The Role of Defense Mechanisms in Emerging Personality Disorders in Clinical Adolescents

Abstract

Background: Defensive functioning is related to overall mental functioning and personality traits in adults but only few studies investigated the role of defenses in adolescence. The present study analyzed the use of defense mechanisms in clinical adolescents to test how defensive functioning is related to age, gender, and personality traits.Design: 102 self-referred outpatients were interviewed using the Clinical Diagnostic Interview (CDI). Defense mechanisms and personality profile were assessed using the Defense Mechanisms Rating Scale (DMRS) and the Shedler-Westen Assessment Procedure-200 for Adolescence (SWAP-200-A) respectively.Findings: Multivariate analysis of variance showed significant age and gender differences in clinical adolescents; while younger teenagers used more immature defenses, older adolescents scored significantly higher in high-neurotic and mature defenses. Girls showed higher use of minor image distortion and neurotic defenses, whereas boys recurred more frequently to obsessional level defenses. Neither age nor gender differences were found for narcissistic defense level. Significant correlations between personality disorders and specific defenses were found for all personalities with sufficient base rate, with the exception of paranoid, schizotypal, and schizoid personalities.Conclusions: In line with previous studies we confirmed the hypothesis of an ontogenetic line of development of defense mechanisms. In addition, the present study found that age and gender differences in adolescence are related to the use of specific defenses that contribute to the development of the personality and various psychological capacities. Several clinical implications are linked to the systematic investigation of defense mechanisms in youth, although further studies are required to confirm these findings.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Mariagrazia Di Giuseppe

Mariagrazia Di Giuseppe, PhD, is a  Child Dynamic Psychotherapist and Lecturer of Psychology at the University of Pisa. Alessandro Gennaro, PhD, is a Senior Researcher in Psychology at University of Rome “La Sapienza”. Vittorio Lingiardi, MD, is a Psychoanalyst and Professor of Psychology at University of Rome “La Sapienza”. J. Christopher Perry, MPH, MD, is a  Professor of Psychiatry at McGill University, and Director of Psychotherapy Research Institute of Community & Family Psychiatry at Jewish General Hospital.

Alessandro Gennaro

Mariagrazia Di Giuseppe, PhD, is a  Child Dynamic Psychotherapist and Lecturer of Psychology at the University of Pisa. Alessandro Gennaro, PhD, is a Senior Researcher in Psychology at University of Rome “La Sapienza”. Vittorio Lingiardi, MD, is a Psychoanalyst and Professor of Psychology at University of Rome “La Sapienza”. J. Christopher Perry, MPH, MD, is a  Professor of Psychiatry at McGill University, and Director of Psychotherapy Research Institute of Community & Family Psychiatry at Jewish General Hospital.

Vittorio Lingiardi

Mariagrazia Di Giuseppe, PhD, is a  Child Dynamic Psychotherapist and Lecturer of Psychology at the University of Pisa. Alessandro Gennaro, PhD, is a Senior Researcher in Psychology at University of Rome “La Sapienza”. Vittorio Lingiardi, MD, is a Psychoanalyst and Professor of Psychology at University of Rome “La Sapienza”. J. Christopher Perry, MPH, MD, is a  Professor of Psychiatry at McGill University, and Director of Psychotherapy Research Institute of Community & Family Psychiatry at Jewish General Hospital.

J. Christopher Perry

Mariagrazia Di Giuseppe, PhD, is a  Child Dynamic Psychotherapist and Lecturer of Psychology at the University of Pisa. Alessandro Gennaro, PhD, is a Senior Researcher in Psychology at University of Rome “La Sapienza”. Vittorio Lingiardi, MD, is a Psychoanalyst and Professor of Psychology at University of Rome “La Sapienza”. J. Christopher Perry, MPH, MD, is a  Professor of Psychiatry at McGill University, and Director of Psychotherapy Research Institute of Community & Family Psychiatry at Jewish General Hospital.