Personality and defense mechanisms in adolescents Rachão and Campos

Personality styles and defense mechanisms in a community sample of adolescents: An exploratory study Inês Rachão, MSc Rui C. Campos, PhD

This study aimed to test if the preference for using certain types of defense mechanisms, according to Ihilevich and Gleser’s (1969, 1986) perspective, is associated with personality styles, proposed by Millon (1993), and also, aimed to test if both constructs give a contribution to the identification of global types of psychological functioning in adolescents. Eight hundred and thirty adolescents, ranging in age from 14 to 19 years (M = 16.64, SD = 1.9) participated in the study. The Portuguese versions of the Defense Mechanisms Inventory for Adolescents and the Millon Adolescents Clinical Inventory were administered. Multiple linear regression analysis and principal component analysis were computed. Results demonstrate an association between defense mechanisms and personality styles and both constructs contribute to the identification of two types of psychological functioning in adolescents: an internalizing type and an externalizing type. (Bulletin of the Menninger Clinic, 79[1], 14–40)

Understanding personality and identifying its basic components has been the main goal of many authors throughout the history of psychology (e.g., Eysenck, 1950; Fruyt, Bolle, McCrae, Terracciano, & Costa, 2009; Jung 1921/1958). Personality can be considered as a complex pattern of stable psychological This article is based in part on the first author’s master thesis in clinical psychology under the supervision of the second author. Grateful thanks are extended to all of the participants in this study. Inês Rachão is a Master in Clinical Psychology in the Department of Psychology, University of Évora, Portugal. Rui C. Campos is an Assistant Professor in the Department of Psychology, and is a member of the Research Center in Education and Psychology (CIEP), University of Évora, Portugal. Correspondence may be sent to Rui C. Campos, Department of Psychology, University of Évora, Apartado 94, Évora, Portugal 7002–554; e-mail: [email protected] (Copyright (©) 2015 The Menninger Foundation)

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characteristics or traits that are expressed in different areas of human functioning (Hjelle & Ziegler, 1981; Millon & Davis, 1996; Phares, 1988; Schultz & Schultz, 2002). According to Millon (1993), clusters of personality traits can be understood on a continuum from normal personality styles to its more severe variants—personality disorders. Millon (1993) proposed 12 personality styles in adolescence, which are characterized by particular modes of inner functioning, expressed through various dimensions, including ego defense mechanisms. Several approaches to defense mechanisms have been proposed throughout history. Ihilevich and Gleser (1986) defined five types of defense mechanisms, characterized by a specific set of mental operations, emotional responses, and behaviors. According to the authors, these categories are distinct enough from each other and encompass most of the defense mechanisms classically identified in the psychoanalytic literature (Ihilevich & Gleser, 1986, 1994). Both personality traits and defense mechanisms have been considered central constructs in psychological functioning, although they are derived from different traditions of personality research and conceptualization (Hewitt & Flett, 1996; Mischel, 1981; Parker & Endler, 1996; Wiedeman, 1977). The purpose of this exploratory study is to test the relationship between personality styles according to Millon’s (1993) perspective and defense mechanisms according to Ihilevich and Gleser’s (1969, 1986) perspective, and also to test whether both constructs contribute to the identification of global types of psychological functioning in adolescents. Theodore Millon’s perspective about personality styles A major advance in the study of personality in recent years relates to the growing acceptance that the same traits that characterize “normal” personality functioning can also be determinants of psychopathology (Costa & McCrae, 2006). When personality traits are inflexible and maladaptive, according to cultural norms, and cause a significant clinical impairment in important areas of individual functioning or significant anxi-

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ety or distress, they can be considered pathological (American Psychiatric Association [APA], 2000; Jordan, 2004; Millon & Grossman, 2006; Strack, 1987). The theoretical model of Theodore Millon, developed in the late 1960s, accepted the previous proposition and is useful in the description and understanding of both normal personality and personality disorders (Millon & Grossman, 2006; Sánchez, 2003; Strack, 1987). According to this theoretical model, the concept of personality style involves a holistic organization of needs, motivations, characteristics, and defense mechanisms (Alchieri, Cervo, & Núñez, 2005; Millon & Davis, 1996). Millon (1993) proposed 12 prototypes or personality styles in adolescence: introversive, inhibited, doleful, submissive, dramatizing, egotistic, unruly, forceful, conforming, oppositional, selfdemeaning, and borderline. When traits that characterize each of these styles are rigid, inflexible, and dysfunctional regarding life context, they can be considered pathological. Research has shown that individuals with specific personality styles may have a preference for using specific defense mechanisms (e.g., Berman & McCann, 1995; Bornstein, 2006; Lingiardi et al., 1999; Millon, Grossman, Millon, Meagher, & Ramnath, 2004). Millon (Millon, 1993; Millon & Davis, 1996; Millon, Davis, & Millon, 2007) proposed a theoretical correspondence between specific defense mechanisms and particular personality styles in adolescents. Individuals with an introversive style would use intellectualization as a primary defense. These teens pay more attention to the formal and objective aspects of their experiences than to their personal and emotional aspects. For adolescents with an inhibited style, the proposed defenses are fantasy and repression. The main objective of these defensive maneuvers is to repress painful emotions and thoughts. The individual focus on irrelevant aspects of reality lessens the impact of these emotions and thoughts. The doleful style, in turn, is associated with what Millon and Davis (1996) refer to as asceticism. The main objective of teens with this style is to confirm their belief that they should experience suffering and be deprived of any pleasure in life. For the submissive style, the proposed defenses by Millon and Davis (1996) are introjection and denial.

