Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T08:58:38.152Z Has data issue: false hasContentIssue false

Pathways of ego development: Contributions to maladaptation and adjustment

Published online by Cambridge University Press:  31 October 2008

Gil G. Noam
Affiliation:
Hall-Mercer Laboratory of Developmental Psychology and Developmental Psychopathology, Harvard Medical School
Christopher J. Recklitis
Affiliation:
Hall-Mercer Laboratory of Developmental Psychology and Developmental Psychopathology, Harvard Medical School
Katherine Frome Paget
Affiliation:
Hall-Mercer Laboratory of Developmental Psychology and Developmental Psychopathology, Harvard Medical School

Abstract

This article investigates the impact of ego development on the course of psychiatric illness in a group of 37 psychiatrically hospitalized adolescents ages 12 to 16. The subjects, 21 males and 16 females, were evaluated at time of admission and again after 9 months of hospitalization. Using the Loevinger Sentence Completion Test (Loevinger, Wessler, & Redmore, 1970), two ego pathway groups were defined: progressors, those subjects who had advanced at least one-half stage in ego development, and nonprogressors, those who did not progress at least one-half state in ego development. Significant differences in clinical course were found between the two groups. Progressors demonstrated more significant decreases in psychiatric symptoms as measured by the Achenbach and Edelbrock (1987) Youth Self Report and had a significant change in their use of coping and defense processes compared with the nonprogressors. The findings are discussed in the context of a constructivist approach to developmental psychopathology.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (1982). Developmental psychopathology. (2nd ed.) New York: Wiley.Google Scholar
Achenbach, T. M., & Edelbrock, C. (1983). Manual for the child behavior checklist. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
Achenbach, T. M., & Edelbrock, C. (1987). Manual for the youth self report and profile. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.Google Scholar
Ball, L., & Chandler, M. (1989). Identity formation in suicidal and non-suicidal youth: The role of self continuity. Development and psychopathology, 1, 257275.CrossRefGoogle Scholar
Bond, M. P., Gardner, S. T., Christian, J., & Sigal, J. J. (1983). Empirical study of self-related defense styles. Archives of General Psychiatry, 40, 333338.CrossRefGoogle Scholar
Borst, S., Noam, G. G., & Bartok, J. (1991). A developmental approach to suicidality in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry, 30(5), 796803.Google Scholar
Browning, D. L. (1986). Psychiatric ward behavior and length of stay in adolescent and young adult inpatients: A developmental approach to prediction. Journal of Consulting and Clinical Psychology, 54, 227230.CrossRefGoogle Scholar
Chandler, M. J., Paget, K. F., & Koch, D. A. (1978). The child's demystification of psychological defense mechanisms: A structural and developmental analysis. Developmental Psychology, 14(3), 197205.CrossRefGoogle Scholar
Cicchetti, D. (1984). The emergence of developmental psychopathology. Child Development, 55(1), 17.CrossRefGoogle ScholarPubMed
Cicchetti, D. (1989). Developmental psychopathology: Some thoughts on its evolution. Development and Psychopathology, 7(1), 14.CrossRefGoogle Scholar
Cicchetti, D., & Schneider–Rosen, K. (1986). An Organizational Approach To Childhood Depression. In Rutter, M., Izard, C. E., & Read, P. B. (Eds.), Depression in young people: Developmental and clinical perspectives (pp. 71134). New York: Guilford.Google Scholar
Compas, B. E., Malcarne, V. L., & Fundacaro, K. M. (1988). Coping with stressful events in older children and young adults. Journal of Consulting and Clinical Psychology, 56(3), 405411.CrossRefGoogle Scholar
