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Natural History of Male Psychological Health:  V. The Relation of Choice of Ego Mechanisms of Defense to Adult Adjustment

George E. Vaillant, MD
Arch Gen Psychiatry. 1976;33(5):535-545. doi:10.1001/archpsyc.1976.01770050003001.
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• Ninety-five men, selected in college on the basis of health, have been prospectively followed up for 30 years. Their adaptive styles have been isolated, labeled by the ego mechanisms of defense that their behavior reflects, and studied by semiquantitative techniques. A hierarchy of ego mechanisms was devised that ordered defenses along a continuum that reflected the following two dimensions: (1) immaturity-maturity and (2) psychopathology-mental health. The most important finding was that despite blind assessment, a scale reflecting the maturity of a subject's defenses correlated with scales measuring his objective psychopathology (r = —.35) and his objective adaptation to the external environment (r =.65). Highly significant shifts in defensive style occurred as individuals matured. In order to conceptualize the continuum that underlies mental health, identification of a person's dominant defensive styles may be superior to our current scheme of static unitary diagnoses.

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