A 28-year-old man with antisocial personality disorder is described by his family as charming, superficial, lacking remorse for hurting others, with a history of juvenile conduct disorder. Which defence mechanisms are most characteristic of antisocial/narcissistic cluster?

• A Omnipotence, devaluation, and projective identification ✓
• B Repression and undoing
• C Regression and conversion
• D Isolation of affect and intellectualisation

Explanation

Antisocial and narcissistic personality disorders (Cluster B) share primitive defence mechanisms: omnipotence (grandiose belief in one's own power/superiority), devaluation (dismissing others as inferior to protect the grandiose self), and projective identification (projecting unacceptable traits onto others and then interacting with them as if the projected traits are real). These defences protect a fragile self from perceived threats and shame. Repression and undoing are neurotic-level defences seen more in OCD and phobic disorders. Isolation of affect and intellectualisation characterise obsessional defences.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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