psychiatric signs & symptoms

7/31/2019 Psychiatric Signs & Symptoms

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OT FOR PSYCHOSOCIAL DYSFUNCTION PSYCHIATRIC SIGNS ANDSYMPTOMS

I. Consciousness: State of awarenessA. Disturbances of consciousness

- Apperception is perception modified by a persons own emotions and thoughts- Sensorium is the state of cognitive functioning of the special senses (synonym

of apperception)- Disturbances of consciousness are most often associated with brain pathology

Disorientation Disturbance of orientation in time, place, person orsituation

Clouding of consciousness

Incomplete clear-mindedness with disturbances inperception and attitudes

Stupor Lack of reaction to, and unawareness of, surroundingsDelirium Bewildered, restless, confused, disoriented reaction

associated with fear and hallucinationsComa Profound unconsciousness

Coma vigilAka: akinetic mutism Coma in which a patient appears to be awake with eyesopen but cannot be arousedTwilight state Disturbed consciousness with hallucinationsDreamlike state Often used as a synonym for complex partial seizure or

psychomotor epilepsySomnolence Abnormal drowsinessConfusion Disturbance of consciousness in which reactions to

environmental stimuli are inappropriate; manifested bydisordered orientation in relation to time, place or person

Drowsiness A states of impaired awareness associated with desire orinclination to sleep

Sundowning

Aka: sundownerssyndrome

Syndrome in older persons that usually occurs at night

and is characterized by drowsiness, confusion, ataxia andfalling as a result of being overly sedated withmedications

Somnambulism Sleep walking

B. Disturbances of attention- Attention is the amount of effort exerted in focusing on certain portions of an

experience- Ability to sustain a focus on one activity- Ability to concentrate

Distractibility Inability to concentrate attentionState in which attention is drawn to unimportant or

irrelevant external stimuliSelective inattention Blocking out only those things that generate anxietyHypervigilance Excessive attention and focus on all internal and external

stimuliUsually secondary to delusional or paranoid statesSimilar to hyperagia (excessive thinking and mentalactivity)

Trance Focused attention and altered consciousness


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Usually seen in hypnosisDissociative disorders and ecstatic religious experiences

Disinhibition Removal of an inhibitory effect that permits persons tolose control of impulses as occurs during alcoholintoxication

C. Disturbances in suggestibility- Compliant and uncritical response to an idea or influence

Folie a deux (or folie atrios)

Communicated emotional illness between two (or three)persons)

Hypnosis Artificially induced modifications of consciousnesscharacterized by heightened suggestibility

II. Emotion- Complex feeling state with psychic, somatic and behavioural components that

is related to affect and moodA. Affect

- Observed expression of emotion, possibly inconsistent with patientsdescription of emotion

Appropriate affect Condition in which the emotional tone is in harmony withthe accompanying idea, thought or speechDescribed as broad or full affect in which a full range ofemotion is appropriately expressed

Inappropriate affect Disharmony between the emotional feeling tone and theidea, thought or speech accompanying it

Blunted affect Disturbance in affect manifested by severe reduction inthe intensity of externalized feeling tone

Restricted orconstricted affect

Reduced in intensity of feeling toneLess severe than blunted affect but clearly reduced

Flat affect Absence or near absence of any signs of affectiveexpressionVoice monotonousFace immobile

Labile affect Rapid and abrupt changes in emotional feeling toneUnrelated to external stimuli

Full affect You can see patients affect

Levels of affect1. Full2. Blunted3. Restricted or constricted

4. Flat

B. Mood- Pervasive and sustained emotion subjectively experienced and reported by a

patient and observed by others- Examples: depression, elation and anger

Dyphoric mood An unpleasant moodEuthymic mood Normal range of mood


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Implying absence of depressed or elevated moodExpansive mood A persons expression of feelings without restraint

Frequently qith overestimation of their significance orimportance

Irritable mood State in which a person is easily annoyed and provoked toanger

Mood swings (labilemood)

Oscillations between euphoria and depression or anxiety

Elevated mood Air of confidence and enjoymentMood more cheerful than usual

Euphoria Intense elation with feeling of grandeurEcstasy Feelings of intense raptureDepression Psycopathological feeling of sadnessAnhedonia Loss of interest in, and withdrawal from all regular and

pleasurable activitiesOften associated with depression

Grief or mourning

Aka: bereavement

Sadness appropriate to a real loss

Alexithymia A persons inability to or difficulty in describing or beingaware of mood

