USMLE Step 1 Question 372

Question:

A researcher is studying different reactions in patients to psychological stress. Which of the following is an example of an immature ego defense in response to psychological stress?

Correct Answer: E.  Patient with newly diagnosed HIV becomes an expert on HIV/AIDS research

A patient with newly diagnosed HIV who becomes an expert on HIV/AIDS research may be exhibiting intellectualization. This immature defense mechanism allows one to avoid the stressful, emotional aspect of the situation and focus on the intellectual component. For example, a patient who has just been diagnosed with a terminal illness focuses on learning everything about the disease in order to avoid distress and remain distant from the reality of the situation.

A patient about to undergo surgery who jokes about color of hospital gown is using humor as a defense mechanism, one of the mature defenses, in which the subject appreciates the humorous nature of a stressful circumstance. (choice A) A patient recently diagnosed with cancer who makes large donation to cancer research is exhibiting altruism, one of the mature defense mechanisms in which unpleasant feelings are alleviated by kindness towards others. (choice B) A patient with fear of shots who does not think about flu shot until arriving at clinic is displaying suppression, a mature defense mechanism in which the subject voluntarily suppresses an idea or feeling from awareness (unlike repression which is involuntary and an immature defense mechanism). (Choice D) A patient with a desire to cut self and others who trains to become a surgeon is using sublimation, a mature defense mechanism in which unwanted desires are channeled into acts that fit with one’s values. (Choice C)