Psychological Defense Styles in Late Adolescence and Young Adulthood: A Follow-up Study

doi:10.1097/00004583-199708000-00025

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 36, Issue 8, August 1997, Pages 1148-1153

https://doi.org/10.1097/00004583-199708000-00025 Get rights and content

ABSTRACT

Objective

The aims of this follow-up study were to examine in both sexes (1) the stability of defense styles from late adolescence to early adulthood and (2) the ability of adolescent defense styles to predict later psychiatric symptoms.

Method

Defense styles were examined using the Defense Style Questionnaire. Five hundred sixteen high school students (337 females and 179 males) completed the questionnaire at 15 through 19 years of age, and again 5 years later. In the follow-up examination the General Health Questionnaire was used to assess psychiatric disturbance.

Results

Neurotic and immature defense style scores decreased significantly in both sexes, whereas mature defense style scores did not change significantly. Females had significantly higher neurotic defense style scores than males in both late adolescence and young adulthood. Psychiatric disturbance at follow-up was associated positively with baseline immature defense style scores in both sexes, and negatively with baseline mature defense style scores in females.

Conclusions

Development of defenses was apparent as a decrease in neurotic and immature defense style scores. In both sexes, immaturity of defenses in late adolescence predicted psychiatric symptoms in young adulthood. J. Am. Acad. Child Adolesc. Psychiatry, 1997, 36(8):1148–1153.

REFERENCES (28)

American Psychiatric Association
Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised (DSM-III-R)
(1987)
T Anderson et al.
The relationship between the Defense Mechanisms Inventory and reported symptomatology in college females
Pers Indiv Diff
(1991)
G Andrews et al.
The determination of defense style by questionnaire
Arch Gen Psychiatry
(1989)
M Bond et al.
Empirical study of self-rated defense styles
Arch Gen Psychiatry
(1983)
K Bridges et al.
Self-administered scales of neurotic symptoms
SJ Erickson et al.
Defense mechanisms and adjustment in normal adolescents
Am J Psychiatry
(1996)
SS Feldman et al.
Defense mechanisms in adolescents as a function of age, sex and mental health status
J Am Acad Child Adolesc Psychiatry
(1996)
RB Flannery et al.
Self-rated defense style, life stress, and health status: an empirical assessment
Psychosomatics
(1990)
E Frydenberg et al.
Adolescent coping: the different ways in which boys and girls cope
J Adolesc
(1991)
D Goldberg
The Detection of Psychiatric Illness by Questionnaire
(1972)

FA Huppert et al.

The value of an improved scoring system (CGHQ) for the General Health Questionnaire in a representative community sample

Psychol Med

(1988)

DB Kandel et al.

Adult sequelae of adolescent depressive symptoms

Arch Gen Psychiatry

(1986)

RG Kneepkens et al.

Rapid improvement in the defense style of depressed women and men

J Nerv Ment Dis

(1996)

DB Levit

Gender differences in ego defenses in adolescence: sex roles as one way to understand the differences

J Pers Soc Psychol

(1991)

Cited by (30)

