Descriptive psychopathology Flashcards
Descriptor for the quality of affect e.g. happy, anxious, angry
Valence
Descriptor for the responsiveness of affect to environmental stimuli
Reactivity
Descriptor for affectivity which shows a lessened response to environmental stimuli
Blunted affect
Descriptor for a lack of range of expression
Restricted or constricted range of expression
Descriptor for the maintenance of an affective state in the absence of any environmental stimuli that should change the affect
Stability
Descriptor for affect which changes quickly despite a lack of environmental cues
Labile affect
Conditions in which labile affect is commonly seen
Emotionally unstable personality disorder
Histrionic personality disorder
PTSD
Extreme form of labile affectivity seen in organic illnesses where the patient might laugh and cry within minutes despite lack of environmental cues
Emotional incontinence
Elements of mania
Disturbed emotion
Disturbed thought e.g. pressured speech, delusions
Disturbed will e.g. grandiose plans and ideas
Mixed state where there is high mood but low will and thought
Manic stupor
Mixed state where there is high mood and will but low thought
Mania with poverty of thought
Mixed state where there is high mood and thought but low will
Inhibited mania
Mixed state where there is low mood but high will and thought
Depressive mania
Mixed state where there is low mood and thought but high will
Excited depression
Mixed state where there is low mood and will but high thought
Depression with flight of ideas
Mixed state where there is predominantly mania with some depressive symptoms
Dysphoric mania
Mixed state where there is predominantly depression with some manic symptoms
Depressive mixed state
Features of organic pain
Confined to certain anatomical areas Remits and fluctuates Can often describe the quality Can wake from sleep Tenderness present Typical postural changes e.g. broken leg hurts on moving it
Features of non-organic pain
Diffuse Constant and unremitting Difficult to describe the quality Rarely wakes from sleep Tenderness rare No postural variation
Common areas for non-organic pain to be found
Head, neck and back
Most common symptoms in hypochondriasis
GI symptoms
The inability to derive pleasure and the decreased interest in activities
Anhedonia
The inability to label or describe one’s own emotions
Alexithymia
Definition of age disorientation
Misstating one’s age by 5 years or more
Perceptual error where the correct object is perceived, but its quality is altered somehow
Perceptual distortion
Perceptual error where there is a stimulus present but a different object is perceived
Illusion
Perceptual error where there is no stimulus but an object is perceived
Hallucination
Perceptual error where there is a stimulus but no object is perceived
Negative hallucination
States in which hyperacusis is commonly seen
Migraine
Hangover
States in which intense perceptions occur
Mania
Hyperactive delirium
Drug induced states
Perceptual error where an object’s shape is changed, especially when it loses its symmetry and one side becomes larger than the other
Dysmegalopsia
Perceptual error where an object appears smaller than it is
Micropsia
Perceptual error where an object appears larger than it is
Macropsia
Occurs when an image is produced voluntarily in the mind, with full knowledge it is not present
Imagery
Occurs when visual images are taken accurately from memory and described as if they are currently occurring
Eidetic imagery
Type of illusion where the current emotional state leads to a misperception
Affect illusion
Quality of an affect illusion
Provokes an emotion, often fear
Disappears on increased concentration
Type of illusion where an object is seen in an ambiguous stimulus
Pareidolic illusion
Quality of a pareidolic illusion
Often playful
Becomes more intense on increased concentration
Type of illusion where a stimulus that does not form a complete object might be perceived to be complete
Completion illusion
Quality of a completion illusion
Occurs due to inattention
Usually disappears on increased concentration
Example of an affect illusion
E.g. seeing a figure caused by the movement in the wind of trees at night
Example of a pareidolic illusion
E.g. seeing Jesus’ face in a slice of toast
Example of a completion illusion
E.g. Reading a road sign as it should read when the last letter is missing
Common states that trigger pareidolic illusions
Delirium especially children who are febrile
Hallucinogen use
Type of illusion that are typically under some voluntary control
Pareidolic illusion
Features of true hallucinations
Absence of insight
Sought for in other modalities e.g. reached out for
In an objective spatial location
Features of pseudohallucinations
Often presence of insight
Not sought for in other modalities
In subjective space
States where pseudohallucinations are seen
Dissociative states
Personality disorders
Following trauma
Auditory hallucinations that occur as human voices
Phonemes
Most common characteristics of schizophrenic phoneme hallucinations
Male
Speaking in mother tongue
Episodic
Organic causes of visual hallucinations
Occipital lobe tumours Post-concussion Post-seizure Hepatic failure Delirium Dementia
Type of visual hallucinations caused by hallucinogens
Elemental e.g. light flashes
Type of hallucination often seen in temporal lobe epilepsy
Visual-verbal hallucinations e.g. a child that speaks to them
Features of hallucinations in Charles Bonnet syndrome
Simple patterns
Well coloured, formed hallucinations of people
Often decrease on e.g. closing eyes, moving head etc.
