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MRCPsych Part A > Dynamic Psychopathology > Flashcards

Dynamic Psychopathology Flashcards

1
Q

Who organised Freudian defences?

A

Anna Freud

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2
Q

Who classified defences into mature, immature and neurotic?

A

Vaillant (1977)

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3
Q

Who created psychotic defences?

A

Klein

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4
Q

How are defence mechanisms formed?

A

Prohibitions lead to wish/impulse, or signal anxiety, by which defence operation is formed and symptoms occur

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5
Q

What are the mature defences?

A 
Altruism
Humour
Anticipation
Sublimation
Suppression
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6
Q

What is the conflict in altruism?

A

Defeat in a situation

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7
Q

What is the conflict in humour?

A

Failure, loss or destruction of belongings

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8
Q

Importance of Anticipation?

A

Goal-orientated

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9
Q

Conflict in Anticipation?

A

Sudden threat event

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10
Q

Describe suppression

A

Consciously or semiconsciously postponing attention to a conscious impulse or conflict.
Discomfort acknowledged but minimised

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11
Q

Conflict in suppression?

A

Painful event or sexual impulse

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12
Q

What are neurotic defences?

A

Act at level of mental inhibition and thereby patient is deprived of freedom in decision-making but retains insight

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13
Q

Name the neurotic defences

A 
Displacement
Dissociation
Isolation
Rationalisation
Reaction formation
Repression
Intellectualisation
Identification with aggressor
Undoing
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14
Q

What is isolation?

A

Splitting an idea from the affect that accompanies it but is now repressed

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15
Q

Which disease is isolation seen in?

A

OCD

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16
Q

Conflict in isolations?

A

Painful emotions or memories

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17
Q

Result of isolation?

A

Talking about emotional events without feeling

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18
Q

What is reaction transformation?

A

Transforming an unacceptable impulse into its exact opposite

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19
Q

Clinical affect of reaction formation?

A

If used at early state of ego development, can become permanent character trait - obsessional personality

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20
Q

Conflict in reaction formation

A

Hostility and disinterest

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21
Q

Result of reaction formation

A

Devotion, self-sacrificing, correctness

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22
Q

What is primary repression?

A

Curbing ideas and feelings before they have attained consciousness

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23
Q

What is secondary repression?

A

Excludes from awareness what was once experienced at a conscious level

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24
Q

Difference between repression and suppression

A

Suppression is mere postponement, not loss of thoughts from conscious perception

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25
Q

Result of repression?

A

Gaps in memory - often unnoticed

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26
Q

Difference in result between intellectualisation and rationalisation

A

Intellectualisation: deals with inanimate objects (emphasises facts rather than emotions)
Rationalisation: provides excuses

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27
Q

Conflict in intellectualisation

A

Disturbing feelings and thoughts

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28
Q

What is undoing associated with?

A

OCD - magic thinking and rituals

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29
Q

Conflict in Undoing

A

Sadistic wishes

Unacceptable impulses

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30
Q

Result of Undoing

A

Superstitions

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31
Q

Name the narcissistic defences

A

Projection

Denial

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32
Q

Name the Kleinian defences

A 
Splitting
Introjection
Projective identification
Denial
Omnipotence
Grandiosity
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33
Q

When might projective identification be seen?

A

Psychotic paranoid states

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34
Q

What does Ogden’s model divide projective identification into?

A

Three steps

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35
Q

Step one of projective identification?

A

Projection of oneself to an external object. 1a is the blurring of self

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36
Q

What is step 2 of projective identification?

A

Interpersonal interaction in which projector actively pressures recipient to think, feel and act with the projection

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37
Q

What is step 3 of projective identification?

A

Reinternalization of projection after the recipient has psychologically processed it

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38
Q

What is omnipotence?

A

Belief that one can transform or influence the external world through ones thoughts

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39
Q

Which disease is omnipotence seen in?

A

OCD

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40
Q

Conflict in omnipotence

A

Helplessness

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41
Q

Name some immature defences

A 
Acting out
Passive aggression
Somatisation
Regression
Somatosensory amplification
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42
Q

Which defence mechanism is considered part of the creative process?

A

Regression

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43
Q

What is somatosensory amplification?

