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Videnscenter for Psykotraumatologi


Forsvarsmekanismer er i en række sammenhænge blevet undersøgt som potentiel medierende faktor for posttraumatiske reaktioner. Vi har i vores forskning bl.a. fundet, at særligt den neurotiske og umodne forsvarsmekanisme er signifikant positivt relateret til en øget grad af posttraumatisk stress. Ligeledes er umodne forsvarsmekanismer i sig selv en risikofaktor for udviklingen af en øget psykologisk belastning efter at have være udsat for traumatiske begivenheder.



In the current study, we aim to examine the link between exposure to multiple traumatic events (polyvictimization), posttraumatic stress disorder (PTSD) symptoms (PTSS), and psychiatric symptomatology in early adolescence. Furthermore, we aim to explore the mediating roles of defense styles and coping styles in the associations between polyvictimization, PTSS, and psychiatric symptomatology. Data from a Danish national representative sample of 390 eighth-grade students with a mean age of 13.95 (SD= 0.37) years were used. Participants responded to validated self-report questionnaires in 2001. The dimensions of immature defense styles and emotional and avoidance coping mediated the positive associations between polyvictimization, PTSS, and psychiatric symptomatology. Serial multiple mediation indicated that the sum of exposure to traumatic events was significantly associated with more immature defense styles, associated with both high levels emotional and avoidance coping, which, in turn, were associated with high levels of PTSS and psychiatric symptomatology. Polyvictimization is related to adverse outcomes in early adolescence. Both immature defense styles and emotional and avoidance coping styles should be considered as risk factors for the development of psychological distress following exposure to multiple traumas.


Relevante publikationer:
Ferrajão, P., Batista, C.I. & Elklit, A. Polytraumatization, defense mechanisms, PTSD and complex PTSD in Indian adolescents: a mediation model. BMC Psychol 11, 411 (2023). DOI: 10.1186/s40359-023-01456-0

Zerach, G. & Elklit, A. (2017). Polyvictimization and psychological distress in early adolescence: A mediaton model of defense mechanisms and coping styles. Journal of Interpersonal Violence, Doi: 10.1177/0886260517716944

This study aimed to test theoretical alternative models to explain the role of defense styles play in mediating the relationship between traumatic experiences and posttraumatic stress severity. The data were collected from a survey based on a national representative probability sample of 390 Danish school children age 13 to 15. The survey included questions about demographic variables, traumatic events and life events, the Harvard Trauma Questionnaire, and the Defense Style Questionnaire. Based on these variables, three models were proposed that specified the relationship between trauma exposure and posttraumatic stress severity to be either (1) direct with no effect for defense styles, (2) fully mediated by defense styles, or (3) both direct and mediated. Structural equation modelling was used to fit each of the models and assess model fit. The fit for the combined direct and mediated model was acceptable, and was superior in explanatory power compared to the direct effect and the fully mediated models. The number of traumas experienced was positively and significantly related to all defense styles. The Neurotic and Immature defense style variables were positively and significantly related to posttraumatic stress severity.


Relevante publikationer:
Shevlin, M. & Elklit, A. (2008). Modelling the role of defence styles as mediating the trauma-PTSD relationship in Danish adolescents. Irish Journal of Psychology, 29 (3-4), 179-191.

This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV‐positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio‐demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.


Relevante publikationer:
Pedersen, S.S. & Elklit, A. (1998). Traumatisation, Psychological Defense Style, Coping, Symptomatology, and Social Support in HIV-positive: A Pilot Study. Scandinavian Journal of Psychology, 39 (2), 55-60. Doi: 10.1111/1467-9450.00056

There is strong evidence that the experience of several adverse childhood experiences (ACEs) is a risk factor for higher anxiety and depression symptoms severity among adolescents. Defense mechanisms may influence the link between exposure to ACEs and anxiety and depression symptoms severity. We analyzed the associations between direct and indirect exposure to ACEs and anxiety and depression symptoms in Kenyan adolescents and explored the mediating role of defense mechanisms in the associations between direct and indirect exposure to anxiety and depression symptoms severity. A sample of 475 Kenyan adolescents (M = 16.4; SD = 1.4) completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modeling employing Preacher and Hayes’ (2008) procedures. Higher direct exposure to ACEs was related to higher levels of depression symptoms and higher indirect exposure to ACEs was related to higher levels of anxiety symptoms. Importantly, higher direct exposure to ACEs was significantly linked to high immature defense mechanisms levels, which in turn were linked with high anxiety and depression symptoms. High levels of immature defense mechanisms might aggravate anxiety and depression symptoms, which might be seen as a possible psychological distress mechanism subsequent to exposure to multiple ACES in African adolescents.


Relevante publikationer:
Paulo Ferrajão, Bárbara Tourais & Ask Elklit (2023) Attachment Anxiety and Dissociation Mediate Associations Between Polytrauma and Somatization in Kenyan Adolescents, Journal of Trauma & Dissociation, DOI: 10.1080/15299732.2023.2231958

Paulo Ferrajão, Inês Faria & Ask Elklit (2023) World Assumptions Mediate Associations Between Polytrauma With Psychological Symptoms in Kenyan Adolescents, Journal of Loss and Trauma, Doi: 10.1080/15325024.2023.2217035

Ferrajão, P., Dias, J., & Elklit, A. (2022). Defense mechanisms mediate associations between exposure to adverse childhood experiences and anxiety and depression in Kenyan adolescents. Traumatology. Doi: 10.1037/trm0000426