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Phenomenology > Phenomenology > Flashcards

Phenomenology Flashcards

1
Q

reduplicative hallucination of seeing one’s own body a at a distance

A

heautoscopy

symptom in schizophrenia and epilepsy

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2
Q

a constant real perceptual object that is perceived in a distorted way that result from a change in the intensity and quality of the stimulus or the spatial form of the perception

A

sensory distortion

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3
Q

a new perception occurs that may or may not be in response to an external stimulus

A

sensory deception

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4
Q

increased intensity of sensations

A

hyperaesthesia

e. g. hyperacusis (increased sensitivity to noise) seen in anxiety and depressive disorders as well as hangover from alcohol or migraines
e. g. more vivid colours in hypomania, epileptic aura, LSD, also in intense normal emotions

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5
Q

decreased intensity of sensations

A

hypoaesthesia

e.g. hypoacusis in delirium, threshold for all sensations is raised. Defect of attention in delirium further reduces sensory acuity.
hypoacusis also seen in disorders with attentional deficit such as depression and ADHD
visual or gustatory experience might also be lowered in depression

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6
Q

colouring of yellow, green or red

A

xanthopsia, chloropsia, erythropsia. Mainly the result of drugs e.g. santonin, mescaline or digitalis poisoning used in the past to treat various disorders.

metallic taste of lithium - true perception.

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7
Q

everything appears abnormal and strange

A

derealisation

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8
Q

changes in spatial form

A

dysmegalopsia

micropsia: visual disorder where objects are seen smaller than they really are
macropsia: the opposite
porropsia: experiences of the retreat of objects into the distance without any change in size.
lilliputian hallucinations: describe the changes of size in dreams and hallucinations.

Dysmegalopsia may result from

  • retinal disease
  • disorders of accommodation and convergence
  • most commonly from temporal and parietal lobe lesions
  • rarely, in schizophrenia
  • occasionally can occur from poisoning with atropine or hyoscine
  • chronic arachnoiditis
  • central lesions, mainly those affecting the posterior temporal lobe

Micropsia can occur when:

  • oedema of the retina causes separation of visual elements so that the image falls on a functionally smaller part of the retina than usual
  • partial paralysis of accommodation will lead to experience during near vision that objects is very near

Macropsia:

  • results from scarring of the retina -> the scarring is usually irregular, leading to metamorphopsia
  • complete paralysis of accommodation or overactivity of accommodation during near vision

metamorphopsia:
- describing objects that are irregular in shape

macropsia, micropsia or irregular distortions may occur either during the aura or in the course of the fit itself

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9
Q

distorted experience of time in which disorders?

A

mania, depression and schizophrenia, acute organic states:

severe depression, time may have even reached a stand-still

slowing down of time is most marked in people with severe depression

in schizophrenia: believes that time moves in fits and starts, and may have a delusional elaboration that clocks are being interfered with.

in acute organic states - in milder forms, there may be an over-estimation of the progress of time.

temporal lobe lesions

in schizophrenia, there is some evidence that there are abnormalities of time judgement, estimating intervals to be less than they are
- age disorientation is another feature present in patients with chronic schizophrenia, noted even in the absence of other features of confusion

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10
Q

illusions and hallucinations are examples of

A

sensory deceptions

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11
Q

misinterpretation of stimuli arising from an external object

A

illusion

stimuli from a perceived object are combined with a mental image to produce a false perception

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12
Q

perceptions without an adequate external stimulus

A

hallucination

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13
Q

inattention or missing imprints because we read it as if it were complete, or misreading a word on the basis of our previous experience, our interests.

e.g.. a person who enjoys reading, misreads -ook to be ‘book’ even though the faded letter was an l

A

complete illusion

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14
Q

a bereaved person momentarily believes they ‘see’ the deceased person

a delirious person in a perplexed and bewildered state may perceive the innocent gestures of others as threatening

disorder of perception which arises in the context of a particular mood state

A

affect illusions

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15
Q

vivid images occur without the patient making any effort

result from excessive fantasy and a vivid visual imagery.

e.g. seeing vivid pictures in fires or in clouds, without any conscious effort on their part, sometimes even against their will

A

pareidolia

- type of illusion, vivid illusions appear without effort

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16
Q

perceptual abnormality in which moving objects are seen as a series of discreet and discontinuous images

A

trailing phenomena

associated with hallucinogens

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17
Q

two parts to a functional hallucination

A
  1. the stimulus and hallucination are perceived by the patient simultaneously
  2. they can be identified as separate and not as a transformation of the stimulus
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18
Q

a false perception

Jaspers: a false perception which is not a sensory distortion or a misinterpretation, but which occurs at the same time as real perceptions

A

hallucination

- the perception comes from within, although the subject reacts as though they come from ‘without’

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19
Q

auditory, tactile or visual modality of hallucination

thought clear and vivid, lacks the substantiality of perceptions; they are seen in full consciousness, known to be not real perceptions and are located not in objective space but in subjective space.

