Psychopathology 1 - Argosy SFBA 2

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DENIAL: AVOIDING THE AWARENESS OF SOME PAINFUL ASPECT OF REALITY BY NEGATING SENSORY DATA. DENIAL ABOLISHES EXTERNAL REALITY. DENIAL USED IN BOTH NORMAL AND PATHOLOICAL STATES.
DISTORTION: GROSSLY RESHAPING EXTERNAL REALITY TO MEET INNER NEEDS.
PROJECTION: PERCEIVING AND REACTING TO UNACCEPTABLE INNER IMPULSES AND THEIR DERIVATIVES AS THOUGH THEY WERE OUTSIDE THE SELF.
ACTING OUT: EXPRESSING AN UNCONSCIOUS WISH OR IMPULSE THROUGH ACTION TO AVOID BEING CONSCIOUS OF AN ACCOMPNYING AFFECT. THE UNCONSCOUS FANTSY IS LIVED OUT IMPULSIVELY IN BEHAVIOR, THEREBY GRATIFYING THE IMPULSE, RATHER THAN THE PROHIBITION AGAINST IT. ACTING OUT INVOLVES CHRONICALLY GIVING IN TO AN IMPULSE TO AVOID THE TENSION THAT WOULD RESULT FROM THE POSTPONEMENT OF EXPRESSION.
BLOCKING: TEMPORARILY OR TRANSIENTLY INHIBITING THINKING. AFFECTS ADN IMPULSES MAY ALSO BE INVOLVED. CLOSELY RESEMBLES REPRESSION BUT DIFFERS IN THAT TENSION ARISES WHEN THE IMPULSE, AFFECT, OR THOUGHT IS INHIBITED.
HYPOCHONDRIASIS: EXAGGERATING OR OVEREMPHASIZING AN ILLNESS FOR THE PURPOSE OF EVASION AND REGRESSION. REPROACH ARISING FROM BEREAVEMENT, LONELINESS, OR UNACCEPTABLE AGGRESSIVE IMPULSES TOWARD OTHERS IS TRANSFORMED INTO SELF REPROACH AND COMPLAINTS OF PAIN, SOMATIC ILLNESS, AND NEURASTHENIA. IN HYPOCHONDRIASIS RESPONSIBILITY CAN BE AVOIDED, GUILT MAY BE CIRCUMBENTED, AND INSTINCTUAL IMPULSES ARE WARDED OFF.
INTROJECTION: INTERNALIZING THE QUALITIES OF AN OBJECT. ALTHOUGH VITAL TO DEVELOPMENT, INTROJECTION SERVES SPECIFIC DEFENSIVE FUNCTIONS. WHEN USED AS A DEFENSE IT CAN OBLITERATE THE DISTINCTION BETWEEN THE SUBJECT AND THE OBJECT. FOR EXAMPLE, IDENTIFYING WITH THE AGGRESSOR OR THE VICTIM.
PASSIVE-AGGRESSIVE BEHAVIOR: EXPRESSING AGGRESSION TOWARD OTHERS INDIRECTLY THROUGH PASSIVITY, MASOCHISM, AND TURNING AGAINST THE SELF. MANIFESTATIONS OF PASSIVE-AGGRESSIVE BEHAVIOR INCLUDE INCLUDE FAILURE, PROCRASTINATION, AND ILLNESSES THAT AFFECT OTHERS MORE THAN ONESELF.
REGRESSION: ATTEMPTING TO RETURN TO AN EARLIER LIBIDINAL PHASE OF FUNCTIONING TO AVOID THE TENSION AND CONFLICT EVOKED AT THE PRESENT LEVEL OF DEVELOPMENT. IT REFLECTS THE BASIC TENDENT\CY TO GAIN INSTINCTUAL GRATIFICATION AT A LESS DEVELOPED PERIOD.
SCHIZOID FANTASY: INDULGING IN AUTISTIC RETREAT TO RESOLVE CONFLICT AND TO OBTAIN GRATIFICATION. INTERPERSONAL INTIMACY IS AVOIDED, AND ECCENTRICITY SERVES TO REPEL OTHERS. THE PERSON DOES NOT FULLY BELIEVE IN THE FANTASIES AND DOES NOT INSIST ON ACTING THEM OUT.
