A medical student just finished the USMLE Step 1 exam and is anxious about her performance. She is especially unnerved when fellow students talk about the difficulty of the exam and discuss their answers to certain questions. The student decides not to think about the exam until her score arrives because "worrying isn't going to change the result." She is delighted when she receives a very high score several weeks later. Before receiving the result, the student exhibited which of the following defense mechanisms?

Question

A medical student just finished the USMLE Step 1 exam and is anxious about her performance.  She is especially unnerved when fellow students talk about the difficulty of the exam and discuss their answers to certain questions.  The student decides not to think about the exam until her score arrives because "worrying isn't going to change the result."  She is delighted when she receives a very high score several weeks later.  Before receiving the result, the student exhibited which of the following defense mechanisms?

Quizplus · Accepted Answer

11ec160b_3611_7da8_9249_ada22806cc8d_MD0001_00 Defense mechanisms are means of protecting oneself from awareness of uncomfortable feelings. They can be classified as immature or mature. Immature defense mechanisms (eg, denial, acting out, regression, splitting) are maladaptive and generally seen in children and in psychopathologic states. Mature defense mechanisms (eg, altruism, sublimation, suppression, humor) are more often used by adults and allow for a healthy, adaptive response to emotional distress. This student is using suppression to alleviate anxiety about her exam results as she is aware of her discomfort but decides not to attend to it. Suppression is a mature defense mechanism in which an individual intentionally puts aside unpleasant thoughts or feelings to better cope with the present reality. Suppression should not be confused with repression (Choice F), in which unacceptable thoughts or feelings are blocked from entering conscious awareness (eg, an adult who was sexually abused as a child unconsciously buries feelings about the trauma). (Choice A) Denial involves avoiding awareness of an external reality (eg, a student who has failed an exam denies having done so). (Choice B) Dissociation is an immature defense in which a transient disruption to memory, identity, and/or consciousness occurs as a way to cope with a distressing event (eg, this student does not remember taking the exam and feels numb when her peers discuss the questions). (Choice C) Intellectualization is an immature defense mechanism that involves focusing on nonemotional components of a distressing event to make it more tolerable (eg, this student becomes preoccupied with thinking about the passing rates and other statistics of the exam). (Choice D) Rationalization involves making excuses for unacceptable feelings or situations (eg, a student explaining that poor performance on an exam was due to the trickiness of the questions). (Choice E) Reaction formation involves unconsciously transforming an unacceptable thought or feeling into its opposite (eg, a student hiding fears of failing the exam by being overly confident). Educational objective: Suppression is a mature defense mechanism involving a conscious choice not to dwell on a particular thought or feeling. __________ References: Change in coping and defense mechanisms across adulthood: longitudinal findings in a European-American sample. (http://www.ncbi.nlm.nih.gov/pubmed/23834293)

A Medical Student Just Finished the USMLE Step 1 Exam