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Feelings of inadequacy cause fears of loneliness and inner emptiness, fears that are controlled by internalization of beliefs and values of others. The dramatizing style is associated with the defenses of dissociation and repression. Being dependent and turned to the external world is a typical orientation in dramatic or histrionic teenagers who act to reach a positive evaluation from others. For the egotistic style, characteristic defenses are rationalization and fantasy. In adolescents with this personality style, it is common to see the expression of arrogance, haughtiness, and expansive behaviors. Adolescents with an unruly personality style use acting out and projection as defenses. Unlike the majority of the individuals with other personality styles, individuals with an unruly style do not repress impulses; instead they allow themselves to project and act out their impulses, regardless of their socially offensive nature. The forceful style is associated with the defenses of isolation and projection. These teens are cold and notably detached from any awareness of the impact of their destructive acts. For the conforming style, the proposed defenses are reaction formation and identification. Conformists use defense mechanisms to maintain control over their conflictual feelings, with the most typical defense being reaction formation. To transform their negative impulses, these teens use identification with the aggressor. The typical defense of the oppositional style is displacement. One of the distinctive features of individuals with an oppositional style is the paucity of intrapsychic mechanisms of control. These adolescents consistently use displacement in their tendency to transfer anger from real targets to less significant targets in a precipitated and unconscious way. Exaggeration is the typical defense used by individuals with a self-demeaning style (Millon & Davis, 1996). In fact, excessive exposure to pain seems to decrease its impact. Finally, individuals with a borderline tendency use regression as the main defense. These teens tend to regress to earlier developmental stages under stressful conditions. The inability to cope with demands and conflicts is notorious, especially in their immature behavior.

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Ihilevich and Gleser’s perspective about defense mechanisms According to Ihilevich and Gleser (1986), perspective defense mechanisms are relatively stable response dispositions that unconsciously distort reality to solve internal conflicts and cope with external threats, whenever individuals cannot do it through the use of their personal resources, skills, or motivations. In their model, the authors consider defense mechanisms as adaptive maneuvers, insofar as they are used flexibly. However, when these defensive responses are rigid, excessive, or inadequate, they can lead to or be related to psychopathology. Thus, what characterizes psychopathology is not the type of defenses used, but instead, their rigidity and the extent to which they distort reality (Ihilevich & Gleser, 1986). Ihilevich and Gleser (1986) defined five types or categories of defense mechanisms: Turning Against Object (TAO), Projection (PRO), Principalization (PRN), Turning Against Self (TAS), and Reversal (REV). Each type is characterized by a specific set of mental operations, emotional responses, and behaviors (Ihilevich & Gleser, 1986, 1994; Juni, 1999). TAO involves the direct or indirect expression of aggression in order to maintain an illusion of control of external threats or to mask internal conflicts. PRO involves the attribution of negative intent or negative characteristics of self to others. This attribution serves to justify the expression of hostility toward others. This category includes defenses such as projection and externalization. PRN describes mechanisms that deal with conflicts through a reinterpretation of reality and using a process of separation of affective content from events. In order to alleviate anxiety, the ego triggers abstract and general responses, which by a reinterpretation of reality transform threats into emotionally neutral experiences. This category includes classic defenses such as intellectualization, rationalization, and isolation. TAS is characterized by a tendency of the individual to resolve psychological conflicts by turning behaviors, feelings, and aggressive fantasies against the self. This type of defense includes intrapunitive maneuvers. Fi-