Suicidal ideation Thoughts or act of taking ones own lifeElation Feelings of joy, euphoria, triumph, intense self-satisfaction

or optimismHypomania Mood abnormality with the qualitative characteristics of

mania but somewhat less intenseMania Mood state characterized by elation, agitation,

hyperactivity, hypersexuality, and accelerated thinkingand speaking

Melancholia Severe depressive state

Used in the term involutional melancholia bothdescriptivelyAlso in reference to an distinct diagnostic entity

Le belie indifference Inappropriate attitude of calm or lack of concern aboutones disability

C. Other emotionsAnxiety Feeling of apprehension caused by anticipation of anger

Which may be internal or externalFree-floating anxiety Pervasive unfocused fear not attached to any ideaFear Anxiety caused by consciously recognized and realistic

danger

Agitation Severe anxiety associated with motor restlessnessSimilar to irritability characterized by excessiveexcitability with easily triggered anger or annoyance

Tension Increased and unpleasant motor and psychological activityPanic Acute, episodic, intense attack of anxiety associated with

overwhelming feelings of dread and autonomic dischargeApathy Dulled emotional tone associated with detachment or

indifference


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Ambivalence Coexistence of two opposing impulses toward the samething in the same person at the same time

Abreaction Emotional release or discharge after recalling a painfulexperience

Shame Failure to live up to self-expectationsGuilt Emotion secondary to doing what is perceived wrongImpulse control Ability to resist an impulse, drive or temptation to perform

an actionIneffability Ecstatic state in which a person states it is indescribable,

inexpressible and impossible to convey to another personAcathexis Lack of feeling associated with an ordinarily emotionally

charged subjectIn cathexis feeling is connected

Decathexis Detaching emotions from thoughts, ideas or persons

D. Physiological disturbances associated with mood

- Signs of somatic (usually autonomic) dysfunctions, most often associated withdepression- Aka: vegetative signs

Anorexia Loss of, decrease in appetiteHyperphagia Increase intake of foodInsomnia:InitialMiddle

Terminal

Lack of, or diminished ability to sleepa. Initial: difficulty falling asleepb. Middle: difficulty sleeping through the night without

waking up and difficulty going back to sleepc. Terminal: early morning awakening

Hypersomnia Excessive sleepingDiurnal variation Mood is regularly worse in the morning immediately after

awakeningImproves as the day progresses

Diminished libido Decreased sexual interest, drive and performanceIncreased libido is often associated with manic states

Constipation Inability to defecate or difficulty defecatingFatigue A feeling of weariness, sleepiness or irritability following a

period of mental or bodily activityPica Craving and eating non-food substances, such as paint

and clayPseudocyesis Rare condition in which a patient has the signs and

symptoms of pregnancy such as abdominal distention,breast enlargement, pigmentation, cessation of menses

and morning sicknessBulimia Insatiable hunger and voracious eating

Seen in bulimia nervosa and atypical depressionAdynamia Weakness and fatigability

III. Motor behavior (conation)


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- Aspect of the psyche that includes impulses, motivations, wishes, drives,instincts and cravings as expressed by a persons behavior or motor activity

Echopraxia Pathologic imitation of movements of one person byanother

Catatonia andpostural

abnormalities:CatalepsyCatatonic excitementCatatonic stuporCatatonic rigidityCatatonic posturingCerea flexibilitasAkinesia

Seen in catatonic schizophrenia and some patients withbrain diseases such as encephalitis

a. Catalepsy: general term for an immobile positionthat is constantly maintained

b. Catatonic excitement: agitated, purposeless motoractivity, uninfluenced by external stimuli

c. Catatonic stupor: markedly slowed motor activity,often to the point of immobility and seemingunawareness of surroundings

d. Catatonic rigidity: voluntary assumption of a rigidposture, held against all efforts to be moved

e. Catatonic posturing: voluntary assumption of aninappropriate or bizarre posture, generallymaintained for long periods

f. Cerea flexibilitas (waxy flexibility): condition inwhich a person can be molded into a position thatis then maintained. When the examiner moves thepersons limb feels as if it were made of wax

g.Akinesia: lack of physical movement as in theextreme immobility of catatonic schizophrenia.May occur as an extrapyramidal adverse effect ofantipsychotic medication

