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Normal Adolescents
Sarah Erickson, PhD
S. Shirley Feldman, PhD
Hans Steiner, MD
Stanford University
ABSTRACT: In exploring the relationship between defense reactions and coping strate-
gies in a non-clinic sample of adolescents (N —81), we assessed: defense structure by
the Bond Defense Style Questionnaire (DSQ); coping behaviors by the Coping Re-
sponses Inventory-Youth Form (CRI-Youth); and general adjustment by Global Assess-
ment of Functioning (GAF) ratings. Defense reactions and coping strategies were mod-
estly associated and made independent contributions in predicting the GAF. Mature
and immature defenses and avoidance coping comprised the optimal combination in
predicting the GAF, accounting for 20% of GAF variance. It is therefore important to
assess both unconscious and conscious processes when assessing general functioning in
normal adolescents.
KEY WORDS: Defense Reactions; Coping Strategies; Adjustment; Adolescents.
Method
Subjects
As part of a larger study of adaptive style, a non-clinic sample of conveni-
ence was obtained from two local suburban high schools (for details of sample
selection and description, see Steiner & Feldman9). Potential subjects were
offered a soft drink if they completed demographic data and two screening
instruments. Because they were underrepresented in initial distributions,
special effort was undertaken to recruit minority students. Research staff
telephoned parents of interested subjects and obtained parental consent. The
sample that completed the protocol (N =81) was representative of the high
school population in terms of sex (54% male), age (mean age = 16.4, s.d. =
1.4 years, range = 12.0-19.0), race (predominantly Caucasian), and socio-
economic status (predominantly middle class).
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 49
Instruments
Defense Style Questionnaire (DSQ-78). The DSQ-78 is a 78-item modifica-
tion of Bond's Defense Style Questionnaire originally designed for use with
adults." The final instrument, the DSQ, contained 59 items assessing 19 de-
fense mechanisms: projection, passive aggressiveness, somatization, denial,
regression, undoing, inhibition, splitting, acting out, fantasy, repression,
withdrawal, anticipation, affiliation, humor, sublimation, suppression, reac-
tion formation and altruism. Subjects completed the DSQ by rating each item
on a 9 point scale ranging from strongly disagree to strongly agree. Alpha
coefficients, calculated separately for each defense, were generally quite mod-
est across four comparison groups. The items, scales, and their psychometric
properties are described in an earlier paper.2 Test-retest stabilities of the 19
defenses over 6 to 12 months for a sample of 68 nonclinic adolescents yielded
a mean correlation of .53.
A Principal Component Analysis (PCA) with quartiinax rotations on the 19
defense mechanism scores of the entire sample of adolescents yielded three
stable and interpretable factors with eigen values greater than 1 and with
Kaiser sampling adequacy reaching acceptable limits. These factors included:
Immature Defenses, consisting of 12 defense mechanisms including proj-
ection, denial, regression, somatization, and repression, among others; Ma-
ture Defenses, consisting of five defense scores—suppression, humor, affilia-
tion, sublimation, and anticipation; and Prosocial Defenses consisting of two
scores—altruism and reaction formation. Test-retest stabilities over a 6-12
month interval for the three composites exceeded .55.2
Coping Response Inventory-Youth Form (CRI-Youth). The CRI-Youth as-
sesses coping processes in response to stressful life circumstances in adoles-
cents 12 to 18 years old.10 The eight coping subscales represent eight types of
coping strategies representing two superordinate processes: approach and
avoidance. Respondents are asked to identify a recent stressful episode and
rate their reliance on each of the 48 coping items using a four point scale
(from "not at all" to "fairly often"). Each of the eight scales includes six items
and scale scores can vary from a low of 0 to a high of 18. The psychometric
properties of the eight scales (logical analysis, positive reappraisal, seeking
guidance and support, problem solving, cognitive avoidance, acceptance/resig-
nation, seeking alternative rewards, and emotional discharge) and the com-
posites that they comprise are described by Moos.10
Similar to Moos'10 findings among CRI-Youth subscales, we found substan-
tial positive intercorrelations among the two coping composite factors and the
eight subscales. In fact, the superordinate coping composites, Approach and
Avoidance, correlated at .36 (p<.001) and 11 of 28 intercorrelations among
the eight subscales demonstrated substantial positive relationships (p<-05).
