5:27 7 aul Fw Question 1700 ID Title Commonality of morbid jealousy in mental disorders C Flag as important Font Siz: A A A Which one of the following conditions is more likely to be associated with morbid jealousy? A Alcoholism. B Schizophrenia. ic Bipolar disorder. D Depression. E Obsessive compulsive disorder.Title Commonality of morbid jealousy in_ ee mental disorders ss (© Flag as important Font Size: A A A Which one of the following conditions is more likely to be associated with morbid jealousy? x A Alcoholism. v B Schizophrenia. x Cc Bipolar disorder. x D Depression. x E Obsessive compulsive disorder. planations5:27 7 . Option B is correct Jealousy a common yet complex emotion which has been well-recognized throughout mankind history. Jealousy is defined as ‘feeling or showing a resentful suspicion that one’s partner is attracted to or involved with someone else’. This definition indicates that it is a belief in the presence of rivalry that is the key issue and that whether or not such a rivalry truly exists is less important. While normal jealousy is considered a normal human emotion, morbid jealousy is pathological. Morbid jealousy is not a diagnosis rather it describes a range of irrational thoughts and emotions that is accompanied by unacceptable or extreme behavior, in which the dominant theme is a preoccupation with a partner’s sexual unfaithfulness based on unfounded evidence. The following features in morbid jealousy can distinguish it from normal jealousy: Excessive amount of time taken up by jealous concerns © Difficulty in putting the concerns out of the mind © Impairment of the relationship © Limitation of the partner's freedom © Checking on the partner's behavior There are three forms of morbid jealousy: (1) delusional jealousy, (2) obsessional jealousy, and (3) overvalued jealousy. In delusional | eee esrsetertetic feature is© Limitation of the partner's freedom 5:27.47 : : ao " Checking on the partner's behavior ey There are three forms of morbid jealousy: (1) delusional jealousy, (2) obsessional jealousy, and (3) overvalued jealousy. In delusional jealousy the characteristic feature is the presence of strong false belief of the partner being unfaithful (certainty) while in obsessive jealousy the affected individual suffers from unpleasant and irrational jealous rumination that the partner could be unfaithful (considering a possibility not in the form of a strong belief) which is followed by compulsive checking of the partner’s behavior. The difference between these two is the presence of a strong beliefs in unfaithfulness in delusional jealousy versus the bothersome lingering thoughts of the possibility of unfaithfulness. Overvalued jealousy shared many features with obsessional jealousy. In overvalued jealousy, there is an acceptable and comprehensible idea which is excessively pursued by the patient beyond the bounds of reason. The main difference could be lack of compulsions and compulsive behavior in overvalued jealousy Morbid jealousy is not a diagnosis rather a comorbidity seen in many psychiatric conditions, personality disorders, and other settings including but not limited to drugs and alcohol abuse, psychotic disorders and schizophrenia, mania, depression, obsessive compulsive disorder (OCD), and anxiety disorders. Arecent study showed that of all psychiatric illnesses, schizophrenia is most likely to be associated with morbid jealousy, most commonly in form of delusions sjseteesy=ressteey concludedMorbid! jealousy is not a diagnosis rather a 4) > | comorbidity seen in many psychiatric conditions, personality disorders, and other settings including but not limited to drugs and alcohol abuse, psychotic disorders and schizophrenia, mania, depression, obsessive compulsive disorder (OCD), and anxiety disorders. Arecent study showed that of all psychiatric illnesses, schizophrenia is most likely to be associated with morbid jealousy, most commonly in form of delusional jealousy. The study concluded that depression (option D) could be the second most significant condition associated with morbid jealousy. Interestingly, all three forms of morbid jealousy were identified across the patients with depression in the study. Other conditions identified to be potentially associated with morbid jealousy in order of strength of such association were drug and alcohol abuse (option A), bipolar mood disorders (option C), and lastly other conditions such as anxiety disorders, OCD (option E), dementia and other. The same study concluded that morbid jealousy in more common in men than woman, and also more common among married versus single men. Treatment of morbid jealousy is with psychotherapy (e.g., CBT) and pharmacotherapy (e.g., SSRIs or