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Research ArticleRegular Articles

Countertransference, Defense Mechanisms, and Vicarious Trauma in Work With Sexual Offenders

Alcina J. S. Barros, Stefania P. Teche, Carolina Padoan, Pricilla Laskoski, Simone Hauck and Claudio L. Eizirik
Journal of the American Academy of Psychiatry and the Law Online September 2020, 48 (3) 302-314; DOI: https://doi.org/10.29158/JAAPL.003925-20
Alcina J. S. Barros
Dr. Barros is a forensic psychiatrist in the Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul/Brazil (UFRGS), Porte Alegre, Brazil. Dr. Teche is a clinical psychiatrist at Hospital de Clinicas de Porto Alegre/HCPA, UFRGS, Porto Alegre, Brazil and PhD student at UFRGS. Ms. Padoan is a psychotherapist and PhD student in Psychiatry and Behavioral Sciences at UFRGS. Dr. Laskoski is a clinical psychologist in Psychiatry and Behavioral Sciences at UFRGS. Dr. Hauck is Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS. Dr. Ezirik is Emeritus Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS.
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Stefania P. Teche
Dr. Barros is a forensic psychiatrist in the Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul/Brazil (UFRGS), Porte Alegre, Brazil. Dr. Teche is a clinical psychiatrist at Hospital de Clinicas de Porto Alegre/HCPA, UFRGS, Porto Alegre, Brazil and PhD student at UFRGS. Ms. Padoan is a psychotherapist and PhD student in Psychiatry and Behavioral Sciences at UFRGS. Dr. Laskoski is a clinical psychologist in Psychiatry and Behavioral Sciences at UFRGS. Dr. Hauck is Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS. Dr. Ezirik is Emeritus Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS.
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Carolina Padoan
Dr. Barros is a forensic psychiatrist in the Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul/Brazil (UFRGS), Porte Alegre, Brazil. Dr. Teche is a clinical psychiatrist at Hospital de Clinicas de Porto Alegre/HCPA, UFRGS, Porto Alegre, Brazil and PhD student at UFRGS. Ms. Padoan is a psychotherapist and PhD student in Psychiatry and Behavioral Sciences at UFRGS. Dr. Laskoski is a clinical psychologist in Psychiatry and Behavioral Sciences at UFRGS. Dr. Hauck is Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS. Dr. Ezirik is Emeritus Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS.
MS
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Pricilla Laskoski
Dr. Barros is a forensic psychiatrist in the Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul/Brazil (UFRGS), Porte Alegre, Brazil. Dr. Teche is a clinical psychiatrist at Hospital de Clinicas de Porto Alegre/HCPA, UFRGS, Porto Alegre, Brazil and PhD student at UFRGS. Ms. Padoan is a psychotherapist and PhD student in Psychiatry and Behavioral Sciences at UFRGS. Dr. Laskoski is a clinical psychologist in Psychiatry and Behavioral Sciences at UFRGS. Dr. Hauck is Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS. Dr. Ezirik is Emeritus Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS.
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Simone Hauck
Dr. Barros is a forensic psychiatrist in the Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul/Brazil (UFRGS), Porte Alegre, Brazil. Dr. Teche is a clinical psychiatrist at Hospital de Clinicas de Porto Alegre/HCPA, UFRGS, Porto Alegre, Brazil and PhD student at UFRGS. Ms. Padoan is a psychotherapist and PhD student in Psychiatry and Behavioral Sciences at UFRGS. Dr. Laskoski is a clinical psychologist in Psychiatry and Behavioral Sciences at UFRGS. Dr. Hauck is Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS. Dr. Ezirik is Emeritus Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS.
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Claudio L. Eizirik
Dr. Barros is a forensic psychiatrist in the Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul/Brazil (UFRGS), Porte Alegre, Brazil. Dr. Teche is a clinical psychiatrist at Hospital de Clinicas de Porto Alegre/HCPA, UFRGS, Porto Alegre, Brazil and PhD student at UFRGS. Ms. Padoan is a psychotherapist and PhD student in Psychiatry and Behavioral Sciences at UFRGS. Dr. Laskoski is a clinical psychologist in Psychiatry and Behavioral Sciences at UFRGS. Dr. Hauck is Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS. Dr. Ezirik is Emeritus Professor, Department of Psychiatry and Legal Medicine and the Post Graduate Program in Psychiatry and Behavioral Sciences at UFRGS.
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    Fig. 1.

    Flow chart for selection of study participants.

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    Table 1

    Characteristics of the Study Population

    VariableStatistic
    Age, y45.5 (33.5–56.0)
    Female sex28 (50.0)
    Profession
        Forensic psychiatrist37 (66.0)
        Forensic psychologist19 (34.0)
    Length of forensic expertise, years10.5 (4.0–22.5)
    Previous psychotherapy51 (91.0)
        Length of psychotherapy, y8.0 (4.0–12.0)
    Psychotherapy expertise34 (60.7)
    Time between forensic evaluation and study participation, months4.5 (2.0–24.5)
    • n = 56 participants. Data are presented as n (%) or median (interquartile range).

