Rosenthal - Personality Disorders and Defense Mechanisms Flashcards
1
Q
What is regression?
A
- Acting in a way appropriate to an earlier stage of development, i.e., “I want my mommy”
- Needy, helpless, can’t do anything
- Common in inpatient situations where pt is acting more helpless and dependent than is justified by the medical problem
- DEFENSE MECHANISM
2
Q
What is denial?
A
- Not accepting the reality of the situation
- Some denial is healthy, if the sheer reality is too stark
- Too much denial stands in the way of taking care of one’s medical problems
- DEFENSE MECHANISM
3
Q
What is repression?
A
- “Cannot remember,” i.e., not accessible to conscious memory
- Truly unable to recall certain information, because the anxiety was too overwhelming
- May reveal itself in unexpected context, such as during invasive procedures
- DEFENSE MECHANISM
4
Q
What is intellectualization?
A
- Gaining control over an emotionally charged and frightening situation by engaging in intellectual mastery
- Excessively perusing scientific articles, books, internet
- Engaging on an intellectual level rather than processing or expressing emotions
- Excessive abstract thinking to avoid confrontation with conflicts or disturbing feelings
- DEFENSE MECHANISM
5
Q
What is distortion?
A
- Twisting the truth to be less painful or anxiety provoking; or to fit better into a schema
- May be a conscious OR unconscious process
- Often happens as pt tries to recall events that led up to a lawsuit -> in that scenario, pts may really believe what they seem to recall
- DEFENSE MECHANISM
6
Q
What are the 3 adolescent defense mechanisms? Describe them.
A
- PROJECTION: accusing others of things one is doing or feeling oneself, projecting blame on others; not owning up
- Unconscious; what is emotionally unacceptable in the self is rejected and attributed to others
- DENIAL: not accepting the reality of the situation
- RATIONALIZATION: making up “plausible” reasons for one’s behavior, after the fact
7
Q
What is a defense mechanism?
A
- Unconscious cognitive strategies serving to provide relief from emotional conflict and anxiety, helping us to deal with things that are too uncomfortable to contemplate
- Conscious efforts frequently made for same reasons, but true defense mechanisms are unconscious
8
Q
What is dissociation?
A
- Splitting off of clusters of mental contents from conscious awareness
- Mechanism central to hysterical conversion and dissociative disorders
- Also used to describe separation of idea from its emotional significance and affect, as seen in the inappropriate affect of schizophrenic pts
- DEFENSE MECHANISM
9
Q
What is introjection?
A
- Unconscious mechanism whereby loved or hated external objects are symbolically absorbed within oneself (converse of projection)
- May serve as defense against conscious recognition of intolerable hostile impulses -> in severe depression, for example, pt may unconsciously direct unacceptable hatred or aggression toward him or herself
- DEFENSE MECHANISM
10
Q
What is projection?
A
- Unconscious mechanism in which what is emotionally unacceptable in the self is rejected and attributed (projected) to others
- May explain irrational outbursts and accusations when pt feels wronged and vulnerable, even though no-one meant them any harm
- DEFENSE MECHANISM
11
Q
What is reaction formation?
A
- Pt unconsciously adopts affects, ideas, and behaviors that are in opposition of impulses harbored either consciously or unconsciously
- EX: excessive moral zeal may be reaction to strong, but repressed asocial impulses
- DEFENSE MECHANISM
12
Q
What is sublimation?
A
- Consciously unacceptable instinctual drives are unconsciously diverted into personally and socially acceptable channels
- DEFENSE MECHANISM
13
Q
What is substitution?
A
- Unattainable or unacceptable goal, emotion, or object is unconsciously replaced by one that is more acceptable or attainable
- DEFENSE MECHANISM
14
Q
What is the definition of a personality disorder?
A
- Enduring pattern of inner experience and behavior that deviates markedly from expectations of the individual’s culture,
- Is pervasive and inflexible,
- Has its onset in adolescence or early adulthood,
- Is STABLE OVER TIME,
- And leads to clinically significant distress or impairment in social, occupational, or other important areas of function
- Present in a VARIETY OF CONTEXTS
- NOTE: traits are NOT a disorder (we all have these, and there is a wide normal range) -> never seize on one or two symptoms to make a dx
15
Q
What is the epi of personality disorders?
A
- 9-16% of population
- Starts in late adolescence, often with signs in childhood, but is not dx’d until adulthood, where we see established patterns
- Symptoms wax and wane in response to life stress
- Late-onset personality changes are suggestive of undiagnosed “other” problem -> dementia, substance abuse, medical illness, neurological problem
16
Q
What are some lasting trait dimensions that cut across cultures? Why are they important?
A
- Emotional stability vs. neuroticism (anxiety-prone)
- Agreeableness vs. antagonism
- Extraversion (seeks stimulation and excitement; short attention span) vs. introversion (avoids stimulation, and likes being left alone; long attention span)
- Conscientiousness: plans ahead, gets things done
- Openness to experience
- These traits FEATURE IN PREDICTING: health and mortality, academic success, job performance, capacity for lasting relationships, drug abuse and criminality