antipsychotics depending on the underlying condition and diagnosis). NOTE - Of the personality disorders, borderline personality disorder is most prone to morbid jealousy.5:27 7 ” Question 1666 ID Title Diagnosing the most likely cause of bizarre behaviour in 35-year-old imprisoned man © Flag as important Font Size: A A A A 35-year-old man is brought from prison to the Emergency Department by the police and prison staff for assessment. He is doing time in prison. Recently, he has causes problems inside. He has picked up fights with inmates over trivial issues and had several anger outbursts. He writes sanity words in his cell walls such as ‘I’m all ok’, ‘beat it and keep it up’, ‘you are doing just fine’, etc. He has mutilated himself several times and has cuts on both his wrists. According to the prison staff, his condition has been progressively worsening in the past few days. Which one of the following could be the most likely? A Psychosis. B Schizophrenia.5:27 7 a Font Siz: A A A A 35-year-old man is brought from prison to the Emergency Department by the police and prison staff for assessment. He is doing time in prison. Recently, he has causes problems inside. He has picked up fights with inmates over trivial issues and had several anger outbursts. He writes sanity words in his cell walls such as ‘I’m all ok’, ‘beat it and keep it up’, ‘you are doing just fine’, etc. He has mutilated himself several times and has cuts on both his wrists. According to the prison staff, his condition has been progressively worsening in the past few days. Which one of the following could be the most likely? A Psychosis. B Schizophrenia. Cc Antisocial personality disorder. D Borderline personality disorder. E Factitious disorder.inside. He has picked up fights with inmates, =- over trivial issues and had several anger outbursts. He writes sanity words in his cell walls such as ‘I’m all ok’, ‘beat it and keep it up’, ‘you are doing just fine’, etc. He has mutilated himself several times and has cuts on both his wrists. According to the prison staff, his condition has been progressively worsening in the past few days. Which one of the following could be the most likely? *% (DA | Psychosis. x B Schizophrenia. x c__ Antisocial personality disorder. vo D Borderline personality disorder. * (Ee Factitious disorder. Cotes EE ory5:28 7 ” Option D is correct At first glance, there might be a diagnostic confusion because critical pieces of information in history and mental status exam (MSE) are missing. The question, however, asks about the most likely diagnosis based in the given information rather than a certain diagnosis. There are some pieces of the puzzle that can be elicited from the scenario. This patient has been having anger outbursts and fights over trivial issues that suggest ‘impulse contro!’ problems. He has been self-mutilating and self-cutting as well as refusing to eat or drink. Moreover, his sanity writings on the cell walls indicates reassurance- seeking behavior. Since there is no one to reassure him, he is doing it himself. These features make borderline personality disorder (BPD) the most likely explanation with just this amount of available information (read the DSM 5 diagnostic criteria for BPD below). This patient has been in imprisoned, and this could suggest antisocial personality disorder (ASPT) as well. In ASPD there is a persistent display of impulsive, reckless, and aggressive behaviors and no remorse about them. There is often a history of violent relationships, legal challenges, and substance abuse if you have this personality disorder. BPD and antisocial ASPD share some similarities. Both ASPT and BPD belong to-cluster Bdisorder. 5:28 7 BPD and antisocial ASPD share some similarities. Both ASPT and BPD belong to cluster B personality disorders (dramatic, emotional, and unpredictable behavior) and have disinhibited behavior as a presentation. They both also have impulsivity in common. However, in ASPT the person involves in violence and aggressiveness because they can (there is the element of control and decision) while in BPD it happens because it cannot be controlled. Another differentiating factor is that in ASPT the harm targets others while in BPD the harm is directed towards self. This makes ASPD less likely of a diagnosis. Psychosis (option A) and schizophrenia (as a psychotic disorder) (option B) are associated with features such as impaired speech, auditory hallucinations, and delusional thinking, none of which is present in the scenario. This makes them a less likely diagnosis. Factitious disorder (option E) is falsification of illness in oneself or another person (factitious by proxy) without any obvious gain. By obvious gain it is meant that the