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nally, REV is related to the tendency to respond positively or neutrally to unpleasant situations that were supposed to produce a negative reaction, creating an illusion of control over this unpleasant reality and decreasing anxiety. Defenses such as denial, repression, and reaction formation can be included in this category (Cramer, 1988; Ihilevich & Gleser, 1986, 1994; Juni, 1999). Ihilevich and Gleser (1986) conceptualize defense mechanisms differently from Millon and Davis (1996) when describing personality styles, and also differently from other authors (e.g., Freud, 1936/1972; Vaillant, 1971, 1977, 1992). The main difference is that Ihilevich and Gleser (1986) propose global categories of defense mechanisms (see Campos, Besser, & Blatt, 2011). Personality styles and defense mechanisms Several studies have tested the relation between personality styles or disorders and defense mechanisms. Lingiardi et al. (1999) used the Structural Clinical Diagnostic Interview-II (First, Spitzer, Gibbon, Williams, & Benjamin, 1994) to assess personality psychopathology and the Defense Mechanisms Rating Scale (Perry, 1991) to assess defensive style in a sample of 50 psychiatric patients. Antisocial disorder was related to the defenses of intellectualization, projection, and acting out; avoidant disorder was related to self-absorption and reaction formation; borderline and narcissistic disorders were related to acting-out defenses; and dependent disorder was related to self-assertion. Histrionic disorder was related to the defense mechanisms of affiliation, splitting, omnipotence, acting out, and idealization; obsessive-compulsive disorder was associated with mood and devaluation. Berman and McCann (1995) studied the relation between personality disorders and defense mechanisms using the Millon Clinical Multiaxial Inventory II (MCMI-II; Millon, 1987) and the Defense Mechanisms Inventory (DMI; Ihilevich & Gleser, 1986) in a sample of 130 adult psychiatric patients. The results revealed significant relations between personality patterns as-

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sessed by the MCMI-II and defense mechanisms assessed by the DMI. The antisocial pattern was associated with high levels of TAO and PRO and low levels of PRN; the borderline pattern was associated with high levels of TAS and low levels of PRN and REV; the histrionic and narcissistic patterns were associated with high levels of TAO and low levels of TAS; the compulsive pattern was associated with high levels of PRN and REV and low levels of TAO; the schizoid pattern was associated with high levels of TAS; the avoidant pattern was associated with high levels of TAS and low levels of PRN; the aggressive-sadistic pattern was associated with high levels of TAO and low levels of PRN and REV; the self-defeating pattern was associated with high levels of TAS and low levels of PRN; the paranoid pattern was associated with high levels of PRO and low levels of PRN; the dependent pattern was associated with high levels of TAS and REV and low levels of TAO; and the schizotypal pattern was associated with high levels of PRO and TAS and low levels of PRN and REV. Sinha and Watson (1999) used the Defense Style Questionnaire (DSQ-40) to assess defense styles (mature, immature, neurotic), with the aim of predicting the 11 personality disorders proposed in the DSM-III-R, in a nonclinical sample of 300 university students. Results demonstrated that immature defenses (e.g., projection, acting out, denial, displacement, fantasy) were positively associated with the avoidant, antisocial, passive-aggressive, borderline, paranoid, dependent, narcissistic, obsessive-compulsive, and schizotypal disorders. Neurotic defenses (e.g., idealization, reaction formation) were positively associated with dependent personality disorder, and mature defenses (e.g., sublimation, humor, anticipation) were negatively associated with borderline, passive-aggressive, and dependent personality disorders. Muris, Winands, and Horselenberg (2003) studied the relationship between defensive styles (immature, neurotic, and mature), personality traits (neuroticism, extraversion, and psychoticism) and psychopathological symptoms in a nonclinical sample of 437 adolescents. Results demonstrated a significant relation between personality traits of neuroticism and psychoti-

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cism and neurotic and immature defenses. The authors also found a small but still positive significant correlation between extraversion and mature defenses. Aim of the present study and predictions The present exploratory study aims to test if the preference for certain types of defense mechanisms, according to the perspective of Ihilevich and Gleser (1986), characterizes personality styles in adolescents, according to Millon’s (1993) perspective. To the best of our knowledge, no study has tested this relation in adolescents. According to Ihilevich and Gleser (1986) and on the basis of other studies (e.g., Berman & McCann, 1995; Campos, Besser, & Blatt, 2011; Freud, 1936/1972; Millon & Davis, 1996; Noam & Recklitis, 1990; Vaillant, 1992), we can match defenses used by Millon and Davis (1996) in their theoretical description of personality styles with the five types of defenses proposed by Ihilevich and Gleser (1986). Acting out, regression, identification, and displacement can be included in TAO; fantasy, denial, reaction formation, and dissociation can be included in REV; introjection, exaggeration, and asceticism can be included in TAS; intellectualization, rationalization, and isolation can be included in PRN; and projection can be included in PRO. Thus, we expect the introversive style to be related to PRN (intellectualization); the inhibited style to be related to REV (fantasy); the doleful style to TAS (asceticism); the submissive style to TAS (introjection) and REV (denial); the dramatizing style to REV (dissociation and repression); the egotistic style to PRN (rationalization) and REV (fantasy); the unruly style to TAO (acting out) and PRO (projection); the forceful style to PRN (affective isolation) and PRO (projection); the conforming style to REV (reaction formation) and TAO (identification with the aggressor); the oppositional style to TAO (displacement); the self-demeaning style to TAS (exaggeration); and the borderline style to TAO (regression).