Are involuntary

A

pseudo hallucinations
-> their presence does not necessarily indicate psychopathology

Hare (1973) definition of pseudo hallucination is based on insight
- because insight fluctuates and at times is partial

Jaspers’ (1962) definition is based on whether the image lies in outer or inner perceptual space.

SCAN (WHO, 1998) does not define pseudo-hallucination but:

  • has an item for rating insight
  • as well as item for rating whether the experience occurs inside or outside the head
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20
Q

caused by:

  • intense emotions or psychiatric disorder
  • suggestion
  • disorders of sense organs
  • sensory deprivation
  • disorders of the CNS
A

hallucinations

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21
Q

ddx for:
- voices reproaching them, with fragmentary or single or short phrases such as ‘rotter’ ‘kill yourself’

  • continuous persistent voices persecute the person, they may give a commentary on the person’s actions and discuss him in a hostile manner
A
  • short phrases of a/h: in a severely depressed person with guilt
  • continuous: raise suspicion for intercurrent physical disease or schizophrenia
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22
Q

a newly coined word or expression

A

neologism

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23
Q

where subject gives approximate answers, showing understanding of the question but giving wrong answer e.g. 2+2 = 5 or a horse has five legs

A 
Ganser syndrome (in DSM III). 
seen in schizophrenia, dissociative disorder, malingering, organic states
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24
Q

where subject gives approximate answers, showing understanding of the question but giving wrong answer e.g. 2+2 = 5 or a horse has five legs

A 
Ganser syndrome (in DSM III). 
seen in schizophrenia, dissociative disorder, malingering, organic states
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25
Q

condition in which complex visual hallucinations occurs in the absence of any psychopathology and in clear consciousness

A

Charles Bonnet syndrome
(phantom visual images)

associated with central or peripheral impact on vision
episodes are of variable duration and can last for years
images may be static or in motion.
importance of this diagnosis is as a differential from psychopathological causes of hallucinations

peripheral lesions may play a role in hallucinations
- negative scotoma is found in patients with alcohol misuse

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26
Q

impact of sensory deprivation

A

will begin hallucinating after a few hours.
hallucinations are usually visual and repetitive word or phrases.

e. g. sensory isolation produced by deafness may cause paranoid disorders in the deaf.
e. g. sensory deprivation due to eye patches after cataract surgery may contribute to delirium (as well as ageing)

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27
Q

four disorders where A/H occur

A

schizophrenia
delirium
dementia
severe depression

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28
Q

four disorders where A/H occur

A

schizophrenia
delirium
dementia
severe depression

29
Q

voices that give instructions to the patients

A

imperative hallucinations

30
Q

hearing one’s own thoughts spoken aloud

a Schneider first rank symptom

A

Gedankenlautwerden

  • hearing one’s own thoughts just before or at the same time as they are occurring

or “thought echo” or “thought sonorisation”

31
Q

phenomenon of hearing one’s thoughts spoken after the thoughts have occurred

A

French: echo de la pensee

or “thought echo” or “thought sonorisation”

32
Q

classifies thought echo as a disorder of thought

A

SCAN WHO, 1998

33
Q

patient complains that their thoughts are no longer private but are accessible to others

A

“thought broadcasting” or “thought diffusion”

different definitions of that make thought echo a prerequisite to thought broadcasting

34
Q

delusional elaboration of hallucinatory experience

A

Greek woman long-term inpatient always denied hearing voices but made unprovoked attacks on fellow patients. One day, she was offered a Greek newspaper or Greek visitor - she said this was not necessary because everybody in the hospital spoke Greek.
- became obvious she was hearing A/H in Greek tongue and attacks were motivated by these voices.

35
Q

may range from flashes of lights, to partly organised patterns, or complete visions of people, objects or animals, may see entire scenes

A

visual hallucinations

36
Q

V/H of small animals or insects

A

most often hallucinated in delirium
- usually associated with fear or terror

in delirium - are often extremely suggestible so that one could be persuaded to read off a blank piece of paper

37
Q

combined A/H and V/H

A

temporal-lobe epilepsy

schizophrenia of late onset, particularly when the illness is protracted may see and hear people being tortured, murdered and mutilated

38
Q

combined A/H and V/H

A

temporal-lobe epilepsy

schizophrenia of late onset, particularly when the illness is protracted may see and hear people being tortured, murdered and mutilated

39
Q

micropsia affecting visual hallucinations

A

Lilliputian hallucinations

see miniature people and animals. Often accompanied by pleasure and amusement.

