Disorders of perception
Sensory distortions: changes in perception that are result of a change in intensity and quality of stimulus or spatial form of perception
Sensory deceptions
Changes in intensity (hyper- or hypo-aesthesia)
Illusions: misinterpretations of stimuli arising from an external object
Hallucinations: perceptions w/o an adequate external stimulus
Disorders of thought and speech
Disorders of intelligence
Disorders of thinking
Speech disorders
form
content
stream
Obsessions, compulsions and disorders of the possession of thought
tempo
continuity
Inhibition or slowing of thinking
Circumstantiality: occurs when thinking proceeds slowly w/ many unnecessary and trivial details, but finally point reached (if not, then it's tangentiality)
Flight of ideas: Typical of mania;
Perseveration
Thought blocking
Obsessions and compulsions
Thought alienation
Primary delusions
Secondary delusions and systematisation
The content of delusions
Delusions of infidelity
Delusions of love
Grandiose delusions
Delusions of persecution
Delusions of ill health
Delusions of guilt
Nihilistic delusions
Delusions of poverty
Transitory thinking
Drivelling thinking
Desultory thinking
Disorders of memory
The amnesias
Distortions of recognition
Paramnesia: falsification of memory by distortion
Psychogenic amnesias
Organic amnesias
Other amnesias
Distortions of recall
Retrospective falsification: Retrospective falsification refers to the unintentional distortion of memory that occurs when it is filtered through a person’s current emotional, experiential and cognitive state
False memory
Screen memory: A screen memory is a recollection that is partially true and partially false; it is thought that the individual only recalls part of the true memory because the entirety of the true memory is too painful to recall
Confabulation: Confabulation is the falsification of memory occurring in clear consciousness in association with organic pathology. It manifests itself as the filling-in of gaps in memory by imagined or untrue experiences that have no basis in fact. Some of the statements may be contradictory yet no attempt is made to correct them. The confabulation diminishes as the impairment worsens
Pseudologia fantastica: Pseudologia fantastica or fluent plausible lying (pathological lying) is the term used, by convention, to describe the confabulation that occurs in those without organic brain pathology such as personality disorder of antisocial or hysterical type
Munchausen’s syndrome: Munchausen’s syndrome is a variant of pathological lying in which the individual presents to hospitals with bogus illnesses, complex medical histories and often multiple surgical scars
Vorbeireden or approximate answers
Cryptamnesia
Retrospective delusions
Hyperamnesia
Disorders of the experience of self
Disturbances in the immediate awareness of self-unity
Disturbances of the boundaries of the self
Disturbance of the continuity of self
Disturbance of awareness of self-activity
Depersonalisation: px feels that they are no longer their normal natural self; Often a. w/:
Loss of emotional resonance
derealisation: a feeling of unreality so that environment experienced as flat, dull and unreal
Déjà vu: not strictly a disturbance of memory, but a problem w/ familiarity of places and events; feeling of having experienced a current event in past, although has no basis in fact
jamais vous: knowledge that an event has been experienced before but not presently a. w/ appropriate feelings of familiarity
special kinds
Body image distortions
Functional hallucinations:
An auditory stimulus causes a hallucination but stimulus is experienced as well as the hallucination. In other words the hallucination requires the presence of another real sensation.
ex: a px w/ schizophrenia first heard voice of God as her clock ticked; So both the noises and the voices were audible. pxs can distinguish both features from each other and crucially, the hallucination does not occur w/o the stimulus.
Both stimuli and experience are in one sense modality
Reflex hallucinations
Synaesthesia: experience of a stimulus in one sense modality producing a sensory experience in another. ex, feeling of cold in one’s spine on hearing a fingernail scratch a blackboard.
can occur under the influence of hallucinogenic drugs such as LSD or mescaline
Hyperschemazia: perceived magnification of body parts
hyposchemazia: perception of body parts as diminished
of individual senses
Auditory
second person
third person (voices talking to themselves; may be running commentary)
Pseudo-hallucinations: a type of mental image that, although clear and vivid, lack 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
clang associations (punning)
Dissociative or hysterical amnesia is the sudden amnesia that occurs during periods of extreme trauma and can last for hours or even day. The amnesia will be for personal identity such as name, address and history as well as for personal events, while at the same time the ability to perform complex behaviours is maintained. Dissociation may be associated with a fugue or wandering state in which the subject travels to another town or country and is often found wandering and lost
The more limited amnesia for specific traumatic events is known as katathymic amnesia or motivated forgetting, though the terms are often used interchangeably with dissociative amnesia. Katathymic amnesia is the inability to recall specific painful memories, and is believed to occur due to the defence mechanism of repression
Acute brain disease: disorders of perception and attention--> failure to encode material in long-term memory
In acute head injury there is an amnesia, known as retrograde amnesia, that embraces the events just before the injury. This period is usually no longer than a few minutes but occasionally may be longer, especially in subacute conditions.
Anterograde amnesia is amnesia for events occurring after the injury. These occur most commonly following accidents and are indicative of failure to encode events into long-term memory.
Blackouts are circumscribed periods of anterograde amnesia experienced particularly by those who are alcohol dependent during and following bouts of drinking. They indicate reversible brain damage and vary in length but can span many hours. They also occur in acute confusional states (delirium) due to infections or epilepsy.
Subacute coarse brain disease: characterised by the inability to learn new information (anterograde amnesia), and the inability to recall previously learned material (retrograde amnesia). However, memories from the remote past remain intact, as does recall of over learned material from the past and immediate recall.
Korsakoff’s syndrome is the amnestic syndrome caused by thiamine deficiency,
cerebrovascular disease, multiple sclerosis, head injury
transient global amnesia
electroconvulsive treatment (ECT)
Amnesias in anxiety and depressive disorders are generally caused by impaired concentration and resolve once the underlying disorder is treated.
More severe forms of amnesia in depressive disorders resemble dementia and are known as depressive pseudodementia
Disorders of emotion
A feeling can be defined as a positive or negative reaction to some experience or event and is the subjective experience of emotion. By contrast emotion is a stirred-up state caused by physiological changes occurring as a response to some event and which tends to maintain or abolish the causative event
Mood is a pervasive and sustained emotion that colours the person’s perception of the world. Descriptions of mood should include intensity, duration and fluctuations as well as adjectival descriptions of the type
Affect, meaning short-lived emotion, is defined as the patient’s present emotional responsiveness
Classification
Normal emotional reactions
Abnormal emotional reactions
Morbid disorders of emotion
Abnormal expressions of emotion
Morbid expressions of emotion
grief; though a period of 6−12 months is usually mentioned in relation to the usual duration of normal grief reactions