Original ArticlesDefense Mechanisms and Parenting Styles in Patients With Anorexia and BulimiaCraba, Ambra MD, PhD∗; Mazza, Marianna MD, PhD∗; Marano, Giuseppe PsyD∗; Crosta, Maria Luigia MD, PhD∗; Moroni, Federica MD∗; Di Pietro, Salvatore MD∗; Balocchi, Marta PsyD∗; Della Casa, Silvia MD†; Rinaldi, Lucio MD∗; Janiri, Luigi MD∗; Sani, Gabriele MD∗ Author Information ∗Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics †Department of Endocrinology, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. Send reprint requests to Ambra Craba, MD, PhD, Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy. E-mail: [email protected]. Ambra Craba and Marianna Mazza contributed equally to this article. The Journal of Nervous and Mental Disease 211(3):p 174-181, March 2023. | DOI: 10.1097/NMD.0000000000001597 Buy Metrics Abstract Dysfunctional parenting styles are risk factors for eating disorders (EDs). In this observational study, we examined 57 women with ED, a psychiatric control group (n = 26), and healthy participants (n = 60). Several instruments were administered: Defense Style Questionnaire (DSQ-40) to examine the type of defense mechanism used, Parental Bonding Instrument (PBI) to investigate the perception of the relationship with parents, Eating Disorder Examination Questionnaire and Eating Disorder Inventory-3 to assess the severity of the ED, and Body Shape Questionnaire to investigate the perception of their body shape. In patients with anorexia and bulimia, neurotic factor (p = 0.007) and immature factor (p = 0.002) are associated with perception of relationship with their own parents. In the PBI, maternal care was associated with higher scores in the DSQ-40 in the immature factor (p = 0.012), whereas paternal overprotection was associated with lower scores in the DSQ-40 in the mature factor (p = 0.016). Patients with anorexia and bulimia overutilize more neurotic and primitive defense mechanisms compared with nonclinical subjects, and this use is associated with greater severity of eating symptomatology. This can be related to diversified ego forces, can inform about the nature and severity of disease, and can characterize prognostic and psychotherapeutic value. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.