Defense Reactions and Coping Strategies in

Normal Adolescents
Sarah Erickson, PhD
S. Shirley Feldman, PhD
Hans Steiner, MD
Stanford University

ABSTRACT: In exploring the relationship between defense reactions and coping strate-
gies in a non-clinic sample of adolescents (N —81), we assessed: defense structure by
the Bond Defense Style Questionnaire (DSQ); coping behaviors by the Coping Re-
sponses Inventory-Youth Form (CRI-Youth); and general adjustment by Global Assess-
ment of Functioning (GAF) ratings. Defense reactions and coping strategies were mod-
estly associated and made independent contributions in predicting the GAF. Mature
and immature defenses and avoidance coping comprised the optimal combination in
predicting the GAF, accounting for 20% of GAF variance. It is therefore important to
assess both unconscious and conscious processes when assessing general functioning in
normal adolescents.
KEY WORDS: Defense Reactions; Coping Strategies; Adjustment; Adolescents.

An inevitable and substantive part of life involves addressing and

managing a vast range of stressors, conflicts, and challenges. Both
defense reactions and coping strategies serve as means of managing
such stressors, both normative and non-normative, internal and ex-
ternal. Given specific demands on an individual, unconscious defense
processes and conscious cognitive and behavioral efforts are activated
to mediate the challenge. However, because they have emerged from
distinct traditions, their relationship to one another has not been sys-
tematically examined. In fact, with the exception of Lazarus and Folk-
man's1 work, the transactional analysis literature on coping largely
ignores any contribution from psychoanalytic ego psychology and vice
Received June 17, 1996; for revision July 10, 1996; accepted August 22,1996.
This research was supported by a grant from the Constance B. Wilson Foundation to
Dr. Steiner and a NIMH (5 T32 MH19908-03) research fellowship to Dr. Erickson.
Address correspondence to Sarah Erickson, Ph.D., Fellow, Division of Child Psychia-
try, Department of Psychiatry, 401 Quarry Rd., Stanford University School of Medi-
cine, Stanford, CA 94305-5540.
Child Psychiatry and Human Development, Vol. 28(1), Fall 1997
© 1997 Human Sciences Press, Inc. 45
46 Child Psychiatry and Human Development

versa. This paper attempts to elucidate the relationship between

these two seemingly disparate, yet overlapping, constructs.
Although their goals in managing stressors are similar, defense re-
actions and coping strategies involve significantly different processes
and properties. In fact, these constructs have often been defined in
contradistinction to one another. Principal differences among defense
reactions and coping strategies include, respectively, distinctions
between: unconscious versus conscious processes, implicit versus ob-
servable evidence of operation, intrapsychically generated versus en-
vironmentally-based triggers, involuntary versus voluntary nature,
trait-versus situationally-determined responses, instinct-driven versus
cognitively informed reactions, and automatic versus transactional
behaviors.
In addition to these profound differences, defense reactions and
coping strategies have similarities beyond their common functional
goal of distress reduction. Specifically, both may be employed to man-
age affect, both are dynamic and potentially reversible in nature, and
both are comprised of discrete types of reactions or strategies that can
be differentiated from each other. In addition, recent evidence sug-
gests that similar to coping strategies, patterns of defense reactions
demonstrate developmental shifts during adolescence and early adult-
hood wherein a greater repertoire, including a greater proportion of
mature defenses, develops as a function of age.2

Defense Reactions, Coping Strategies, and Adjustment

Although defenses have historically been associated with psycho-
pathology, they also serve adaptive purposes.3'4 In fact, both defense
reactions and coping strategies assume clinical importance because of
their association with general adjustment. Not all methods of defense
and coping are equally successful in managing stressors or in predict-
ing adjustment, but rather, within these two distinct paradigms, the
strongest and most unequivocal evidence for associations with adjust-
ment and maladjustment lie in the extremes. For example, associa-
tions have been demonstrated between paranoia on the one hand, and
projection and avoidance coping. Similarly, associations have been
found between mental health, and sublimation and approach coping.
Of particular interest for the purpose of this paper is to delineate the
relationship between these constructs in relation to their contribution
in explaining general adjustment in a non-clinic sample.
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 47