SOMATIZATION: CONVERTING PSYCHIC DERIVATIVES INTO BODILY SYMPTOMS AND TENDING TO REACT WITH SOMATIC MANIFISTATIONS RATHER THAN PSYCHIC MANIFESTATIONS. IN DESOMATIZATION, INFANTILE SOMATIC RESPONSES ARE REPLACED BY THOUGHT AND AFFECT; IN RESOMATIZATON THE PERSON REGRESSES TO EARLIER SOMATIC FORMS IN THE FACE OF UNRESOLVED CONFLICTS.
CONTROLLING: ATTEMPTING TO MANAGE OR REGULATE EVENTS OR OBJECTS IN THE ENVIRONMENT TO MINIMIZE ANXIETY AND TO RESOLVE INNER CONFLIICTS.
DISPLACEMENT: REDIRECTION OF IMPULSES, USUALLY AGGRESSIVE ONES, ONTO A SUBSTITUTE TARGET WHEN THE APPROPRIATE TARGET IS TOO THREATENING.
EXTERNALIZATION: TENDING TO PERCEIVE IN THE EXTERNAL WORLD AND IN EXTERNAL OBJECTS ELEMENTS OF ONE'S OWN PERSONALITY, INCLUDING INSTINCTUAL IMPULSES, CONFLICTS, MOODS, ATTITUDES, AND STYLES OF THINKING. EXTERNALIZATION IS A MORE GENERAL TERM THAN PROJECTION.
INHIBITION: CONSCIOUSLY LIMITING OR RENOUNCING SOME EGO FUNCTIONS, ALONE OR IN COMBINATION, TO EVADE ANXIETY ARISING OUT OF CONFLICT WITH INSTINCTUAL IMPULSES, THE SUPEREGO, OR ENVIRONMENTAL FORCES OR FIGURES.
INTELLECTUALIZATION: EXCESSIVELY USING INTELLECTUAL PROCESSES TO AVOID AFFECTIVE EXPRESSION OR EXPERIENCE. UNDUE EMPHASIS IS FOCUSED ON THE INANIMATE TO AVOID INTIMACY WITH PEOPLE, ATTENTION IS PAID TO EXTERNAL REALITY TO AVOID THE EXPRESSION OF INNER FEELINGS, AND STRESS IS EXCESSIVELY PLACED ON IRRELEVANT DETAILS TO AVOID PERCEIVING THE WHOLE. INTELLECTUALIZATION IS CLOSELY ALLIED TO RATIONALIZATION.
ISOLATION (also called Isolation of Affect): SPLITTING OR SEPARATING AN IDEA FROM THE AFFECT THAT ACCOMPANIES IT BUT IS REPRESSED. SOCIAL ISOLATION REFERS TO THE ABSENCE OF OBJECT RELATIONSHIPS.
RATIONALIZATION: OFFERING RATIONAL EXPLANATIONS IN AN ATTEMPT TO JUSTIFY ATTITUDES, BELIEFS, OR BEHAVIOR THAT MAY OTHERWISE BE UNACCEPTABLE. SUCH UNDERLYING MOTIVES ARE USUALLY INSTINCTUALLY DETERMINED.
DISSOCIATION: TEMPORARILY BUT DRASTICALLY MODIFYING A PERSON'S CHARACTER OR ONE'S SENSE OF PERSONAL IDENTITY TO AVOID EMOTIONAL DISTRESS. FUGUE STATES AND HYSTERICAL CONVERSION REACTIONS ARE COMMON MANIFESTAIONS OF DISSOCIATION. DISSOCIATION MAY ALSO BE FOUND IN COUNTERPHOBIC BEHAVIOR, DISSOCIATIVE IDENTITY DISORDER, THE USE OF PHARMACOLOGICAL HIGHS OR RELIGIOUS JOY.
REACTION FORMATION: TRANSFORMING AN UNACCEPTABLE IMPULSE INTO ITS OPPOSITE. REACTION FORMATION IS CHARACTERISTIC OF OBSESSIONAL NEUROSIS, BUT MAY OCCUR IN OTHER FORMS OF NEUROSES AS WELL. IF THIS MACHANISM IS FREQUENTLY USED AT ANY EARLY STAGE OF EGO DEVELOPMENT, IT CAN BECOME A PERMANENT CHARACTER TRAIT, AS IN AN OBSESSIONAL CHARACTER.
