Psychiatry - Psychology

Question 1

Classical conditioning

Answer 1

• Learning in which a natural response (salivation) is elicited by a conditioned, or learned, stimulus (bell) that previously was presented in conjunction with an unconditioned stimulus (food).
• Usually deals with involuntary responses.
• Pavlov’s classical experiments with dogs—ringing the bell provoked salivation.

Question 2

Operant conditioning

• Definition
• Positive reinforcement
• Negative reinforcement
• Punishment
• Extinction

Answer 2

• Definition
  
  • Learning in which a particular action is elicited because it produces a punishment or reward.
  • Usually deals with voluntary responses.
• Positive reinforcement
  
  • Desired reward produces action (mouse presses button to get food).
• Negative reinforcement
  
  • Target behavior (response) is followed by removal of aversive stimulus (mouse presses button to turn off continuous loud noise).
• Punishment
  
  • Repeated application of aversive stimulus extinguishes unwanted behavior.
• Extinction
  
  • Discontinuation of reinforcement (positive or negative) eventually eliminates behavior.
  • Can occur in operant or classical conditioning.

Question 3

Transference and countertransference

• Transference
• Countertransference

Answer 3

• Transference
  
  • Patient projects feelings about formative or other important persons onto physician
  • e.g., psychiatrist is seen as parent
• Countertransference
  
  • Doctor projects feelings about formative or other important persons onto patient
  • e.g., patient reminds physician of younger sibling

Question 4

Ego defenses

Answer 4

• Unconscious mental processes used to resolve conflict and prevent undesirable feelings
• e.g., anxiety, depression

Question 5

Acting out

• Type of defense
• Description
• Example

Answer 5

• Type of defense
  
  • Immature defense
• Description
  
  • Expressing unacceptable feelings and thoughts through actions.
• Example
  
  • Tantrums.

Question 6

Dissociation

• Type of defense
• Description
• Example

Answer 6

• Type of defense
  
  • Immature defense
• Description
  
  • Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress.
• Example
  
  • Extreme forms can result in dissociative identity disorder (multiple personality disorder).

Question 7

Denial

• Type of defense
• Description
• Example

Answer 7

• Type of defense
  
  • Immature defense
• Description
  
  • Avoiding the awareness of some painful reality.
• Example
  
  • A common reaction in newly diagnosed AIDS and cancer patients.

Question 8

Displacement

• Type of defense
• Description
• Example

Answer 8

• Type of defense
  
  • Immature defense
• Description
  
  • Transferring avoided ideas and feelings to some neutral person or object (vs. projection).
• Example
  
  • Mother yells at her child, because her husband yelled at her.

Question 9

Fixation

• Type of defense
• Description
• Example

Answer 9

• Type of defense
  
  • Immature defense
• Description
  
  • Partially remaining at a more childish level of development (vs. regression).
• Example
  
  • Men fixating on sports games.

Question 10

Identification

• Type of defense
• Description
• Example

Answer 10

• Type of defense
  
  • Immature defense
• Description
  
  • Modeling behavior after another person who is more powerful (though not necessarily admired).
• Example
  
  • Abused child identifies with an abuser.

Question 11

Isolation (of affect)

• Type of defense
• Description
• Example

Answer 11

• Type of defense
  
  • Immature defense
• Description
  
  • Separating feelings from ideas and events.
• Example
  
  • Describing murder in graphic detail with no emotional response.

Question 12

Projection

• Type of defense
• Description
• Example

Answer 12

• Type of defense
  
  • Immature defense
• Description
  
  • Attributing an unacceptable internal impulse to an external source (vs. displacement).
• Example
  
  • A man who wants another woman thinks his wife is cheating on him.

Question 13

Rationalization

• Type of defense
• Description
• Example

Answer 13

• Type of defense
  
  • Immature defense
• Description
  
  • Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame.
• Example
  
  • After getting fired, claiming that the job was not important anyway.

Question 14

Reaction formation

• Type of defense
• Description
• Example

Answer 14

• Type of defense
  
  • Immature defense
• Description
  
  • Replacing a warded-off idea or feeling by an (unconsciously derived) emphasis on its opposite (vs. sublimation).
• Example
  
  • A patient with libidinous thoughts enters a monastery.

Question 15

Regression

• Type of defense
• Description
• Example

Answer 15

• Type of defense
  
  • Immature defense
• Description
  
  • Turning back the maturational clock and going back to earlier modes of dealing with the world (vs. fixation).
• Example
  
  • Seen in children under stress such as illness, punishment, or birth of a new sibling
  • e.g., bedwetting in a previously toilet-trained child when hospitalized

Question 16

Repression

• Type of defense
• Description
• Example

Answer 16

• Type of defense
  
  • Immature defense
• Description
  
  • Involuntary withholding an idea or feeling from conscious awareness (vs. suppression).
• Example
  
  • Not remembering a conflictual or traumatic experience
  • Pressing bad thoughts into the unconscious.

Question 17

Splitting

• Type of defense
• Description
• Example

Answer 17

• Type of defense
  
  • Immature defense
• Description
  
  • Believing that people are either all good or all bad at different times due to intolerance of ambiguity.
  • Commonly seen in borderline personality disorder.
• Example
  
  • A patient says that all the nurses are cold and insensitive but that the doctors are warm and friendly.

Question 18

Mature defenses

Answer 18

• Mature adults wear a SASH:
• Sublimation
• Altruism
• Suppression
• Humor

Question 19

Altruism

• Type of defense
• Description
• Example

Answer 19

• Type of defense
  
  • Mature defense
• Description
  
  • Alleviating guilty feelings by unsolicited generosity toward others.
• Example
  
  • Mafia boss makes large donation to charity.

Question 20

Humor

• Type of defense
• Description
• Example

Answer 20

• Type of defense
  
  • Mature defense
• Description
  
  • Appreciating the amusing nature of an anxiety-provoking or adverse situation.
• Example
  
  • Nervous medical student jokes about the boards.

Question 21

Sublimation

• Type of defense
• Description
• Example

Answer 21

• Type of defense
  
  • Mature defense
• Description
  
  • Replacing an unacceptable wish with a course of action that is similar to the wish but does not conflict with one’s value system (vs. reaction formation).
• Example
  
  • Teenager’s aggression toward his father is redirected to perform well in sports.

Question 22

Suppression

• Type of defense
• Description
• Example

Answer 22

• Type of defense
  
  • Mature defense
• Description
  
  • Intentional withholding of an idea or feeling from conscious awareness (vs. repression).
• Example
  
  • Choosing to not worry about the big game until it is time to play.