patient does not have an known external motivation or achievement by producing the symptoms. Features seen in factitious disorder are: © Inconsistencies between patient history and medical observations. * Vague details that seem plausible on the surface but that don’t hold up to scrutiny. ¢ Lengthy medical records with multiple CT S| elammaendin 2 etl,Features seen in factitious disorder are: 5:28 7 a © Inconsistencies between patient history and medical observations. Vague details that seem plausible on the surface but that don’t hold up to scrutiny. Lengthy medical records with multiple admissions at different hospitals. Willingness to accept any discomfort and tisk from many medical procedures, even surgery. © Overdramatic or outlandish presentation of a factitious illness, or hostility when challenged. Although a detailed mental history might make this condition a diagnosis in this patient later on, absence of the above features in the scenario makes such diagnosis less likely compared to BPD. DSM-5 diagnostic criteria for BPD Apervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) or the following: 1. Frantic efforts to avoid real or imagined abandonment (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5) 2. Apattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation 3. Identity disturbance: markedly and persistently ana:sixesymptoms. wil F Features seen in factitious disorder are: ere aes eee © Inconsistencies between patient history and medical observations. Vague details that seem plausible on the surface but that don’t hold up to scrutiny. Lengthy medical records with multiple admissions at different hospitals. Willingness to accept any discomfort and risk from many medical procedures, even surgery. Overdramatic or outlandish presentation of a factitious illness, or hostility when challenged. Although a detailed mental history might make this condition a diagnosis in this patient later on, absence of the above features in the scenario makes such diagnosis less likely compared to BPD. DSM-5 diagnostic criteria for BPD Apervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) or the following: 1. Frantic efforts to avoid real or imagined abandonment (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5) 2. Apattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluationbetween extremes of idealization and 5:28eValuation . 3. Identity disturbance: markedly and persistently unstable self-image or sense of self 4. Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating) (Note: Do not include suicidal or self- mutilating behavior covered in Criterion 5) 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days) 7. Chronic feelings of emptiness 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) 9. Transient, stress-related paranoid ideation or severe dissociative symptoms Reference(s) | - Psych Central - Symptoms of Bor derline Personality Disorder (BPD) + Australian BPD Foundation Limite d + Very Well Minfd - Antisocial vs. Bo rderline Personality Disorders + Medscape - Factitious Disorder | mposed on Self (Munchausen's Sy ndrome)5:28 7 . Question 1664 ID Title The time of highest risk for suicide in a depressed person (© Flag as important Font Siz: A A A In which one of the following situations a depressed patient has the highest risk of attempting suicide? A When the depression deteriorates. B On commencement of treatment. Cc On improvement with treatment. D After discharge from the hospital. E On admission to the hospital.ey a 5:28 7 . C Flag as important Font Size: A A A In which one of the following situations a depressed patient has the highest risk of attempting suicide? % (.)A When the depression deteriorates. % © )B | Oncommencement of treatment. x Cc On improvement with treatment. ¥(©)pd | After discharge from the hospital. x —E | Onadmission to the hospital.5:28 7 . ey a Option D is correct Studies suggest that in patients with depression severe enough to mandate hospital admission, the highest risk of suicide is within 4 weeks post- discharge after inpatient care of a depressed patient. One study showed that 43% of those who. were treated as inpatient for depression attempted suicide within 1 month of discharge and 47% died before first appointment. Overall, the risk of suicide within 4 weeks after psychiatric inpatient care is 100 higher compared to that of general population. Astrong belief has long been held that during the early improvement phase after commencement of treatment, the risk of suicide is high because the apathy symptoms resolve but depressed mood remains; this believe, however, has been questioned according to recent studies. NOTE - In general, suicide risk in depressed patients is highest when there is