40
Q

a hallucination type more common in clouding of consciousness than in functional psychosis

A

visual hallucinations

important negative in schizophrenia. V/H are extremely rare in schizophrenia

41
Q

which disorders do olfactory hallucinations occur in

A
  • schizophrenia
  • organic states
  • (uncommon) depressive psychosis
42
Q

olfactory disturbance pre-empts this e.g. smell of burning rubber or paint

A

e. g. temporal lobe disturbance

- olfactory hallucination may occur without any fit

43
Q

a pleasant olfactory hallucination e.g. smelling roses around certain saints

A

Padre Pio phenomenon

44
Q

gustatory hallucination common in

A

organic states and schizophrenia (need to distinguish if there is something that takes strange or if it is a delusional explanation of the effect of feeling strangely changed

depressed patients describe a loss of taste or state that all food tastes the same

45
Q

small bugs crawling over the body and delusions of persecution

A

cocaine bug

cocaine psychosis = hallucination and persecutory ideas

46
Q 
experiences of: 
- cool wind blowing
- sensations of heat 
- electrical shocks 
- sexual sensations
patient is convinced these are produced by outside agencies
A

schizophrenia

47
Q 
experiences of: 
- cool wind blowing
- sensations of heat 
- electrical shocks 
- sexual sensations
patient is convinced these are produced by outside agencies
A

schizophrenia

48
Q

Sims: there is almost always a concomitant delusional elaboration of

A

tactile hallucinatory experiences

e.g. one patient complaining they could feel a penis in their vagina even though they could not see the man

49
Q

superficial, kinaestethic and visceral

A

Sims’ division of tactile hallucinations:

Superficial:

thermic: a cold wind blowing across the face
haptic: feeling a hand against the skin
hygric: feeling water flowing down the body
paraestethic: pins and needles (although this often has an organic origin)

Kinaestethic:
affect muscles and joints: patient feels like their limbs are being twisted, pulled or moved.
occur in schizophrenia *distinguish from delusions of passivity by the presence of definite sensations
e.g. vestibular sensations: sinking in the bed or flying through the air - best regarded as variant of kinaesthetic, occur in organic states, commonly in delirium tremens. Also in alcohol intoxication and during benzodiazepine withdrawal and may occur in the absence of any abnormality e.g. after a week’s sailing an undulating feeling may persist for a few days

visceral hallucination:
in chronic schizophrenia, may complain of twisting and tearing pains. e.g. organs being torn out of their flesh. e.g. sensation of layers of brain being peeled off to bring the completion of battle between good and evil!

50
Q

disorders which there is a sense of presence

A

*occurs in healthy individuals
organic states
schizophrenia
hysteria

51
Q

disorders which there is a sense of presence

A

*occurs in healthy individuals
organic states
schizophrenia
hysteria

52
Q

auditory stimulus causing a hallucination but the stimulus is experienced as well as the hallucination. Other a hallucination that requires the presence of a real sensation

A

functional hallucination are not uncommon in chronic schizophrenia

e. g. a person hearing the voice of God as her clock ticked. Both the noise and voices are audible.
* patients can distinguish both features from one another and the hallucination does not occur without the stimulus

53
Q

auditory stimulus causing a hallucination but the stimulus is experienced as well as the hallucination. Other a hallucination that requires the presence of a real sensation

A

functional hallucination are not uncommon in chronic schizophrenia

e. g. a person hearing the voice of God as her clock ticked. Both the noise and voices are audible.
* patients can distinguish both features from one another and the hallucination does not occur without the stimulus

54
Q

the experience of a stimulus in one sense modality producing a sensory experience in another

A

synaesthesia
e.g. feeling cold in one’s spine when hearing a fingernail scratch a blackboard
rare, usually caused by hallucinogenic drugs e.g. LSD or mescaline when individual might describe feeling, tasting or hearing flowers simultaneously

55
Q

a stimulus in one sensory field produces a hallucination in another

A

reflex hallucination

a patient felt pain in her head (somatic hallucination) when she heard other people sneeze (the stimulus) and was convinced that sneezing caused the pain

56
Q

experience of seeing oneself and knowing that it is oneself. Seeing yourself from an external point of view

A

autoscopy or phantom mirror-image

kinaesthetic and somatic sensations must also be present

can occur in healthy subjects when exhausted and there is a change in state of consciousness

more common in acute and sub-acute delirious states
epilepsy, focal lesions affecting pareieto-occipital region and toxic infective states who effect is greatest in the basal regions of the brain

autos copy often a/w disorders of parietal lobe due to cerebrovascular disorders or severe infectious disease accounts for German folklore belief that when someone sees their double or Doppelgänger it indicates they are about to die.

