Dynamic Psychopathology Flashcards
1
Q
Who organised Freudian defences?
A
Anna Freud
2
Q
Who classified defences into mature, immature and neurotic?
A
Vaillant (1977)
3
Q
Who created psychotic defences?
A
Klein
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
5
Q
What are the mature defences?
A
Altruism Humour Anticipation Sublimation Suppression
6
Q
What is the conflict in altruism?
A
Defeat in a situation
7
Q
What is the conflict in humour?
A
Failure, loss or destruction of belongings
8
Q
Importance of Anticipation?
A
Goal-orientated
9
Q
Conflict in Anticipation?
A
Sudden threat event
10
Q
Describe suppression
A
Consciously or semiconsciously postponing attention to a conscious impulse or conflict.
Discomfort acknowledged but minimised
11
Q
Conflict in suppression?
A
Painful event or sexual impulse
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
13
Q
Name the neurotic defences
A
Displacement Dissociation Isolation Rationalisation Reaction formation Repression Intellectualisation Identification with aggressor Undoing
14
Q
What is isolation?
A
Splitting an idea from the affect that accompanies it but is now repressed
15
Q
Which disease is isolation seen in?
A
OCD
16
Q
Conflict in isolations?
A
Painful emotions or memories
17
Q
Result of isolation?
A
Talking about emotional events without feeling
18
Q
What is reaction transformation?
A
Transforming an unacceptable impulse into its exact opposite
19
Q
Clinical affect of reaction formation?
A
If used at early state of ego development, can become permanent character trait - obsessional personality
20
Q
Conflict in reaction formation
A
Hostility and disinterest
21
Q
Result of reaction formation
A
Devotion, self-sacrificing, correctness
22
Q
What is primary repression?
A
Curbing ideas and feelings before they have attained consciousness
23
Q
What is secondary repression?
A
Excludes from awareness what was once experienced at a conscious level
24
Q
Difference between repression and suppression
A
Suppression is mere postponement, not loss of thoughts from conscious perception
25
Result of repression?
Gaps in memory - often unnoticed
26
Difference in result between intellectualisation and rationalisation
Intellectualisation: deals with inanimate objects (emphasises facts rather than emotions)
Rationalisation: provides excuses
27
Conflict in intellectualisation
Disturbing feelings and thoughts
28
What is undoing associated with?
OCD - magic thinking and rituals
29
Conflict in Undoing
Sadistic wishes
| Unacceptable impulses
30
Result of Undoing
Superstitions
31
Name the narcissistic defences
Projection
| Denial
32
Name the Kleinian defences
```
Splitting
Introjection
Projective identification
Denial
Omnipotence
Grandiosity
```
33
When might projective identification be seen?
Psychotic paranoid states
34
What does Ogden's model divide projective identification into?
Three steps
35
Step one of projective identification?
Projection of oneself to an external object. 1a is the blurring of self
36
What is step 2 of projective identification?
Interpersonal interaction in which projector actively pressures recipient to think, feel and act with the projection
37
What is step 3 of projective identification?
Reinternalization of projection after the recipient has psychologically processed it
38
What is omnipotence?
Belief that one can transform or influence the external world through ones thoughts
39
Which disease is omnipotence seen in?
OCD
40
Conflict in omnipotence
Helplessness
41
Name some immature defences
```
Acting out
Passive aggression
Somatisation
Regression
Somatosensory amplification
```
42
Which defence mechanism is considered part of the creative process?
Regression
43
What is somatosensory amplification?
Experiencing bodily sensations as unusually intense or distressing
44
Defences used in alcoholism
Denial
| Rationalization
45
Defences used in anorexia
Denial
| Rationalization
46
Defences used in depression
Regression
47
Defences used in dissocial personality
Acting out
48
Defences used in hysteria
Repression
| Conversion
49
Defences used in OCD
Isolation of affect
Undoing
Reaction formation
Magical thinking
50
Defences used in paranoid delusions
Projection
51
Defences used in phobias
Displacement
| Avoidance
52
Where was the Topographical theory of the mind mentioned?
Interpretation off Dreams (1900)
53
Structure of the mind in the Topographical theory?
Conscious
Preconscious
Unconscious
54
Where does the conscious system receive information from?
Outside world
55
How are the contents of the topographical theory communicated?
Via speech and behaviour
56
What does the conscious system operate
Secondary process thinking
57
What is attention cathexis?
Investment of psychic energy on a particular idea or feeling to process it consciously
58
What does the unconscious system contain?
Contents of censored or repressed wishes
59
What type of thinking is involved in the unconscious?
Primary-process
60
What governs the unconscious?
PLeasure principle
61
How is the unconscious evident?
Parapraxes
| Dreams
62
Describe cathexis in the unconscious
Happens often and quickly
63
What does the preconscious do?
Acts when needed
| Maintains repressive barrier to censor unacceptable wishes and desires
64
What does the preconscious interface with?
