title: 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.
authors.affiliation: *National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Helsinki; †Department of Child Psychiatry, Turku University Central Hospital; ‡Department of Psychiatry, University of Oulu, and Oulu University Hospital; and §Department of Adolescent Psychiatry, Helsinki University Central Hospital, Finland.
authors.forename: Thea
authors.initials: T
authors.lastname: Strandholm
authors.forename: Olli
authors.initials: O
authors.lastname: Kiviruusu
authors.forename: Linnea
authors.initials: L
authors.lastname: Karlsson
authors.forename: Jouko
authors.initials: J
authors.lastname: Miettunen
authors.forename: Mauri
authors.initials: M
authors.lastname: Marttunen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D003674:Defense Mechanisms; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D011237:Predictive Value of Tests; D055815:Young Adult