WBR0402: Difference between revisions

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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
Line 20: Line 20:
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|SubCategory=General Principles
|SubCategory=General Principles
|Prompt=A 32 year male patient is brought by his wife to his psychiatrist because she says he is abusing her. When asking the patient, he confirms because he says she “deserves it”. Upon further questioning of the patient’s social history, the psychiatrist learns that the patient ‘s was in fact abused when he was a child by his parents . Which form of immature defense is the patient demonstrating?
|Prompt= A 32-year-old husband and wife attend therapy. The wife states that her husband is abusing her. When questioned by the counselor, he confirms his wife's accusation and attempts to validate his abusive behavior by claiming that she “deserves it." Upon further questioning, the psychologist learns that as a child, the husband was abused by his father. Which of the following forms of immature defense is the patient exhibiting?
|Explanation=The patient in the vignette is demonstrating a form of secondary identification, a form of immature defense where he identifies himself as an abuser with a history of personal child abuse by his own father, who the patient considers an authority figure.
There are in fact 2 forms of identification.  Primary identification is when a person is attached to a person or object before developing any relation with other objects or persons.  Secondary or partial identification is when the patient feels he has something in common with someone who he considers a leader, such as the patient in this vignette.


Educational Objective:
|Explanation= In this scenario the husband is exhibiting a form of immature defense, termed as secondary identification.  He models his abusive behavior after his father, whom the patient considers an authority figure.
Identification has primary and secondary forms.  The primary form is when the patient is attached to an object without developing relations to other objects. Secondary identification is when the patient feels he has something in common with someone who he considers a leader.
 
Reference:
 
Meissner WW.  Notes of Identification: I. Origins in Freud.  The Psychoanalytic Quarterly.1970; 39(4):563-589.
|EducationalObjectives= Secondary identification refers to modeling one's behavior after a figure of authority.  
|References= Meissner WW.  Notes of Identification: I. Origins in Freud.  The Psychoanalytic Quarterly. 1970; 39(4):563-589.
|AnswerA=Acting out
|AnswerA=Acting out
|AnswerAExp=Acting out is when the patient expresses his feelings through actions.
|AnswerAExp= Acting out is the expression of unacceptable feelings through actions.
|AnswerB=Denial
|AnswerB=Denial
|AnswerBExp=Denial is when the patient refuses to confront a certain undesirable reality.
|AnswerBExp= Denial is the refusal to confront an undesirable aspect of reality.
|AnswerC=Identification
|AnswerC=Identification
|AnswerCExp=Secondary identification is when the patient can associate himself with an authority figure
|AnswerCExp= Secondary identification refers to modeling one's behavior after a figure of authority.
|AnswerD=Projection
|AnswerD=Projection
|AnswerDExp=Projection is when the patient attributes to an external source an improper personal desire or inclination.
|AnswerDExp= Projection refers to the attribution of an improper personal desire or inclination to an external source.  
|AnswerE=Displacement
|AnswerE=Displacement
|AnswerEExp=Displacement is when the patient shifts his feelings from one object to another totally neutral and unrelated object.
|AnswerEExp= Displacement is the transferral of undesirable feelings to a neutral person or object.
|RightAnswer=C
|RightAnswer=C
|Approved=No
|Approved=Yes
}}
}}

Revision as of 19:32, 3 July 2014
Author [[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Behavioral Science/Psychiatry
Sub Category SubCategory::General Principles
Prompt [[Prompt::A 32-year-old husband and wife attend therapy. The wife states that her husband is abusing her. When questioned by the counselor, he confirms his wife's accusation and attempts to validate his abusive behavior by claiming that she “deserves it." Upon further questioning, the psychologist learns that as a child, the husband was abused by his father. Which of the following forms of immature defense is the patient exhibiting?]]
Answer A AnswerA::Acting out
Answer A Explanation AnswerAExp::Acting out is the expression of unacceptable feelings through actions.
Answer B AnswerB::Denial
Answer B Explanation AnswerBExp::Denial is the refusal to confront an undesirable aspect of reality.
Answer C AnswerC::Identification
Answer C Explanation AnswerCExp::Secondary identification refers to modeling one's behavior after a figure of authority.
Answer D AnswerD::Projection
Answer D Explanation AnswerDExp::Projection refers to the attribution of an improper personal desire or inclination to an external source.
Answer E AnswerE::Displacement
Answer E Explanation AnswerEExp::Displacement is the transferral of undesirable feelings to a neutral person or object.
Right Answer RightAnswer::C
Explanation [[Explanation::In this scenario the husband is exhibiting a form of immature defense, termed as secondary identification. He models his abusive behavior after his father, whom the patient considers an authority figure.

Educational Objective: Secondary identification refers to modeling one's behavior after a figure of authority.
References: Meissner WW. Notes of Identification: I. Origins in Freud. The Psychoanalytic Quarterly. 1970; 39(4):563-589.]]

Approved Approved::Yes
Keyword
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