an initial symptoms improvement brought about by treatment. In this period, the depressed patient is out of the low mood and apathy and more likely to act on a suicide plan. However, admitted patients are monitored and cared for during their stay and risk of suicide is lower compared to after discharge when patient is more likely to feel left on his/her own and there is no ongoing support or monitoring. Reference(s) fostdischarge PPreece eee REE remee eater 53€8dhg belief has long been held that durihg te early improvement phase after commencement of treatment, the risk of suicide is high because the apathy symptoms resolve but depressed mood remains; this believe, however, has been questioned according to recent studies. NOTE - In general, suicide risk in depressed patients is highest when there is an initial symptoms improvement brought about by treatment. In this period, the depressed patient is out of the low mood and apathy and more likely to act on a suicide plan. However, admitted patients are monitored and cared for during their stay and risk of suicide is lower compared to after discharge when patient is more likely to feel left on his/her own and there is no ongoing support or monitoring. Reference(s) + Medscape - Early Postdischarge P eriod Linked to Very High Suicide R isk + Post-Discharge Suicidal Behavior Ri sk + CHIR - Are Patients With Depressi on at Heightened Risk of Suicide as They Begin to Recover? org Hide the correc5:29 7 . Question 1646 ID Title Manaement of insomnia in 75-year-old man C Flag as important Font Size: A A A A75-year-old man is being assessed for insomnia. He has metastatic prostate cancer for which he is taking morphine for pain control. Because of the sleeplessness, he had been using cannabis until recently when it was no more effective. He feels agitated and edgy most of the time in daytime. Which one of the following is most likely to help him with his problem? A Supportive psychotherapy. B Interpersonal therapy. ie Sleep hygiene and routine. D Motivational therapy.FontSiz:: A A A A 75-year-old man is being assessed for insomnia. He has metastatic prostate cancer for which he is taking morphine for pain control. Because of the sleeplessness, he had been using cannabis until recently when it was no more effective. He feels agitated and edgy most of the time in daytime. Which one of the following is most likely to help him with his. problem? A Supportive psychotherapy. B Interpersonal therapy. Cc Sleep hygiene and routine. D Motivational therapy. E Syntonic phototherapyFontSiz:: A A A A 75-year-old man is being assessed for insomnia. He has metastatic prostate cancer for which he is taking morphine for pain control. Because of the sleeplessness, he had been using cannabis until recently when it was no more effective. He feels agitated and edgy most of the time in daytime. Which one of the following is most likely to help him with his. problem? % (A Supportive psychotherapy. % ()B__ Interpersonal therapy. ¥ (© c | Sleep hygiene and routine. x D Motivational therapy. % ()E — Syntonic phototherapy5:29.77 ’ . Option C is correct Insomnia disorder is characterized by inadequate sleep despite adequate sleep opportunity, accompanied by daytime dysfunction. Both pharmacologic and psychological interventions could be used for treatment of insomnia disorder; however, selecting the right treatment depends on the chronicity of symptoms, taking into account medical and psychiatric factors. Current guidelines recommend cognitive behavioural therapy for insomnia (CBT-i) as the gold standard and first-line treatment for insomnia. This may be complemented with short-term pharmacological intervention. The following diagram illustrates a stepwise approach to treatment of insomnia: Fee guyAdapted form Morgan, 2011 The very first step in management of patients with insomnia is gathering a detailed sleep history and treatment of any contributing factors and comorbidities. The second step is utilizing CBT-I. CBT-I includes the following components: ¢ Implementation of good sleep hygiene © Sleep restriction* and stimulus control programs**, and relaxation procedures*** © Cognitive therapy for insomnia Sleep hygiene and routine is a term that encompasses most of the above and is the next best step and in fact the most important arm of treatment for this patient. However, if CBT was an option, it would be a more exact and appropriate ‘one to choose. Sleep hygiene and routing include the following pieces of advice for patients suffering from insomnia: Following a nightly routine: © Budgeting 30 minutes for winding down before sleep (soft music, light stretching, reading and/or relaxation exercise © Dimming the light Unplugging from electronics (e.g., TV, mobiles, tablets, etc,reading and/or relaxation exercise 5:29,7 Dimming the light oe © Unplugging from electronics (e.g., TV, mobiles, tablets, etc.) ¢ Relaxation techniques ® Not tossing and turning in the bed and walking out of the bedroom if not fell sleep within 15-30 minutes. Cultivation of healthy daily habits: © Adequate daytime light exposure © Day time regular exercise * Cutting down on alcohol © Cutting down on caffeine in the afternoon and evening hours © Smoking cessation © Avoiding late dining * Avoiding using the bed for anything but sleep and sex Bedroom optimization: * Comfortable beddings ® Setting a cool yet comfortable temperature © Blocking out noise and light in the bedroom ¢ Using calming scents (Option A) Supportive psychotherapy is a talking- based therapy designed to allow a person with mental health issues to voice their concerns and receive encouragement and help in finding practical solutions. Supportive psychotherapy is used to help people dealing with serious addiction, eating disorders, stress, and other mental health issues. This method works to build a person’s adaptability and resilience and better coping strategies for the future. Although this treatment could be beneficial to treatment the underlying Sareceive encouragement and help in finding SpeSbeal solutions. Supportive psychotherapy iF used to help people dealing with serious addiction, eating disorders, stress, and other mental health issues. This method works to build a person’s adaptability and resilience and better coping strategies for the future. Although this treatment could be beneficial to treatment the underlying mental issues associated with or underlying insomnia, it is not a recommended stand-alone therapy for it. (Option B): Interpersonal therapy focuses on the interpersonal relationships of the depressed person. The idea of interpersonal therapy is that depression can be treated by improving the communication patterns and how people relate to others. Techniques of interpersonal therapy include: © Identification of emotion — Helping the person identify what their emotion is and where it is coming from. Example - Roger is upset and fighting with his wife. Careful analysis in therapy reveals that he has begun to feel neglected and unimportant since his wife started working outside the home. Knowing that the relevant emotion is hurt and not anger, Roger can begin to address the problem. ¢ Expression of Emotion - This involves helping the person express their emotions in a healthy way. Example - When Roger feels neglected by his wife, he responds with anger and sarcasm, This in tum leads his wife to reacthealthy I. Cy pe teteld na “ Example - When Roger feels neglected by his wife, he responds with anger and sarcasm. This in turn leads his wife to react negatively. By expressing his hurt and his anxiety at no longer being important in her life in a calm manner, Roger can now make it easier for his wife to react with nurturance and reassurance. ® Dealing with emotional baggage - Often, people bring unresolved issues from past relationships to their present relationships. By looking at how these past relationships affect their present mood and behavior, they are in a better position to be objective in their present relationships. Example — Growing up, Roger’s mother was not a nurturing woman. She was very involved in community affairs and often put Roger's needs on the back burner. When choosing a wife, Roger subconsciously chose a woman who was very attentive and nurturing. While he agreed that the family needed the increased income, he did not anticipate how his relationship with his own mother would affect his reaction to his wife working outside the home. (Option D) Motivational therapy/interviewing is a therapy technique that empowers patients to make actionable behavioral changes in their lives through an interview-style discussion with a licensed mental health professional. This technique focuses on change talk where patients verbalize their need and desire to make changes in their lives.licensed mental health professional. | nis technique 5#@@s€s on change talk where patients verbaliz& their need and desire to make changes in their lives. Since the benefits of motivational interviewing for mental health are numerous, it has become a common treatment method for people struggling with various mental health problems and co- occurring disorders like substance abuse. This therapy technique identifies and accepts the fact that individuals who need to make changes in their lives approach counselling at different levels of readiness to change their behavior. In some cases, patients may have thought about making a behavior change but have not taken the