FINALS Flashcards
PERCEPTUAL/SENSORY DISTURBANCES
- HALLUCINATIONS
- ILLUSION
COGNITIVE/THOUGHT DISTURBANCES
- IDEAS OF REFERENCE (REFERENTIAL DELUSIONS)
- DELUSIONS
- FLIGHT OF IDEAS
- WORD SALAD
- RHYMING
- CLANG ASSOCIATIONS
- PUNNING
- LOOSENESS OF ASSOCIATION
- NEOLOGISM
- BLOCKING
- POVERTY OF THOUGHT
- AUTISM
- PERSEVERATION
- ALOGIA
BEHAVIORAL DISTURBANCES
- NEGATIVISM
- AUTOMATIC OBEDIENCE
- STEREOTYPING
- WAXY FLEXIBILITY (CEREA FLEXIBILITY)
- STUPOR
AFFECTIVE DISTURBANCES
- APATHY
- AFFECT
- EUPHORIA
- ELATION
- DEPERSONALIZATION
MEMORY DISTURBANCES
- AMNESIA
- PARAMNESIA
- DÉJÀ VU (French for “already seen”)
- JAMAIS VU (French for “Never seen”)
OTHER ASSOCIATED FEATURES
- TICS AND SPASMS
- CIRCUMSTANTIALITY
- TANGENTIALITY
- AMBIVALENCE
- PSEUDOLOGICA FANTASTICA
- VOLITION
- PSYCHOMOTOR RETARDATION
PERCEPTUAL/SENSORY DISTURBANCES
1. HALLUCINATIONS
a. Auditory hallucination
b. Visual hallucination
c. Olfactory hallucination
d. Tactile hallucinations
e. Gustatory hallucinations
f. Cenesthetic hallucination
g. Kinesthetic hallucination
– false sensory perceptions, or perceptual
experiences that do not exist in reality
HALLUCINATIONS
– involve hearing sounds, most often
voices, talking to or about the
client
– are the most common type of
hallucination.
Command hallucinations are voices
demanding that the client take
action, often to harm himself or herself or
others, and are considered dangerous.
accidents
Auditory hallucination
– involve seeing images that do not exist at all, such
as lights or a dead person, or may be a distortion,
such as seeing a frightening monster instead of the
nurse.
Visual hallucination
– involve smells or odors where none exist. It may
be a specific scent, such as urine or feces, or more
general in nature, such as a rotten or rancid odor.
– this type of hallucination is often found in clients
with dementia, seizures, or cerebrovascular
Olfactory hallucination
– refer to sensations such as electricity
running through the body or bugs
crawling on the skin.
– Are found most often in clients
undergoing alcohol withdrawal
Tactile hallucinations
– involve a taste lingering in the mouth, or
the sense that food tastes like something
else.
– the taste may be metallic or bitter or may
be represented as a specific taste.
Gustatory hallucinations
What type of disturbance does HALLUCINATIONS belong to?
PERCEPTUAL/SENSORY DISTURBANCES
–involve the client’s report that he or she
feels bodily functions that are usually
undetectable.
–Examples would be the sensation of urine
forming or impulses being transmitted
through the brain.
Cenesthetic hallucination
–occur when the client is motionless but
reports the sensation of bodily movement.
Occasionally the bodily movement is
something unusual, such as floating above
the ground.
Kinesthetic hallucination
What type of disturbance does ILLUSION belong to?
PERCEPTUAL/SENSORY DISTURBANCES
– a misinterpretation of
an external stimulus by
any of the special
senses.
– e.g. hearing a thunder
and identifying it as a
bomb, seeing a
shadow on the wall
and identifying it as an
animal.
ILLUSION
What type of disturbance does IDEAS OF REFERENCE (REFERENTIAL DELUSIONS) belong to?
COGNITIVE/THOUGHT DISTURBANCES
– involve the client’s belief that television
broadcasts, music, or newspaper articles have
special meaning for him or her.
– e.g The client may report that the president was
speaking directly to him on a news broadcast, or
that special messages are sent through
newspaper articles.
IDEAS OF REFERENCE (REFERENTIAL DELUSIONS)
DELUSIONS belong to
COGNITIVE/THOUGHT DISTURBANCES
– fixed, false beliefs that have no basis in
reality
DELUSIONS
Types of DELUSIONS
a. Persecutory/Paranoid delusions
b. Grandiose (grandeur) delusions
c. Religious delusions
d. Somatic delusions
e. Nihilistic delusions
f. Delusions of self-depreciation
g. Delusions of Alien Control
– involve the client’s belief that
“others” are planning to harm
the client or are spying,
following, ridiculing, or
belittling the client in some
way. Sometimes the client
cannot define who these
“others” are.
– e.g. the client may think that
food has been poisoned or that
rooms are bugged with
listening devices. Sometimes
the “persecutor” is the
government, FBI, or other
powerful organization.
Occasionally, specific
individuals, even family
members, may be named as the
“persecutor.”
Persecutory/Paranoid delusions
– are characterized by the client’s claim to
association with famous people or
celebrities, or the client’s belief that he or
she is famous or capable of great feats.
