title: A 50-year longitudinal study of defense use among inner city men: a validation of the DSM-IV defense axis.
abstract: The patterns of use of defense mechanisms by 306 inner-city men were rated from interviews at age 47 and these ratings were analyzed by cluster analysis. Five clusters resulted. The correlates of cluster membership were examined using data from the 50-year longitudinal study of these men. One cluster exhibited the greatest use of mature defenses; the men in this cluster functioned best on all psychosocial and health variables. Two clusters of men used primarily neurotic defenses; these men functioned at an intermediate level on all outcomes. The men in two clusters primarily used immature defenses. The men in one of these clusters used primarily action defenses, whereas the men in the other cluster were the greatest users of projection and fantasy. In general, the men in both these clusters functioned worse than those in the other three. However, the users of action defenses exhibited greater sociopathy, alcohol problems, and marital instability. The findings provide general support for the DSM-IV hierarchy for nonpsychotic defenses, with mature defenses at the top, neurotic defenses in the middle, and action defenses toward the bottom. In particular, the study supports the DSM-IV distinction of action defenses from other immature defenses.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: S
authors.initials: S
authors.lastname: Soldz
authors.forename: G E
authors.initials: GE
authors.lastname: Vaillant
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D016000:Cluster Analysis; D003674:Defense Mechanisms; D005201:Fantasy; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008571:Men / Q000523:psychology*; D008875:Middle Aged; D011385:Projection; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012907:Smoking / Q000453:epidemiology; D012917:Social Adjustment; D012923:Social Class; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D009626:Terminology as Topic; D014505:Urban Population / Q000706:statistics & numerical data*