A 50-YEAR LONGITUDINAL-STUDY OF DEFENSE USE AMONG INNER-CITY MEN - A VALIDATION OF THE DSM-IV DEFENSE AXIS

The patterns of use of defense mechanisms by 306 inner-city men were r ated from interviews at age 47 and these ratings were analyzed by clus ter analysis. Five clusters resulted. The correlates of cluster member ship were examined using data from the 50-year longitudinal study of t hese men. One cluster exhibited the greatest use of mature defenses; t he men in this cluster functioned best on all psychosocial and health variables. Two clusters of men used primarily neurotic defenses; these men functioned at an intermediate level on all outcomes. The men in t wo clusters primarily used immature defenses. The men in one of these clusters used primarily action defenses, whereas the men in the other cluster were the greatest users of projection and fantasy. In general, the men in both these clusters functioned worse than those in the oth er three. However, the users of action defenses exhibited greater soci opathy, alcohol problems, and marital instability. The findings provid e general support for the DSM-IV hierarchy for nonpsychotic defenses, with mature defenses at the top, neurotic defenses in the middle, and action defenses toward the bottom. In particular, the study supports t he DSM-IV distinction of action defenses from other immature defenses.