidity, and heterotj^ic nature of violence. Third, the information guides assessors and cUnicians to focus on factors that are relevant to a specific subtype of violence (Loeber & SchmaUng, 1985b).
Fourth, k aUows researchers in the field to reduce the troublesome kiconsistency ki thek
106 findings regarding causal factors, cortelates, and underlying mechanisms of violence
(Hmshaw & Anderson, 1996),
Many subtypes (e.g.. Gold 8c Mann, 1984, Hartup, 1974; Hewitt & Jenkms, 1946;
Sears, Maccoby, & Levin, 1957; Toch, 1969; VitieUo, Behar, Hunt, Stoff, & Ricciuti,
1990) of violence have been proposed. One of them is a typology based on the target of
violence (e.g., Kandel-Englander, 1992; Shields et al, 1988; Straus, 1980), differentiating
between people who are violent toward partners only, violent to non-partners only, and
violent to both partners and non-partners. Dromgoole and Cogan (1995) investigated
prevalence rates ofthe three subtypes of physical violence in a sample of single, college
student men who had been ki a romantic relationship vyithki the past year. They found that 39% ofthe 312 coUege men reported perpetratkig violence ki the previous year. Of the violent men, 57.8% were sttanger violent, 11,8% were partner violent, and 30,5% were violent toward both partners and strangers. In a sample of 85 violent men who had been ki a close relationship. Shields et al. (1988) found that both "non-famUy only" and
"generaUy" violent husbands were more likely than "family only" violent husbands to have alcohol/substance problems, suggesting that "famUy only" violence is not related to alcohol/dmg problems. Similarly, Cogan et al, (2001) found no significant difference between non-violent men and partner violent men on a compUmentary MMPI-2 scale
(MAC-R), kidicatkig that partner violent men do not have a greater tendency than non violent men to have alcohol/substance problems. However, both stranger violent men and generally violent men scored significantly higher than both non-violent men and partner violent men on the MAC-R, suggestmg that the relationship between violence and a tendency to have alcohol problems depends on the type of violence.
107 Regarding sexual attacks, Gudjonsson and Sigurdson (2000) exammed
differences and similarities between 91 inmates incarcerated for violent crimes (e.g.,
homicide), rape, or chUd molestation, and reported that violent offenders (90%) and
rapists (75%) were more lUcely than chUd molesters (13%) to have been intoxicated when
they committed the offense. Regardless ofthe type of offenses (e.g., violence), 86% of
offenders toward strangers were reported being intoxicated at the time of offense,
compared to 69% of offenders toward acquaintances and 34% of offenders toward
relatives/fiiends. Offenses (e.g., violence) toward strangers were more Ukely than
offenses toward relatives/fiiends or acquakitances to be related to alcohol. In a sample of
362 sex offenders dravyn from a national sample of about 50,000 family units, BreckUn
and UUman (2001) investigated an association between alcohol drinking prior to the
offense and the outcomes ofthe offense. Sex offenders who drank alcohol prior to thek
offenses were not more likely than offenders who did not drink prior to thek offenses to
be aggressive, use a weapon, result in mjury in victims, and use physical force during the
offense. They also found that offenders who drank alcohol prior to the offense were more
Ukely than offenders who did not drink alcohol prior to the offense to commit the sex offenses agamst strangers. Bownes, O'Gorman, and Sayers (1991) studied a relationship between alcohol use problems and sexual assault from a sample of 51 female victkns of a rape, and found that 31% of victkns reported that they drank alcohol prior to the attack.
Victkns of a rape by a stranger were more Ukely than victkns of a rape by an acquaintance to have been drinking before the attack.
Although the field is ki general agreement that violence is related to alcohol use problems, the current Uterature review reveals that the degree to which violence is related
108 to alcohol use problems varies depending on samples recmited, types of violence investigated, and other mediating variables (e,g,, severity of alcohol use). Nevertheless, not many investigators have examined a relationship between a narrowly defined types of violence and alcohol use problems in a community sample. Considering that the nature of violence is heterogeneous, considering that violence is most prevalent ki young aduks, and considering that alcohol causes serious problems ki a coUege population, k should be helpful to conduct a comparative study investigatkig the relationship between stranger violence and alcohol use problems ki a coUege population.