A

Experiencing bodily sensations as unusually intense or distressing

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44
Q

Defences used in alcoholism

A

Denial

Rationalization

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45
Q

Defences used in anorexia

A

Denial

Rationalization

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46
Q

Defences used in depression

A

Regression

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47
Q

Defences used in dissocial personality

A

Acting out

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48
Q

Defences used in hysteria

A

Repression

Conversion

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49
Q

Defences used in OCD

A

Isolation of affect
Undoing
Reaction formation
Magical thinking

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50
Q

Defences used in paranoid delusions

A

Projection

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51
Q

Defences used in phobias

A

Displacement

Avoidance

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52
Q

Where was the Topographical theory of the mind mentioned?

A

Interpretation off Dreams (1900)

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53
Q

Structure of the mind in the Topographical theory?

A

Conscious
Preconscious
Unconscious

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54
Q

Where does the conscious system receive information from?

A

Outside world

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55
Q

How are the contents of the topographical theory communicated?

A

Via speech and behaviour

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56
Q

What does the conscious system operate

A

Secondary process thinking

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57
Q

What is attention cathexis?

A

Investment of psychic energy on a particular idea or feeling to process it consciously

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58
Q

What does the unconscious system contain?

A

Contents of censored or repressed wishes

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59
Q

What type of thinking is involved in the unconscious?

A

Primary-process

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60
Q

What governs the unconscious?

A

PLeasure principle

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61
Q

How is the unconscious evident?

A

Parapraxes

Dreams

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62
Q

Describe cathexis in the unconscious

A

Happens often and quickly

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63
Q

What does the preconscious do?

A

Acts when needed

Maintains repressive barrier to censor unacceptable wishes and desires

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64
Q

What does the preconscious interface with?

A

Both unconscious and conscious

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65
Q

How do thoughts go from the unconscious to the conscious?

A

Via the preconscious

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66
Q

What are the characteristics of an instinct?

A

Source
Impetus
Aim
Object

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67
Q

What is the impetus of an instinct?

A

Intensity or force of it

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68
Q

What does the dual instinct theory state?

A

Sexual and aggressive energy are dual insticts. Libido if the force by which sexual instinct in presented in the mind. Aggression is an instinct with destruction as aim

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69
Q

Where does the aggression instinct originate?

A

Skeletal muscles

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70
Q

According to Freud, what is the dominant force in Biology?

A

Thanatos - death

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71
Q

What is the hierarchy of anxiety?

A 
Signal anxiety
Disintegration/annihilation
Stranger
Separation
Fear of object loss
Castration
Superego
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72
Q

What is signal anxiety?

A

Unconscious perception of external/internal threat which leads to resource mobilization and aversion of threat.

73
Q

What is disintegration anxiety?

A

Concerns about fusion with external object

74
Q

When does stranger anxiety occur?

A

7-9 months of age

75
Q

What is separation anxiety?

A

When mother is recognized as an independent object

76
Q

When does fear of object loss occur?

A

Often in girls during phallic stage

77
Q

What is superego anxiety?

A

Id vs ego conflicts

78
Q

What is Analytical Psychology known as?

A

Jungian Model

79
Q

What is the personal unconscious as per Jung?

A

Collection of repressed individual memories

80
Q

What is archetype a part of?

A

Collective unconscious

81
Q

What is an archetype?

A

Representational images with universal symbolic meanings

82
Q

What is complex a part of?

A

Personal unconscious

83
Q

What are complexes?

A

Toned ideas developing due to interactions of complexes with archetypes

84
Q

What is persona?

A

Mask covering ones personality - presented to outside world

85
Q

What is anima?

A

Unconscious feminine aspect of man

86
Q

What is animus?

A

Unconscious masculine aspect of woman

87
Q

What is shadow?

A

An archetype?

88
Q

Describe shadow?

A

Personificatino of unacceptable aspects of oneself symbolised as a dark internal alien

89
Q

What is individuation?

A

Ultimate goal of life where an individual develops a sense of self-identity

90
Q

Who introduced the terms Extra and introversion?

A

Jung

91
Q

What is abreaction?

A

Process of recovering and verbalizing suppressed feelings that cause symptoms

92
Q

What is resistance?

A

When patients cannot recall significant memories

93
Q

What did Freud suggest resistance was due to?

A

Unconscious forces involved in repression

94
Q

What is Freud’s wish fulfilment theory?

A

Dreams are attempts to fulfil unconscious wishes in a surrogate manner

95
Q

What are the content of dreams made up of?

A

Nocturnal sensory stimuli (thirst etc)
Daytime residue (from waking life)
Repressed impulse

96
Q

What are the two layers of dream content according to Freud?

A

Manifest content

Latent content

97
Q

What is the manifest content?

A

That which is recalled by the dreamer

98
Q

What is the latent content?