Both unconscious and conscious
65
How do thoughts go from the unconscious to the conscious?
Via the preconscious
66
What are the characteristics of an instinct?
Source
Impetus
Aim
Object
67
What is the impetus of an instinct?
Intensity or force of it
68
What does the dual instinct theory state?
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
69
Where does the aggression instinct originate?
Skeletal muscles
70
According to Freud, what is the dominant force in Biology?
Thanatos - death
71
What is the hierarchy of anxiety?
```
Signal anxiety
Disintegration/annihilation
Stranger
Separation
Fear of object loss
Castration
Superego
```
72
What is signal anxiety?
Unconscious perception of external/internal threat which leads to resource mobilization and aversion of threat.
73
What is disintegration anxiety?
Concerns about fusion with external object
74
When does stranger anxiety occur?
7-9 months of age
75
What is separation anxiety?
When mother is recognized as an independent object
76
When does fear of object loss occur?
Often in girls during phallic stage
77
What is superego anxiety?
Id vs ego conflicts
78
What is Analytical Psychology known as?
Jungian Model
79
What is the personal unconscious as per Jung?
Collection of repressed individual memories
80
What is archetype a part of?
Collective unconscious
81
What is an archetype?
Representational images with universal symbolic meanings
82
What is complex a part of?
Personal unconscious
83
What are complexes?
Toned ideas developing due to interactions of complexes with archetypes
84
What is persona?
Mask covering ones personality - presented to outside world
85
What is anima?
Unconscious feminine aspect of man
86
What is animus?
Unconscious masculine aspect of woman
87
What is shadow?
An archetype?
88
Describe shadow?
Personificatino of unacceptable aspects of oneself symbolised as a dark internal alien
89
What is individuation?
Ultimate goal of life where an individual develops a sense of self-identity
90
Who introduced the terms Extra and introversion?
Jung
91
What is abreaction?
Process of recovering and verbalizing suppressed feelings that cause symptoms
92
What is resistance?
When patients cannot recall significant memories
93
What did Freud suggest resistance was due to?
Unconscious forces involved in repression
94
What is Freud's wish fulfilment theory?
Dreams are attempts to fulfil unconscious wishes in a surrogate manner
95
What are the content of dreams made up of?
Nocturnal sensory stimuli (thirst etc)
Daytime residue (from waking life)
Repressed impulse
96
What are the two layers of dream content according to Freud?
Manifest content
| Latent content
97
What is the manifest content?
That which is recalled by the dreamer
98
What is the latent content?
Unconscious thoughts and wishes that threaten to awaken the dreamer
99
What is dream work?
Unconscious mental operation by which latent content is transformed into manifest content
100
what is condensation?
Several unconscious impulses combined into a single image in dream cnotent
101
What is irradiation/diffusion?
Converse of condensation - multiple images in dreams represent one unconscious impulse
102
What is symbolic representation in dreams?
Highly charged objects represented by using innocent images that are in some way connected
103
What characterizes the primary process of thinking in dreams?
Condensation
Displacement
Symbolic representation
104
What is the primary process of thinking in dreams?
Defies logic, lacks a sense of time and space, can accept presence of contradictory items simultaneously and often incoherent
Modus operandi for Id
105
What is secondary revision of dreams?
When the more mature aspect of the ego helps to organise primary aspects of dreams more coherently
106
How does secondary revision occur
Via secondary process
107
What is the secondary process?
Logical, intact with time and space, mature
108
What do anxiety dreams represent?
Failure in protective function of dream-work mechanism
109
Importance of punishment dreams?
Defy wish fulfilment theory
| Freud explained these existed as a compromise between conscience and repressed wish
110
What is Bell mania?
Disorganized hyperactivity that can be fatal is untreated
111
Why is Bell mania rare?
Widespread use of antipsychotics
112
What is Binswanger disease?
Type of multi-infarct dementia (vascular) in which infarcts selectively affect white matter
113
What is Briquet syndrome?
Somatization disorder - disorder of multiple somatic complaints across different organ systems due to anxiety
114
What is Brueghel syndrome?
Trigeminal dystonia that affects mouth
115
What may provoke Brueghel syndrome?
Antipsychotics
116
What is Charcot-Wilbrand syndrome?
Loss of all or part of dreaming after brain injury
117
What is Clerambault-Kandinsky syndrome?
Any paranoid psychosis in which thought insertion predominates
118
What is Cornelia de Lange syndrome?
```
Congenital mental retardation
Patients self-injure
Hyperactivity
Sleeplessness
Aggression
```
119
What is Da Costa syndrome?
Panic disorder - debilitating anxiety attacks accompanied by atetmpts to avoid such attacks
120
What is Fahr disease?
Idiopathic calcification of basal ganglia
121
Signs in Fahr disease?
Abnormal extra movements
| Comorbid with obsessive-compulsive and mood symptoms
122
What is Ganser syndrome?
Symptom of answering all questions approximately, e.g. 2+7=27
123
What is Gardner-Diamond syndrome?