109 APPENDIX B
THE MODIFIED PARTNER VIOLENCE SCREEN (PVS)
Have you hit, kicked, punched, or otherwise hurt someone within the past year?
0 = No 1 = Yes
1, Stranger 2, Friend or someone you know 3. Partner or ex-partner 4. Someone in your famUy
110 APPENDIX C
THE DEFENSIVE STYLE QUESTIONNAIRE-40 (DSQ-40)
Instmctions; The questionnake consists of a number of statements about personal attitudes. There are no right or wrong answers. Using the 9-point scale shovyn below, please indicate how much you agree or disagree wkh each statement by circling one of the numbers on the scale beside the statement. For example, a score of 5 would indicate that you neither agree nor disagree with the statement, a score of 3 that you moderately disagree, a score of 9 that you strongly agree.
12 3 4 5 6 7 8 9 Stiongly Sttongly Disagree Agree
1.1 get satisfaction from helpkig others and if this were taken away from me I would get depressed, 12 3 4 5 6 7 8 9
2 I'm able to keep a problem out of my mind untU I have tune to deal with k 12 3 4 5 6 7 8 9
3.1 work out my anxiety through dokig somethkig constmctive and creative lUce pamtkig or woodwork 12 3 4 5 6 7 8 9
4 I'm able to find good reasons for everythkig I do. 12 3 4 5 6 7 8 9
5 I'm able to laugh at myself pretty easUy. 12 3 4 5 6 7 8 9
6 People tend to mistreat me. ^ o Q 123456789 ed me and stole my money, I'd rather he be helped than punished. 7. ff someone mugg 1 2 8 People say I tend to ignore unpleasant facts as if they didn't exist^ 12 3 4 5 6 7 8
9 I ignore danger as if I was Superman. 12 3 4 5 6 7 8
111 10.1 pride myself on my ability to cut people down to size. 123456789
11.1 often act knpulsively when something is bothering me. 123456789
12.1 get physically ill when things aren't gouig well for me. 123456789
13. I'm a very inhibked person. 123456789
14.1 get more satisfaction from my fantasies than from my real Ufe. 123456789
15. I've special talents that allow me to go through Ufe with no problems. 123456789
16. There are always good reasons when things don't work out for me. 123456789
17.1 work more things out ki my daydreams than ki my real life. 123456789
18.1 fear nothkig. 123456789
19. Sometimes I think I'm an angel and other times I think I'm a devil. 123456789
20.1 get openly aggressive when I feel hurt. 123456789
21.1 always feel that someone I know is Uke a guardian angel. 123456789
22. As far as I'm concemed, people are ekher good or bad. 123456789
23. If my boss bugged me, I might make a mistake ki my work or work more slowly so as to get back at him. 12 3 4 5 6 7 8 9
24 There is someone I know who can do anythkig and who is absolutely fak and just. 12 3 4 5 6 7 8 9
112 25.1 can keep the Ud on my feelings if letting them out would kiterfere with what I'm dokig. 12 3 4 5 6 7 8 9
26. I'm usually able to see the fiinny side of an otherwise painfiil predicament 12 3 4 5 6 7 8 9
27.1 get a headache when I have to do something I don't like 12 3 4 5 6 7 8 9
28.1 often find myself being very nice to people who by aU rights I should be angry at 12 3 4 5 6 7 8 9
29.1 am sure I get a raw deal from Ike. 123456789
30. When I have to face a difficuk situation I try to imagine what k vyiU be Uke and plan ways to cope with it. 123456789
31. Doctors never reaUy understand what is wrong vyith me. 123456789
32. After I fight for my rights, I tend to apologize for my assertiveness. 123456789
33. When I'm depressed or anxious, eatkig makes me feel better. 123456789
34. I'm often told that I don't show my feeUngs. 123456789
35. If I can predict that I'm going to be sad ahead of tkne, I can cope better. 123456789
36. No matter how much I complain, I never get a satisfactory response. 123456789
37. Often I find that I don't feel anythkig when the situation woiUd seem to warrant strong emotions. 123456789
38. Sticking to the task at hand keeps me from feeUng depressed or anxious. 123456789
113 39. If I were in a crisis, I would seek out another person who had the same problem. 123456789
40. ff I have an aggressive thought, I feel the need to do something to compensate for k. 123456789
114