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This study will also examine whether both personality styles and defense mechanisms contribute to the identification of more global types of psychological function in adolescents. Principal component analysis will be used. Although some studies (Adkisson, Burdsal, Dorr, & Morgan, 2012; Romm, Bockian, & Harvey, 1999; Salekin, 2002) have factor analyzed scales of personality patterns of the Millon Adolescents Clinical Inventory (Millon, 1993), to the best of our knowledge, only the study of Berman and McCann (1995) has factor analyzed together the Defense Mechanisms Inventory scales (Ihilevich & Gleser, 1986) and the personality patterns scales of the Millon Multiaxial Clinical Inventory (Millon, 1987), although in a sample of adults. Method Participants and procedures A convenience sample of 830 high school students living in the region of Setúbal, Portugal, (60.5% females) and ranging in age from 14 to 19 years (M = 16.64, SD = 1.091) participated in the study. The majority of participants were Caucasian (> 95%). The initial sample comprised 879 participants, but 49 were excluded due to incorrect completion of at least one of the questionnaires. Missing values were treated using the statistical procedure of replace by mean. Data were collected in several high schools in the Setúbal region. Prior to data collection, authorization from school directors was obtained. Parents of students under 18 years of age signed an informed consent form. Protocols were collected in groups of 15 to 30 participants during class time. Participants were given a brief explanation about the study and then responded to the questionnaires. They were informed that the study was about adolescent personality. Participation was voluntary and anonymous. The guidelines of the Portuguese Psychologists Board were followed. Participants were allowed to discontinue their participation at any time.

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Measures Millon Adolescent Clinical Inventory (MACI). The MACI (Millon, 1993) is a 160-item inventory developed to assess clinical symptoms and personality traits in adolescents (McCann, 2008). This inventory of true-false responses obtains results for 31 scales (27 clinical scales and 4 validity indices). Scales are organized in three major areas: personality patterns, expressed concerns, and clinical syndromes. Scales of personality patterns were developed to operationalize personality styles proposed by Millon (1993; see also Millon, Green, & Meagher, 1982; Stefurak & Calhoun, 2007; Vinet, Faúndez, & Larraguibel, 2009). The psychometric properties of the inventory are adequate and are presented in the manual (Millon, 1993). The MACI was adapted for the Portuguese population by Cavaco (2004). The psychometric properties of the Portuguese version are satisfactory, with Cronbach’s alphas ranging between .70 and .80 (Cavaco, 2004). Defense Mechanisms Inventory–Youth (DMI-Y). The DMI-Y (Ihilevich & Gleser, 1986) is a multiple-choice self-report instrument developed to assess defense mechanisms. This instrument is composed of 10 brief vignettes describing conflict situations of everyday life. Each vignette has five response options (one for each of the five types of defense mechanisms operationalized by the inventory). For each vignette, respondents are asked to choose the option that most closely reflects what they would do and the option that less reflects what they would do in four areas: (a) real behavior, (b) in fantasy, (c) thinking, and (d) feeling. The DMI-Y obtains results for five scales related to the five types of defenses proposed by Ihilevich and Gleser (1986): Reversal (REV), Principalization (PRN), Projection (PRO), Turning Against Object (TAO), and Turning Against Self (TAS). The DMI-Y was adapted for the Portuguese population by Justo, Silva, Neves, and Frade (2011). The Portuguese version of the DMI presents acceptable psychometric properties, with Cronbach’s alphas ranging between .71 and .86 for the five scales.