Negativism Motiveless resistance to all attempts to be moved or to allinstructions

Cataplexy Temporary loss of muscle tone and weakness precipitatedby a variety of emotional states

Stereotypy Repetitive fixed pattern of physical action or speechMannerism Ingrained, habitual involuntary movementAutomatism Automatic performance of an act or acts generally

presenting unconscious symbolic activityCommand automatism Automatic following of suggestion

Also automatic obedienceMutism Voicelessness without structural abnormalitiesOveractivity:Psychomotor agitationHyperactivity

Tic

SleepwalkingAkathisiaCompulsion

- Dipsomania- Kleptomania- Nymphomania- Satiriasis- Trichotillomania- Ritual

a. Psychomotor agitation: excessive motor andcognitive activity. Usually non-productive and inresponse to inner tension

b. Hyperactivity (hyperkinesis): restless, aggressice,

destructive activity, often associated with someunderlying brain pathologyc. Tic: involuntary spasmodic motor movementd. Sleepwalking (somnambulism): motor activity

during sleepe. Akathisia: subjective feeling of muscular tension

secondary to antipsychotic or other medication,which can cause restlessness, pacing, repeatedsitting and standing. Can be mistaken for psychotic


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AtaxiaPolyphagia

TremorFloccillation

agitationf. Compulsion: uncontrollable impulse to perform an

act repetitively

Dipsomania: compulsion to drink alcohol

Kleptomania: compulsion to steal

Nymphomania: excessive and compulsiceneed for coitus in a woman

Satiriasis: excessive and compulsive need forcoitus in a man

Trichotillomania: compulsion to pull out hair

Ritual: automatic, compulsive activity,anxiety reducing in origin

g. Ataxia: failure of muscle coordination; irregularity ofmuscle action

h. Polyphagia: pathological overeatingi. Tremor: rhythmical alteration in movement, which

is usually faster than one beat a second. Decreased

during period of relaxation and sleep and increaseduring periods of anger and increased tension.

j. Floccillation: aimless picking usually at clothing orbedclothes, commonly seen in delirium

Hypoactivity(hypokinesis)

Decreased motor and cognitive activityPsychomotor retardationVisible slowing of thought, speech and movements

Mimicry Simple, imitative motor activity of childhoodAggression Forceful, goal-directed action that may be verbal or

physicalThe motor counterpart of the affect of rage, anger orhostility

Acting out Direct expression of an unconscious wish or impulse inactionLiving out unconscious fantasy impulsively in behavior

Abulia Reduced impulse to act and thinkAssociated with indifference about consequences of actionResult of a neurological deficit

Anergia Lack of energyAstasia abasia Inability to stand or walk in a normal manner, even though

normal leg movements can be performed in a sitting orlying down position

The gait is bizarre and does not suggest a specific organiclesion

Seen in conversion disorderCoprophagia Eating of filth or fecesDyskinesia Difficulty performing voluntary movements as in

extrapyramidal disorderMuscle rigidity State in which the muscles remain immovable

Seen in schizophreniaTwirling a sign present in autistic children who continually rotate in

the direction in which their head is turned


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Bradykinesia Slow motor activity decreased normal, spontaneousmovement

Chorea Random and involuntary quick, jerky, purposelessmovements

ConvulsionClonic convulsion

Tonic convulsion

Involuntary violent muscular contraction or spasma. Clonic convulsion: convulsion in which muscles

alternately contract and relaxb. Tonic convulsion: convulsion in which the muscles

contraction is sustainedSeizureGeneralized tonic-clonicseizureSimple partial seizureComplex partial seizure

An attack or sudden onset of certain symptoms, such asconvulsion, loss of consciousness and psychic or sensorydisturbances seen in epilepsy and can be substanceinduced

a. Generalized tonic-clonic seizure: generalized onsetof tonic-clonic movements o fthe limbs, tonguebiting and incontinence followed by slow, gradualrecovery of consciousness and cognition. Aka:grand mal seizure andpsychomotor seizure

b. Simple partial seizure: localized ictal onset ofseizure without altered consciousness

c. Complex partial seizure: localized ictal onset ofseizure with altered consciouness