    • View popup
    Table 2

    Spearman Correlation Coefficients for the Association Between Countertransference and Vicarious Trauma Scores

    ClosenessDistanceIndifference
    Total TABS Score−.06.11.28*
    Self-safety−.03.23.25
    Other-safety−.11.22.43*
    Self-trust.24−.02.07
    Other-trust−.17.02.04
    Self-esteem.01−.05.09
    Other-esteem−.19.08.16
    Self-intimacy.09.12.21
    Other-intimacy.10−.10.16
    Self-control−.03.07.25
    Other-control−.08.05.18
    • n = 56 participants.

    • Countertransference was evaluated with the Assessment of Countertransference Scale (ACS); vicarious trauma was evaluated with the Trauma and Attachment Belief Scale (TABS). The strength of correlation is classified as follows: .0–.19 = very weak; .20–39 = weak; .40–.59 = moderate; .60–.79 = strong; .8–1.0 = very strong.

    • ↵* P < .01.

    • View popup
    Table 3

    Subgroup Analysis of Correlations Between Indifference and Vicarious Trauma Scores

    Spearman Coefficient for the Correlation Between TABS and Indifference ScoresP
    Gender
        Male.30.11
        Female.31.10
    Profession
        Psychiatrist.23.16
        Psychologist.29.21
    Length of forensic expertise
        > 10.5 y.32.08
        ≤ 10.5 y.43.02
    Previous psychotherapy
        Yes.29.03
        No.89.04
    Psychotherapy expertise
        Yes.21.21
        No.39.06
    Time between forensic evaluation and study participation
        > 4.5 months.35.06
        ≤ 4.5 months.14.47
    • n = 56 participants.

    • Indifference was evaluated with the Assessment of Countertransference Scale (ACS); vicarious trauma was evaluated with the Trauma and Attachment Belief Scale (TABS). The Spearman correlation coefficient is demonstrated in the table. The strength of correlation is classified as follows: .0–.19 = very weak; .20–39 = weak; .40–.59 = moderate; .60–.79 = strong; .8–1.0 = very strong.

    • View popup
    Table 4

    Spearman Correlation Coefficient for the Association Between Defense Mechanisms and Vicarious Trauma Scores

    MatureMature Without RationalizationImmatureNeurotic
    Total TABS Score−.11−.05.45*.30**
    Self-safety−.11−.07.15.15
    Other-safety−.02−.00.26**.22
    Self-trust−.29**−.23.29**.17
    Other-trust−.00.06.26.06
    Self-esteem−.24−.17.31**.22
    Other-esteem.03.11.06.06
    Self-intimacy−.11−.09.16.10
    Other-intimacy−.09−.07.44*.16
    Self-control−.10−.03.50*.40*
    Other-control.00.05.55*.26**
    • n = 56 participants.

    • Defense mechanisms were evaluated with the Defensive Style Questionnaire (DSQ); vicarious trauma was evaluated with the Trauma and Attachment Belief Scale (TABS). The strength of correlation is classified as follows: .0–.19 = very weak; .20–39 = weak; .40–.59 = moderate; .60–.79 = strong; .8–1.0 = very strong.

    • ↵* P < .01;

    • ↵** .01 ≤ P < .05.

    • View popup
    Table 5

    Subgroup Analysis of Correlations Among Immature and Neurotic Defense Mechanisms and Vicarious Traumatization Scores

    Spearman Coefficient for the Correlation Between TABS and Immature Defense Mechanism ScoresPSpearman Coefficient for the Correlation Between TABS and Neurotic Defense Mechanism ScoresP
    Gender
        Male.50< .01.20.30
        Female.56< .01.43.02
    Profession
        Psychiatrist.41.01.09.55
        Psychologist.62< .01.49.03
    Length of forensic expertise
        > 10.5 y.50< .01.22.24
        ≤ 10.5 y.38.04.34.06
    Previous Psychotherapy
        Yes.44< .01.27.04
        No.90.03.90.03
    Psychotherapy expertise
        Yes.49< .01.23.18
        No.30.17.32.14
    Time between forensic evaluation and study participation
        > 4.5 months.36.05.31.09
        ≤ 4.5 months.34.07.26.17
    • n = 56 participants.

    • Immature and neurotic defense mechanisms were evaluated with the Defensive Style Questionnaire (DSQ); vicarious trauma was evaluated with the Trauma and Attachment Belief Scale (TABS). The strength of correlation is classified as follows: .0–.19 = very weak; .20–39 = weak; .40–.59 = moderate; .60–.79 = strong; .8–1.0 = very strong.

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Journal of the American Academy of Psychiatry and the Law Online: 48 (3)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 48, Issue 3
1 Sep 2020
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Countertransference, Defense Mechanisms, and Vicarious Trauma in Work With Sexual Offenders
Alcina J. S. Barros, Stefania P. Teche, Carolina Padoan, Pricilla Laskoski, Simone Hauck, Claudio L. Eizirik
Journal of the American Academy of Psychiatry and the Law Online Sep 2020, 48 (3) 302-314; DOI: 10.29158/JAAPL.003925-20

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Countertransference, Defense Mechanisms, and Vicarious Trauma in Work With Sexual Offenders
Alcina J. S. Barros, Stefania P. Teche, Carolina Padoan, Pricilla Laskoski, Simone Hauck, Claudio L. Eizirik
Journal of the American Academy of Psychiatry and the Law Online Sep 2020, 48 (3) 302-314; DOI: 10.29158/JAAPL.003925-20
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