Defense Mechanisms in Severe Adolescent Anorexia Nervosa

DORON GOTHELF, ALAN APTER, GIDI RATZONI, ISRAEL ORBACH, RONIT WEIZMAN, SAM TYANO, CYNTHIA PFEFFER

Research output: Contribution to journalArticlepeer-review

Abstract

To compare ego defense mechanisms in adolescents with anorexia nervosa and other major psychiatric disorders, to defenses in healthy adolescents. Thirty-seven patients with anorexia nervosa, 30 with major depressive disorder, 20 with obsessive-compulsive disorder, 53 with borderline personality disorder, 60 with schizophrenia, and 81 healthy controls were assessed with Pfeffer's Ego Defense Scale. Regression, denial, projection, repression, introjection, and total defenses were common to all psychiatric patients and distinguished them from normal adolescents. In addition to these defenses, anorectic patients also used intellectualization more frequently than normal adolescents and psychiatric patients. They used sublimation more than other psychiatric patients. Patients with disorders, apart from obsessive-compulsive disorder, that are considered to be often comorbid with anorexia did not have different defenses than schizophrenic patients. Anorectic adolescents overutilize relatively more mature defenses than do psychiatrically ill adolescents, and they overutilize immature defenses compared with normal adolescents. This combination of mature and immature defenses may be related to the uniquely heterogeneous ego functioning seen in anorectic patients, and it may provide insight into the nature of the psychopathology of anorexia nervosa. It also could have important psychotherapeutic and prognostic value.

Original languageEnglish
Pages (from-to)1648-1654
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume34
Issue number12
DOIs
StatePublished - 1995

Keywords

  • adolescents
  • anorexia nervosa
  • defense mechanisms

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