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Adaptive styles in adolescents with psychosomatic illness.

Repressive defense style, characterized by low levels of self-reported distress and high levels of defensiveness, has been well studied in adult patients. This study identified four adaptive styles (repressor, impression manager, low anxious, and high anxious) in an adolescent psychosomatic patient sample (n = 120) by standardized psychometric examination. Adolescents with an active medical diagnosis on DSM III-R axis III or with an axis I diagnosis associated with physical symptoms (conversion disorder, somatization disorder, and psychological factors affecting physical condition) were more likely to be repressors. Those with affective disorders were more likely to be impression managers. Implications for pediatric and psychiatric management are discussed.