1 Flashcards
Illusion
A type of false perception in which the perception of a real world object is combined with internal imagery to produce a false internal percept. Three types of illusion: affect, completion and pareidolic.
Affect illusions
combination of heightened emotion and misperception e.g. see a moving tree as an attacker when walking at night
Completion illusions
rely on brains tendency to fill in presumed missing parts of an object (optical illusions based on these)
Pareidolic illusions
meaningful percepts produced when experiencing poorly defined stimulus eg seeing faces in a fire
Hallucination
An internal percept without a corresponding external object. A true hallucination will be perceived as in external space, distinct from imagined images, outside conscious control, and as possessing relative permanence. A pseudo-hallucination will lack one or all of these characteristics.
Pseudo-hallucination
A false perception which is perceived as occurring as part of one’s internal experience, not as part of the external world. It may be described as been seen with the minds eye. eg hallucination of deceased spouse
Types of hallucination
auditory, visual, gustatory, tactile, olfactory, kinaesthetic.
auditory = schizo, visual = organic
Over-valued idea
Strongly held beliefs which are particularly important to 4 disorders: depressive, anxiety, eating & sexual. They differ from obsessions in that they can be put out of the mind with effort. They come to unreasonably dominate the pts life
Delusion
Fixed false beliefs which are firmly held despite evidence to the contrary and go against the individual’s normal social and cultural belief system
Delusion arising out of the blue
autochthonous delusion
Delusion arising from seeing a normal thing eg passing the salt
delusional percept
delusion arising on recalling a memory
delusional memory
whats delusional mood
a delusion arising on a background of anticipation, odd experiences, and increased awareness
12 types of delusion
persecutory grandoise delusions of control of thought interference of reference of guilt of love delusional misidentification jealousy hypochondrial delusions nihilistic delusions delusions of infestation
Persecutory delusions
other people are conspiring against them in order to inflict harm or destroy their reputation
delusions of grandoise
fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful
delusions of reference
random events, objects or the behaviour of others have special significance to oneself
delusions of control
False belief that another person, group of people, or external force controls one’s general thoughts, feelings, impulses, or behaviour
nihilistic delusions
they are worthless or dying
In severe cases they claim that everything is non existent including themselves (Cotard’s syndrome)
delusional perception
A primary delusion which is recalled as having arisen as a result of a perception (e.g. a patient who, on seeing 2 white cars pull up in front of his house became convinced that he was therefore about to be wrongly accused of being a paedophile. This percept is a real external object, not a hallucinatory experience.
Thought alienation
A symptom of psychosis in which patients feel that their own thoughts are in some way no longer within their control. It includes thought insertion, thought withdrawal, and thought broadcast. Any form of thought alienation is a Schneiderian first-rank symptom, highly indicative of schizophrenia.
Thought insertion
A delusional belief that thoughts are being placed into the patients head - 1st rank schizophrenia symptom
Thought withdrawal
The delusional belief that thoughts have been ‘taken out’ of the patient’s mind, and the patient has no power over this
Thought broadcast
The delusional belief that one’s thoughts are accessible directly to others. 1st rank schizophrenia symptom
Thought echo
The experience of an auditory hallucination in which the content is the individuals current thoughts. 1st rank schizophrenia symptom
Thought block
During thought blocking, a person stops speaking suddenly and without explanation in the middle of a sentence. Schizo
First rank symps of schizophrenia
Schneider described these. 11 symps 4 categories 1 - Auditory hallucinations a) 'voices heard arguing' b) thought echo c) 'running commentry'
2 - Delusions of though interference
a) thought insertion
b) thought withdrawal
c) thought broadcasting
3 - Delusions of control
a) passivity of affect
b) passivity of impulse
c) passivity of volitions
d) somatic passivity
4 - Delusional perception
A primary delusion arising from a normal perception
Concrete thinking
the loss of the ability to understand abstract concepts and metaphorical ideas leading to strictly literal form of speech and inability to comprehend allusive language. Seen in schizophrenia and in dementing illnesses.
