A 29-year-old married woman tells the PMHNP that she is not going to leave her abusive husband because he is really "a good man" deep down. "He was abused as a child and needs help. I just need to love him harder." This is an example of which defense mechanism?
Projection
Denial
Rationalization
Displacement
The Correct Answer is B
Choice A reason: Projection involves attributing one’s own unacceptable thoughts or feelings to another person. For example, someone who is angry may accuse others of being hostile. This does not apply to the woman’s behavior, as she is not externalizing her own feelings.
Choice B reason: Denial is the refusal to accept reality or facts, often to avoid emotional pain. In this case, the woman is denying the seriousness and danger of her abusive relationship. She minimizes the abuse and reframes her husband’s behavior as a result of his own trauma, thereby avoiding the painful truth of her situation.
Choice C reason: Rationalization involves creating logical explanations to justify unacceptable behavior or feelings. While the woman’s statements may contain elements of rationalization, the dominant mechanism is denial—she is refusing to acknowledge the abuse as a threat to her safety.
Choice D reason: Displacement involves redirecting emotions from a threatening target to a safer one. For example, someone angry at their boss might yell at their spouse. This mechanism is not evident in the woman’s response.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Hyperactivity, flight of ideas, and rapid speech are more indicative of manic or hypomanic states. These symptoms are not typically associated with intimate partner violence.
Choice B reason: Withdrawal, fearfulness, and hypersensitivity to touch are classic signs of trauma and abuse. These behaviors may reflect hypervigilance, fear of physical contact, and emotional distress, all of which are consistent with a history of intimate partner violence.
Choice C reason: Defensiveness and anger may be present in various psychiatric conditions, including personality disorders or trauma responses. However, they are not as specific or telling as the signs in choice B.
Choice D reason: Disorganized thinking and labile mood may suggest psychosis or mood disorders but are not specific indicators of intimate partner violence. They lack the trauma-related behavioral cues seen in choice B.
Correct Answer is D
Explanation
Choice A reason: Borderline personality disorder may involve transient psychotic symptoms under stress, but it does not typically present with sustained delusions and visual hallucinations. It is not a primary differential diagnosis in this context.
Choice B reason: Steroid-induced psychosis is a valid diagnosis but requires a history of corticosteroid use. There is no mention of steroid exposure in this case, making it less likely.
Choice C reason: Brief psychotic disorder involves sudden onset of psychotic symptoms lasting less than one month, often triggered by stress. Given the patient’s chronic psychiatric and substance use history, this diagnosis is less appropriate.
Choice D reason: Substance/medication-induced psychotic disorder is highly relevant in this case. Alcohol dependence can lead to psychotic symptoms, especially during withdrawal or intoxication. This diagnosis accounts for both substance use and the presence of hallucinations and delusions.
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