Dystonia Slow sustained contractions of the trunk or limbsSeen in medication0induced dystoria

Amimia Inability to make gestures or to comprehend those madeby others

IV.Thinking- Goal-directed flow of ideas, symbols and associations initiated by a problem or

task and leading towards a reality-oriented conclusion- When a logical sequence occurs, thinking is normal- Parapraxis: unconsciously motivated lapse from logic (aka: Freudian slip) is

considered part of normal thinking- Abstract thinking is the ability to grasp the essentials of a whole to break it into

its parts and to discern common propertiesMental disorder Clinically significant behavior or psychological syndrome

associated with distress or disabilityNot just an expected response to a particular event or

limited to relations between a person and societyPsychosis Inability to distinguish reality from fantasyImpaired reality testing, with the creation of a new realityOpposed to neurosis; mental disorder in which realitytesting is intactBehavior may not violate gross social norms but isrelatively enduring or recurrent without treatment

Reality testing Objective evaluation and judgement of the world outsidethe self


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Formal thoughtdisorder

Disturbance in the form of thought rather than the contentof thought

Thinking characterized by loosened associationsNeologism and illogical constructs

Thought process is disordered and the person is definedas psychotic

Illogical thinking Thinking containing erroneous conclusions or internalcontraindicationsPsychopathological only when it is marked and when notcaused by cultural values or intellectual deficits

Dereism Mental activity not concordant with logic or experienceAutistic thinking Preoccupation with inner private world

Term used somewhat synonymously with dereismMagical thinking A form of dereistic thought

Thinking similar to that of the preoperational phase inchildren (Jean Piaget) in which thought, words or actionsassume power (e.g. to cause or prevent events)

Primary processthinking

General term for thinking that is dereistic, illogical,magicalNormally found in dreams, abnormally in psychosis

Emotional insight Deep level of understanding or awareness that is likely tolead to positive changes in personality and behavior

B. Specific disturbances in form of thoughtNeologism New word created by a patient often by combining

syllables of their wordsFor idiosyncratic psychological reasons

Words salad Incoherent mixture of words and phrasesCircumstantiality Indirect speech that is delayed in reaching the point but

eventually gets from original point to desired goalCharacterized by overinclusion of details and parentheticalremarks

Tangentiality Inability to have goal-directed associations of thoughtSpeaker never gets from point to desired goal

Incoherence Thought that is generally not understandableRunning together of thoughts or words with no logical orgrammatical connectionResulting in disorganization

Perseveration Persisting response to a previous stimulus after a newstimulus has been presentedOften associated with cognitive disorders

Verbigeration Meaningless repetition of specific words or phrasesEcholalia Psychopathological repeating of words or phrases of one

person by anotherTends to be repetitive and persistentMay be spoken with mocking or staccato intonation

Condensation Fusion of various concepts into oneIrrelevant answer Answer that is not in harmony with question asked

Person appears to ignore or not attend to question


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Loosening of association

Flow of thought in which ideas shift from one subject toanother in a completely unrelated way, when sever:speech may be incoherent

Derailment Gradual or sudden deviation in train of thought withoutblockingSometimes used synonymously with loosening of

associationsFlight of ideas Rapid, continuous verbalizations or play on words produce

constant shifting from one idea to anotherIdeas ten to be connected and in the less severe form alistener may be able to follow them

Clang associations Association of words similar in sound but not in meaningWords have no logical connections, may include rhymingand punning

Blocking Abrupt interruption in train of thought before a thought oridea is finishedAfter a brief pause, person indicates no recall of what wasbeing said or was going to be saidAka: thought deprivation

Glossolalia Expression of revelatory message through unintelligiblewordsAka: speaking in tonguesNot considered a disturbance in thought if associated withpractices of specific Pentecostal religions; cryptolalia, aprivate spoken language

C. Specific disturbances in content of thoughtPoverty of content Thought that gives little information because of

vagueness, empty repetitions or obscure phrases

Overvalued idea Unreasonable, sustained false belief maintained less firmlythan a delusionDelusionBizarre delusionSystematized delusionMood-congruent delusionMood-incongruentdelusionNihilistic delusionDelusion of povertySomatic delusionParanoid delusions