REPRESSION: EXPELLING OR WITHHOLDING FROM CONSCIOUSNESS AN IDEA OR FEELING. PRIMARY REPRESSION REFERS TO THE CURBING OF IDEAS AND FEELINGS BEFORE THEY HAVE ATTAINED CONSCIOUSNESS: SECONDARY REPRESSION EXCLUDES FROM AWARENESS WHAT WAS ONCE EXPERIENCED AT A CONSCIOUS LEVEL. THE REPRESSED IS NOT REALLY FORGOTTEN IN THAT SYMBOLIC BEHAVIOR MAY BE PRESENT. THIS DEFENSE DIFFERS FROM SUPPRESSION BY EFFECTING CONSCIOUS INHIBITION OF IMPULSES TO THE POINT OF LOSING AND NOT JUST POSTPONING CHERISHED GOALS. CONSCIOUS PERCEPTION OF INSTINCTS AND FEELINGS IS BLOCKED IN REPRESSION.
SEXUALIZATION: ENDOWING AN OBJECT OR FUNCTION WITH SEXUAL SIGNIFICANCE THAT IT DID NOT PREVIOUSLY HAVE OR POSSESSED TO A SMALLER DEGREE TO WARD OFF ANXIETIES ASSOCIATED WITH PROHIBITED IMPULSES OR THEIR DERIVATIVES.
ALTRUISM: USING CONSTRUCTIVE AND INSTINCTUALLY GRATIFYING SERVICE TO OTHERS TO UNDERGO A VICARIOUS EXPERIENCE. IT INCLUDES BENIGN AND CONSTRUCTIVE REACTION FORMATION. ALTRUISM IS DISTINGUISHED FROM ALTRUISTIC SURRENDER, IN WHICH A SURRENDER OF DIRECT GRATIFICATION OR OF INISTINCTUAL NEEDS TAKES PLACE IN FAVOR OF FULFILING THE NEEDS OF OTHERS TO THE DETRIMENT OF THE SELF, AND THE SATISFACTION CAN ONLY BE ENJOYED VICARIOUSLY THROUGH INTROJECTION.
ANTICIPATION: REALISTICALLY ANTICIPATING OR PLANNING FOR FUTURE INNER DISCOMFORT. THE MECHANISM IS GOAL DIRECTED AND IMPLIES CAREFUL PLANNING OR WORRYING AND PREMATURE BUT REALISTIC AFFECTIVE ANTICIPATION OF DIRE AND POTENTIALLY DREADFUL OUTCOMES.
ASCETISCISM: ELIMINATING THE PLEASURABLE EFFECTS OF EXPERIENCES. THERE IS A MORAL ELEMENT IN ASSIGNING VALUES TO SPECIFIC PLEASURES. GRATICATON IS DERIVED FROM RENUNCIATON, AND ASCETICISM IS DIRECTED AGAINST ALL BASE PLEASURES PERCEIVED CONSCIOUSLY.
HUMOR: USING COMDEDY TO OVERTLY EXPRESS FEELINGS AND THOUGHTS WITHOUT PERSONAL DISCOMFORT OR IMMOBILIZATION AND WITHOUT PRODUCING AN UNPLEASANT EFFECT ON OTHERS. IT ALLOWS THE PERSON TO TOLERATE AND YET FOCUS ON WHAT IS TOO TERRIBLE TO BE BORNE; IT IS DIFFERENT FROM WIT, A FORM OF DISPLACEMENT THAT INVOLVES DISTRATION FROM THE AFFECTIVE ISSUE.
SUBLIMATION: ACHIEVING IMPULSE GRATIFICATION AND THE RETENTION OF GOALS BUT ALTERING A SOCIALLY OBJECTIONABLE AIM OR OBJECT TO A SOCIALLY ACCEPTABLE ONE. SUBLIMATION ALLOWS INSTINCTS TO BE CHANNELED, RATHER THAN BLOCKED OR DIVERTED. FEELINGS ARE ACKNOWLEDGED, MODIEFIED, AND DIRECTED TOWARD A SIGNIFICANT OBJECT OR GOAL, AND MODEST INSTINCTUAL SATISFACTION OCCURS.
SUPPRESSION: CONSCIOUSLY OR SEMICONSCIOUSLY POSTPONING ATTENTION TO A CONSCIOUS IMPULSE OR CONFLICT. ISSUES MAY BE DELIBERATLEY CUT OFF, BUT THEY ARE NOT AVOIDED. DISCOMFORT IS ACKNOWLEDGED BUT MINIMIZED.
