Original ArticlesDefense Mechanisms, Gender, and Adaptiveness in Emerging Personality Disorders in Adolescent OutpatientsDi Giuseppe, Mariagrazia PhD∗; Perry, John Christopher MD, MPH†; Conversano, Ciro PhD∗; Gelo, Omar Carlo Gioacchino PhD‡,§; Gennaro, Alessandro PhD∥Author Information ∗Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy †Institute of Community and Family Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada ‡Department of History Society and Human Studies, University of Salento, Lecce, Italy §Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria ∥Department of Clinical and Dynamic Psychology, University La Sapienza of Rome, Rome, Italy. Send reprint requests to Mariagrazia Di Giuseppe, PhD, Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Via Paradisa 2, 56126 Pisa, Italy. E-mail: [email protected]. The Journal of Nervous and Mental Disease: December 2020 - Volume 208 - Issue 12 - p 933-941 doi: 10.1097/NMD.0000000000001230 Buy Metrics Abstract The present study focused on demographic and personality differences in the use of 30 defense mechanisms in adolescents with personality psychopathology and explored the hierarchical organization of personality traits based on the adaptiveness of defensive functioning. A total of 102 self-referred adolescent outpatients were interviewed and assessed on defense mechanisms and personality traits using the Defense Mechanisms Rating Scales and the Shedler-Westen Assessment Procedure 200 for Adolescents, respectively. Age and gender differences were found throughout the hierarchy. Pearson's correlations revealed a hierarchical organization of emerging personality disorders (PDs) in adolescence. More adaptive defenses were clearly associated with healthier personality style, whereas more pathological personality styles such as those with borderline traits were characterized by more rigid and maladaptive defenses. Dissociation was also associated with maladaptive personality types. Identifying the defenses associated with emerging personality disorders may inform the unconscious function of defense mechanisms in specific PDs. The systematic assessment of defense mechanisms might also help therapists to monitor changes during treatment. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.