- Delusion of persecution- Delusion of grandeur- Delusion of reference

Delusion of self-accusationDelusion of control

- Thought withdrawal- Thought insertion

False belief based on incorrect inference about externalrealityNot consistent with patients intelligence and culturalbackgroundCannot be corrected by reasoning

a. Bizarre delusion: an absurd, totallyimplausible, strange false beliefb. Systematized delusion: false belief or beliefsunited by a single event or themec. Mood-congruent delusion: delusion with

mood appropriate contentd. Mood-incongruent delusion: delusion withcontent that has no association to mood or is moodneutrale. Nihilistic delusion: feeling that self, others orthe world is nonexistent or coming to endf. Delusion of poverty: a persons false beliefthat he or she is bereft or will be deprived of allmaterial possessions


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- Thought broadcasting- Thought control

Delusion of infidelityErotomaniaPseudologia phantastica

g. Somatic delusions: false belief involvingfunctioning of the bodyh. Paranoid delusions: include persecutorydelusions and delusions of reference, control andgrandeur

Delusion of persecution: a persons falsebelief that he or she is being harassed,cheated or persecuted. Often found inlitigious patients who have pathologicaltendency to take legal action because ofimagines mistreatment.

Delusion of grandeur: a personsexaggerated conception of his or herimportance, power or identity

Delusion of reference: a persons false beliefthat the behavior of others refers to himselfor herself that events, objects or other

persons have a particular and unusualsignificance, usually of a negative nature.Derived from idea of reference in which aperson falsely feels that others are talkingabout him or her.

i. Delusion of self-accusation: false feeling ofremorse and guilt

j. Delusion of control: false feeling that apersons will, thoughts or feelings are beingcontrolled by external forces

Thought withdrawal: delusion that thoughtsare being removed from a persons mind by

others or forces Thought insertion: delusion that thoughts are

being implanted in a persons mind by otherpersons or forces

Thought broadcasting: delusion that apersons thought can be heard by others, asthough they were being broadcasting overthe air

Thought control: delusion that a personsthoughts are being controlled by otherpersons or forces

k. Delusion of infidelity (delusional jealousy):

false belief derived from pathological jealousy abouta persons lover being unfaithfull. Etotomania: delusional belief more commonin women that someone is deeply in love with them.Aka: clerambault-kandinsky complexm. Pseudologia phantastica: type of lying inwhich a person appears to believe in the reality ofhis or her fantasies and acts on them. Associated


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with Munchausen syndrome, repeated feigning ofillness.

Trend orpreoccupation ofthought

Centering of thought content on a particular ideaAssociated with a strong affective tone

Egomania Pathological self-preoccupationMonomania Preoccupation with a single objectHypochondria Exaggerated concern about health that is based not on

real organic pathology but rather on unrealisticinterpretations of physical signs or sensations as abnormal

Obsession Pathological persistence of an irresistible thought orfeeling that cannot be eliminated from consciousness bylogical effort associated with anxiety

Compulsion Pathological need to act on an impulse that, if resisted,produces anxietyRepetitive behavior in response to an obsession orperformed according to certain rules with no true end initself other than to prevent something from occurring inthe future

Coprolalia Compulsive utterance of obscene wordsPhobiaSpecific phobiaSocial phobiaAcrophobiaAgoraphobiaAlgophobiaAilurophobiaErythrophobiaPanphobia

ClaustrophobiaXenophobiaZoophobiaNeedle phobia

Persistent irrational exaggerated and invariablypathological dread of specific stimulus or situationResults in a compelling desire to avoid fear stimulus

a. Specific phobia: circumscribed dread of a discreteobject or situation

b. Social phobia: dread of public humiliation as in fearof public speaking, performing, eating in public

c. Acrophobia: dread of high placesd. Agoraphobia: dread of open places

e. Algophobia: dread of painf. Ailurophobia: dread of catsg. Eryhtrophobia: dread of red (fear of blushing)h. Panphobia: dread of everythingi. Claustrophobia: dread of closed spaces

j. Xenophobia: dread of strangersk. Zoophobia: dread of animalsl. Needle phobia: the persistent intense pathological

fear of receiving an injection (aka: blood injectionphobia)