Loosening of associations
A symptom of formal thought disorder (abnormalities in the way thoughts are linked together)
- loss of the normal structure of thinking
- mainly in schizophrenia
3 types
1. derailment of thought - discourse consisting of a sequence of unrelated or only remotely related ideas
2. tangential thinking - diverts from original train of thought but never returns to it.
3. word salad - speech that is reduced to a senseless repetition of sounds and phrases
Circumstantial thinking
A symptom of formal thought disorder (abnormalities in the way thoughts are linked together)
Thinking proceeds slowly with many unnecessary details and digressions, before returning to the original point. It is seen in mania and in anankastic (obsessive) personality disorder
Perseveration
A symptom of formal thought disorder (abnormalities in the way thoughts are linked together)
Uncontrollable and inappropriate repetition of a particular response, such as a word, phrase or gesture. Most often occurs in dementia.
Confabulation
The process of describing plausibly false memories for a period for which the pt has amnesia. Occurs in Korsakoff psychosis, dementia and following alcoholic palimpsest.
Neologisms
A symptom of formal thought disorder (abnormalities in the way thoughts are linked together)
Are words and phrases devised by the patient or a new meaning to an already known word. May be seen in schizophrenia and autism
Clouding of consciousness
Conscious level between full consciousness and coma. Covers a range of increasingly severe loss of function with drowsiness and impairment of concentration and perception.
Catatonia
Increased resting muscle tone which is not present on active or passive movement (in contrast to EPSE of Parkinson’s).
A motor symptom of schizophrenia
Anhedonia
The feeling of absent or significantly diminished enjoyment of previously pleasurable activities.
A core symptom of depressive illness, also a negative symptom of schizophrenia.
Akathisia
Sense of uncomfortable desire to move / restlessness. Relieved by repeated movement of affected part (usually legs).
Is a SE of neuroleptic drugs
Belle indifference
A surprising lack of concern for, or denial of, apparently sever functional disability. It is part of classical descriptions of hysteria
Blunting of affect
Loss of the normal degree of emotional sensitivity and sense of the appropriate emotional response to events. A negative symptom of schizophrenia.
Depersonalisation
An unpleasant subjective experience where the patient feels as if they have become ‘unreal’.
Derealisation
An unpleasant subjective experience where the patient feels as if the world has become unreal.
Conversion
The development of features suggestive of physical illness but which are attributed to psychiatric illness or emotional disturbance rather than organic pathology
Dissociation
The separation of unpleasant emotions and memories from consciousness awareness with subsequent disruption to the normal integrated function of consciousness and memory.
Conversion and dissociation are related concepts. In conversion the emotional abnormality produces physical symptoms, while in dissociation there is impairment of mental functioning.
Flight of ideas
Subjective experience of one’s thoughts being more rapid than normal, with each thought having a greater range of consequent thoughts than normal. Meaningful connections between thoughts are maintained.
Formal thought disorder
all pathological disturbances in the form of thought
Mannerism
Abnormal and occasionally bizarre performance of a voluntary, goal-directed activity e.g. dramatic manner of walking
Obsession / compulsion
An idea, image or impulse which is recognised by the patient as their own, but which is experienced as repetitive, intrusive and distressing. In some cases the accompanying obsessional thoughts can be relieved by associated compulsions e.g. a patient with an obsession that his wife may have come to harm feeling compelled to phone her constantly during the day to check she is still alive
Incongruity of affect
Refers to the objective impression that the displayed affect is not consistent with the current thoughts or actions, (e.g. laughing while discussing traumatic experiences). Schizophrenia
Pressure of speech
The speech pattern consequent upon pressure of thought. The speech is rapid, difficult to interrupt and with increasing severity of illness the connection between sequential ideas may be increasingly hard to follow. Occurs in manic illness
Psychomotor retardation
Decreased spontaneous movement and slowness in instigating voluntary movement. Actions = more effort. Retardation of thought. Occurs in mod to sev depression
Stupor
Absence of movement and mutism where there is no impairment of consciousness. Functional stupor occurs in a variety of psychiatric illnesses. Organic stupor is caused by lesions in the midbrain.