necessary steps to make that change happen. During this fragile time, people may express a fear of change and deal with internal struggles that need to be broken down. This is where motivational interviewing steps in. A motivational interview allows individuals to learn how to effectively change unhealthy behaviors to aid the addiction recovery process. (Option E) Syntonic phototherapy (light therapy) uses visible colored lights to enhance visual attention and decrease the symptoms of stress and trauma. The goal of this therapy is to balance the autonomic nervous system which controls visual perceptual fields. Colored light delivered through the eyes helps control biological development and function. For example, red light activates the sympathetic nervous system (‘fight-or-flight’ responses such as heart rate and blood pressure) and blue/indigo stimulates the parasympathetic nervous system (‘rest and digest’ responses like Salivation, Urinabiiidenstidilsihdédidsiadss:|).nervous system (‘rest and digest’ responses like 52R Aion, urination, and even arousal). "" Syntonic phototherapy consists of patients focusing their eyes at a dot of color at the end of a 50cm tube. Patients view specific safe light frequencies for approximately 20 minutes at a time over a prescribed number of sessions (usually around 20, done over the course of 4-5 weeks). As light enters the eyes, it travels from nerves connected to the retina to brain centers that influence chemical, hormonal, and electrical balances. These centers control the balance of all body functions, and years of study have proven that selected light frequencies delivered through the retina can create favorable results that benefit the entire body. In addition to red and blue lights and their systemic healing of the parasympathetic and sympathetic nervous systems, green lights promote physiological balance. Once this balance is achieved, the effect is long lasting for most individuals. Because the practice affects the entire nervous system, the potential benefits of syntonic therapy are numerous and varied. Syntonics can enhance visual acuity by improving blurred vision, contrast, night vision issues, and light and allergy sensitivity. This therapy is also used to help alleviate pain, headaches, eyestrain, and mental and emotional stress levels. Based on lack of evidence for usefulness of this method for insomnia, it is not currently a recommended treatment option for sleep problems. *Sleep restriction — The aim of sleep restriction is to increase Sle @piutlididdiepiacletiacicdatbe time awakeRn ae ee ae ee eee Pepe 5s2@pypproblems. wer *Sleep restriction — The aim of sleep restriction is to increase sleep drive and reduce the time awake in bed. Time in bed must be aimed to align with the patient's sleep duration. Gradually, more time is spent in bed as sleep improves. Sleep restriction is typically administered by trained professionals and requires close monitoring of daily sleep-wake patterns. “Stimulus control — Behaviors that require wakefulness (e.g., watching TV, reading books) in bed could result in bed being associated with hyperarousal, thereby perpetuating sleep difficulties. Stimulus control helps to re-associate bed with being asleep. The patient is instructed to go to bed only when sleepy. This helps re- associate bed with sleepiness. Activities in bed should be limited to only sleeping and sex. The patient is instructed to leave the bed and bedroom if unable to fall sleep within what feels like 15-30 minutes (without looking at the clock). During the time out, the patient is instructed to complete a non-stimulating task, returning to bed when they feel comfortable. The same morning wake-time is recommended even if sleep the night before is poor. “Relaxation — Relaxation strategies can include progressive muscle relaxation and diaphragmatic breathing. The goal is to release tension and arousal; however, close monitoring of patients is important as relaxation may become sleep effort in disguise.should be limited to only sleeping and sex. The Sp&PeMt is instructed to leave the bed and betiroemn! if unable to fall sleep within what feels like 15-30 minutes (without looking at the clock). During the time out, the patient is instructed to complete a non-stimulating task, returning to bed when they feel comfortable. The same morning wake-time is recommended even if sleep the night before is poor. “Relaxation — Relaxation strategies can include progressive muscle relaxation and diaphragmatic breathing. The goal is to release tension and arousal; however, close monitoring of patients is important as relaxation may become sleep effort in disguise. Reference(s)» RACGP ~ AJGP - Insomnia manag ement Hide explanations