Cooper, C., & Kline, P. (1982). A validation of the Defense Mechanisms Inventory. British Journal of Medical Psychology, 55, 209214.CrossRefGoogle Scholar
Costello, E. J., Edelbrock, C. S., & Costello, A. J. (1985). Validity of the NIMH Diagnostic Interview Schedule for Children: A comparison between psychiatric and pediatric referrals. Journal of Abnormal Child Psychology, 13, 519595.CrossRefGoogle ScholarPubMed
Cramer, P. (1988). The Defense Mechanisms Inventory: A review of research and discussion of the scales. Journal of Personality Assessment, 52, 142164.CrossRefGoogle Scholar
Delamater, A., Kurtz, S., Bubb, J., White, N., & Santiago, J. V. (1987). Stress and coping in relation to metabolic control of adolescents with type 1 diabetes. Journal of Developmental and Behavioral Pediatrics, 8(3), 136140.CrossRefGoogle ScholarPubMed
Dill, D., & Noam, G. G. (1990). Ego development and treatment requests. Psychiatry, 55(1), 8591.CrossRefGoogle Scholar
Frank, S., & Quinlan, D. (1976). Ego development and adjustment patterns in adolescence. Journal of Abnormal Psychology, 85, 505510.CrossRefGoogle Scholar
Garmezy, N. (1983). Stress, coping and development in children. New York: McGraw-Hill.Google Scholar
Gleser, G. C., & Ihilevich, D. (1969). An objective instrument for measuring defense mechanisms. Journal for Consulting and Clinical Psychology, 33, 5160.CrossRefGoogle ScholarPubMed
Gold, S. N. (1980). Relations between level of ego development and adjustment patterns in adolescents. Journal of Personality Assessment, 44, 630638.CrossRefGoogle ScholarPubMed
Gordon, N. G., & Brackney, B. E. (1979). Defense mechanism preference and dimensions of psychopathology. Psychological Reports, 44, 188190.CrossRefGoogle ScholarPubMed
Haan, N. (1977). Coping and defending. New York: Academic.Google Scholar
Hauser, S. T. (1976). Loevinger's model and measure of ego development: A critical review. Psychological Bulletin, 83, 928955.CrossRefGoogle Scholar
Ihilevich, D., & Gleser, G. C. (1971). Relationship of defense mechanisms to field dependence-independence. Journal of Abnormal Psychology, 77, 196302.CrossRefGoogle ScholarPubMed
Ihilevich, D., & Gleser, G. C. (1986). Defense Mechanisms. Owosso, MI: DMI Associates.Google Scholar
Jacobson, A., Beardslee, W., Hauser, S., Noam, G. G., & Powers, S. (1986). An approach to evaluating adolescent ego defense mechanisms using clinical interviews. In Vaillant, G. (Ed.), Empirical studies of ego mechanisms of defense (pp. 4859). The Monograph Series of the American Psychiatric Press, Inc., Washington, DC: American Psychiatric Press.Google Scholar
Jennings, W., Kilkenny, R., & Kohlberg, L., (1983). Moral development theory and practice in youthful and adult offenders. In Laufer, W. & Day, J. (Eds.), Theory, Moral Development, and Criminal Behavior. Lexington, MA: D. C. Heath.Google Scholar
Juni, S., & Maslig, J. (1980). Reaction to aggression and the defense mechanisms inventory. Journal of Personality Assessment, 44, 484486.CrossRefGoogle Scholar
Kazdin, A. (1989). Developmental psychopathology. American Psychologist, 44(2), 180187.CrossRefGoogle ScholarPubMed
Keating, D. P., & Rosen, H. (Eds.) (1990). Constructivist perspectives on developmental psychopathology and atypical development. Hillsdale, NJ: Erlbaum.Google Scholar
Kernberg, O. (1975). Borderline conditions and pathological narcissism. New York: Aronson.Google Scholar
Klerman, G. L., Vaillant, G. E., Spitzer, R. L., & Michels, R. (1984). A debate on DSM-III. American Journal of Psychiatry, 141(4), 539553.Google ScholarPubMed
Kurdek, L. (1987). Gender differences in the psychological symptomatology and coping strategies of young adolescents. Journal of Early Adolescence, 7(4), 395410.CrossRefGoogle Scholar
Labouvie–Vief, G., Hakim-Larson, J., & Hobart, C. J. (1987). Age, ego level, and the life-span development of coping and defense processes. Psychology and Aging, 2(3), 286293.CrossRefGoogle ScholarPubMed