WHAT DOES TR STAND FOR AFTER DSM IV?: TEXT REVISION
WHAT MAKES DSM-IV-TR DIFFERENT FORM THE DSM-IV?: DSM-IV WAS BASED ON A REVIEW OF THE LITERATURE UP TO 1992. DSM-IV-TR WAS BASED ON LITERATURE BETWEEN 1992-2000.
AXIS I: CLINICAL DISORDERS, OTHER CONDITIONS THAT MAY BE A FOCUS OF CLINICAL ATTENTION.
AXIS II: PERSONALITY DISOERDERS, MENTAL RETARDATION
AXIS III: GENERAL MEDICAL CONDITIONS
AXIS IV: PSYCHOSOCIAL ENVIRONMENTAL PROBLEMS
AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING
TYPICAL OPTIONS = CURRENT AND HIGHEST LEVEL PAST YEAR. AND ADMISSION AND DISCHARGE
THE INFORMATION ON AXIS V INDICATES YOUR IMPRESSION OF THE PATIENT'S OVERALL LEVEL OF FUNCTIONING. HOW IS THIS MEASURED?: USE OF THE GAF SCALE.
DEFINE SUBTYPES: SUBTYPES ARE MUTUALLY EXCLUSIVE AND JOINTLY EXHAUSTIVE PHENOMENOLOGICAL SUBGROUPINGS WITHIN A DIAGNOSIS AND ARE INDICATED BY THE INSTRUCTION "SPECIFY TYPE" IN THE CRITERIA SET. E.G., DELUSIONAL DISORDER, PERSECUTORY TYPE.
DEFINE SPECIFIERS: SPECIFIERS ARE NOT INTENDED TO BE MUTUALLY EXCLUSIVE OR JOINTLY EXHAUSTIVE AND ARE INDICATED BY THE INSTRUCTION "SPECIFY" OR "SPECIFY IF" IN THE CRITERIA SET. E.G., MAJOR DPERESSIVE DISORDER, WITH MELANCHOLIC FEATURES.
AXIS IV: LIST ALLOF THE CATEGORIES THAT CAN BE NOTED ON AXIS IV.: PROBLEMS WITH PRIMARY SUPPORT GROUP, PROBLEMS RELATED TO THE SOCIAL ENVIRONMENT, EDUCATIONAL PROBLEMS, OCCUPATIONAL PROBLEMS, HOUSING PROBLEMS, ECONOMIC PROBLEMS, PROBLEMS WITH ACCESS TO HEALTH CARE SERVICES, PROBLEMS RELATED TO INTERACTION WITH THE LEGAL SYSTEM/CRIME, OTHER PSYCHOSOCIAL AND ENVIRONMENTAL PROBLEMS.
LIST SEVERITY AND COURSE SPECIFIERS: MILD, MODERATE, SEVERE, PARTIAL REMISSION, IN FULL REMISSION, PRIOR HISTORY.
WHY ARE THESE THREE SECTIONS, DELIRIUM, DEMENTIA, AND AMNESTIC AND OTHER COGNITIVE DISORDERS, MENTAL DISORDERS DUE TO A GENERAL MEDICAL CONDITION, AND SUBSTANCE RELATED DISORDERS, PLACED BEFORE THE REMAINING DISORDERS IN THE MANUAL?: BECAUSE OF THEIR PRIORITY IN DIFFERNTIAL DIAGNOSIS - YOU MUST RULE THEM OUT BEFORE MAKING ANOTHER DIAGNOSIS.
NOT OTHERWISE SPECIFIED: YOU CAN INDICATE THE CLASS OF DISORDER BUT FURTHER SPECIFICATION IS NOT POSSIBLE.
PROVISIONAL: YOU CANMAKE A WORKING DIAGNOSIS BUT THERE IS SOME DIAGNOSTIC UNCERTAINTY.
V71.09: NO AXIS I OR AXIS II DISORDER IS PRESENT.
V CODE: INSUFFICIENT INFORMATION TO KNOW WHETHER OR NO A PRESENTING PROBLEM IS ATTRIBUTABLE TO A MENTAL DISORDER.
298.9: YOU KNOW THERE IS A PSYCHOTIC DISORDER BUT CAN'T SPECIFY WHICH ONE.
300.9: YOU HAVE RULED OUT A PSYCHOTIC DISORDER AND KNOW THERE IS SOME UNSPECIFIED MENTAL DISORDER.
799.9: DIAGNOSIS DEFERRED ON AXIS I OR AXIS II.

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