eer UA Poa AA na5:29 7 all Sl Question 1644 ID Title Identifying the most likely defense mechanism used by a 50-year-old man C Flag as important FontSiz:: A A A A 50-year-old farmer is in significant financial debts dues to a recent severe drought. He is planning to commit suicide so that his family can use his life insurance. He feels anxious and is irritable but does not show symptoms of depressive disorders. You know him well and consulted him for alcohol use and problem gambling and know, from his wife, that he is reckless around money, spends a lot in pubs and casinos, and has problem drinking issues. He blames the government and authorities for what he is going through and believes that if they were more responsible and did their jobs right, he was not like this. Which one of the following defense mechanisms is he using? A Denial. B Projection.Font Size: A A_A 5:29 7 uses A 50-year-old farmer is in significant financial debts dues to a recent severe drought. He is planning to commit suicide so that his family can use his life insurance. He feels anxious and is irritable but does not show symptoms of depressive disorders. You know him well and consulted him for alcohol use and problem gambling and know, from his wife, that he is reckless around money, spends a lot in pubs and casinos, and has problem drinking issues. He blames the government and authorities for what he is going through and believes that if they were more responsible and did their jobs right, he was not like this. Which one of the following defense mechanisms is he using? A Denial. B Projection. C Displacement. D Rationalization. E Regression.gaging and know, from his wife, that he i> | reckless around money, spends a lot in pubs and casinos, and has problem drinking issues. He blames the government and authorities for what he is going through and believes that if they were more responsible and did their jobs right, he was not like this. Which one of the following defense mechanisms is he using? * Oa __ Denial. ¥ (©)B Projection. x c Displacement. x D Rationalization. x E Regression. Hide the correct option ations5:29 7 ” Option B is correct Base on the facts in the scenario, this man is most likely utilizing projection as a defense mechanism. Projection is the misattribution of a person’s undesired thoughts, feelings, or impulses onto another person who does not have those thoughts, feelings, or impulses. Projection is used especially when the thoughts are considered unacceptable for the person to express. For example, a man may be angry at their wife for not listening, when in fact it is the angry man who does not listen. Projection is often the result of a lack of insight and acknowledgement of one's own motivations and feelings. In this scenario, the drought might really has caused his financial problems, but putting all the blame on the government and authorities and not accepting his share of irresponsibility helps him, subconsciously, to misattribute the root cause of this feeling on someone or something else. In other words, he is projecting the negative feelings of recklessness and irresponsibility elsewhere to protect his ego. In projection, in fact, some negative feelings or perceptions are completely or partially mirrored out. Some other examples of projection are: © You really dislike your manager at work who treats you just like they treat everyone else. Instead of admitting your dislike, you tell ie Oepartially mirrored out. 5:297 ” Some other examples of projection are © You really dislike your manager at work who treats you just like they treat everyone else. Instead of admitting your dislike, you tell everyone the manager has a grudge against you and is trying to sabotage your career. © Awoman is in a bad mood all day and comes home to her husband. After greeting her warmly and asking about her day, she instantly accuses him of being in a bad mood and ruining her evening. © A father has body image issues but refuses to make lifestyle changes that would help him lose weight. Instead, he blames his daughter for her weight, projecting his lack of self-confidence onto her. (Option A) Denial is one of the most common defense mechanisms. When a situation or fact becomes too much to handle, the person copes by refusing to experience it. By denying reality, one essentially protects himself from the need to face and deal with the unpleasant consequences and pain that comes with acceptance. Examples of denial are: @ Asmoker denies that his habit has negative health consequences so he can continue smoking. © Aparent denies that her son has dropped out of college even though the school administrator has left her three voicemails telling her so. © A businger aeneenerner business