Whereas defense reactions have historically been associated with

psychopathology, we are interested in determining their level of util-
ity in predicting healthy adjustment. Despite a paucity of research on
this association, healthy adjustment is conceptually linked to mature
defenses.6,6 Increasing organization, complexity, and maturity of de-
fense patterns arise over time in this hierarchical model. The only
empirical study to address the developmental nature of defense orga-
nization and its relation to adjustment is Vaillant's forty year longi-
tudinal study of normal men. He assessed defense structure using a
developmentally-based hierarchy of defenses and found an associa-
tion between more mature defenses and successful adaptation, as
measured by independent outcome criteria, and between more primi-
tive defenses and less optimal functioning.7
Parallel to defense reactions, coping strategies serve to negotiate
stressors with varying levels of success. Despite everday parlance
wherein coping connotes success, when the coping process is differen-
tiated from the coping outcome, specific behaviors and strategies have
different levels of success and efficacy. Coping strategy refers to the
specific behaviors used in dealing with a stressor and may even be
considered independent of outcome. In addition, the efficacy of a given
coping strategy depends on the context. For example, an avoidant
strategy may be maladaptive in dealing with work demands but
highly successful in dealing with terminal illness.
Two distinct conceptual approaches to categorizing coping processes
emerge from the literature: one emphasizes the focus of coping whereas
the other emphasizes the method of coping. The focus of coping in-
cludes a person's orientation and activity in response to the stressor,
specifically, whether the individual approaches the problem with ac-
tive efforts to resolve it or avoids the problem with varying efforts to
manage the associated emotions. Methods of coping can be divided
into cognitive and behavioral attempts. Moos' integrated conceptual-
ization combines both focus and method approaches to yield four ba-
sic coping processes: cognitive approach, behavioral approach, cogni-
tive avoidance, and behavioral avoidance8
In contrast to defense reactions' intrapsychic foundation, coping in-
cludes an environmental or social ecological focus that incorporates
the appraisal of a stressor in eliciting a particular coping response.
This focus, however, also allows for a developmental perspective in
that a person's coping does not reflect a maturational process as much
as it reflects both the progression of physical or external challenges
and intrapsychic demands.
48 Child Psychiatry and Human Development

No study to date has examined the relative contributions, including

the level of overlap, between defense reactions' and coping strategies'
association with general adjustment. In light of the literature, we hy-
pothesize that defense reactions and coping strategies are related to
each other, and each, in turn, is related to general adjustment in a
school-based sample of normal adolescents. We also hypothesize that
defense reactions and coping behaviors contribute uniquely to adjust-
ment. It is worth considering whether they assess the same construct
and merely reflect differences in terminology, or whether they in fact
contribute uniquely to adjustment. This study seeks to empirically
examine this issue.

Rationale for Addressing These Relationships in an

Adolescent Population
The focus of our study is on the interrelationships between defense
reactions, coping strategies, and adjustment in adolescence. Adoles-
cence was deliberately chosen because at no other time of life are
individuals required to adapt or cope with as many stressors and
challenges, including biological, social, academic, and familial changes
and challenges. This stage of life, therefore, provides an abundance of
opportunities to address challenges and stressors in a normative con-
text. In addition to the exponential and synergistic nature of the
changes during this period, increased stability in personality charac-
teristics make research on constructs such as defense reactions and
coping strategies informative and reliable.

Method

Subjects
As part of a larger study of adaptive style, a non-clinic sample of conveni-
ence was obtained from two local suburban high schools (for details of sample
selection and description, see Steiner & Feldman9). Potential subjects were
offered a soft drink if they completed demographic data and two screening
instruments. Because they were underrepresented in initial distributions,
special effort was undertaken to recruit minority students. Research staff
telephoned parents of interested subjects and obtained parental consent. The
sample that completed the protocol (N =81) was representative of the high
school population in terms of sex (54% male), age (mean age = 16.4, s.d. =
1.4 years, range = 12.0-19.0), race (predominantly Caucasian), and socio-
economic status (predominantly middle class).
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 49