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Data analytic strategy To examine the association between defense mechanisms of TAO, TAS, PRO, PRN, and REV and personality styles (introversive, inhibited, doleful, dramatizing, egotistic, unruly, forceful, conforming, submissive, oppositional, self-demeaning, and borderline in adolescents), a series of multiple linear regression analyses were computed. In each analysis, we entered each of the personality styles as the dependent variable and the five types of defense mechanisms as the independent variables. Because of the exploratory nature of the study (Field, 2005), a stepwise forward method was used to select independent variables to the models, enabling the software to define “the best models,” selecting the best set of predictors from the initial pool of five variables. In the first step of regression analysis, the forward method enters the independent variable that presents the highest correlation with the dependent variable. The next variables to enter, one at each step, are those with the highest correlations with the dependent variable after controlling for the shared variance with the independent variables previously entered. We examined the multicollinearity between variables. Eigenvalues of the cross-products matrix, condition indexes along with variance inflation factors (VIF), and tolerances from multicollinearity analyses indicated the absence of any multicollinearity. We also examined the normality of residuals using the Kolmogorov-Smirnov Z test. The results indicated that the distributions of residuals from the regression analyses were normal. In order to identify more global types of inner psychological functioning, principal component analysis was used, entering the 12 MACI scales of personality patterns and the five DMI scales of defense mechanisms. Prior to the analysis, the adequacy of the data was verified through Kaiser-Meyer-Oklin (KMO) and Bartlett’s test of Sphericity. The obtained values (KMO .658 > .6; Bartlett .000, p < .05) confirmed the adequacy of the data to the principal component analysis. The Kaiser criterion was used to choose the number of components to retain (eigenvalues > 1). According to this criterion, three components should be retained. To confirm the number of components, we computed

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Personality and defense mechanisms in adolescents Table 1. Means, Standard Deviations, Minimum and Maximum Ranges of the Study Variables Variable Defense Mechanisms TAO PRO PRN TAS REV Personality Styles Introversive Inhibited Doleful Submissive Dramatizing Egotistic Unruly Forceful Conforming Oppositional Self-demeaning Borderline

M

SD

Minimum

Maximum

38.95 40.41 47.19 35.15 38.35

9.44 5.86 6.28 6.39 8.01

9 21 30 14 18

70 61 63 59 62

21.76 19.71 13.58 50.08 38.26 33.85 27.46 10.63 46.91 22.52 22.03 12.96

9.26 10.98 9.50 10.14 9.87 10.11 11.16 7.47 8.89 9.74 13.80 7.22

3 1 0 16 1 5 2 0 16 3 0 0

65 64 47 79 57 59 61 38 64 60 62 38

Note. TAO = Turning Against Others; PRO = Projection; PRN = Principalization; TAS = Turning Against Self; REV = Reversal.

a parallel analysis using the Monte Carlo principal component analysis statistical simulation procedure (Watkins, 2000). This analysis confirmed the existence of three components. Prior to interpretation, components were rotated through varimax rotation. Results Table 1 presents descriptive statistics for the study variables. Multiple linear regression analysis Table 2 presents the final models of multiple linear regression analyses. In the prediction of introversive style, the final model was obtained after one step and is statistically significant (F = 106.77, p < .001, R² = .114). The defense mechanism of TAS was related to the introversive style (β = .338, p < .001). In the prediction of inhibited style, the final model was obtained after

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Unruly

Egotistic

Dramatizing

Submissive

Doleful

Inhibited

Introversive

TAO TAS

TAS

TAS

TAO TAS

TAS REV PRN

TAS PRO

TAS

Defense Mechanisms

.241 −.356

−.582

−.558

−.299 .397

.411 −.143 −.109

.677 .146

.490

B

.204 −.204

−.368

−.362

−.279 .250

.276 −.121 −.072

.394 .078

.338

β

4.15 −5.42

−11.40

−11.16

−8.30 7.44

8.39 −3.38 −2.02

11.51 2.27

10.33

t

.000 .000

.000

.000

.000 .000

.000 .001 .043

.000 .023

.000

p

.423 .719

1.00

1.00

.867 .867

.994 .847 .848

.887 .887

1.00

Tol.