High Beck Depression Inventory 21 scores in adolescents without depression are associated with negative self-image and immature defense style
2018, Psychiatry Research
Citation Excerpt :
Also our observation that low BDI-21 scores in adolescents without depression were associated with mature defense styles is in agreement with previous reports on the association between mature defense styles and low prevalence of psychiatric symptoms (Muris et al., 2003; Ruuttu et al., 2006). In a five-year follow-up mature defense style was negatively associated with psychiatric problems, but only among female subjects (Tuulio-Henriksson et al., 1997). Muris et al. observed in their non-clinical study population that neurotic defense style was associated with various anxiety symptoms, among girls in particular (Muris et al., 2003).
Beck Depression Inventory (BDI) is widely used in assessing adolescents’ psychological wellbeing, but occasionally the result diverges from diagnostics. Our aim was to identify factors associated with discrepancies between BDI scores and diagnostic assessment in adolescent psychiatric patients and general population.
The study comprised 206 inpatients (13–17 years old) and 203 age and gender matched non-referred adolescents. Study subjects filled self-reports on depression symptoms (BDI-21), alcohol use (AUDIT), defense styles (DSQ-40) and self-image (OSIQ-R), and on background information and adverse life events. Diagnostics was based on K-SADS-PL interview, and/or clinical interview and clinical records when available.
We compared subjects who scored in BDI-21 either 0–15 points or 16–63 points firstly among subjects without current unipolar depression (n = 284), secondly among those with unipolar depression (n = 105). High BDI-21 scores in subjects without depression diagnosis (n = 48) were associated with female sex, adverse life events, parents’ psychiatric problems, higher comorbidity, higher AUDIT scores, worse self-image and more immature defense styles. Low BDI-21 scores among subjects with depression diagnosis (n = 23) were associated with male sex, more positive self-image and less immature defense style.
In conclusion, high BDI-21 scores in the absence of depression may reflect a broad range of challenges in an adolescent's psychological development.
A treatise on secondary psychopathy: Psychobiological pathways to severe antisociality
2016, Aggression and Violent Behavior
Citation Excerpt :
Childhood abuse and neglect have been associated with immature defense mechanisms in adults with heroin dependency (Evren et al., 2012). Furthermore, longitudinal follow-up studies have confirmed that adolescents who use immature defense mechanisms are more likely to be diagnosed with personality disorders and other psychiatric disorders in adulthood (Strandholm, Kiviruusu, Karlsson, Miettunen, & Marttunen, 2016; Tuulio-Henriksson, Poikolainen, Aalto-Setälä, & Lönnqvist, 1997). Within the group of personality disorders, those with greater use of immature defense mechanisms were also found to be more hostile and more likely to be diagnosed with BPD (Paris, Zweig-Frank, Bond, & Guzder, 1996).
Since its inception, the concept of “secondary psychopathy” has been contrasted with primary psychopathy on the grounds of neuroticism, affect instability, and anxiety. Nonetheless, while the etiology of primary psychopathy, and its various possible expressions, has received ample attention, secondary psychopathy has been largely neglected and only discussed in cluster-analytic studies. This paper seeks to fill that caveat by delineating the continuum on which secondary psychopathic individuals may be set apart and exploring potential sources of within group homogeneity and heterogeneity. While secondary psychopathic individuals share a number of etiological antecedents (attachment problems, childhood maltreatment, neurobiological dysfunctions) they can vary on different temperamental predispositions and specific types of maltreatment experienced in childhood (neglect/abuse vs. trauma/abuse, low vs. high prefrontal catecholaminergic activity), thus creating the heterogeneity observed in this group. Secondary psychopathic individuals may be situated on a continuum that spans from attentional hyposensitivity and cognitive distractibility on the far left side, associated with deficient prefrontal catecholamine activity and childhood neglect/abuse, ultimately culminating in more detached expressions of secondary psychopathy (callousness, hedonism, and low worrying), to attentional hypersensitivity and cognitive rigidity on the far right side, associated with non-optimally high levels of catecholamine activity and childhood relational trauma/abuse leading to more unstable expressions of secondary psychopathy (hostility, neuroticism, instability, and worrying).
Exploring the association of ego defense mechanisms with problematic internet use in a Pakistani medical school
2016, Psychiatry Research
Citation Excerpt :
It has been demonstrated to have adequate reliability, validity and test-retest reliability (Canan et al., 2010; Pui et al., 2008; Widyanto and McMurran, 2004). It has also been translated and validated in several other languages including French (Khazaal et al., 2008), Portuguese (Pontes et al., 2014), Greek (Tsimtsiou et al., 2014) and Arabic (Hawi, 2013). Its psychometric properties, demonstrating its unidimensional nature, high reliability, good readability and no floor and ceiling effects in the present sample were explored by Waqas et al. (2015).
The present study was designed to analyze association between problematic internet use and use of ego defense mechanisms in medical students. This cross-sectional study was undertaken at CMH Lahore Medical College (CMH LMC) in Lahore, Pakistan from 1st March, 2015 to 30th May, 2015. 522 medical and dental students were included in the study. The questionnaire consisted of three sections: a) demographic characteristics of respondent b) the Defense Style Questionnaire-40 (DSQ-40) and c) the Internet Addiction Test (IAT). All data were analyzed in SPSS v20. Chi square, Independent sample t test and One Way ANOVA were run to analyze association of different variables with scores on IAT. Multiple regression analysis was used to delineate ego defenses as predictors of problematic internet use. A total of 32 (6.1%) students reported severe problems with internet usage. Males had higher scores on IAT i.e had more problematic use of internet. Scores on internet addiction test (IAT) were negatively associated with sublimation and positively associated with projection, denial, autistic fantasy, passive aggression and displacement. There was a high prevalence of problematic use of internet among medical and dental students. It had significant associations with several defense mechanisms.
Defensive functioning and psychopathology: A study with the REM-71
2014, Comprehensive Psychiatry
The aim of the present study is to explore the association between defensive functioning (as assessed through the REM-71) and psychiatric symptoms in a large sample from the community, and the moderating role of age and gender on that association. Furthermore, we explored the concurrent validity of REM-71 as compared with “caseness” (SCL-90-R).
The REM-71 was administered together with SCL-90-R to a community sample of 1,060 Italian high-school and university students (mean age = 19.01 ± 3.85 years; 66.7% females).
Factor 1 defenses were by far the primary contributors to the predictor synthetic variable (i.e. association between defenses and psychopathology). Gender proved to moderate the association between immature defenses and symptoms. Using ROC analysis, we derived a cut-off score for Factor 1 defenses.
Our results support the adoption of the REM-71 as a useful instrument for the assessment of defensive array and psychopathological liability in adolescents and adults.
Defensive functioning in MtF and FtM transsexuals
2014, Comprehensive Psychiatry
Citation Excerpt :
The first aim of the present study is therefore to ascertain whether the defensive profile of transsexuals seeking SRS can generically be defined more primitive, immature and maladaptive than that of controls from the general population. Secondly, given that the defensive profile of men and women has shown significant differences across all age groups [11,28–30], each of the transsexual groups will be compared with male and female controls in order to assess whether similarities in the defensive profile can be found as a result of constitutional variables or adherence to gender stereotypes. The comparison with both control groups is also necessary given that research on whether personality traits in transsexuals are congruent with the preferred sex is still lacking [31]; also, evidence from previous studies using self-report instruments (mainly the MMPI-II) in GID patients exists that the psychological profiles as derived using norms of the desired gender are less deviant and dysfunctional than those obtained adopting the anatomical sex as reference [14].
In spite of the potential clinical utility of defense mechanisms in the assessment of gender identity disorder patients as candidates to sex reassignment surgery, there is paucity of research in this field. The aim of the present study is therefore to ascertain whether the defensive profile of MtF and FtM transsexuals seeking sex reassignment surgery can be defined more primitive, immature and maladaptive than that of the two control groups. We compared the defensive profiles as assessed through the REM-71 (Steiner et al., 2001) of 104 MtF transsexuals, 46 FtM transsexuals and two control groups of males and females.
Our results show that MtF transsexuals present an overall more primitive defensive array than that of both control groups, while FtMs show a profile not dissimilar from that of both control groups. Our results support the hypothesis that MtF transsexuals are characterized by higher proneness to psychopathology than the general population and show a more immature level of psychological functioning than FtM transsexuals.
Psychosocial Outcomes and Service Use Among Young Adults With Cancer
2009, Seminars in Oncology
Citation Excerpt :
Yet, this literature suggests a unique set of psychosocial and developmental issues facing young adults with a cancer history, and has urged greater development of support services and specialized care programs to help meet the needs of this population.1,9,13,16,18,23–27 It demonstrates that cancer often has a long-term and significant impact on aspects of young adulthood such as sexuality and fertility concerns,28–33 treatment outcomes and physical symptoms,34–37 psychosocial adjustment, coping and QOL issues,12,34,38–54 healthcare,55–57 and family relations.58,59 Investigations of QOL in adults of all ages also are informative for understanding how cancer affects the lives of AYAs in that they identify important factors associated with QOL and psychosocial outcomes.
At the crossroads between pediatric and older adult groups, young adults with cancer may be underserved or inadequately or inappropriately served by existing support services. Empirical evidence has not established well the extent to which utilization of psychosocial support services delivered throughout a continuum of care results in desired outcomes. If self-efficacy is demonstrated to play a significant role in promoting quality of life and psychological well-being in young adult cancer patients, then a cancer-specific self-efficacy model can serve as an evidence-based framework for developing, implementing, and testing new interventions. A focus on self-efficacy has the potential to promote young adults' abilities to remain active and independent, seek and understand medical information, manage stress, cope with treatment-related side effects, maintain a “positive attitude,” regulate emotions, and seek social support. Future research should aim to identify which patients represent at-risk targets for intervention, as well as the most appropriate time points along the continuum of care at which patients/survivors are most likely to benefit from delivery/utilization of psychosocial support services.