A

Unconscious thoughts and wishes that threaten to awaken the dreamer

99
Q

What is dream work?

A

Unconscious mental operation by which latent content is transformed into manifest content

100
Q

what is condensation?

A

Several unconscious impulses combined into a single image in dream cnotent

101
Q

What is irradiation/diffusion?

A

Converse of condensation - multiple images in dreams represent one unconscious impulse

102
Q

What is symbolic representation in dreams?

A

Highly charged objects represented by using innocent images that are in some way connected

103
Q

What characterizes the primary process of thinking in dreams?

A

Condensation
Displacement
Symbolic representation

104
Q

What is the primary process of thinking in dreams?

A

Defies logic, lacks a sense of time and space, can accept presence of contradictory items simultaneously and often incoherent
Modus operandi for Id

105
Q

What is secondary revision of dreams?

A

When the more mature aspect of the ego helps to organise primary aspects of dreams more coherently

106
Q

How does secondary revision occur

A

Via secondary process

107
Q

What is the secondary process?

A

Logical, intact with time and space, mature

108
Q

What do anxiety dreams represent?

A

Failure in protective function of dream-work mechanism

109
Q

Importance of punishment dreams?

A

Defy wish fulfilment theory

Freud explained these existed as a compromise between conscience and repressed wish

110
Q

What is Bell mania?

A

Disorganized hyperactivity that can be fatal is untreated

111
Q

Why is Bell mania rare?

A

Widespread use of antipsychotics

112
Q

What is Binswanger disease?

A

Type of multi-infarct dementia (vascular) in which infarcts selectively affect white matter

113
Q

What is Briquet syndrome?

A

Somatization disorder - disorder of multiple somatic complaints across different organ systems due to anxiety

114
Q

What is Brueghel syndrome?

A

Trigeminal dystonia that affects mouth

115
Q

What may provoke Brueghel syndrome?

A

Antipsychotics

116
Q

What is Charcot-Wilbrand syndrome?

A

Loss of all or part of dreaming after brain injury

117
Q

What is Clerambault-Kandinsky syndrome?

A

Any paranoid psychosis in which thought insertion predominates

118
Q

What is Cornelia de Lange syndrome?

A 
Congenital mental retardation
Patients self-injure
Hyperactivity
Sleeplessness
Aggression
119
Q

What is Da Costa syndrome?

A

Panic disorder - debilitating anxiety attacks accompanied by atetmpts to avoid such attacks

120
Q

What is Fahr disease?

A

Idiopathic calcification of basal ganglia

121
Q

Signs in Fahr disease?

A

Abnormal extra movements

Comorbid with obsessive-compulsive and mood symptoms

122
Q

What is Ganser syndrome?

A

Symptom of answering all questions approximately, e.g. 2+7=27

123
Q

What is Gardner-Diamond syndrome?

A

Purpura associated with psychological stress.

124
Q

What reproduces the rash in Gardner-Diamond syndrome?

A

Subcut injection of patients own blood

125
Q

What is Gelineau syndrome?

A 
Narcolepsyl
daytime sleepiness
Cataplexy
Sleep paralysis
Hypnagogic hallucinations
126
Q

What is Gerstmann-Straussler-Scheinker?

A

Transmissible prion disease causing dementia

127
Q

Who does Gerstmann-Straussler-Scheinker occur in?

A

Only those with particular AD defect of chromosome

128
Q

What is Geschwind syndrome?

A

Interictal behaviour including hyposexuality, hyperreligiosity, hypergraphia and viscosity (not observing social boundaries in conversation)

129
Q

In which patients is Geschwind syndrome seen in?

A

TLE

130
Q

What is Gjessing syndrome?

A

Periodic catatonia - disorganized state of withdrawl or agitation that fluctuates

131
Q

What is Hakim-adams syndrome?

A

Normal pressure hydrocephalus

132
Q

What is Heller syndrome?

A

Childhood disintegrative disorder - loss of milestones in multiple domains after age

133
Q

What is Hoover sign?

A

Unconsciously exerting downward pressure with healthy leg when paretic leg is challanged

134
Q

What does absence of Hoover sign suggest?

A

Feigned deficit

135
Q

What is Kahlbaum syndrome?

A

Catatonia; syndrome of waxy posturing or purposeless agitation or speech

136
Q

How is Kahlbaum syndrome treated?

A

Benzos

ECT

137
Q

What is Kanner syndrome?

A

Autism

138
Q

What is Kozhevnikov syndrome?