2.36 1.39

1.00

1.00

1.15 1.15

1.00 1.18 1.17

1.12 1.12

1.00

VIF

Table 2. Final Models of Multiple Linear Regression Analysis

.402

.368

.362

.437

.332

.375

.338

R

.161

.136

.131

.191

.110

.141

.114

R²

52.98

130.02

124.66

97.85

34.06

67.74

106.77

F

.000

.000

.000

.000

.000

.000

.000

p

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PRN

.878 .183 .201

−.274 −.213

−.255 .184

.343 .175 .116

−.231

REV TAS

TAS TAO PRO

PRN REV

TAO PRN

TAO PRO REV

PRN

−.131

−.144 .180

.407 .126 .085

−.177 −.176

−.271 .130

.433 .137 .125

−.130

−3.62

−3.99 5.40

11.45 3.38 2.32

−4.91 −4.87

−6.41 3.07

9.87 3.53 2.56

−2.84

.000

.000 .000

.000 .001 .020

.000 .000

.000 .002

.000 .000 .010

.005

.848

.847 .994

.828 .758 .775

.849 .849

.586 .586

.516 .658 .420

.486

1.17

1.18 1.00

1.20 1.32 1.29

1.17 1.17

1.70 1.70

1.93 1.51 2.38

2.05

.302

.370

.294

.368

.423

.091

.137

.086

.136

.179

27.64

43.80

39.12

64.87

59.89

.000

.000

.000

.000

.000

Note. TAO = Turning Against Others; PRO = Projection; PRN = Principalization; TAS = Turning Against Self; REV = Reversal; Tol. = Tolerance; VIF = Variance inflation factors.

Borderline

Self-demeaning

Oppositional

Conforming

Forceful

Personality and defense mechanisms in adolescents

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two steps and is statistically significant (F = 67.74, p < .001, R² = .141). The defense mechanisms of TAS (β = .394, p < .001) and PRO (β = .078, p < .05) were related to the inhibited style. In the prediction of doleful style, the final model was obtained after three steps and is significant (F = 34.06, p < .001, R² = .110). The mechanisms of TAS (β = .276, p < .001), REV (β = .121, p < .001), and PRN (β = −.072, p < .05) were related to the doleful style. For the submissive style, the final regression model was obtained after two steps and is statistically significant (F = 97.85, p < .001, R2 = .191). The TAO (β = −.279, p < .001) and TAS (β = .250, p < .001) mechanisms were related to the submissive style. In the prediction of dramatizing and egotistic style, the final models were obtained after one step. In the prediction of dramatizing style (F = 124.66, p < .001, R2 = .131) and egotistic style (F = 130.02, p < .001, R2 = .136), the final models were significant. The TAS mechanism was related to the dramatizing (β = −.362, p < .001) and egocentric (β = −.368, p < .001) styles. In the prediction of unruly style, the final model was obtained after three steps and is statistically significant (F = 52.98, p < .001, R² = .161). The mechanisms of TAO (β = .204, p < .001), TAS (β = –.204, p < .001), and PRN (β = −.130, p < .05) were related to the unruly style. In the prediction of forceful style, the final model was obtained after three steps and is statistically significant (F = 59.89, p < .001, R² = .179). The TAO (β = .433, p < .001), PRO (β = .137, p < .001), and REV (β = .125, p < .05) mechanisms were related to the forceful style. In the analysis to predict the conforming style, the final model was obtained after two steps and is statistically significant (F = 64.87, p < .001, R² = .136). The mechanisms of TAO (β = −.271, p < .001) and PRN (β = .130, p < .05) were related to the conforming style. In the prediction of oppositional style, the final model was obtained after two steps and is significant (F = 39.12, p < .001, R² = .086). PRN (β = −.177, p < .001) and REV (β = −.176, p < .001) mechanisms were related to the oppositional style. In the prediction of self-demeaning style, the final model was obtained after three steps and is statistically significant (F = 43.80, p < .001, R² = .137). The TAS (β = .407, p < .001), TAO (β = .126, p < .001), and PRO (β = .085, p < .05) defense

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Personality and defense mechanisms in adolescents Table 3. Principal Component Analyses: Rotated Component Matrix Components Variables Inhibited Dramatizing Introversive Self-demeaning Egotistic Doleful Borderline Unruly Forceful Conforming Oppositional Submissive TAS TAO REV PRO PRN % Variance

I .919 −.896 .883 .860 −.859 .845 .675 −.275 −.119 −.201 .431 .530 .480 −.119 −.099 −.103 −.153 34.97

II −.085 .190 .106 .367 .233 .331 .566 .871 .869 −.852 .795 −.642 −.169 .244 −.101 .101 −.085 24.04

III .051 −.012 −.002 .040 .025 .057 .085 .164 .221 −.197 .135 −.200 −.191 .836 −.816 .776 −.746 16.17

Note. TAO = Turning Against Others; PRO = Projection; PRN = Principalization; TAS = Turning Against Self; REV = Reversal. For the purpose of interpretation, we considered loadings values above .45 as significant (Tabachnick & Fidell, 2007). These values are highlighted in bold in the table.

