When 2-year-old Jay is hospitalized for tonsillitis, he will drink only from a bottle, even though his mother states he has been drinking from a cup for 6 months. What is the defence mechanism shown by the child?

Appeared in: AIIMS Raipur lecturer 2021

Explanation

Regression is an unconscious defense mechanism where an individual reverts to an earlier, less mature stage of development in response to stress or anxiety.
The 2-year-old child, Jay, is under the stress of hospitalization, which is a significant environmental and emotional change.
He returns to bottle-feeding, a behavior from infancy that provides comfort and security, despite having already learned to drink from a cup. This is a classic example of regression.

Why Other Options Were Wrong

Option A: Displacement involves shifting emotions from the original source to a less threatening target. The child is not redirecting his feelings about the hospital onto the bottle; he is seeking comfort from the bottle.
Option B: Projection is attributing one's own unacceptable feelings to another person. The child is not accusing others of wanting a bottle or being babyish.
Option D: Sublimation is a mature defense mechanism where unacceptable impulses are channeled into socially constructive activities. This is far beyond the cognitive and emotional capacity of a 2-year-old, and the behavior is a retreat, not a constructive channeling.

Related Visual

Clinical Relevance

Nursing practice connection: Use the key finding related to Psychological Defense Mechanisms to guide bedside assessment, documentation, and the next nursing action.
Nurses must recognize regression as a normal, temporary coping mechanism in hospitalized children, not a developmental setback.
The primary nursing role is to provide emotional support, accept the regressive behavior without judgment, and reassure parents that it will likely resolve once the child is back home and healthy.
What if? If a 7-year-old who has been toilet-trained for years starts bedwetting again in the hospital, this is also regression. The nursing priority is to manage the situation with empathy, use protective bedding discreetly, and reassure both the child and parents to reduce shame and anxiety.

How to Approach the Question

First, analyze the scenario to identify the key elements: a young child, a stressful situation (hospitalization), and a specific behavior change.
Note the core behavior: the child is reverting to a past action (bottle-feeding) that he had already outgrown.
Review the options, which are all psychological defense mechanisms, and recall their basic definitions.
Match the observed behavior—reverting to an earlier developmental stage under stress—to the correct definition.
Conclude that the behavior is a classic example of Regression, as it involves going back to a safer, earlier stage of life to cope with present anxiety.

Concept Tested & Keywords

Concept Tested: Psychological Defense Mechanisms
Stem keywords: 2-year-old, hospitalized, tonsillitis, drink only from a bottle, defence mechanism
Lead-in keywords: What is
Clinical cues: The key clinical cue is the child reverting to a previous behavior (bottle-feeding) after achieving a more mature milestone (cup-drinking), which is triggered by a stressor (hospitalization).
Negative lead-in flag: false

Question ID

QbbNBkLtYafgSS0DZKeJys

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 2993-2995

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 3346-3348

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