Usually preserved insight
Hallucinations which involve tiny people or animals
Lilliputian hallucinations
Hallucinations involving the visual experience of seeing oneself
Autoscopic hallucinations
The experience of looking into a mirror and seeing nobody there
Negative autoscopy
Visual disturbance where images persist even after the stimulus has left
Palinopsia
Difference between palinopsia and afterimage
Afterimages often show colour inversion and distortion but palinopsia does not
Somatic hallucinations involving the sense of touch
Tactile
Somatic hallucinations involving the sense of wetness
Hygric
Somatic hallucinations involving the sense of heat or cold
Thermic
Pain-like visceral somatic hallucinations
Coenesthetic hallucinations
Somatic hallucinations involving joint or muscle sense
Kinaesthetic or proprioceptive hallucinations
Hallucinations involving the feeling of insects crawling under the skin
Formication
Common causes for formication hallucinations
Alcohol withdrawal
Cocaine intoxication
Causes of olfactory hallucinations
Temporal lobe epilepsy in the aura
In depression with nihilism
Hallucinations that occur outwith the normal field of perception e.g. images seen behind someone’s back
Extracampine hallucinations
Hallucinations that occur when going to sleep
Hypnagogic hallucinations
Hallucinations that occur on waking up
Hypnopompic hallucinations
Most common form of hypnogogic hallucination
Hearing one’s name called
Hallucinations that occur in the context of a genuine stimulus in the same modality - the hallucination and external stimulus are individually perceived
Functional hallucinations
Example of functional hallucinations
Hearing screaming every time the noise of the radio is heard
Hallucinations that occur in the context of a genuine stimulus in a different modality
Reflex hallucinations
Example of a reflex hallucination
Hearing your voice called when you see a yellow car
A stimulus is perceived in a different modality to the one it is occurring in
Synaesthesia
Differences between synaesthesia and reflex hallucinations
In synaesthesia the stimulus is the thing that is perceived, but in a different modality
In a reflex hallucination the stimulus is perceived as it is, and there is also a perception of something else in a different modality
In synaesthesia the perception is simple and non-bizarre e.g. seeing music as colours
First reported synaesthesia
Francis Galton
Most common sex to have synaesthesia
Female
Most common form of synaesthesia
Colour-number
Dimensions of delusions according to Kendler
- Conviction
- Extension
- Disorganisation
- Bizarreness
- Pressure
- Acting on delusion
- Seeking evidence
- Lack of insight
Dimension of a delusion that refers to the extent to which the delusion spreads to other areas of life
Extension
Dimension of a delusion that refers to the degree of internal consistency to the belief
Disorganisation
Dimension of a delusion that refers to the implausibility of the belief
Bizarreness
Dimension of a delusion that refers to the extent to which the person is upset or preoccupied by the delusion
Pressure
Delusions that occur out of the blue, without any identifiable preceding events
Autochthonous delusions/delusional intuitions
Delusions where a normally perceived object is given a delusional meaning
Delusional perception
Type of delusion which is included in Schneider’s first rank symptoms
Delusional perception
Example of a delusional perception
A tree with blossom on is perceived normally but the person on seeing the tree that it means that their partner has been unfaithful
Sense of confusion or uncertainty that precedes psychosis and can precede a primary autochthonous delusion
Delusional mood
Two definitions of a delusional memory
- A false memory which never occurred but is believed in to a delusional extent
- A true memory which is retrospectively given a delusional meaning e.g. my mother took me to France as a child and I now understand she did this because I am an angel
Most common theme for delusions
Persecutory
Delusions in which someone is convinced their partner is cheating on them
