Defense Mechanisms in Adolescence as Predictors of Adult Personality Disorders

Abstract

Our study examines whether defense styles and separate defenses in depressed adolescent outpatients predict adult personality disorders (PDs). We obtained data from consecutive adolescent outpatients who participated in the Adolescent Depression Study at baseline and at the 8-year follow-up (N = 140). Defense styles were divided into mature, neurotic, image-distorting, and immature and a secondary set of analyses were made with separate defenses as predictors of a PD diagnosis. Neurotic, image-distorting, and immature defense styles in adolescence were associated with adulthood PDs. Neurotic defense style associated with cluster B diagnosis and image-distorting defense style associated with cluster A diagnosis. Separate defenses of displacement, isolation, and reaction formation were independent predictors of adult PD diagnosis even after adjusting for PD diagnosis in adolescence. Defense styles and separate defenses predict later PDs and could be used in the focusing of treatment interventions for adolescents.

Interrelations between neurotic syndromes and defense mechanisms

“…The revealed correlations yield the following characteristic of a personality with the impostor syndrome: -with the isolation defense mechanism (r=0.337 at р≤0.01) makes a person emotionally reserved, closed, lacking response to significant events [25]. S. Freud thought that with isolation an individual puts oneself into an active position instead of a passive one, while staging one's own disappearance in response to a traumatic event [26].…”

Die Zusammenhänge von psychischer Struktur, psychodynamischen Konflikten und Abwehrstilen bei Adoleszenten mit psychischen Beschwerden

“…Demnach weisen die hier untersuchten Jugendlichen im Durschnitt ein eher reifes Abwehrniveau auf. In vorherigen Studien konnte gezeigt werden, dass ein unreifer Abwehrstil mit externalisierenden sowie Persönlichkeitsstörungen assoziiert ist [28]. Diese Befunde konnten begründet durch den Einsatz des PHQ-D, welcher die Erhebung von externalisierenden und Persönlichkeitsstörungen nicht einschließt, in der vorliegenden Studie zwar nicht repliziert werden, die stärkere Ausprägung des adaptiven Abwehrstils deutet jedoch auf eine geringere Vertretung von externalisierenden und Persönlichkeitsstörungen bei den hier untersuchten Jugendlichen hin.…”

Personality pathology severity, cluster type and specific therapeutic interventions in outpatient psychotherapy

“…Further, patients' overall pretreatment defensive functioning predicted specific PI and CB techniques used, and therapists tended to use more PI techniques early in treatment with patients of lower defensive functioning. While defensive functioning is not a direct measure of Axis II pathology severity or cluster type, several studies demonstrate that lower level defensive functioning is related to clinician‐rated Axis II pathology severity as well as interpersonal difficulty, global distress and other domains of psychological functioning that are common features across cluster types (Granieri et al, 2017; Lowyck, Luyten, Verhaest, Vandeneede, & Vermote, 2013; Siefert et al, 2006; Strandholm, Kiviruusu, Karlsson, Miettunen, & Marttunen, 2016; Tabar, 2017; van Wijk‐Herbrink, Andrea, & Verheul, 2011).…”