mechanisms were related to self-demeaning style. Finally, in the prediction of borderline style, the final model was obtained after three steps and is statistically significant (F = 27.64, p < .001, R² = .091). The REV (β = −.144, p < .001), TAS (β =. 180, p < .001), and PRN (β = −.131, p < .05) mechanisms were related to the borderline style. Principal component analysis -- presents loadings of each variable in the three components obtained in the principal component analysis. Loading values above .45 were considered significant (see Tabachnick & Fidell, 2007). The variables with the highest loadings on the first component were inhibited (.919), introversive (.883), self-demeaning (.860), and doleful (.845) with positive loading values and dramatizing (−.896) and egotistic (−.859) with negative loading values. Regarding defense mechanisms, only TAS (.480) presented a moderate loading value on the first component. Vari-

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ables with the highest loadings on the second component were unruly (.871), forceful (.869), and oppositional (.795) with positive loading values and conforming (−.852) and submissive (−.642) with negative loading values. No defense mechanism loaded on this component. Only defense mechanisms loaded in the third component, with TAO (.836) and PRO (.776) presenting positive loading values and REV (−.816) and PRN (−.746) with negative values. The submissive and borderline styles present significant loadings on Components I and II. The submissive style presents a positive loading on Component I and a negative loading on Component II, and the borderline style presents a positive loading on both components. Discussion The present study aimed to test if the preference in adolescents for certain types of defense mechanisms according to the perspective of Ihilevich and Gleser (1986) could be associated with personality styles according to the perspective of Millon (1993). As a second goal, the study intended to identify more global types of inner psychological functioning based on the two constructs of personality styles and defense mechanisms. Results support some of the predictions, in particular the association between doleful, submissive, and self-demeaning styles and TAS, between the unruly style and TAO, and between the forceful style and PRO. However, the doleful style also related negatively to REV and PRN, the unruly style negatively related to TAS and PRN (and not with PRO), and the forceful style also related to TAO and REV (and not with PRN). Some of the results obtained were not in accordance with predictions. The inhibited style related to both TAS and PRO. This finding is, in part, in accordance with results reported by Berman and McCann (1995) with adult psychiatric patients. This result can be understood in the light of Millon’s (1993) definition of this personality style, which is related to the tendency to experience guilt and to withdraw from interpersonal relationships (Berman & McCann, 1995). However, according to the present results, this guilt may also be projected onto others. According 30

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to the present results, the introversive style is associated with TAS, and this result also accords well with results reported by Berman and McCann (1995). This style in adolescents is similar to schizoid style in adulthood and implies some inability to feel or express emotions and to establish interpersonal relationships (Esterberg, Goulding, & Walker, 2010; Millon & Davis, 1996). This withdrawal from relationships with others and the consequent investment in oneself may explain the positive relation of the style with TAS. Regarding the submissive style, the prediction of a significant relation with REV was not confirmed. Instead, results demonstrated a negative relation between this style and TAO. This negative relation can be explained by the continuous avoidance of confrontation with others, a maneuver that is typical of individuals with this style (Brewer, 2003). The dramatizing and egotistic styles presented a negative relation with TAS. A similar result was obtained by Berman and McCann (1995). Dramatizing or histrionic individuals tend to blame others for their failures and disappointments (Blais, Smallwood, Groves, & Rivas-Vazquez, 2008), which may explain the negative relation with TAS. Egotistic or narcissistic teens, in turn, are extremely self-centered and have an excessive confidence in themselves (L. Cooper, Balsis, & Oltmanns, 2012), which leads them to easily ignore their flaws (Millon & Davis, 1996), in contrast to individuals who use TAS as their main defensive maneuver. Results also showed a positive relation between the conforming style and PRN and a negative relation between the conforming style and TAO, with the latter relation being in the opposite direction of what was predicted. The use of PRN can be justified by the use of isolation and neutralization of emotions to avoid embarrassment following stressful situations, which is a characteristic of this style. However, some studies show a high interpersonal ambivalence in individuals with this style, which is equivalent to the obsessive-compulsive style in adults (Moritz, Kempke, Luyten, Randjbar, & Jelinek, 2011; Moritz, Niemeyer, Hottenrott, Schilling, & Spitzer, 2013). According to Moritz et al. (2013), obsessive/conforming individuals tend to exhibit prosocial attitudes and latent aggression. Their exagger-

