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What are the mature ego defenses?

SASH

Suppression
Altruism
Sublimation
Humor

1

What is acting out?

Immature ego defense in which a patient expresses unacceptable thoughts/feelings through action

Ex: Tantrum

2

What is Dissociation?

Immature ego defense in which a patient temporarily drastically changes personality, memory, or behavior to avoid emotional stress.

Extreme form is dissociative identity disorder (split personalities).

3

What is denial?

Immature ego defense in which the patient avoids the awareness of some painful reality.

Ex: AIDS and cancer patients commonly react this way

4

What is Displacement?

Immature ego defense in which the takes emotions toward one thing and directs them toward another.

Ex: My boss yells at me, I'm mad at my boss, I yell at my wife.

5

What is Projection?

Attributing an unacceptable INTERNAL impulse to an external source.

Ex: Patient wants another women, accuses his wife of cheating.

6

What is Fixation?

Immature ego defense in which a patient remains partially at a more childish level of development.

7

What is Identification?

Immature ego defense in which a person will model behavior after another person who is more powerful (even if not admired).

Ex: Abused child identifies with an abuser

8

What is Isolation?

Isolation of affect is an immature ego defense in which a person separates feelings from ideas & events.

Ex: Describes a murder in gory detail without an emotional response.

9

What is Rationalization?

Proclaiming logical reasons for actions performed for other reasons. Usually to avoid self-blame.

Ex: After getting fired, claiming that you didn't want the job anyway.

10

What is Reaction Formation?

Immature ego defense in which a person replaces a feeling with an emphasis on its opposite.

Ex: A very sexual person joins a monastery.

11

What is Regression?

Immature ego defense in which a person reverses their maturation to go back to an earlier mode of dealing with the world. Seen in children under new stressors (birth of a sibling, hospitalization).

12

What is Repression?

Immature ego defense in which a person INVOLUNTARILY withholds a feeling/idea from conscious thought.

Ex: Not remembering that a traumatic experience happened.

13

What is Splitting?

Immature ego defense in which patients believe that people are either all good or all bad at different times. Commonly seen in borderline personality disorder.

14

What is Altruism?

A mature ego defense in which people alleviate guilty feelings by generosity toward others.

15

What is Humor?

A mature ego defense in which a person can laugh about an adverse or anxious situation.

16

What is Sublimation?

A mature ego defense in which a person replaces an unacceptable wish with an action that is similar but acceptable.

Ex: A teen's aggression toward his father is channeled into sports

17

What is Suppression?

A mature ego defense in which a person intentionally withholds an idea/feeling from conscious awareness.

18

What is the treatment for separation anxiety disorder?

SSRI's & behavioral interventions

19

When must ADHD present to be diagnosable?

Before age 12

20

What is seen with autism spectrum disorder?

Poor social interactions
Communication deficits
Repetitive behaviors
Restricted interests

Seen more in boys

21

What is seen with Rett disorder?

X-linked seen only in females (males die in utero)

Symptoms at age 1-4
Regression/loss of development
Loss of speech
Ataxia
Stereotyped hand wringing

22

What NT changes are seen in Huntinton's disease?

Decreased GABA & ACh
Increased Dopamine

23

What NT changes are seen in Parkinson's disease?

Decreased Dopamine
Increased 5-HT & ACh

24

What NT changes are seen in schizophrenia?

Increased Dopamine

25

What is lost first with regard to orientation in a confused patient?

1) Time
2) Place
3) Person

26

What is the treatment for delirium?

Identify & address underlying cause
Optimize brain function (O2, etc.)
Haloperidol

27

What is pseudodementia?

Depression in the elderly may present like dementia

28

What type of hallucinations are usually medical in etiology & what type are psychiatric?

Auditory --> psychiatric

Visual --> medical

29

What are the time cutoffs on the spectrum of schizophrenic disorders?

Brief psychotic disorder (stress)

1-6 months --> Schizophreniform disorder

>6 months --> Schizophrenia