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: This study was supported by grants from the Academy of Finland and the Yrj$oU Jahnsson Foundation.

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SPECIAL ARTICLEPsychological Defense Styles in Late Adolescence and Young Adulthood: A Follow-up Study

ABSTRACT

Objective

Method

Results

Conclusions

Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised (DSM-III-R)

The relationship between the Defense Mechanisms Inventory and reported symptomatology in college females

Pers Indiv Diff

The determination of defense style by questionnaire

Arch Gen Psychiatry

Empirical study of self-rated defense styles

Arch Gen Psychiatry

Self-administered scales of neurotic symptoms

Defense mechanisms and adjustment in normal adolescents

Am J Psychiatry

Defense mechanisms in adolescents as a function of age, sex and mental health status

J Am Acad Child Adolesc Psychiatry

Self-rated defense style, life stress, and health status: an empirical assessment

Psychosomatics

Adolescent coping: the different ways in which boys and girls cope

J Adolesc

The Detection of Psychiatric Illness by Questionnaire

The value of an improved scoring system (CGHQ) for the General Health Questionnaire in a representative community sample

Psychol Med

Adult sequelae of adolescent depressive symptoms

Arch Gen Psychiatry

Rapid improvement in the defense style of depressed women and men

J Nerv Ment Dis

Gender differences in ego defenses in adolescence: sex roles as one way to understand the differences

J Pers Soc Psychol

SPECIAL ARTICLE
Psychological Defense Styles in Late Adolescence and Young Adulthood: A Follow-up Study