SUICIDAL ADOLESCENTS AND EGO DEFENSE-MECHANISMS

To identify defense mechanisms that characterize adolescents with a ra nge of suicidal behaviors and to differentiate them from nonsuicidal a dolescents, Method: Fifty-five suicidal adolescent inpatients admitted for a definite suicide attempt were compared with 87 adolescent inpat ients who had no history of suicide attempt or ideation and 81 nonpati ents, Defense mechanisms were assessed by the Ego Defense Scale (EDS) which is part of a larger semistructured interview, the Child Suicide Potential Scale (CSPS), and by a self-report questionnaire, the tife S tyle index (LSI), The CSPS was also used to quantify violent and suici dal behaviors. Results: On the LSI suicidal adolescent patients scored higher on denial, displacement, repression, and total defenses than t he nonpatients. On the EDS they scored higher on regression, denial, p rojection, introjection, repression, and total defenses and lower on s ublimation. LSI scores on displacement (higher) and on compensation (l ower) distinguished suicidal from nonsuicidal inpatients. Denial and r egression correlated positively and sublimation correlated negatively with both suicidal and violent behaviors, Introjection and repression correlated with suicidal behavior only. Conclusions: Overuse of displa cement is connected with increased risk for suicidal and aggressive be haviors, while sublimation is probably a protective factor, In additio n, several immature ego defenses possibly amplify aggression, which th en is directed against the self by the maladaptive overuse of introjec tion, displacement, and repression.