– e.g. The client may claim to be engaged to
a famous movie star or related to some
public figure, such as claiming to be the
daughter of the President of the United
States; may claim he or she has found a
cure for cancer.
Grandiose (grandeur) delusions
– often center around the second
coming of Christ or another significant
religious figure or prophet.
– these religious delusions appear
suddenly as part of the client’s
psychosis and are not part of his or
her religious faith or that of others.
– e.g. Client claims to be the Messiah
or some prophet sent from God;
believes that God communicates
directly to him or her, or that he or she
has a “special” religious mission in life
or special religious powers.
Religious delusions
– are generally vague and unrealistic
beliefs about the client’s health or
bodily functions. Factual information
or diagnostic testing does not change
these beliefs.
– e.g. A male client may say that he is
pregnant, or a client may report
decaying intestines or worms in the
brain.
Somatic delusions
– * A patient states, “I am dead.” In
response to “If you are dead, how can you
talk?” the patient says, “I don’t know, but
I’m dead.”
Nihilistic delusions
– the individual feels unworthy, ugly, or
sinful.
– e.g. “I don’t deserve to live, I’m so
unworthy of your love.”
Delusions of self-depreciation
– the person believes his feelings, thoughts,
impulses, or actions are controlled by an
external source.
– e.g. “A spaceman sends me messages by TV
and tells me what to do.”
Delusions of Alien Control
FLIGHT OF IDEAS belong to
COGNITIVE/THOUGHT DISTURBANCES
– a continuous (jumping) stream of
conversation with rapid shifts in topics
owing to pressure of thoughts, sometimes
characterized as topic jumping.
– e.g. “I like the color blue. Do you ever feel
blue? Feelings can change from day to day.
The days are getting longer.”
– it is most commonly observed in clients
with manic disorders.
FLIGHT OF IDEAS
WORD SALAD belong to
COGNITIVE/THOUGHT DISTURBANCES
– is a combination of jumbled words and
phrases that are disconnected or
incoherent and make no sense to the
listener.
– e.g. “corn, potatoes, jump up, play games,
grass, cupboard.
WORD SALAD
RHYMING belongs to
COGNITIVE/THOUGHT DISTURBANCES
- rhyming of phrases or whole sentences in a
lyrical poetic manner during conversation or
writing which may symbolize the conflictual
elements and need associated with a mental
conflict. - e.g. “I am knitting a halter for Walter to lead
me to the altar.”
RHYMING
- choice of words is governed by sounds.
- e.g. “It is very cold. I am cold and bold. The
gold has been sold
CLANG ASSOCIATIONS
- the injection of witty or clever remarks into a conversation, or the humorous use of a word in such a way as to suggest a different meaning, or the use of words having the same sound but different
meanings, which attract the listener’s attention and gain for the patient the control of the immediate environment.
PUNNING
- is the stringing together of unrelated topics with a vague connection (as
opposed to flight of ideas, in which there is no connection). - e.g. The children’s rhyme “Mary had a little lamb” may lead to “Mary was the mother of Christ who was born in a manger. I hate to lie on straw. It makes my skin itch. Have you ever had poison ivy? I have.” The patient may even leave out some of the phrases; for example, “Mary had a little lamb. I hate to lie on straw. Have you ever had poison ivy?” but may be able to clarify the connections if asked.
LOOSENESS OF ASSOCIATION
- the coining of new words that have
symbolic meaning, or the conferring
of new meanings upon words that are
used commonly. - e.g. newspulp (newspaper),
Eisenhead (Eisenhower)
NEOLOGISM
- sudden stopping of speech which
occurs when the trend of thought has
been lost owing to anxiety-producing
thought associations. - may be caused by intrusion of
hallucination, delusions or emotional
factors.
BLOCKING
- is manifested by the inability to
formulate and articulate thoughts that
are relevant to the discussion at hand.
POVERTY OF THOUGHT
- describes the condition created by the person with
schizophrenia who focuses inward on a fantasy world, while distorting or excluding the external
environment.
AUTISM
- is the persistent adherence to a single idea or topic
and verbal repetition of a sentence, phrase, or word,
even when attempts are made by another to change
the topic.
e.g. Nurse: “How have you been sleeping
lately?”
Client: “I think people have been
following me.”
Nurse: “Where do you live?”
Client: “At my place people have
been following me.”
Nurse: “What do you like to do in
your free time?”
Client: “Nothing because people are following
me.”
PERSEVERATION
- describes the lack of any real meaning or
substance in what the client says:
Nurse: “How have you been sleeping
lately?”
Client: “Well, I guess, I don’t know,
hard to tell.”
ALOGIA
AUTOMATIC OBEDIENCE
a. Echolalia
b. Echopraxia
a. Echolalia
b. Echopraxia
AUTOMATIC OBEDIENCE
- repeating the speech of another, like a
resounding echo, as if experiencing a
compulsion to respond.
e.g. Nurse: “Can you tell me how
you’re feeling?”
Client: “Can you tell me how
you’re feeling, how you’re
feeling?”
Echolalia
- compulsive displacement of anxiety
through automatic duplication of the
immediately observed movements and
gestures made by another individual in
the patient’s presence.
