Defensiveness reaps psychiatric benefits.

Defensiveness reaps psychiatric benefits

Defensiveness has taken a bad rap. That, at least, is the implication of a report in the May AMERICAN JOURNAL OF PSYCHIATRY, which suggests defensiveness--the tendency not to report unfavorable information about oneself -- is a protective trait against such psychiatric disorders as depression, anxiety and substance abuse.

"The monolithic view that mental health always involves opening up to, rather than avoiding, emotions and impulses is not supported by our data," says study director Richard D. Lane of the University of Arizona Health Sciences Center in Tucson.

Lane and his colleagues conducted interviews with 98 individuals. Half suffered from severe depression, while the rest had no psychiatric diagnoses. The researchers also interviewed 282 spouses and first-degree relatives of the study participants. To further check psychiatric histories, the team reviewed medical records for all 380 individuals and, when possible, contacted friends and relatives.

Each participant also completed a 33-item true/false questionnaire designed to gauge defensiveness. A response of "false" to some items, such as "I am sometimes irritated by people who ask favors of me," indicates denial of unpleasant emotions and counts toward greater defensiveness. A "true" response to others, such as "No matter who I'm talking to, I am always a good listener," also increases the defensiveness score.

Overall, subjects with high defensiveness scores had a significantly lower lifetime history of psychiatric disorders. People scoring low on defensiveness more often had met diagnostic criteria for severe depression, pervasive anxiety, drug abuse or alcoholism at some time during their lives.

Several pieces of evidence suggest defensiveness protects against psychiatric disorders, rather than merely reflecting an underreporting of psychiatric symptoms by people intent on denying "socially undesirable" characteristics, Lane and his co-workers assert. First, the statistical relationship between defensiveness and mental health held up when the team made psychiatric diagnoses by consulting an individual's close relatives and medical records. Second, the defensiveness-mental health pattern was strongest for the initial 98 depressed and nondepressed subjects, whose diagnoses had been meticulously established on several occasions as part of a separate study.

Also, the association between high defensiveness and mental health was greater among those at higher risk for developing mental disturbances. Relatives of depressed subjects are a known high-risk group, but those in the sample with no psychiatric history rated significantly more defensive than those who did have a history of mental disturbance. The same trend did not show up among relatives of subjects without depression.

There may be a physiological trade-off for the psychiatric benefits linked to defensiveness, the investigators note. Research conducted by study coauthor Gary E. Schwartz of Yale University has linked high defensiveness to increased risks of hypertension, breast cancer and elevated heart rate in response to stressful stimuli.

Further studies must establish whether low defensiveness is strongly associated only with certain categories of psychiatric disorder, or is linked to mental disturbances in general, the researchers point out.