Narcissism and Attachment: The Importance of Early Parenting.

Research often shows that narcissism and attachment style are related. The present research examines the question of whether early parenting style contributes to adult attachment style, beyond the relation between narcissism and attachment. Parents reported on their parenting style at age 3, and offspring were assessed for attachment style and narcissism at age 23. The results indicated that early parenting style was not directly related to narcissism, but along with narcissism added to the prediction of attachment style. In combination with vulnerable narcissism, authoritarian parenting was positively related to secure attachment, and negatively related to preoccupied attachment, whereas permissive and responsive parenting were negatively related to secure attachment and positively related to preoccupied attachment.

What Has Happened to Hysteria?

This article traces the history of the diagnosis of hysteria from the earliest medical formulations in the 17th century to the present, including the presence of this diagnosis in the five iterations of the Diagnostic Statistical Manual (DSM) of the American Psychiatric Association. Several different types of hysteria are discussed, with alternative causal explanations. Research focusing on this disorder is summarized.

Change in Children's Self Confidence and the Use of Defense Mechanisms.

Change in the personality trait of self-confidence was studied in a group of children from the Berkeley Guidance Longitudinal study. Self-confidence was assessed at age 6 (n = 99) and again at age 10 (n = 97). Results indicated that a change in level of self-confidence was related to the use of defense mechanisms, as assessed from Thematic Apperception Test stories. A decrease in self-confidence was positively related to the use of the immature defense of denial and negatively related to the use of the relatively mature defense of identification. In contrast, an increase in self-confidence was unrelated to the use of defense mechanisms.

The Development of Defense Mechanisms During the Latency Period.

The developmental period of latency, during middle childhood, has not been previously studied for possible change in the use of defense mechanisms. Using a validated narrative method to assess defenses, the present research examines change in children's defense use during this period. As predicted from theory, there was a significant increase in the use of the defense of Identification. This finding is consistent with theory that posits a shift at this time from defense against anxiety that is based on lack of impulse control to defense that is based on anxiety due to violation of conscience.

Childhood Precursors of the Narcissistic Personality.

This research identifies the childhood personality characteristics that predict the presence of narcissism in adulthood. Using data from the longitudinal study of Block and Block (The California Child Q-set. Palo Alto, CA: Consulting Psychologists Press, 1980), childhood personality characteristics were assessed at age 11 (N = 100) using the California Child Q-set. A number of these were shown to differentially predict the presence of grandiose or vulnerable narcissism at age 23. Factor analyses of the Child Q-set items showed that the presence of Grandiose Narcissism was positively related to childhood factors representing social presence and negatively related to planfulness. In contrast, vulnerable narcissism was positively related to childhood impulsivity and negatively related to stable self-esteem. Both types of narcissism were positively related to childhood factors representing need for control.

Defense Mechanisms and Utilization in Cancer Patients Undergoing Radiation Therapy: A Pilot Study.

A group of 49 patients who had been diagnosed with cancer during the preceding year and who were receiving radiation therapy were assessed for their use of defense mechanisms, as well as for their level of psychological distress. In addition, their utilization of medical services was determined. It was predicted that the use of services that were under the patients' control-namely, requesting extra outpatient visits and making trips to the emergency department-would be related to the patients' use of defense mechanisms, whereas a treatment option not under the patients' control-overnight hospitalization based on physicians' assessment of condition-would not be related to defense use. The findings confirmed the hypotheses. Outpatient visits were strongly predicted by defense use, whereas hospitalization was determined by psychological distress. However, emergency department visits were determined by both defense use and psychological distress. In addition, an interaction between defense and distress was found to predict hospitalization.

Using the TAT to Assess the Relation Between Gender Identity and the Use of Defense Mechanisms.

The purpose of this study is to explore whether 2 different dimensions of personality, when assessed at an implicit level with the Thematic Apperception Test (TAT; Murray, 1943 ) will show a theoretically meaningful coherence not demonstrated when 1 is assessed at an implicit level and the other at an explicit level. Gender identity and defense mechanisms were assessed implicitly using the TAT. Gender identity was compared with a self-report measure of gender-related attributes assessed at the explicit level. The results showed a theoretically meaningful coherence when different dispositions were assessed at the same level, but a lack of agreement when similar dispositions were assessed at different levels. The study is based on a secondary analysis of data from 2 previously published papers (Cramer, 1998 ; Cramer & Westergren, 1999 ).

