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Twenty-nine successive admissions to an acute psychiatric ward of a VA hospital and 40 college undergraduates were given group administrations of six Thematic Apperception Test (TAT: Murray, 1943) cards. The written responses were coded according to Cramer's defense mechanism manual (1990), which codes three types of defense: Denial, Projection, and Identification. Denial is supposed to be the most “primitive.” and Identification is supposed to be the least primitive of these. Each is codable on seven levels, which also range from more primitive to more mature types of defense. The psychiatric patients both used more primitive types of defense (more Denial and Projection, less Identification) and within types, used a higher percentage of lower level fprimitive) defenses. The results are viewed as providing validity for Cramer's manual from a research team unaffiliated with her lab. Reliability issues are also discussed.
Hibbard et al. (1994) studied this question.