Instruments
Defense Style Questionnaire (DSQ-78). The DSQ-78 is a 78-item modifica-
tion of Bond's Defense Style Questionnaire originally designed for use with
adults." The final instrument, the DSQ, contained 59 items assessing 19 de-
fense mechanisms: projection, passive aggressiveness, somatization, denial,
regression, undoing, inhibition, splitting, acting out, fantasy, repression,
withdrawal, anticipation, affiliation, humor, sublimation, suppression, reac-
tion formation and altruism. Subjects completed the DSQ by rating each item
on a 9 point scale ranging from strongly disagree to strongly agree. Alpha
coefficients, calculated separately for each defense, were generally quite mod-
est across four comparison groups. The items, scales, and their psychometric
properties are described in an earlier paper.2 Test-retest stabilities of the 19
defenses over 6 to 12 months for a sample of 68 nonclinic adolescents yielded
a mean correlation of .53.
A Principal Component Analysis (PCA) with quartiinax rotations on the 19
defense mechanism scores of the entire sample of adolescents yielded three
stable and interpretable factors with eigen values greater than 1 and with
Kaiser sampling adequacy reaching acceptable limits. These factors included:
Immature Defenses, consisting of 12 defense mechanisms including proj-
ection, denial, regression, somatization, and repression, among others; Ma-
ture Defenses, consisting of five defense scores—suppression, humor, affilia-
tion, sublimation, and anticipation; and Prosocial Defenses consisting of two
scores—altruism and reaction formation. Test-retest stabilities over a 6-12
month interval for the three composites exceeded .55.2
Coping Response Inventory-Youth Form (CRI-Youth). The CRI-Youth as-
sesses coping processes in response to stressful life circumstances in adoles-
cents 12 to 18 years old.10 The eight coping subscales represent eight types of
coping strategies representing two superordinate processes: approach and
avoidance. Respondents are asked to identify a recent stressful episode and
rate their reliance on each of the 48 coping items using a four point scale
(from "not at all" to "fairly often"). Each of the eight scales includes six items
and scale scores can vary from a low of 0 to a high of 18. The psychometric
properties of the eight scales (logical analysis, positive reappraisal, seeking
guidance and support, problem solving, cognitive avoidance, acceptance/resig-
nation, seeking alternative rewards, and emotional discharge) and the com-
posites that they comprise are described by Moos.10
Similar to Moos'10 findings among CRI-Youth subscales, we found substan-
tial positive intercorrelations among the two coping composite factors and the
eight subscales. In fact, the superordinate coping composites, Approach and
Avoidance, correlated at .36 (p<.001) and 11 of 28 intercorrelations among
the eight subscales demonstrated substantial positive relationships (p<-05).
Like Moos, we believe these intercorrelations demonstrate that adolescents
who rely on one type of approach coping also use other types of approach
coping, and are also more likely to employ avoidance coping. In short, employ-
ing one type of coping, whether approach or avoidance, lends itself to employ-
ing other types of coping.
The CRI-Youth is conceptually comparable to the Coping Responses Inven-
50 Child Psychiatry and Human Development

tory-Adult Form.8 Psychometric properties of the CRI-Youth are based on data

from 315 youth who participated in the first field trial of this scale. There is
moderate internal consistency for the eight scales for both boys and girls (al-
pha =.55-.79). The coping scales demonstrated moderate short term stability
(over 12 to 15 months) for both genders, although boys showed slightly less
stability than girls (average rs = .29 and .34, respectively).'"
Global Assessment of Functioning (GAP). GAF ratings were obtained for all
subjects by two independent raters who had established satisfactory interra-
ter reliability (r<.75, /><.05) with a board certified psychiatrist with at least
17 years experience. Raters were blind to self-report results. Although some
interviews were done in person and others were completed over the phone,
there were no systematic differences between the two groups. GAF ratings,
based on clinical interviews, utilized DSM-IH-R" criteria regarding current
overall functioning of subjects on a continuum from psychological illness to
health. Specifically, interviewers asked subjects about their physical health,
frequency of doctor appointments, history of hospitalizations and medications;
appetite and sleep patterns; mood and mood disturbance; weight regulation
and concerns; hearing, language, or speech disturbance; peer relationships;
family interactions; type, duration, and frequency of therapeutic interven-
tion^); and subjective sense of "happiness." In addition to standardized ques-
tions in these domains, interviewers were trained to probe further into any
areas of potential concern.
The GAF scale, ranging form 0 to 90, is subdivided into 9 equal intervals:
1-10,11-20,..., 81-90, which reflect a subject's symptoms, behaviors, char-
acteristics, and level of functioning in a variety of areas. Interviewers selected
the interval which best describes the subject's current functioning, utilizing
the interval's defining characteristics to determine where within the interval
the rating should fall. Psychometric properties of the instrument are de-
scribed by its authors as adequate with evidence for moderate reliability
(r= .61-.91)12, which is enhanced by training raters to achieve high interrater
reliability with an experienced clinician, such as was done in this study. Pear-
son correlations and simultaneous linear regressions were utilized for statisti-
cal analyses.

