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Mature Defense mechanisms

1. Altruism (relieve guilt by unsolicited generosity)
2. Humor
3. Sublimation (shift bad energy to good outlet)
4. Suppression (voluntary)

1

Ego Defenses:
Suppression vs. Repression vs. Denial

Suppression: mature, voluntary choice to NOT think about X
Repression: IMmature, INvoluntary witholding of thoughts of X (don't remember)
Denial: IMmature, full awareness of X but choose NOT to believ

2

Ego defenses:
Dissociation vs. Splitting vs. Isolation

Dissociation: IMmature, BIG change in personality/Bx to avoid stress
Splitting: IMmature, categorizing all ppl as 100% good OR bad
Isolation: Separation of feelings from thoughts/memory (tell story w/O emotional response)

3

Ego defenses:
Reaction formation vs. Sublimation

Reaction formation: IMmature, replace "bad" feeling w/ OPPosite feeling/action (not matching own value system)
Sublimation: mature, re-directing unacceptable X with acceptable outlet w/in value system (ie: aggression --> sports energy)

4

Ego defenses:
Projection vs. Displacement

Projection: IMmature, attribute unacceptable thoughts to external source & blame them for it
Displacement: releasing feelings about X onto a separate neutral person/object (ie: work stress => yell at kids)

5

Ego defenses:
Fixation vs. Regression

Fixation: IMmature, stop partially STAY at same ~child-ish level of dvpt

Regression: IMmature, going backwards to less developed coping mechs (even Bx patterns, ie: bed-wetting in kids who were potty-trained)

6

Ego defense mech: Identification

IMmature coping mech, where person models Bx after someone more powerful *may be negative Bxs
ie: Abused child mimics Bx of abuser

7

"4 W's" of infant social/affection deprivation

1. Weak (weight loss, lack mm tone, ill)
2. Wordless (poor language development)
3. Withdrawn (depression, lack social skills)
4. Wary (lack trust)
*> 6 months = IRreversible, CAN be fatal.

8

Characteristics of Oppositional Defiant Disorder

consistent patterns of hostile, defiant Bx toward authority figures.
BUT no serious violations of social norms
(vs. Conduct disorder/Antisocial personality disorder => violate basic rights of others)

9

Drugs used to treat ADHD

Methylphenidate, amphetamines, atomoxetine
*also Bx interventions
(onset age <7, may last into adulthood)

10

Criteria for diagnosis of Tourette's, and Tx

Onset before age 18, recurrent NON-rhythmic motor or vocal tics
*persist > 1 year.
Tx: anti-psychotics, Bx therapy

11

Case:
Girl age 3, brought to pediatrician by mom bc noticed loss of previously established language skills, difficulty walking, and unusual "hand-wringing."

Rett's disorder, X-linked dominant (boys don't survive)
Onset: age 1-4.
= regression of language, social/play, &/or motor skills.
*may also lose bowel or bladder control.

12

Case:
Boy, age 4 brought to pediatrician by dad. Had met normal developmental milestones at each yearly visit until this year. Now has significant loss of expressive & receptive language skills, and does not play well with siblings.

Childhood disintegrative disorder, mostly in boys.
Onset: age 3-4 (at least 2 years of normal development before onset)
=> BIG loss of language, social, &/or motor skills.
*may also lose bladder/bowel control.

13

Autism vs. Asperger's
(both = "pervasice developmental disorders")

both: repetitive Bxs, greater focus on objects than people.
Autism: severe language impairment, below avg. intelligence.
Asperger's: mild. NO language or cognitive impairment.
* w/ all-absorbing interests, social difficulty.