Defense Mechanism Card Pull in TAT Stories.

This study investigates the question of whether different Thematic Apperception Test (TAT; Murray, 1943 ) cards are likely to prompt stories that are characterized by different defense mechanisms. This condition is known as card pull and refers to the probability that different TAT cards elicit different personality scores for the same variable. If so, the assessment of defense use would be importantly influenced by the TAT cards used in an assessment. TAT stories from 3 different community samples were examined (Ns = 91, 98, 121), using a statistical method developed by Stein et al ( 2014 ). The results indicated that different TAT cards pull for different defenses, as assessed by the Defense Mechanism Manual (DMM: Cramer, 1991b ). However, the nature of card pull was not always consistent across samples. These dissimilarities could be due to group differences, or to the presence of different TAT cards used in the test battery, indicating that card pull is importantly determined by context.

Childhood Precursors of Adult Borderline Personality Disorder Features: A Longitudinal Study.

This study identifies childhood personality traits that are precursors of adult Borderline Personality Disorder (BPD) features. In a longitudinal study, childhood personality traits were assessed at age 11 (N = 100) using the California Child Q-set (CCQ: Block and Block, 1980). A number of these Q-items were found to be significantly correlated (p < 0.001) with a prototype-based measure of BPD features at age 23. Factor analysis of these Q-items suggested that they could be characterized by two underlying personality dimensions: Impulsivity and Nonconformity/Aggression. The findings thus provide evidence that childhood personality traits predict adult BPD features. Identifying such childhood precursors provides an opportunity for early intervention.

Working With Sidney Blatt: Developing Interactions.

This tribute to Sidney J. Blatt describes our collaboration in the study of therapy change among hospitalized patients at the Austen Riggs Center. In particular, the use of defense mechanisms by these patients, and the relation of defenses to change in personality after treatment, were examined. The unfolding of this work is described.

Understanding Defense Mechanisms.

Understanding defense mechanisms is an important part of psychotherapy. In this article, we trace the history of the concept of defense, from its origin with Freud to current views. The issue of defense as an unconscious mechanism is examined. The question of whether defenses are pathological, as well as their relation to pathology, is discussed. The effect of psychotherapy on the use of defenses, and their relation to a therapeutic alliance is explored. A series of empirical research studies that demonstrate the functioning of defense mechanisms and that support the theory is presented. Research also shows that as part of normal development, different defenses emerge at different developmental periods, and that gender differences in defense use occur.

Change in children's externalizing and internalizing behavior problems: the role of defense mechanisms.

This study investigates the relation of defense mechanism to children's externalizing and internalizing behavior problems, as assessed from mothers' report at age 9 and 12 years, based on archival data. The defense mechanisms of denial, projection, and identification were assessed from Thematic Apperception Test stories told by the children at age 9 years, using the Defense Mechanism Manual (Cramer, The development of defense mechanisms: Theory, research and assessment. New York: Springer-Verlag, 1991a; Protecting the self: Defense mechanisms in action. New York: Guilford Press, 2006). The results showed that the use of identification predicted a decrease in externalizing behaviors between age 9 and 12 years. In contrast, change in internalizing behaviors was not predicted by defense use, but the use of projection was related to fewer internalizing behaviors at both ages. These findings are consistent with the idea that behavioral intervention stressing self-regulation can be effective in reducing externalizing problems, but internalizing problems require an intervention that is sensitive to the underlying behavioral inhibition in these children.

Defense mechanisms: 40 years of empirical research.

This article reviews research on defense mechanisms carried out over the past 40 years with children, adolescents, adults, and psychiatric patients. Both experimental and observational studies are included.

Estudios empíricos sobre mecanismos de defensa / Empirical studies of defense mechanisms

El presente artículo evalúa el uso de tres defensas: desmentida, proyección e identificación, de acuerdo con su manifestación en relatos disparados por láminas del Test de Apercepción Temática (TAT). La evaluación de cada defensa se realiza según criterios de siete categorías, cada una de ellas diseñada para evaluar un aspecto de la defensa. El artículo propone que los niveles de patología mental se manifiestan por el uso de una u otra defensa así como también por el uso de formas más o menos maduras de la misma.

