Psychiatric Interview 2 Flashcards
- The mildest thought disorder, consisting of speech w/ unnecessary detail, indirection, and delay in reaching the point
- Some topics may have meaningful connection
- Many people w/o mental disorders have this… (give example)
- Circumstantiality (obsessions)
- Ex: children obsessed w/ super heros or trains
- “tangential speech” w/ shifting topics that are loosely connected or unrelated
- Pt is unaware of lack of association
- (schizophrenia, manic episodes, and other psychotic disorders)
Derailment (loosening of associations)
- An almost c_ontinuous flow of accelerated speech_ w/ abrupt changes from one topic to the next
- Changes are based on understandable associations, play on words, or distracting stimuli, but ideas are not well connected
Flight of Ideas (manic episodes)
- Invented or distorted words
- Words w/ new and highly idiosyncratic meanings
Neoglisms
(associated w/ schizophrenia and aphasia)
- Speech that is incomprehensible and illogical w/ lack of meaningful connections, abrupt changes in topic, or disordered grammar or word use
- Flight of ideas (when severe) may produce this type of thought process
Incoherence
-Associated w/ severe psych disturbances like schizo
- Sudden interruption or speech in midsentence or before the idea is completed
- Attributed to “losing the though”
- Occurs in normal people
Blocking (schizo)
- Fabrication of facts or events in response to questions (to fill in the gaps from impaired memory)
Confabulation
- Persistent repetition of words or ideas
Perseveration
(schizo and other disorders)
- Repetition of words and phrases of others
- Manic episodes and Schizo
Echolalia
- Speech w/ choice of words based on sound, rather than meaning (rhyming or punning)
- Ex: “look at my eyes and nose, wise eyes and rosy nose. Two to one, the ayes have it!”
- Manic episodes and Schizo
Clanging
- Repetitive behaviors that the person feels driven to perform in response to an obsession, aimed at preventing or reducing anxiety or a dreaded event or situation
- These behaviors are excessive and unrealistically connected to the provoking stimulus
Compulsion (anxiety)
•Recurrent persistent thoughts, images, or urges experienced as intrusive and unwanted that the person tries to ignore, suppress, or neutralize with other thoughts or actions
- Ex: performing a compulsive behavior
Obsessions (anxiety)
•Persistent irrational fears, accompanied by a compelling desire to avoid the provoking stimulus
Phobias (anxiety)
Apprehensive anticipation of future danger or misfortune accompanied by feelings of worry, distress, and/or somatic symptoms of tension
Anxieties
•A sense that the environment is strange, unreal, or remote
Feelings of unreality
•A sense that one’s self or identity is different, changed, or unreal.
- lost or detached from one’s mind or body
Feelings of depersonalization
- False fixed personal beliefs that are not amenable to change in light of conflicting evidence;
- types include: persecutory, grandiose, jealous, erotomanic (believing someone is in love w/ you), somatic, reference (TV news stories refer to “me”)
Delusions
(psych disorders)
What are the 2 types of false perceptions?
- Illusions
- Hallucinations
•Misinterpretations of real external stimuli
- (mistaking rustling leaves for the sound of voices)
Illusions
- false sensory perceptions
- auditory, visual, olfactory, gustatory (tasting), tactile (feeling things) or somatic (physical sxs)
Hallucinations
- awareness of one’s own illness and/or situation
- “What brings you in today?”
- “What do you think is wrong?”
Insight
- the ability to anticipate the consequence of one’s behavior and make decisions to safeguard your well being and that of others
- “How are you going to manage if you lose your job?”
- “How do you plan to get help after leaving the hospital?”
Judgement
•Orientation (person, place and time)
•Attention (digit span, serial 7s, spelling backwards)
- Remote memory (birthdays, school names, important personal past historical events)
- Recent memory (events of the day, todays weather)
- New learning ability (repeat 3-4 words)
Basic Level Cognition
•Information (name of the president, vice president or governor)
•Calculating ability
•Abstract thinking (interpret proverbs)
•MMSE (mini mental status exam)
Higher level cognition
