Defensive mechanisms and personality structure in an early adolescent boy: process and outcome issues in a non-intensive psychoanalytically oriented psychotherapy.

The main aim of this paper is to empirically assess defense mechanisms trends and personality structure in a once a week psychoanalytically oriented psy- chotherapy with an early adolescent, affected by a General Anxiety Disorder (GAD). Assessment and outcome measure included the Shedler-Westen Assess- ment Procedure for Adolescents (SWAP-200-A); process was evaluated through de- fensive mechanisms analysis, using Defense Mechanisms Rating Scale (DMRS). The paper focused on 12 sessions divided into three periods, along 2 years of treat- ment. Quantitative and narrative profiles of SWAP-200-A and DMRS were inte- grated; a log linear procedure was chosen to assess defensive mechanisms trends longitudinally during the treatment. Moreover a Multiple Correspondence Analysis (MCA) was applied to DMRS to provide a map of the evolution of the patterns of defense mechanisms throughout the course of treatment. Personality assessment and defensive mechanisms showed an inhibited self-critical image with obsessive, narcissistic and disavowal patterns. According to trends during treatment phases, MCA analysis identified decreasing in defensive patterns, while mature defenses in- creased significantly. The study highlighted how non-intensive psychoanalytic psy- chotherapy can help early adolescents with clinical problems to improve their over- all mental functioning. Outcome in terms of personality structural changes and pro- cess according to defense mechanisms were discussed to highlight improvement not just in symptomatology, but also in personality structure and functioning.