Echopraxia
– Verbigeration
* is the stereotyped repetition of words or phrases
that may or may not have meaning to the listener.
e.g. “I want to go home, go home, go
home, go home.”
STEREOTYPING
- is the stereotyped repetition of words or phrases
that may or may not have meaning to the listener.
e.g. “I want to go home, go home, go
home, go home.”
Verbigeration
- describes a condition in which the client with
schizophrenia passively yields all moveable
parts of the body to any efforts made at
placing them in certain positions. - Patient who may be perceiving an
overwhelming emotion or threatening
stimulus, such as fear or hallucination. - e.g. Once placed in position, the arm, leg, or
head remains in that position for long periods,
regardless of how uncomfortable it is for the
client.
WAXY FLEXIBILITY (CEREA FLEXIBILITY)
- a state in which the person
does not react to or is
unaware of the surroundings.
He may be motionless and
mute but conscious.
STUPOR
- The client with schizophrenia often
demonstrates an indifference to or
disinterest in the environment.
The bland or flat affect is a
manifestation of the emotional
apathy.
APATHY
describes the behavior associated
with an individual’s feeling state or
emotional tone.
AFFECT
AFFECT
a. Flat
b. Blunt
c. Inappropriate
d. Labile
– absence of facial expression
Flat
– exhibiting few observable facial
expressions
– the typical facial expression is often
described as masklike.
Blunt
– the individual’s emotional tone is
incongruent with the circumstances.
– e.g. A young woman who laughs when told
of the death of her mother.
Inappropriate
– is a condition in which emotional tone
changes quickly.
– e.g. A patient may be telling a happy story,
suddenly begin to cry, and then quickly
return to a happy disposition.
Labile
- an abnormal, exaggerated feeling of wellbeing which is out of proportion to
environmental and interpersonal stimuli - e.g. “I feel great!” “Terrific!”
EUPHORIA
- an affective reaction extending beyond a
state of euphoria. - Characterized by increased anxiety and
psychomotor activity in which the
person’s thinking, communications, and
body movements escalate.
ELATION
- clients feel detached from their behavior.
- e.g. Clients can state their name
correctly, they feel as if their body
belongs to someone else, or that their
spirit is detached from their body.
DEPERSONALIZATION
MEMORY DISTURBANCES
- AMNESIA
- PARAMNESIA
- DÉJÀ VU (French for “already seen”)
- JAMAIS VU (French for “Never seen”)
– impaired in their ability to recall information or
past events.
AMNESIA
AMNESIA
a. anterograde amnesia
b. retrograde amnesia
– loss of memory for recent events
anterograde amnesia
– forgetting events in one’s past life
retrograde amnesia
PARAMNESIA
– Confabulation
– falsification of facts or distortion of memory
which is not deliberate but the result of mental
deterioration which produces gaps in memory
that motivate defensive compensatory actions.
Confabulation
– the sensation that a new situation has occurred
previously
DÉJÀ VU (French for “already seen”)
– the sensation of being a stranger when with a
person one knows or when in a familiar place.
JAMAIS VU (French for “Never seen”)
– involuntary jerking and twitching
of some part of the body; usually
localized in the neck, face and
head.
– of organic etiology but may be of
psychic origin
– anxiety is displaced through such
actions as intermittent eye blinking
and spasmodic movements of the
mouth or neck which are
motivated by unconscious
emotional conflict.
TICS AND SPASMS
– the individual is delayed in reaching the point of a
communication because of unnecessary and
tedious details.
– Nurse: “How have you been sleeping lately?”
– Client: “Oh, I go to bed early, so I can get plenty
of rest. I like to listen to music or read before bed.
Right now I’m reading a good mystery. Maybe
I’ll write a mystery someday. But it isn’t helping,
reading I mean. I have only been getting 2 or 3
hours of sleep at night.”
CIRCUMSTANTIALITY
– differs from circumstantiality in that the person
never really gets to the point of the communication.
e.g. Nurse: “How have you been sleeping lately?”
Client: “Oh, I try to sleep at night. I like to
listen to music to help me sleep. I really like
country-western music best. What do you
like? Can I have something to eat pretty soon? I’m
hungry.”
Nurse: “Can you tell me how you’ve been
sleeping?
TANGENTIALITY
– the coexistence of two opposing drives, desires,
feelings or emotions.
E.g. An individual may have feelings of both love
and hostility toward someone or of wanting and
also fearing an anticipated happening.
AMBIVALENCE
– false logic of a fantastic nature that is motivated by
a low self-esteem and weak superego.
– Impersonation of celebrities, pathological lying, and the writing of false signature are abnormal uses of the mechanism of identification.
PSEUDOLOGICA FANTASTICA
– has to do with impairment in the ability to initiate
goal-directed activity.
– in the individual with schizophrenia, this may take
the form of inadequate interest, drive, or ability to
follow a course of action to its logical conclusion.
VOLITION
– a general slowing of all movements
– sometimes the client may be almost immobile,
curled into a ball (fetal position).
PSYCHOMOTOR RETARDATION
