Psychopathology Flashcards
What are the three components of a repsonse to a stressful event?
- An emotional response, with somatic accompaniments. This is either a kind of anxiety response (autonomic arousal, apprehension, irritability etc.) or a depressive response (pessimistic thinking and reduced physical activity). Events that pose a threat usually elicit an anxious response, events that involve separation or loss often produce a depressive response.
- A coping strategy.
- A defense mechanism.
What is the difference between a coping strategy and a defence mechanism?
The term coping strategy is derived from research in social psychology; it is applied to activities of which the person is aware—for example, deliberately avoiding further stressors.
Defense mechanisms are unconscious responses to external stressors as well as to anxiety arising from internal conflict. They were originally described by Sigmund Freud and later elaborated by his daughter, Anna Freud (1895–1982). E.g. sublimation, regression, displacement.
What are the types of coping strategies?
Coping strategies are of two kinds: problem-solving strategies, which can be used to make adverse circumstances less stressful; and emotion-reducing strategies, which alleviate the emotional response to the stressors.
Problem-solving strategies include:
- Obtaining information or advice that would help to solve the problem.
- Solving problems—making and implementing plans to deal with the problem.
- Confrontation—defending one’s rights, and persuading other people to change their behaviour.
Emotion-reducing strategies include:
- Ventilation of emotion—talking to another person and expressing emotion.
- Evaluation of the problem—to assess what can be changed and try to change it (by problem-solving), and what cannot be changed and try to accept it.
- Positive reappraisal of the problem—recognizing that it has led to some good (e.g. that the loss of a job is an opportunity to find a more satisfying occupation).
- Avoidance of the problem—by refusing to think about it, avoiding people who are causing it, or avoiding reminders of it. A common coping strategy.
Maladaptive coping strategies include:
- Use of alcohol or unprescribed drugs
- Deliberate self-harm
- Unrestrained display of feelings
- Aggressive behaviour
Describe repression
Repression- This is the exclusion from consciousness of impulses, emotions, or memories that would otherwise cause distress. For example, especially painful aspects of the memory of distressing events such as sexual abuse in childhood may be kept out of full awareness for many years.
Describe denial
This is a related concept to repression, which is inferred when a person behaves as if they are unaware of something that they may reasonably be expected to know. For example, on learning that they are dying of cancer, a patient may continue to live normally as if they are unaware of the diagnosis. In this example, denial is adaptive, as it can help to reduce depression. However, in the early stage of illness, denial may delay help-seeking or lead to refusal of necessary investigations and treatment. In this second example, denial is maladaptive.
Describe displacement
Displacement- This is the transfer of emotion from a person, object, or situation with which it is properly associated, to another source. For example, after the recent death of his wife, a man may blame the doctor for failure to provide adequate care, and may thus avoid blaming himself for putting his work before his wife’s needs during the last months of her life.
Describe projection
Projection- This is the attribution to another person of thoughts or feelings similar to one’s own, thereby rendering one’s own thoughts or feelings more acceptable. For example, a person who dislikes a colleague may attribute reciprocal feelings of dislike to him; it is then easier to justify his own feelings of dislike for the colleague.
Describe regression
Regression- This is the adoption of behaviour appropriate to an earlier stage of development—for example, dependence on others. Regression often occurs among physically ill people. In the acute stages of illness it can be adaptive, enabling the person to acquiesce passively to intensive medical and nursing care. If regression persists into the stage of recovery and rehabilitation, it can be maladaptive because it reduces the patient’s ability to make efforts to help themself.
Describe reaction formation
This is the unconscious adoption of behaviour that is the opposite to that which would reflect the person’s true feelings and intentions. For example, excessively prudish attitudes to sex are sometimes (but not always) a reaction to the person’s own sexual urges that they cannot accept. Or classically a homophobic who is secretly homosexual
Describe rationalisation (defence mechanism)
This is the unconscious provision of a false but acceptable explanation for behaviour that has a less acceptable origin. For example, a husband may leave his wife at home because he does not enjoy her company, but he may reassure himself falsely that she is shy and would not enjoy going out.
Describe sublimation (defence mechanism)
This is the unconscious diversion of unacceptable impulses into more acceptable outlets—for example, turning the need to dominate others into the organization of good works for charity. (There are, of course, many other motives for charitable work.)
Describe identification
This is the unconscious adoption of the characteristics or activities of another person, often to reduce the pain of separation or loss. For example, a widow may undertake the same voluntary work that her husband used to do. Or a victim of a child abuse may become a child abuser in adulthood.
Describe splitting (defence mechanism)
Splitting is a common immature defense mechanism in borderline personality disorder where the patient is unable to reconcile both good and bad traits in a given person, and therefore sees people as either all good or all bad.
What are the types of formal thought disorders?
These include:
- Thought block - when stream of thought is suddenly interrupted. Strongly suggests schizophrenia.
- Preservation - when a person gives the same answer to questions (inappropriate repetition of thought) commonly seen in dementia.
- Flight of ideas - thoughts move rapidly, but maintain a logical link. Characteristic of mania.
- Loosening of associations
What are the types of disorders of thought content?
These include:
- Pre-occupationsand worries
- Overvalued ideas - comprehensible and understandable ideas, but which are perused beyond the bounds of reason.
- Obsessions - intrusive thoughts that enter the mind despite efforts to exclude them
- Delusions