Results
In order to determine the relationship between defense reactions
and coping strategies, and their unique contributions in predicting
adjustment in normal adolescents, two types of analyses were per-
formed. First, the three defense composites (Mature, Prosocial, and
Immature) were correlated with the two coping composites (Approach
and Avoidance) and the significant associations were then disaggre-
gated. Second, regressions were employed to determine the relative
contribution of defense reactions and coping responses in predicting
adjustment. Because differences between males and females in mean
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 51

scores of defense reaction composites, coping response composites,

and general adjustment were consistently non-significant, gender was
employed in the analyses only to elucidate differences in associations.
Among defense composites, coping composites, and general adjust-
ment, age was significantly correlated with only the Immature com-
posite: with increasing age, subjects reported employing fewer or less
frequent immature defenses.1

Association Between Defense Reactions and Coping Responses

To assess whether defense reactions and coping strategies repre-

sent overlapping domains, we correlated defense reaction composites
with coping composites and found scattered associations of modest
magnitude. Specifically, the Immature composite was positively asso-
ciated with the Avoidance Coping composite (r= .32,p<.01) and nega-
tively associated with the Approach Coping Composite (r=-.25,
p<.05). Mature and prosocial defenses were not significantly corre-
lated with coping behaviors.
These results held for males but not females, although the pattern
and direction of associations were similar. A solitary gender differ-
ence in correlations was observed: the association between the Ma-
ture factor and Approach coping held for males but not for females,
and the difference between these correlations was significant (2=2.60,
p<.01). This difference in direction of association may be explained by
sex role stereotypes wherein females who employ mature defenses
may not be assertive or problem solving-focused (approach coping),
but still cope adaptively with difficulties.
To better understand the significant association between the Imma-
ture factor and the Avoidance and Approach coping composites, the
three composites were partitioned into their components and subse-
quently correlated. Ten of the twelve immature defenses correlated
positively with one or more of the avoidance coping behaviors (p<.05).
Coping by resigned acceptance was particularly consistently associ-
ated with immature defenses, correlating with seven of twelve imma-
ture defenses (p<.05 with three additional trends, p<.10).
Further, five of the twelve immature defenses correlated negatively

1 Because males (mean age=16.9, s.rf. = 1.5) were significantly older than females
(mean age 15.9, s.d. = 1.2) (t= 1.43, df=42,361p<.01), we employed age as a covariate to
assess whether relationships between defense reactions, coping responses, and general
adjustment were partly explained as a function of age. Because controlling for age did
not alter the results, the following analyses do not include age as a covariate.
52 Child Psychiatry and Human Development

with approach coping behaviors (p<.05), indicating that adolescents

who employ immature defense reactions such as splitting, withdrawal,
and repression are less likely to employ approach coping strategies.
Correlational analyses separately by gender revealed similar associa-
tions in males and females. The strength of association, both in
magnitude and frequency, between immature defenses and approach
coping appeared weaker than the association between immature de-
fenses and avoidance coping, both at the composite and individual
component levels.