Like Moos, we believe these intercorrelations demonstrate that adolescents
who rely on one type of approach coping also use other types of approach
coping, and are also more likely to employ avoidance coping. In short, employ-
ing one type of coping, whether approach or avoidance, lends itself to employ-
ing other types of coping.
The CRI-Youth is conceptually comparable to the Coping Responses Inven-
50 Child Psychiatry and Human Development
Results
In order to determine the relationship between defense reactions
and coping strategies, and their unique contributions in predicting
adjustment in normal adolescents, two types of analyses were per-
formed. First, the three defense composites (Mature, Prosocial, and
Immature) were correlated with the two coping composites (Approach
and Avoidance) and the significant associations were then disaggre-
gated. Second, regressions were employed to determine the relative
contribution of defense reactions and coping responses in predicting
adjustment. Because differences between males and females in mean
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 51
1 Because males (mean age=16.9, s.rf. = 1.5) were significantly older than females
(mean age 15.9, s.d. = 1.2) (t= 1.43, df=42,361p<.01), we employed age as a covariate to
assess whether relationships between defense reactions, coping responses, and general
adjustment were partly explained as a function of age. Because controlling for age did
not alter the results, the following analyses do not include age as a covariate.
52 Child Psychiatry and Human Development
Discussion
demonstrates that females are more mature than males at this age,13
even taking into account the older age of males in this sample. This
difference in maturity level may lead to reporting style differences
wherein males' self-report of stress and conflict management is con-
sistent, hence the overlap, yet relatively unrelated to an objective per-
ception of their functioning. Because males are less mature, there
is less differentiation between defense mechanims and coping re-
sponses: immaturity drives males to employ more "defensive" coping
so that when stressed, males' planful actions are similar to their de-
fensive maneuvers.
In contrast, a smaller degree of overlap between defense mecha-
nisms and coping strategies in females suggests that females employ
more diverse strategies, both conscious and unconscious, to manage
conflict and are able to report their functioning more adequately.
These two processes of coping and defending tend to diverge as a
function of maturity and age,2 and females' greater maturity thereby
allows the two systems, in combination, to predict general adjusment.
These results suggest that a cautious interpretation of self-report
results is particularly important for males, especially when they are
asked about such sensitive and emotionally-laden matters as how
they manage stress and conflict. In addition, it is possible that what
males report is accurate in terms of their objective functioning, but
raters, all female in this study, are influenced more by gender than
by general adjustment. Or perhaps males' adjustment is obscured by
their reticence to disclose information to a female interviewer who
therefore doer, not have enough information to make accurate assess-
ments. In fact, these results indicate that a longitudinal study of gen-
der-specific defense and coping development is warranted.
Summary
References
1. Lazarus r, Folkman, S: Stress, appraisal, and coping. New York: Springer Publish-
ing Company, 1984.
2. Feldman S, Araujo K, Steiner H: Defense mechanisms in adolescents as a function
of age, sex, and mental health status. In print.
3. Vaillant G: Adaptation to life. Canada: Little, Brown & Co., 1977.
4. Steiner, H: Defense styles in eating disorders. Int J Eating Disord 9: 141-151,
1990.
5. Bond M, Gardner S, Christian J, Sigal C: Empirical study of self-related defense
styles. Arch Gen Psychiatry 40:333-338, 1983.
6. Andrews G, Pollock C, Stewart G: The determination of defense style by question-
naire. Arch Gen Psychiatry 46:455-460,1989.
7. Vaillant G: Theoretical hierarchy of adaptive ego mechanisms: a 30 year follow-up
of men selected for psychological health. Arch Gen Psychiatry 24:107-117, 1971.
8. Moos R: Coping Response Inventory-Adult Form professional manual. Odessa FL:
Psychological Assessment Resources, 1993.
9. Steiner H, Feldman S: Two approaches to the measurement of adaptive style: a
comparison of normal, psychosomatically ill, and delinquent adolescents. J Am
Acad Child Adolesc Psychiatry 34:180-190, 1995.
10. Moos R: Coping Response Inventory-Youth Form professional manual. Odessa FL:
Psychological Assessment Resources, 1993.
11. American Psychiatric Association: Diagnostic and statistical manual of mental dis-
orders, third edition, revised. Washington, DC: American Psychiatric Press, 1987.
12. Endicott J, Spitzer R, Fleiss J, Cohen J: The global assessment scale. Arch Gen
Psychiatry 33, 766-771, 1976.
13. Feldman S, Elliott G: At the threshold:The developing adolescent. Cambridge,
MA:Harvard University Press, 1993.