A

Continuous partial epilepsy leading to progressive cognitive deterioration

139
Q

What is Landau-Kleffner syndrome?

A

Continuous partial simple epilepsy causing loss of language development in children

140
Q

What is Langfeldt psychosis?

A

Psychosis without declining curse of schizophrenia

141
Q

What is Marchiafava-Bignami disease?

A

Dementia due to callosal degeneration, related to chronic alcohol (wine) abuse

142
Q

What is Marinescu reflex?

A

Palmomental reflex;

Movement of chin after stroking palm

143
Q

What is an abnormal Marinescue reflex?

A

If movement of chin is unilateral, suggests frontal or diffuse brain damage

144
Q

What is Martin Bell syndrome?

A

Fragile X

145
Q

What is Meige syndrome?

A

Dystonic blepharospasm

146
Q

What is morvan disease?

A

Involuntary fiber activity, hyperhidrosis and sleeplessness that leads to death in weeks if not treated

147
Q

What is Rasmussen syndrome?

A

Unilateral brain atrophy and continuous epilepsy resulting in cognitive decline until affected portion of brain is removed

148
Q

What is Sanfilippo syndrome?

A

Congenital mental retardation
Aggression
Insomnia

149
Q

Cause of Sanfilippo syndrome?

A

Chromosone 12 deletion

150
Q

What is Smith-Magnes syndrome?

A

Congenital mental retardation
Severe self-injury
Self-hugging behaviour

151
Q

What is Steele-Richardson-Olszewski disease?

A

Dementia with ataxia, loss of ability to look up or down and Parkinsonism

152
Q

What is Strauss syndrome?

A

ADHD

153
Q

What is Sydenham chorea?

A

Movement disorder that follows rheumatic fever

Preceded by obsessive-compulsive symptoms

154
Q

What is Von Economo?

A

Encephalitis Lethargica;
lethargy
obsessive-compulsive symptoms

155
Q

What causes Wolfram syndrome?

A

AR syndrome caused by defect in chromosome 4

156
Q

How does Wolfram Syndrome present?

A

Diabetes
Bilateral optic atrophy
Diversive psych disorders

157
Q

What are heterozygotes for Wolfram syndrome at risk of?

A

Psych illness

158
Q

Who coined the term schizophrenia?

A

Blueler

159
Q

Who coined the term hebephrenia?

A

Hecker

160
Q

Who coined the term catatonia?

A

Kahlbaum

161
Q

Who coined the term dementia precoce?

A

Morel

162
Q

Who coined the term schizoaffective?

A

Kasanin

163
Q

Who coined the term neurasthenia?

A

Beard

164
Q

Who coined the term unipolar and bipolar?

A

Kleist

165
Q

Who coined the term hypnosis?

A

Braid

166
Q

Who coined the term group dynamics?

A

Lewin

167
Q

Who coined the term group psychotherapy?

A

Moreno

168
Q

Who coined the term psychopathic inferiority?

A

Koch

169
Q

Who coined the term Psychiatry?

A

Reil

170
Q

Who coined the term institutional neurosis?

A

Barton

171
Q

Duration of sx for diagnosis of alcohol dependence for ICD 10?

A

12months

172
Q

How many sx needed for diagnosis of alcohol dependence under the ICD 10?

A

At least 3

173
Q

Sx for alcohol dependence under ICD 10

A
  1. intense desire to drink alcohol
  2. difficulty in controlling the onset, termination and the level of drinking
  3. experiencing withdrawal symptoms if alcohol is not taken
  4. use of alcohol to relieve from withdrawal symptoms 5. tolerance as evidenced by the need to escalate dose over time to achieve same effect
  5. salience - neglecting alternate forms of leisure or pleasure in life
  6. A narrowing personal repertoire of alcohol use.
174
Q

Who suggested that psychiatric diseases were brain diseases?

A

Greisinger

175
Q

Edwards and Gross criteria (1976) for alcohol dependence?

A
  1. narrowed repertoire
  2. salience of alcohol seeking behaviour
  3. increased tolerance
  4. repeated withdrawals
  5. Drinking to prevent or relieve withdrawals.
  6. subjective awareness of compulsion
  7. reinstatement after abstinence
176
Q

Atypical anorexia in ICD?

A

Normal body image perception

177
Q

Atypical anorexia in DSM?

A

Normal body weight

178
Q

At what developmental stage is OCD?

A

Anal stage

179
Q

At what developmental stage are people with alcohol abuse?

A

Oral stage

MRCPsych Part A (22 decks)

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