Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies

International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications.

Defense Mechanisms, Gender, and Adaptiveness in Emerging Personality Disorders in Adolescent Outpatients

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.

Defense Style of Children and Adolescents: Differences and Ability to Discriminate Among Clinical Categories

This study assessed the defense style of children referred to an outpatient clinic and examined what this style contributes to discriminating among various disorder categories, beyond internalizing and externalizing symptoms. A sample of 433 children and adolescents were grouped into four disorder categories: disruptive, depressive, anxiety, and attention deficit hyperactivity disorder. Their parents completed the Comprehensive Assessment of Defense Style (CADS: mature, self-oriented, and other-oriented) and the Child Behavior Checklist (CBCL: internalizing and externalizing symptoms). The disorder categories differed in the use of other-oriented defenses (e.g., acting-out, projection), whereas the CADS helped in properly discriminating most diagnostic categories beyond the CBCL. Information provided by the children themselves was missing, as was a subsample of nonclinical participants; these sources could strengthen the conclusions of the study. Assessing children's defense style together with their symptoms may result in better statistical discrimination among diagnostic categories.