57
Q

experience of seeing oneself and knowing that it is oneself. Seeing yourself from an external point of view

A

autoscopy or phantom mirror-image

kinaesthetic and somatic sensations must also be present

can occur in healthy subjects when exhausted and there is a change in state of consciousness

more common in acute and sub-acute delirious states
epilepsy, focal lesions affecting pareieto-occipital region and toxic infective states who effect is greatest in the basal regions of the brain

58
Q

occur when patient is waking up __ or when they fall asleep ___

A

hypnopompic
or falling asleep (hypnagogic)
not indicative of any psychopathology but true hallucinatory experiences. Can occur in narcolepsy

suggested that they are the same thing and the hypnopompic hallucinations are occurring in the morning when the subject is dozing off
hypnopompic should be reserved for those hallucinatory experiences that persist from sleep when the eyes are open

hypnagogic: occur during drowsiness, are discontinuous, appear to force themselves on the subject and do not form an experience where the subject participates like in a dream

hypnagogic are 3x more common than hypnopompic hallucinations, although the latter are a better indicator of narcolepsy

the subject believes the hallucination has woken them up e.g. alarm going off. Subjects often assert they are fully awake.

EEG shows low of alpha rhythm at the time of the hallucination.

hypnagogic visual hallucinations may be geometrical designs, abstract shapes, faces, figures or scenes from nature. A/H may be animal noises, music or voices. Or hearing a person’s name or a voice saying a sentence of phrase that has no discoverable meaning.

when deprived of sleep, subject hears hallucinatory voices, V/H, IOR and no insight into the morbid phenomena. resolves once the subject has a good sleep.

59
Q

occur when patient is waking up __ or when they fall asleep ___

A

hypnopompic
or falling asleep (hypnagogic)
not indicative of any psychopathology but true hallucinatory experiences. Can occur in narcolepsy

suggested that they are the same thing and the hypnopompic hallucinations are occurring in the morning when the subject is dozing off
hypnopompic should be reserved for those hallucinatory experiences that persist from sleep when the eyes are open

hypnagogic: occur during drowsiness, are discontinuous, appear to force themselves on the subject and do not form an experience where the subject participates like in a dream

hypnagogic are 3x more common than hypnopompic hallucinations, although the latter are a better indicator of narcolepsy

the subject believes the hallucination has woken them up e.g. alarm going off. Subjects often assert they are fully awake.

EEG shows low of alpha rhythm at the time of the hallucination.

hypnagogic visual hallucinations may be geometrical designs, abstract shapes, faces, figures or scenes from nature. A/H may be animal noises, music or voices. Or hearing a person’s name or a voice saying a sentence of phrase that has no discoverable meaning.

when deprived of sleep, subject hears hallucinatory voices, V/H, IOR and no insight into the morbid phenomena. resolves once the subject has a good sleep.

60
Q

organic hallucinations

A

visual in:

  • eye disorders
  • CNS disorders
  • optic tract
  • temporal lobe lesions
  • Charles Bonnet syndrome when V/H is only psychopathology present, impaired vision also present
  • dementia
  • delirium
  • substance abuse

somatic in:

  • phantom limb
  • third limb in thalami-parietal lesions
  • parietal lobe lesions can also cause splitting off of body parts or distortions of them

temporal lobe lesions:
- a/w multi-sensory hallucinations but they do not include somatic hallucinations, which is to be expected because the somatic sensory area is separated from the temporal lobe by the Sylvian fissure

61
Q

perception of body parts as absent or diminished

A

aschemazia or hyposchemazia

most likely in parietal lobe lesions such as thrombosis of R MCA, following transection of spinal cord or when underwater

62
Q

delusional belief of being dead, decomposed or annihilated, having lost one’s own internal organs or even not existing entirely as a human being.

A

nihilistic delusion

63
Q

belief that penis will shrink and will retract back into the abdomen and cause death

A

South-East Asian belief ‘Koro’
thought to be due to limited understanding of anatomy
equivalent is probably anxiety disorder

64
Q

feeling that parts of the body are distorted or twisted or separated from the rest of the body.

A

Paraschemazia

can occur in a/w hallucinogenic use, with an epileptic aura and with migraine on rare occasions

65
Q

unilateral lack of body image in which the person behaves as if one side of the body is missing

A

hemisomatognosia

occurs in migraines or during an epileptic aura.

66
Q

denial of illness

A

anosognosia

Cutting 1978 found that 58% of those with R hemisphere strokes denied their hemiplegia early after stroke and refused to admit to any weakness in their left arm
belief typically remains despite manifest demonstration that it is paralysed

67
Q

delusional beliefs about their body

A

somatoparaphrenia

the limb may be inanimate, distorted, may claim it belongs to another person

68
Q

neglect of hemispace on the contralateral side to the lesion when performing tasks

A

hemispatial neglect

69
Q

lesion of dominant parietal lobe consisting of agraphia, acalculia, finger agnosia and right/left disorientation

A

Gerstmann syndrome

Phenomenology (2 decks)

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