Estudios empíricos sobre mecanismos de defensa / Empirical studies of defense mechanisms

El presente artículo evalúa el uso de tres defensas: desmentida, proyección e identificación, de acuerdo con su manifestación en relatos disparados por láminas del Test de Apercepción Temática (TAT). La evaluación de cada defensa se realiza según criterios de siete categorías, cada una de ellas diseñada para evaluar un aspecto de la defensa. El artículo propone que los niveles de patología mental se manifiestan por el uso de una u otra defensa así como también por el uso de formas más o menos maduras de la misma.(AU)

The present article assesses the use of three defenses-denial, projection, and identification-as revealed in stories told to TAT cards. The scoring for each defense is based on seven categories, each designed to reflect a different aspect of the defense. The article supports the idea that the levels of mental pathology are manifested by the use of one defense or another, as well as by a more or less mature form of the defense.(AU)

Estudios empíricos sobre mecanismos de defensa / Empirical studies of defense mechanisms

El presente artículo evalúa el uso de tres defensas: desmentida, proyección e identificación, de acuerdo con su manifestación en relatos disparados por láminas del Test de Apercepción Temática (TAT). La evaluación de cada defensa se realiza según criterios de siete categorías, cada una de ellas diseñada para evaluar un aspecto de la defensa. El artículo propone que los niveles de patología mental se manifiestan por el uso de una u otra defensa así como también por el uso de formas más o menos maduras de la misma. (AU)

Attachment style and defense mechanisms in parents who abuse their children.

Adult attachment style, defense mechanisms, and personal history of abuse was studied in a group of abusive parents. As a group, these parents made unusually high use of the defense of denial; this was especially true of those with a Fearful attachment style. However, the use of Identification was characteristic of those with a Preoccupied attachment style. Further, personal abuse history was related to adult attachment style. Those who reported having been abused as a child were less likely to have a Secure attachment style, and a history of physical or sexual abuse was associated with a Preoccupied style. In general, these findings support the deactivating/hyperactivating defensive theory of Mikulincer et al (Emotion Regulation in Couples and Families: Pathways to Dysfunction and Health. 2006; pp 77-99. Washington (WA): American Psychological Association).

An increase in early adolescent undercontrol is associated with the use of denial.

This is a longitudinal study of change in undercontrol and its relation to the use of defense mechanisms with participants from the Berkeley Guidance Study of the Institute of Human Development, University of California, Berkeley. I predicted that use of the immature defense of Denial, but not Projection or Identification, would be related at early adolescence to an increase in undercontrol as assessed from 2 independent measures. The assessment of Ego Undercontrol indicated that the majority of children decreased with age, but for those who increased at early adolescence, the increase was significantly related to the use of Denial. Similarly, assessment of Externalizing Behavior Problems at early adolescence indicated that an increase in Externalizing Problems was related to the use of Denial. In addition to indicating psychological immaturity, the use of Denial prevents these children from recognizing the negative impact of their undercontrolled behavior.

Identification and the development of competence: a 44-year longitudinal study from late adolescence to late middle age.

The role of defense mechanisms in the development of planful competence (J. A. Clausen, 1993) was studied over a period of 44 years in participants from the Oakland Growth Study, who are part of the Intergenerational Studies of the Institute of Human Development. Planful competence was assessed on 4 occasions, from late adolescence (ages 15-18) to late middle age (age 62). The use of the defense mechanisms of denial, projection, and identification was assessed in late adolescence, based on Thematic Apperception Test (H. A. Murray, 1943) stories coded with the Defense Mechanism Manual (P. Cramer, 1991b). In late adolescence, the defense mechanism of identification was found to be positively related to competence, whereas the less mature defense of projection was related to lower levels of competence. For the group as a whole, hierarchical linear modeling (Bryk & Raudenbush, 1992) indicated that competence increased across the adult years, with a modest decline at late middle age. Individual differences for intraindividual change in competence were related to the use of identification: high use of identification in late adolescence was associated with relative stability in adult competence, whereas low use of identification in adolescence predicted changes in adult competence.

Longitudinal study of defense mechanisms: late childhood to late adolescence.

Based on longitudinal data from the Institute of Human Development Intergenerational Study, the use and change in defense mechanisms of more than 150 individuals, as assessed from TAT stories, was studied across ages 11, 12, and 18. The findings of this study, based on an earlier generation, were generally consistent with cross-sectional findings from current samples, showing that the defenses of projection and identification were used more frequently than denial at all three ages and that the use of projection and identification increased from early to late adolescence. However, unlike current findings, the 18-year-olds did not show greater use of identification than of projection, perhaps due to IQ differences between this community sample and the samples of more recent studies.