Noesis A revelation in which immense illumination occurs inassociation with a sense that a person has been chosen to

lead and commandUnio mystica An oceanic feeling of mystic unity with an infinite powerNot considered a disturbance in thought content ifcongruent with persons religious or cultural mileu

V. Speech- Ideas, thoughts, feelings as expressed through language, communication

through the use of words and languageA. Disturbances in speech


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Pressure of speech Rapid speech that is increased in amount and difficult tointerrupt

Volubility (logorrhea) Copious, coherent, logical speechPoverty of speech Restriction in the amount of speech used

Replies may be monosyllableNonspontaneousspeech

Verbal responses gives only when asked or spoken todirectlyNo self-initiation of speech

Poverty of content ofspeech

Speech that is adequate in amount but conveys littleinformation because of vagueness, emptiness orstereotyped phrases

Dysprosody Loss of normal speech melody called prosodyDisarthria Difficulty in articulation not in word finding or grammarExcessively loud orsoft speech

Loss of modulation of normal speech volumeMay reflect a variety of pathological conditions rangingfrom psychosis to depression to deafness

Stuttering Frequent repetition or prolongation of a sound or syllable,

leading to markedly impaired speech fluencyCluttering Erratic and dysrhythmic speech consisting of rapid andjerky spurts

Aculalia Nonsense speech associated with markedly impairedcomprehension

Bradylalia Abnormally slow speechDysphonia Difficulty or pain in speaking

B. Aphasic disturbances- Disturbances in language output

Motor aphasia Disturbance of speech caused by a cognitive disorder inwhich understanding remain but ability to speak is grossly

impairedHalting, laborious and inaccurate speechAka: brocas nonfluent and expressive aphasia

Sensory aphasia Organic loss of ability to comprehend the meaning ofwordsFluid and spontaneous but incoherent and nonsensicalspeechAka: wernickes fluent and receptive aphasia

Norminal aphasia Difficulty finding correct name for an objectAlso termed anomia and amnestic aphasia

Synctactical aphasia Inability to arrange words in proper sequenceJargon aphasia Words produced are totally neologistic

Nonsense words repeated with various intonations andinflections

Global aphasia Combination of a grossly non-fluent aphasia and a severefluent aphasia

Alogia Inability to speak because of mental deficiency or aepisode of dementia

Coprophasia Involuntary use of vulgar or obscene languageSeen in tourettes disorder and some patients with


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schizophrenia

VI.Perception- Process of transferring physical stimulation into psychological information- Mental process by which sensory stimuli are brought to awareness

A. Disturbances of perception1. Hallucination

False sensory perception not associated with real external stimuli

There may or may not be a delusional interpretation of the hallucinatoryexperiences

Hypnagogichallucination

False sensory perception occurring while falling asleepGenerally considered non-pathological

hypnopompichallucination

False perception occurring while awakening from sleepGenerally considered non-pathological

Auditory hallucination False perception of sound

Usually voices but also other noisesVisual hallucination False perception involving sight consisting of both formedimages and unformed imagesMost common in medically determined disorders

Olfactoryhallucination

False perception of smellMost common in medically determined disorders

Gustatoryhallucination

False perception of taste, such as unpleasant tasteCause by an uncinate seizure; most common in medicaldisorders

Tactile (haptic)hallucination

False perception of touch or surface sensation, as in froman amputated limb (phantom limb)Crawling sensation on or under the skin (formication)

Somatic hallucinationAka: cenesthesichallucination

False sensation of things occurring in or to the bodyMost often of visceral origin

Lilliputianhallucination

False perception in which objects are seen as reduced insizeAlso termed (micropsia)

Mood-congruenthallucination

Hallucination in which the content is not consistent witheither depressed or manic moodIn depression, hallucinations not involving such themes asguilt, deserved punishment or inadequacyIn mania, hallucinations not involving such themes asinflated worth or power

Hallucinosis Hallucinations, most often auditoryAssociated with chronic alcohol abuse that occur withinclear sensorium as opposed to delirium tremens (DTs)Hallucinations that occur in the context of a cloudedsensorium

Synesthesia Sensation of hallucination caused by another sensationAn auditory sensation accompanied by or triggering avisual sensation


