DESCRIPTIVE PSYCHOPATHOLOGY Flashcards
Mood vs affect
As if climate = mood and weather = affect
Mood (subjetive)
Affect = objective emotional expression
Anhedonia
Alexythymia
Anhedonia - it refers to the inability to derive pleasure in life often leading to
diminished interests in activities.
Alexythymia - the inability to recognize or describe one’s own emotions (eg alex a boy)
dysmegalopsia
micropsia
macropsia
hallucination
negative hallucination
pareidolia
dys- Changes in the shape of objects especially with the loss of symmetry
micropsia - shrink, enlarge macropsia
hallucination - no stimulus but perception occurs
negative hallucination - a stimulus but no perception eg cant see something
pareidolia- fantasy and imagery- common in delerium e..g face in clock
Phonemes
Lilliputian hallucinations
Autoscopic hallucinations
charles bonet -
Phonemes - auditory hallucinations occur as human voices
Lili- tiny people or crawling animas - in delerium tremens
Autoscopic - seeing oneself, phantom mirror images
Charles- elderly with normal consciousness with ocular problems, experience vivid usually well-coloured (in contrast to blurred due to eye disease) hallucinations – mostly humans or
animals/ cartoons.
Palinopsia
somatic hallucinations
Extracampine hallucinations:
Functional hallucinations-
Reflex halluinations
palin for “again” and opsia for “seeing”- images persist when stimulus left eg LSD, migraine, occipital epilepsy
somatic - haptic = touch, hygric = fluid/ wetness, thermic = heat/ cold.
coenesthetic hallucinations = visceral
Extracampine hallucinations: occur outside normal field of percdeption
functional- eg voices heard whenever water through tap - same modality
Reflex hallucinations- eg see angel when listen to music (one modality provokes another)
Synaesthesia
they experience sensations in multiple modalities in response to stimulation of one modality
Females > men
Delusion
Dimensions of delusions - Kendler
Primary delusion
A false belief that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary
Dimensions
- Conviction
- Extension
- Disorganisation
- Bizarreness
- Pressure
- Acting on it
- Seeking evidence
- lack of insight
Primary- jaspers concept- arrive fully formed and cant be reduced to other mental experience +
- first thing to occur when unwell
Monothematic delusions
capgras
cotard
fregoli
mirrored self mis
de clerambault
orthello
Capgras delusion - “That’s not my wife; it is an impostor who looks just like her.”
Cotard delusion “I am dead.”
Fregoli delusion “I am constantly being followed by people I know, but I can’t recognize them because they are always in disguise.”
Mirrored-self misidentification
“The person I see when I look in the mirror isn’t me; it is some stranger
who looks like me.”
De Clerambault’s delusion (erotomania)
“Person X is secretly in love with me” (Person X being some important
or famous person who has never encouraged this idea)
Othello syndrome
(pathological jealousy)
“My wife is having an affair.”
Ideas of reference
overvalued ideas
Ideas of reference are false beliefs that random events in the world are directly related to oneself
overvalued - abnormal beliefs that are neither delusional nor
obsessional in nature, but which dominates a person’s life and his actions eg anorexiam
First rank symptoms
Kurt Schneider (pupil of jaspers)
- used ICD and DSM
- FRS are not of any prognostic importance at all (3,3,3,2)
A- auditory hall
B- broadcast/ insertion
C- control
D - delusional
- 3 hallucinations
thought echo
3rd person
running commenaty - 3 ‘made’ phenomena
controlling mood
controlling action
controlling desire to act - 3 thought phenomena
thought withdrawal
thought insertion
though broadcast - 2 isolated
delusional perception and somatic passivity
Aphonia
Dysarthria
Stammering
Stuttering
Aphonia refers to the inability to vocalize eg vocal cords
Dysarthria refers to disorders of articulation eg lesions of brain or medication caused
Stammering- normal flow of speech is interrupted by pauses or by the repetition of
fragments of words or parts of words
Stuttering- difficulty in uttering speech sounds at the beginning of words.
Logorrhoea -
Alogia
Mutism
Elective mutism
Hysterical mutusm
Akinetic mutism
Logorrhoea - increased quantity of speech
Alogia- poverty of speech and a decrease in spontaneous talking
Mutism - complete lack of speech
Elective mutism - Mostly seen in children who refuse to speak to certain people
Hysterical mutusm - conversion disorder
Akinetic mutism - midbrain lesion- aware of the environment though cannot move or respond.
Verbigeration
Palilalia
Logoclonia
Verbigeration - repetition of phrases or sentences
Palilalia - repetition of last uttered word eg LD
Logoclonia - repetition last syllable word eg parkinsons
Brocos aphasia
Wereneks aphasia
Brocas aphasia - expressive- speech is non-fluent but comprehension is maintained
Wereneks aphasia - comprehension impaired but sounds ‘jargon’
Pure word blindness (alexia)
Pure agraphia
Alexia with agraphia
Pure word deafness
Pure word dumbness:
Pure word blindness (alexia)- reading comprehension impaired
Pure agraphia - inability to write
e.g. Gerstmanns syndrome
Alexia with agraphia- acquired illiteracy
Pure word deafness- speak, write read fluent but cannot comprehend spoken word
Pure word dumbness: can read and write, but not produce words
Paralogia-
Alogia
Akatphasia
Camerons 4 charactertists of FTD
Paralogia- +ve FTD eg tangentiality
Alogia - g poverty of speech content
Akatphasia = eg schizphrenia, speech disorder are result of thought disorder
-metonymy- imprecise expressions used as substitute words e.g. paper skate for pen.