Levit, D. B. (1989). A developmental study of ego defenses in adolescence. Unpublished Doctoral Dissertation, Boston University.Google Scholar
Loevinger, J. (1976). Ego Development: Conceptions and theories. San Francisco: Jossey-Bass.Google Scholar
Loevinger, J. (1979). Construct validity of the sentence completion test of ego development. Applied Psychological Measurement, 3(3), 281311.CrossRefGoogle Scholar
Loevinger, J., Wessler, R., & Redmore, (1970). Measuring Ego Development. Vol. 2: Scoring Manual for Women and Girls. San Francisco: Jossey–Bass.Google Scholar
Massong, S. R., Dickson, A., Ritzier, B. A., & Layne, C. C. (1982). A correlational comparison of defense mechanism measures: The Defense Mechanism Inventory and the Blacky Defense Preference Inventory. Journal of Personality Assessment, 46, 477480.CrossRefGoogle ScholarPubMed
McCrae, R., & Costa, P. (1980). Openness to experience and ego level in Loevinger's sentence completion test: Dispositional contributions to developmental models of personality. Journal of Personality and Social Psychology, 39, 16.CrossRefGoogle Scholar
McCubbin, H., & Patterson, J. (1981). Systematic assessment of family stress, resources and coping. Unpublished manuscript available from The Family Stress Project, University of Minnesota.Google Scholar
Millon, T. (1984). On the renaissance of personality assessment and personality theory. Journal of Personality Assessment, 48, 450466.CrossRefGoogle ScholarPubMed
Nannis, E. D., & Cowan, P. A. (1988). Developmental psychopathology and its treatment. San Francisco: Jossey-Bass.Google Scholar
Neugarten, B. L. (1964). Personality in middle and late life: Empirical studies. New York: Atherton.Google Scholar
Noam, G. G. (1984). Self, morality and biography: Studies in clinical-developmental psychology. Unpublished doctoral dissertation. Harvard University.Google Scholar
Noam, G. G. (1988). A constructivist approach to developmental psychopathology. New Directions for Child Development, 33, 91121.CrossRefGoogle Scholar
Noam, G. G. (1991). Clinical developmental psychology: The study of development dysfunction and recovery. International Society for the Study of Behavioral Development Newsletter, 19(1), 14.Google Scholar
Noam, G. G., Didisheim, D., & Recklitis, C. (1985). Cognitive and moral development in relationship to symptoms in a group of adolescent patients. Paper presented at the 8th Biennial Meetings of the International Society for the Study of Behavioral Development, Tours, France.Google Scholar
Noam, G. G., Hauser, S. T., Santostefano, S., Garrison, W., Jacobson, A. M., Powers, S. I., & Mead, M. (1984). Ego development and psychopathology: A study of hospitalized adolescents. Child Development, 55, 184194.CrossRefGoogle ScholarPubMed
Noam, G. G., & Houlihan, J. C. (1990). Developmental dimensions of DSM-III diagnoses in adolescent psychiatric patients. American Journal of Orthopsychiatry, 50(3), 371378.CrossRefGoogle Scholar
Noam, G. G., Kilburn, D., & Ammen-Elkins, G. (1989). Adolescent Development and Psychiatric Symptomatology. Unpublished McLean Hospital Report.Google Scholar
Noam, G. G., Kohlberg, L., & Snarey, J. (1983). Steps towards a model of the self. In Lee, B. & Noam, G. G. (Eds.). Developmental approaches to the self (pp. 59141). New York: Plenum.CrossRefGoogle Scholar
Noam, G. G., Paget, K. F., Borst, S., & Bartok, J. (under review). Conduct and affective disorders in developmental perspective: A systematic study of adolescent developmental psychopathology.Google Scholar
Noam, G. G., Powers, S., Kilkenny, R., & Beedy, J. (1990). The interpersonal self in lifespan developmental perspective: Theory, measurement and longitudinal case analyses. Lifespan-Developmental Psychology, 10, 59104.Google Scholar
Noam, G. G., & Recklitis, C. (1990). The relationship between defenses and symptoms in adolescent psychopathology. Journal of Personality Assessment, 54(1,2), 311327.CrossRefGoogle ScholarPubMed