Purpura associated with psychological stress.
124
What reproduces the rash in Gardner-Diamond syndrome?
Subcut injection of patients own blood
125
What is Gelineau syndrome?
```
Narcolepsyl
daytime sleepiness
Cataplexy
Sleep paralysis
Hypnagogic hallucinations
```
126
What is Gerstmann-Straussler-Scheinker?
Transmissible prion disease causing dementia
127
Who does Gerstmann-Straussler-Scheinker occur in?
Only those with particular AD defect of chromosome
128
What is Geschwind syndrome?
Interictal behaviour including hyposexuality, hyperreligiosity, hypergraphia and viscosity (not observing social boundaries in conversation)
129
In which patients is Geschwind syndrome seen in?
TLE
130
What is Gjessing syndrome?
Periodic catatonia - disorganized state of withdrawl or agitation that fluctuates
131
What is Hakim-adams syndrome?
Normal pressure hydrocephalus
132
What is Heller syndrome?
Childhood disintegrative disorder - loss of milestones in multiple domains after age
133
What is Hoover sign?
Unconsciously exerting downward pressure with healthy leg when paretic leg is challanged
134
What does absence of Hoover sign suggest?
Feigned deficit
135
What is Kahlbaum syndrome?
Catatonia; syndrome of waxy posturing or purposeless agitation or speech
136
How is Kahlbaum syndrome treated?
Benzos
| ECT
137
What is Kanner syndrome?
Autism
138
What is Kozhevnikov syndrome?
Continuous partial epilepsy leading to progressive cognitive deterioration
139
What is Landau-Kleffner syndrome?
Continuous partial simple epilepsy causing loss of language development in children
140
What is Langfeldt psychosis?
Psychosis without declining curse of schizophrenia
141
What is Marchiafava-Bignami disease?
Dementia due to callosal degeneration, related to chronic alcohol (wine) abuse
142
What is Marinescu reflex?
Palmomental reflex;
| Movement of chin after stroking palm
143
What is an abnormal Marinescue reflex?
If movement of chin is unilateral, suggests frontal or diffuse brain damage
144
What is Martin Bell syndrome?
Fragile X
145
What is Meige syndrome?
Dystonic blepharospasm
146
What is morvan disease?
Involuntary fiber activity, hyperhidrosis and sleeplessness that leads to death in weeks if not treated
147
What is Rasmussen syndrome?
Unilateral brain atrophy and continuous epilepsy resulting in cognitive decline until affected portion of brain is removed
148
What is Sanfilippo syndrome?
Congenital mental retardation
Aggression
Insomnia
149
Cause of Sanfilippo syndrome?
Chromosone 12 deletion
150
What is Smith-Magnes syndrome?
Congenital mental retardation
Severe self-injury
Self-hugging behaviour
151
What is Steele-Richardson-Olszewski disease?
Dementia with ataxia, loss of ability to look up or down and Parkinsonism
152
What is Strauss syndrome?
ADHD
153
What is Sydenham chorea?
Movement disorder that follows rheumatic fever
| Preceded by obsessive-compulsive symptoms
154
What is Von Economo?
Encephalitis Lethargica;
lethargy
obsessive-compulsive symptoms
155
What causes Wolfram syndrome?
AR syndrome caused by defect in chromosome 4
156
How does Wolfram Syndrome present?
Diabetes
Bilateral optic atrophy
Diversive psych disorders
157
What are heterozygotes for Wolfram syndrome at risk of?
Psych illness
158
Who coined the term schizophrenia?
Blueler
159
Who coined the term hebephrenia?
Hecker
160
Who coined the term catatonia?
Kahlbaum
161
Who coined the term dementia precoce?
Morel
162
Who coined the term schizoaffective?
Kasanin
163
Who coined the term neurasthenia?
Beard
164
Who coined the term unipolar and bipolar?
Kleist
165
Who coined the term hypnosis?
Braid
166
Who coined the term group dynamics?
Lewin
167
Who coined the term group psychotherapy?
Moreno
168
Who coined the term psychopathic inferiority?
Koch
169
Who coined the term Psychiatry?
Reil
170
Who coined the term institutional neurosis?
Barton
171
Duration of sx for diagnosis of alcohol dependence for ICD 10?
12months
172
How many sx needed for diagnosis of alcohol dependence under the ICD 10?
At least 3
173
Sx for alcohol dependence under ICD 10
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
6. salience - neglecting alternate forms of leisure or pleasure in life
7. A narrowing personal repertoire of alcohol use.
174
Who suggested that psychiatric diseases were brain diseases?
Greisinger
175
Edwards and Gross criteria (1976) for alcohol dependence?
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
Atypical anorexia in ICD?
Normal body image perception
177
Atypical anorexia in DSM?
Normal body weight
178
At what developmental stage is OCD?
Anal stage
179
At what developmental stage are people with alcohol abuse?
Oral stage