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ated concern with others seems to serve, in part, the purpose of a defense against negative interpersonal feelings. This may explain, in turn, the negative relation between the conforming style and TAO. Oppositional style negatively related with PRN and REV. One of the features that distinguishes the negativistic or oppositional style from the other personality styles is the paucity of defense mechanisms and intrapsychic control (Millon & Davis, 1996). This paucity may explain why the only significant relations with defense mechanisms are negative relations. Furthermore, it seems to be typical of individuals with this style to passively express aggression (Hopwood et al., 2009). For the self-demeaning style, results showed a significant relation with TAS, TAO, and PRO. This result can be explained by the presence of provocative behaviors in these individuals, which have the function of inducing aggressive behaviors in others, so that the individual justifies his or her feelings of injury and humiliation caused by others (A. Cooper, 1993). In addition, some authors argue that aggression directed to others and aggression directed to the self tend to coexist in many personality disturbed individuals (Campos, 2012; Matos, 2001). For the borderline style, results showed a positive relation with TAS and negative relations with REV and PRN. This same result was obtained in the study by Berman and McCann (1995). The use of TAS may be related to self-censured behaviors, feelings of excessive guilt, and low self-esteem. The negative relation with PRN and REV, in turn, can be justified by some impulsivity and affective deregulation (Zanarini, Weingeroff, & Frankenburg, 2009), and a tendency to a labile and reactive mood (Biskin & Paris, 2012) that is typical of this style. Results obtained in principal component analysis indicated the existence of two components that can be related to internalizing and externalizing psychological dimensions. Results also showed the existence of a third component with significant loadings of only defense mechanisms. Personality styles with significant positive loadings on Component I were the inhibited, the introversive, the self-demeaning, and the doleful. The dramatizing and the egotistic styles presented negative loadings on Component I. The only defense with a significant loading on

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this component was TAS. This component is consistent with a psychological dimension of internalization. The unruly, forceful, and oppositional styles present significant positive loadings on Component II, and conforming and submissive styles present negative loadings. Component II is consistent with a psychological dimension of externalization. Aggressive behavior is characteristic of styles with positive loadings on this Component III and is absent in styles with negative loadings (Achenbach, 1991; Millon & Davis, 1996; Salekin, 2002). The submissive and borderline styles present significant loadings on both components. The result regarding the submissive style accords well with the result obtained in our multiple linear regression analysis, in which the submissive style was positively related to TAS but was also negatively related to TAO. According to the DSM-IV-TR, individuals with borderline personality disorder tend to present instability in their interpersonal relationships, mood, and self-image (APA, 2000). These traits may, in fact, manifest in both internalizing and externalizing behaviors (Salekin, 2002). Results also demonstrated that except for TAS, defense mechanism did not load on Component I or II, loading instead on Component III. This result seems to indicate the presence of variance related to the type of assessment method, a situation also found in the study by Berman and McCann (1995). The MACI (Millon, 1993) has a true-false response format, and the DMI (Ihilevich & Gleser, 1986) has a multiple-choice and ipsative response scale. Limitations and clinical implications The present study presents several limitations. Results were obtained with a community sample in a cross-sectional design with only self-report measures. It would be important to replicate the present results in future studies with clinical samples, with longitudinal designs, and using other types of measures, including other informants’ reports. In these studies, it would also be useful to consider other variables that could enhance the understanding of personality styles in adolescents, such as object relations and ego strength (Bornstein, 1993, 2006).

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However, the assessment of dysfunctional personality traits is an important task in clinical practice with adolescents, even in individuals without a formal diagnosis of personality disorder (see Vinet & Santacana, 2006), because the personality styles conceptualized by Millon, and assessed in this study can be conceptualized on a continuum from normality to severe pathology. Some studies have estimated that the prevalence of personality disorder according to the DSM (APA, 2000) in the general population can vary from 6.5% to 13.4% (Jackson & Burgess, 2000; Samuels et al., 2002; Torgersen, Kringlen, & Cramer, 2001). Furthermore, it appears that there is some resistance among mental health professionals to diagnose personality disorders in adolescents, which may compromise the implementation of appropriate therapeutic interventions for this age group (Laurenssen, Hutsebaut, Feenstra, Van Busschbach, & Luyten, 2013). Thus, studies about dysfunctional personality patterns in nonclinical samples of adolescents can and should be performed simultaneously with studies (and with clinical work) with individuals with a diagnosis of personality disorder (Shiner, 2005, 2009). Despite its limitations, this study has implications for clinical practice because the results reinforce the need to assess defensive style to better understand personality functioning. Like the results of other studies (e.g., Berman & McCann, 1995; Muris et al., 2003; Sinha & Watson, 1999), the present results reinforce the association between defense mechanisms and personality styles. To character mental functioning in adolescents, not only personality traits but also defense mechanisms should be considered and assessed. Traits are essential constructs for the study of personality and individual differences (Lima & Simões, 1995); they are explanatory entities and not merely a way of describing inter-individual differences. Moreover, defense mechanisms can be a valuable diagnostic axis in the assessment and understanding of psychopathology (Vaillant, 1994).

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