Phillips, L., & Zigler, E. (1964). Role orientation, the action-thought dimension, and outcome in psychiatric disorder. Journal of Abnormal and Social Psychology, 68, 381389.CrossRefGoogle ScholarPubMed
Powers, S. I. (1984). Coping with stress: A longitudinal study of adolescents and their families. Proceedings of the Second Biennial Meetings on Adolescent Research, Tucson, AZ.Google Scholar
Recklitis, C. J., & Noam, G. G. ( 08 1990). Aggression in Adolescent Psychopathology: Developmental and Personality Dimensions. Presented at the annual meeting of the American Psychological Association, Boston, MA.Google Scholar
Recklitis, C. J., Noam, G. G., & Borst, S. R. (03, 1990). Adolescent suicide and defense mechanisms: Differentiating attemptors from ideators and nonattemptors in a sample of adolescent psychiatric patients. Presented at the Biannual Meetings of the Society for Research in Adolescence, Atlanta, GA.Google Scholar
Redmore, C., & Loevinger, J. (1974). Ego development in adolescence: Longitudinal studies. Journal of Youth and Adolescence, 8, 120.CrossRefGoogle Scholar
Rohsenow, D. J., Erickson, R. C., & O'Leary, M. R. (1978). The defense mechanisms inventory and alcoholics. The International Journal of Addictions, 13, 403414.CrossRefGoogle ScholarPubMed
Rolf, J., Masten, A. S., Cicchetti, D., Nuechterlein, K. H., & Weintraub, S. (Eds.) (1990). Risk and protective factors in the development of psychopathology. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Ross, J. M., & Johnson, R. W. (1976). Social evaluation anxiety and defensive style. Psychological Reports, 38, 10751078.CrossRefGoogle ScholarPubMed
Rutter, M., & Garmezy, N. (1983). Developmental psychopathology. In Hetherington, E. M. (Ed.), Mussen's handbook of child psychology. Socialization, personality and social development. Vol. 4. New York: Wiley.Google Scholar
Scholz, J. A. (1973). Defense styles in suicide attempters. Journal of Consulting and Clinical Psychology, 41, 7073.CrossRefGoogle ScholarPubMed
Schueler, D. E. (1981). Defensive preference, premorbid adjustment and the schizophrenic symptoms. Unpublished doctoral dissertation, St. John's University (University Microfilm No. 81129621).Google Scholar
Schultz, L. H., & Selman, L. (1989). Bridging the gap between interpersonal thought and action in early adolescence: The role of psychodynamic processes. Development and Psychopathology, 1, 133152.CrossRefGoogle Scholar
Shapiro, D. (1965). Neurotic styles. New York: Basic.Google Scholar
Sief, M. N., & Atkins, A. L. (1979). Some defensive and cognitive aspects of phobias. Journal of Abnormal Psychology, 88, 4251.CrossRefGoogle Scholar
Spivack, G., & Shure, M. (1974). Social adjustment of young children: A cognitive approach to solving real-life problems. San Francisco, CA: Jossey-Bass.Google Scholar
Tolor, A., & Fehon, D. (1987). Coping with stress: A study of male adolescents' coping strategies as related to adjustment. Journal of Adolescent Research, 2(1), 3342.CrossRefGoogle Scholar
Trevethan, S. D., & Walker, L. J. (1989). Hypothetical versus real-life moral reasoning among psychopathic and delinquent youth. Development and Psychopathology, 1, 91103.CrossRefGoogle Scholar
Vaillant, G. E. (1977). Adaptation to life. Boston: Little Brown.Google Scholar
Vaillant, G. E., & McCullough, L. (1987). The Washington University Sentence Completion Test compared with other measures of adult ego development. American Journal of Psychiatry, 144(9), 11891194.Google ScholarPubMed
Vaillant, G. E. (Ed.) (1986). Empirical studies of ego mechanisms of defense. The Monograph Series of the American Psychiatric Press, Inc. Washington DC: American Psychiatric Press.Google Scholar
Wechsler, D. (1974). Wechsler Intelligence Scale for Children-Reviesed. New York: Psychological Corporation.Google Scholar