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Also called: dissociative identity disorderin DSM-IVDissociation Unconscious defense mechanism involving the

segregation of a group of mental or behavior processesfrom the rest of the persons psychic activityMay entail separation of an idea from its accompanyingemotional tone

As seen in dissociative and coversion disorders

VII. Memory- Function by which information stored in the brain is later recalled to

consciousness- Orientation is the normal state of oneself and ones surroundings in terms of

time, place and person

A. Disturbance of memoryAmnesiaAnterogradeRetrograde

Partial or total inability to recall past experiencesMay be of organic or emotional origin

a. Anterograde: amnesia for events occurringafter a point of timeb. Retrograde: amnesia for events occurringbefore a point of time

ParamnesiaFausse reconnaissanceRetrospectivefalsificationConfabulationDj vuDj entenduDj pense

Jamais vuFalse memory

Falsification of memory by distortion of recalla. Fausse reconnaissance: false recognitionb. Retrospective falsification: memory becomes

emotionally (unconsciously) distorted by beingfiltered through a persons present emotional,cognitive and experiential state

c. Confabulation: unconscious filling of a gap inmemory by imagined or untrue experiences that aperson believes but that have no basis in fact. Mostoften associated with organic pathology

d. Dj vu: illusion of visual recognition in which a newsituation is incorrectly regarded as a repetition of aprevious memory

e. Dj entendu: illusion of auditory recognitionf. Dj pense: illusion that a new thought is

recognized as a thought previously felt orexpressed

g. Jamais vu: false feeling of unfamiliarity with a realsituation that a person has experienced

h. False memory: a patients recollection of an belief

in and event that did not actually occurHypermnesia Exaggerated degree of retention and recallEidetic image Visual memory of almost hallucinatory vividnessScreen memory A consciously tolerable memory covering for a painful

memoryRepression A defense mechanism characterized by unconscious

forgetting of unacceptable ideas or impulsesLethologica Temporary inability to remember a name r proper nounBlackout Amnesia experience by alcoholics about behavior during


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drinking boutsUsually indicates that reversible brain damage hasoccurred

B. Levels of memoryImmediate Reproduction or recall of perceived material within

seconds to minutesRecent Recall of events over past few daysRecent past Recall of events over past few monthsRemote Recall of events in distant past

VIII. Intelligence- Ability to understand, recall, mobilize and constructively integrate previous

learning in meeting new situationsA. Mental retardation

- Sufficient lack of intelligence to interfere with social and vocationalperformance

i. Mild: IQ of 50 or 55 ro approximately 70ii. Moderate: IQ of 30 or 40 to 55iii. Severe: IQ of 20 or 25 to 35 or 40iv. Profound: IQ below 20 or 25

Obsolete terms

Idiot: mental age less than 3 years

Imbecile: mental age of 3 to 7 years

Moron: mental age of about 8 years

B. Dementia- Organic and global deterioration of intellectual functioning without clouding of

consciousness

Dyscalculia (acalculia) Loss of ability to do calculationsNot caused by anxiety of impairment in concentration

Dyspragphia(agraphia)

Loss of ability to write in cursive styleLoss of word structure

Alexia Loss of a previously possessed reading facilityNot explained by defective visual acuity

C. Pseudodementia- Clinical features resembling dementia not caused by an organic condition- Most often cause by depression (dementia syndrome of depression)

D. Concrete thinking

- Literal thinking one dimensional thought- Limited use of metaphor without understanding nuances of meaning

E. Abstract thinking- Ability to appreciate nuances of meaning- Multidimensional thinking with ability to use metaphors and hypotheses

appropriately


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IX.Insight- Ability to understand the true cause and meaning of a situation (such as a set

of symptoms)

A. Intellectual Insight- Understanding of the objective reality of a set of circumstances without the

ability to apply the understanding in any useful way to master the situation

B. True insight- understanding of the objective reality of a situation, couple with the motivation

and emotional impetus to master the situation

C. Impaired insight- Diminished ability to understand the objective reality of a situation

X. Judgement- Ability to assess a situation correctly and to act appropriately in the situation

A. Critical judgement- Ability to assess, discern and choose among various options in a situation

B. Automatic judgement- Reflex performance of an action

C. Impaired judgement- Diminished ability to understand a situation correctly and to act appropriately

psychiatric signs & symptoms

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