Eliciting First Rank Symptoms Flashcards
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What is important when eliciting first rank symptoms of schizophrenia?
- Start with open questions and then proceed to closed questions
- Listen to the patient/role player and pick up clues
What areas should be explored when eliciting first rank symptoms of schizophrenia?
- Auditory Hallucinations - Third person auditory hallucinations, Running commentary hallucinations
- Thought-Alienation Phenomena - Thought withdrawal, Thought insertion, Thought broadcasting
- Passivity phenomena - Made feelings, made impulses, made volition or acts, somatic passivity
- Delusional perception
- Clarification, effects, and coping
What is a useful open question to elicit first rank symptoms of schizophrenia?
I gather that you had been through a lot of stress and strain recently. When under stress, sometimes people have certain unusual experiences. By unusual experiences, I mean for example, hearing noises or voices when there was no one about to explain it. Have you had any such experiences?
What questions help identify third person auditory hallucinations?
- Do the voices discuss you between themselves?
- Do you hear several voices talking about you?
- Do they refer to you as ‘he’ or ‘she’ as a 3rd person?
- What do they say?
What questions help identify running commentary hallucinations?
- Do you hear voices commenting on what you are doing?
- Do the voices seem to comment on what you are thinking, reading, or doing?
- Do you hear voices like a running commentary instructing you to do things?
What questions help identify hearing thoughts spoken aloud?
- Are the voices repeating your own thoughts back to you?
- Can you hear what you are thinking?
- Do you ever seem to hear your own thoughts echoed or repeated?
- What is it like?
- How do you explain it?
- Where does it come from?
What is an open question for thought alienation phenomenon?
- Are you able to think clearly? (OR)
- Have you experienced any difficulties in your thinking?
- Do you ever get the feeling that someone is interfering with your thoughts? If so, in what way? Could you please explain it?
What questions help identify thought broadcasting?
- Do you feel that your thoughts are private or are they accessible to others in any way?
- Can other people read your mind?
- Are your thoughts broadcast, so that other people know what you are thinking?
- How do you know?
- How do you explain it?
What questions help identify thought insertion?
- Are thoughts put into your head which you know are not your own?
- How do you know they are not your own?
- Where do they come from?
What questions help identify thought withdrawal?
- Do your thoughts ever seem to be taken from your head, as though some external person or forces were removing them? (OR)
- Do your thoughts disappear or seem to be taken out of your head?
- Could someone take your thoughts out of your head? Would that leave your mind empty or blank?
- Can you give an example?
- How do you explain it?
What questions help identify passivity of affect, impulses, and volitions?
- Are you always in control of what you feel and do? (Open question)
- Is there something or someone trying to control you? What is it?
- Do you feel in control of your thoughts, actions, and will? (OR)
- Do you ever get the feeling that you are being controlled? That someone else is forcing your thoughts, moods, or actions on you?
- Do you feel under the control of some force or power other than yourself as though you are a robot or a zombie without a will of your own?
- Does this force make your movements for you without you willing it?
- Does this force or power force its feelings on to you against your will?
- Does this force have any other influence on your body?
What questions help identify somatic passivity?
- Does any force possess you?
- What does that feel like?
- Do you feel that someone or some force plays on your body and produces strange bodily sensations like special waves affecting your body?
- Does this force have any other influence on your body?
- Can you please give me an example and can you also describe it for me?
What questions help identify delusional perception?
- Did you at any time realize that things happening around you have a special meaning for you? Can you give me an example?
- Can you explain that? What happened exactly?
- Has a sudden explanation occurred out of the blue to you?
What questions help clarify, and understand the effects and coping with first rank symptoms of schizophrenia
- What do you think is causing these experiences?
- How long have you had these experiences?
- Who do you think is causing them?
- Why do they do so? And how do they do that?
- How would you explain them? Could it be your imagination?
- How do they affect you? How do they make you feel?
- How would you cope with them? What do you intend to do about them?
