Empirical test of Vaillant's hierarchy of ego functions

Vaillant (I , 2) hypothesized a four-level hierarchy of ego functions based on psychoanalytic psychology. The first, most disturbed level comprises the ‘ ‘narcissistic” (1) or “psychotic” (2) mechanisms ofdenial of reality, delusional projection, and distortion. The second level is characterized by ‘ ‘immature’ ‘ mechanisms: schizoid fantasy, projection, hypochondniasis, passive-aggressive behavior, and acting out. The third level is characterized by the ‘ ‘neurotic’ ‘ mechanisms of intellectualization, repression, reaction formation, displacement, and dissociation. The fourth, most healthy level comprises ‘ ‘mature’ ‘ mechanisms: sublimation, altruism, suppression, anticipation, and humon.