Othello syndrome/morbid jealousy
Delusions in which someone believes someone else, often of higher social standing, is secretly in love with them
De Clerambault’s syndrome/erotomania
Delusions in which someone believes they are dead
Cotard syndrome
Most common cause of Cotard syndrome
Psychotic depression
Age group Cotard syndrome is most commonly seen in
Elderly
Delusions in which someone believes they have body odour despite not being able to smell it themselves
Olfactory reference syndrome
Delusions in which someone believes they are infested with parasites
Ekbom syndrome
Sign related to Ekbom syndrome where someone will present with supposed evidence of their infection in the form of skin scrapings
Matchbox syndrome
Delusions in which someone believes a part of their body is misshapen, abnormal or unattractive
Dysmorphic delusions
Delusion in which someone believes a person close to them has been replaced by an exact double
Capgras syndrome
Delusion in which someone believes strangers to be someone close to them in disguise - they have invaded the body of a stranger
Fregoli syndrome
Delusion in which someone believes another person has transformed into an exact double of themselves
Syndrome of subjective doubles
Delusion in which someone believes people are able to continuously change their physical appearance
Intermetamorphasis
Delusion in which someone believes another person’s face transforms for seconds at a time into a grotesque mask
Paraprosopia
Occurs when someone gives strong personal significance to an innocuous or coincidental event
Idea of reference
Abnormal beliefs which are not delusional, but which dominate a person’s life
Overvalued ideas
Shared delusion between two people, occurs when a psychotic person transfers their delusions to a person close to them
Folie a deux
Outcome of separating two people experiencing folie a deux
The person who was genuinely psychotic stays unwell
The other person loses their delusional beliefs
Most common pairing to experience folie a deux
Partners
Types of hallucination included in Schneider’s first rank symptoms
Thought echo
Running commentary
Voices heard discussing/arguing
‘Made’ phenomena included in Schneider’s first rank symptoms
Made affect
Made volition
Made impulse
Phenomenon where someone believes their mood is being controlled
Made affect
Phenomenon where someone believes their actions are being controlled
Made volition
Phenomenon where someone believes their wish to act is being controlled
Made impulse
Thought phenomena included in Schneider’s first rank symptoms
Thought withdrawal
Thought insertion
Thought broadcast
Symptoms included in Schneider’s first rank symptoms which are not hallucinations, ‘made’ phenomena or thought phenomena
Delusional perception
Somatic passivity - feeling bodily sensations are being imposed by outside forces
Aspect of conversational speech which involves comments made not just in response to questions
Spontaneity
Aspect of conversational speech which involves responses being made at appropriate points in the conversation, while the other person is not talking
Turn-taking
Aspect of conversational speech which involves making comments relevant to what has already been discussed in the conversation
Mutual topic
Aspect of conversational speech which involves non-verbal parts of a conversation
Animation
The inability to vocalise sound - whispering can occur and the speech is otherwise normal
Aphonia
The inability to articulate speech properly
Dysarthria
Speech which is fragmented by pauses or the repetition of words or parts of words
Stammering
Speech which is interrupted by difficulty in producing the start of words
Stuttering
Speech which is slowed down
Bradyphasia
Speech which is sped up
Tachyphasia
Speech which is increased in quantity, usually without pressure or formal thought disorder, sometimes to the point of incoherence
Logorrhoea
Speech which is decreased in quantity, including little spontaneous talking
Alogia
Speech which is adequate in quantity but which conveys little information
Poverty of content of speech