- asyndesis- lack of link in speech
- over-inclusion - conceptual boundaries lost
interpenetration- things cross into others
CARL SCHNEIDER (not kurt) - 5 elements FTD
substitution
omission
fusion
drivelling
derailment
Neologism
Stock words
Thought block
Stilted speech
Flight ideas
Vorbeireden
Neologism - making up words
Stock words- substitution many word with same one eg my friend (ting) has lots of energy (ting)
Thought block- -ve FTD
Stilted speech - pompous formal speech
Flight ideas- rapiad thought flow- can be clang association, punning or rhyming.
Vorbeireden - (ganser syndrome) - causes people to give incorrect answers to questions
Tangentiality va circumstantiality
the patient never reaches the point in tangentiality, whereas they do reach the point in circumstantiality
Testing linguistics of shcizophrenia
cloze
type-token
cohesion
word association
Word association tests are abnormal in schizophrenia –
Cloze procedure: parts of recorded speech are deleted to see if meaning could be still predicted; predictability was reduced in schizophrenia. In reverse cloze procedure patients are asked to predict the missing elements of someone else’s speech– again schizophrenia group performed
worse in prediction.
Type –token ratio: refers to the ratio between number of different words used during a discourse and total number of spoken words. Impoverished vocabulary was noted with low type-token ratio among schizophrenia patients.
Cohesion analysis (analysing links between sentences and words in a discourse) shows that schizophrenia patients use less referential ties (using pronouns without mentioning a subject in
first place) and more lexical ties (connected words).
Also, patients make more errors than controls when asked to construct complex sentences from simple phrases (Hunt test).
Catatonia definition
catatonic syx:
Ambitendence
Automatic obedience
- Mitmachen
- Mitgehen
Catatonia = Rigidity during involuntary movements while volitional
movement is carried out normally
(in neurological spasticity the tone is increased irrespective of passive or active movements)
Ambitendence - a schizophrenic patient brings the spoon to his mouth dozens of times but never completes the act
Automatic obedience- Exaggerated cooperation with examiner’s request or continues with request
- Mitmachen: despite requests to resist manipulation, patient yields into abnormal postures
- Mitgehen: patient yields to slightest pressures without resistance
Cataplexy/ waxy flexibility- aka flexibilitas cerea
compare to automatic obedience (mitmachen ans mitgehen)
Wax-like plastic ‘mouldable’ quality. His limbs can be moved by the examiner to occupy certain postures, which are then
maintained, even if these are uncomfortable and bizarre
- Unlike flexibilitas cerea,
mitmachen there is an explicit request to resist manipulation
The arm comes back to resting position when released by the examiner in mitmachen, but not in
catalepsy
Unlike mitgehen, the manipulation is not gentle with finger tip but full and complete in catalepsy
Echopraxia
Echolalia
Gegenhalten
Negativism
Echopraxia: mimicking examiner’s movements
Echolalia: mimicking examiner’s speech
Gegenhalten- paratonia or opposition) there is a resistance to passive movements with the proportional strength to the increase of muscle tone which seems to be voluntarily controlled by the patient
Patients with negativism resist or oppose all passive movements attempted by the examiner.
Mannerisms
Posturing
Tics
Mannerisms: Odd, but purposeful
movements (hopping, saluting passers-by or
mundane movements)
Posturing refers to the maintenance of odd and bizarre postures.
e.g psychological pillow
Tics - sudden involuntary (but temporarily suppressible) jerking movements
Ganser’s syndrome
A hysterical dissociative disorder
- Approximate answers (give wrong answers)
- Clouding of consciousness with disorientation
- Psychogenic, physical symptoms – analgesia & hyperaesthesia
- Pseudohallucinations – not always present.
- Patients with Ganser’s syndrome are amnesic for their abnormal behaviour
Couvade syndrome
Pseudocyesis
Koro
Lycanthropy
Couvade syndrome- a sympathetic pregnancy that affects husbands
Pseudocyesis = where a woman experiences clinical signs of pregnancy without being pregnant, patient convinced of it
Koro- culture-bound anxiety state where the patient believes that his penis is shrinking into his abdomen, and he will die as a result. (malaysia)
Lynca- posession by animal eg wolf
Insight 4 As
Insight refers to a multidimensional concept which includes 4 A’s:
¬ Awareness of one’s own symptoms (absence - anautognosia)
¬ Attribution of symptoms to mental disorder appropriately (absence – dysautognosia)
¬ Appraisal or analysis of consequences of such symptoms
¬ Acceptance of treatment
Temporal Lobe Epilepsy
Strong affective experiences are reported
complex partial seixures
Parietal lobe epilepsy:
Somatosensory seizures most common in parietal
Physical sensations of numbness and tingling, heat, pressure, electricity and/or pain. Some patients
describe a typical “Jacksonian march”, in which the sensation “marches” in a predictable pattern from the
face to the hand up the arm and down the leg
Somatic illusions and visual illusions occur
Frontal lobe seizures
Complex partial seizures of frontal lobe origin are usually quite different from
temporal lobe seizures.
Frontal lobe seizures tend to be short (less than 1 minute), occur in clusters and during sleep, include strange automatisms such as bicycling movements, screaming, or even sexual
activity.