Association of Defense and Coping Composites with Adjustment

In addition to their modest relationship to one another, the defense

reaction and coping composites were significantly associated with
general adjustment. General adjustment correlated significantly in
the predicted direction with the Immature (r= — .30, p<.01) and Ma-
ture defenses (r = .25, p<.05) and with Avoidance Coping (r= —.33,
p<.01). These associations held for females (r= — .37, p<.05; r=.31,
p<.10; and r= -.48,p<.01, respectively) but not for males. No asso-
ciation was found between general adjustment and either the Proso-
cial defense factor (r = .12, p = ns) or the Approach Coping factor
(r=-.01,p = ns).
Simultaneous linear regression analyses were used to determine
whether the defense and coping composites contributed unique vari-
ance in predicting scores on general adjustment. Results for the total
sample indicate that the five composites explained 20% of the vari-
ance in the GAP score (F=3.8; df=5,75; p<.01). Standardized beta
weights, representing the relative importance of each defense in pre-
dicting variance in GAF scores, were obtained. Of the five composites,
only three, the Immature defense (Beta= -.23, p<.05), Mature de-
fense (Beta = .22, p<.05), and Avoidance coping (Beta = - .23, p<.05),
explained significant levels of unique variance in the regression equa-
tion. The failure of the two other composites to significantly predict
adjustment suggests either considerable shared variance among them
or their lack of explanatory power in predicting the GAF.
Results for females are similar to those of the total sample, wherein
the Immature and Avoidance composites explain unique GAF vari-
ance. However, unlike the total sample, the Mature factor did not
contribute uniquely in predicting the GAF. Overall, the five compos-
ites explained 35% of the GAF score variance in females (F=3.3;
dy=5,31; p<.05) with only the Immature and Avoidance coping com-
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 53

posites contributing unique variance. These two composites explained

30% of GAF variance GF"=7.4; rf/"=2,34; p<.01) (Beta= -.27, p<.10;
Beta= -.42, p<.01, respectively).

Discussion

These results support the contention that the theoretical domains

measured by the DSQ-78 and CRI overlap modestly, but largely tap
distinct arenas of functioning: when adolescents manage stressors,
conflicts, and affect, they employ both unconsious defense processes
and conscious cognitive and behavioral strategies. In essence, both
ethologically driven, situationally-independent, trait-like defense pro-
cesses and contextually dependent, learned and variable coping re-
sponses appear to operate simultaneously and relatively indepen-
dently, with only modest redundancy.
This study suggests that the area of overlap between defense mech-
anisms and coping strategies is partial and in the predicted direction:
adolescents who employ avoidance coping tend to also utilize imma-
ture defenses, and those who employ approach coping tend to eschew
immature defenses. This finding supports a developmental model of
defense maturity wherein adolescents utilizing immature defenses
are limited in the coping strategies to which they have access: their
level of defense maturity impedes their ability to cope in a manner
that "approaches" problems and conflicts. These results held for males
separately, and were in the predicted direction for females but were
not of statistical significance. The latter may be the result of a small
sample size.
Mature defenses neither correlated with approach nor avoidance
coping in the total sample, but were significantly associated with ap-
proach coping for males only. In other words, adolescent males who
employ mature defenses also employ approach coping. Social learning
theory, and sex role stereotyping specifically, suggests that males and
females may be able to cope with stressors in differential ways while
employing mature defenses such as altruism and affiliation. Whereas
males with access to mature defenses may approach problems with
logical analysis and problem solving, females utilizing mature de-
fenses may not rely on these specific coping strategies. In general,
associations between defense mechanisms and coping strategies were
stronger and more numerous for males than for females, suggesting
54 Child Psychiatry and Human Development

that the two domains measured by these theoretical constructs over-

lapped more for males.
Both defense mechanisms and coping are relevant to clinical as-
sessment, as evidenced by their ability to predict general adjustment,
in terms of content and scope. Results suggest that defense mecha-
nisms, representing unconscious attempts to manage intrapsychic
conflict, have conscious analogues, associated with general adjust-
ment, that can be assessed via self-report. In addition, these con-
scious analogues yield significantly different information regarding
an adolescent's overall functioning than do conscious coping strate-
gies. Specifically, the Immature, Mature, and Avoidance coping com-
posites contribute significant and unique variance in predicting objec-
tive ratings of general adjustment for the total sample. It is therefore
clinically warranted to measure both domains in order to capture two
distinct types of functioning. In addition, these findings support the
contention that the GAF accounts for a wide range of functioning,
including conscious and unconsious correlates of adjustment.
These findings, based on moderate correlation and explanatory
power, are particularly significant given the narrow range of GAF rat-
ings. Because this was a non-clinic sample, the mean GAF score was
72.0 (s.d. 12.23). In addition to a nonclinic sample, there was very
little ethnic diversity. Thus, greater predictive power of the DSQ-78
and CRI, both separately and in combination, would be expected in a
more heterogenous sample.
In predicting general adjustment for females, it appears that only
the Immature and Avoidance factors contribute unique variance. This
follows, in part, from the finding that these two constructs do not
significantly overlap for females and therefore can contribute uniquely
in predicting adjustment. The Mature, Prosocial, and Approach com-
posites were nonsignificant in predicting adjustment for females. In
contrast to the findings for the total sample and for females, neither
the five composites taken together, nor any subset of these compos-
ites, predicted adjustment in males. This finding suggests that al-
though there is a higher level of overlap between defense and coping
composites for males, the distinct and overlapping domains do not
significantly tap into general adjustment.
This gender difference in the greater level of overlap between de-
fense mechanisms and coping in males, in contrast to their stronger
power in predicting adjustment in females, may be explained by
gender-based differential maturity levels and subsequent reporting
styles. In short, the literature on developmental gender differences
Sarah Erickson, S. Shirley Feldman, and Hans Steiner 55

demonstrates that females are more mature than males at this age,13
even taking into account the older age of males in this sample. This
difference in maturity level may lead to reporting style differences
wherein males' self-report of stress and conflict management is con-
sistent, hence the overlap, yet relatively unrelated to an objective per-
ception of their functioning. Because males are less mature, there
is less differentiation between defense mechanims and coping re-
sponses: immaturity drives males to employ more "defensive" coping
so that when stressed, males' planful actions are similar to their de-
fensive maneuvers.
In contrast, a smaller degree of overlap between defense mecha-
nisms and coping strategies in females suggests that females employ
more diverse strategies, both conscious and unconscious, to manage
conflict and are able to report their functioning more adequately.
These two processes of coping and defending tend to diverge as a
function of maturity and age,2 and females' greater maturity thereby
allows the two systems, in combination, to predict general adjusment.
These results suggest that a cautious interpretation of self-report
results is particularly important for males, especially when they are
asked about such sensitive and emotionally-laden matters as how
they manage stress and conflict. In addition, it is possible that what
males report is accurate in terms of their objective functioning, but
raters, all female in this study, are influenced more by gender than
by general adjustment. Or perhaps males' adjustment is obscured by
their reticence to disclose information to a female interviewer who
therefore doer, not have enough information to make accurate assess-
ments. In fact, these results indicate that a longitudinal study of gen-
der-specific defense and coping development is warranted.

Summary

This study addresses the degree of overlap versus complementarity

between two distinct theoretical domains: defense reactions and cop-
ing behaviors. In summary, we compared self-reported defense reac-
tion and coping strategy utilization, and used these domains to pre-
dict observer-rated global adjustment in a non-clinic sample of 81
adolescents. Defense reactions and coping strategies were modestly
associated, with Immature defenses and Avoidance coping demon-
strating the greatest overlap. Of lesser, but still significant associa-
tion, the Immature and Approach coping composites yielded a nega-
56 Child Psychiatry and Human Development

tive association. Neither Mature nor Prosocial defense composites

were signficantly correlated with coping behaviors. In addition to
their modest overlap with one another, the Immature and Mature de-
fense reaction composites and the Avoidance coping composite were
significantly associated with general adjustment in the predicted
direction. Both defense reactions and coping strategies made indepen-
dent contributions in predicting observer ratings of global adjust-
ment, accounting for 20% of GAF variance in the total sample. Specif-
ically, the Immature, Mature, and Avoidance composites entered into
the simultaneous linear regression model to predict significant levels
of unique variance in the GAF score. Assessment of general function-
ing in normal adolescents therefore requires consideration of both un-
conscious and conscious processes.

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