Abnormal Psychology: Signs, Symptoms & Disorders

• These are study notes on abnormal psychology concepts, including signs, symptoms, descriptive terms, disturbances of consciousness, emotion, motor behavior, and thinking, as well as personality and substance-related disorders.

Signs & Symptoms

• Signs: Objective indications of a patient's condition observed by a clinician.
• Symptoms: Subjective experiences reported by the patient.

Descriptive Terms

• Organic mental disorder: Mental condition due to physical damage or brain dysfunction.
• Psychogenic: Originating from psychological rather than physical causes.
• Neurosis: Mental disorder involving chronic stress, anxiety, or irrational fears without loss of reality touch.
• Psychosis: Involves loss of reality testing and impaired mental functioning.

Disturbances of Consciousness

• Disorientation: Confusion regarding time, place, or person.
• Stupor: Lack of reaction/awareness of surroundings.
• Delirium: Bewildered, restless, confused reaction associated with fear/hallucination.
• Coma: Profound unconsciousness.
• Twilight state: Disturbed consciousness with hallucinations.
• Somnolence: Abnormal drowsiness.
• Drowsiness: Impaired awareness with sleep desire/inclination.

Disturbances in Attention

• Distractibility: Attention drawn to unimportant stimuli.
• Selective inattention: Blocking out anxiety-generating things.
• Hypervigilance: Excessive attention to internal & external stimuli.
• Trance: Focused attention or altered consciousness.
• Disinhibition: Loss of impulse control.

Disturbances in Suggestibility

• Folie a deux: Communication of emotional illness between 2-3 persons.
• Hypnosis: Artificially induced modification of consciousness with increased suggestibility.

Emotion

• Complex feeling state with psychic, somatic, and behavioral components related to affect & mood.

Affect

• Observed expression of emotion.
  • Can be appropriate or inappropriate
  • Blunted: Severe intensity reduction.
  • Restricted/constricted: Less severe intensity reduction.
  • Flat: Absence/near-absence of expression.
  • Labile: Rapid & abrupt changes unrelated to stimuli.

Mood

• Pervasive & sustained emotion subjectively experienced.
  • Euthymic: Normal range.
  • Dysphoric: Unpleasant mood.
  • Expansive: Expression of feelings without restraint.
  • Irritable: Easily annoyed or provoked to anger.
  • May include mood swings, elevated mood, euphoria, depression, anhedonia, or grief.

Motor Behavior (Conation)

• Impulses, motivations, wishes, drives, instincts & cravings as expressed by a person's behavior or motor activity

• Echopraxia: Imitation of movement.

• Catatonia & postural abnormalities: Abnormal movement and behavior states.

• Catalepsy: Immobility maintained constantly.

• Akinesia: Lack of physical movement.

• Mannerism: Involuntary movement.

• Negativism: Resistance to attempts to be moved.

• Overactivity: Agitation, hyperactivity, etc.

• Compulsion: Impulse to perform a repetitive act.

Disturbances in Thinking

• In Form/Process: Psychosis, illogical/autistic/magical thinking.
• In Content: Delusions.

Specific Disturbances (Form)

• Word salad: Incoherent mixture of words and phrases.
• Circumstantiality: Indirect speech delayed in reaching the point.
• Incoherence: Ununderstandable thought.
• Echolalia: Pathological repeating of words.
• Flight of ideas: Constant shifting from 1 idea to another.
• Clang association: Use of similar-sounding words without logical connection.

Specific Disturbances (Content)

• Delusion: False belief despite contradictory evidence.
  • Bizarre: Totally implausible, strange false belief.
  • Systematized: United by a single event/theme.
  • Delusion of poverty: False belief of being deprived of material things.
  • Somatic: False beliefs about body functioning.
  • Paranoid: Delusion of persecution.
  • Delusion of control: Controlled thoughts/feelings by external forces.
  • Delusion of infidelity: False belief of unfaithful partner.
  • Erotomania: False belief that someone is in love.
  • Hypochondria: Exaggerated concern about health.
• Obsession: Pathological, persistent thought/feeling that cannot be eliminated from consciousness.
• Compulsion: Pathological need to act on an impulse.
• Coprolalia: Compulsive utterance of obscene words.
• Phobia: Persistent, irrational exaggerated dread.

Disturbances in Speech

• Pressure of speech: Rapid and increased.
• Poverty of speech: Decreased amount.
• Stuttering: Frequent repetition or prolongation.
• Motor aphasia (Broca's): Difficulty speaking and writing; comprehension intact.
• Sensory aphasia (Wernicke's): Difficulty understanding speech; fluent but nonsensical speech.

Disturbances in Perception

• Hallucination: False sensory perception without external stimuli.
  • Auditory, visual, olfactory, gustatory, or tactile.
• Illusion: Misinterpretation of real external stimuli.

Disturbances in Memory

• Amnesia: Partial/total inability to recall past experiences.
• Paramnesia: Falsification of memory by distortion of recall.
• Repression: Unconscious forgetting.
• Blackout: Amnesia during drinking bouts.

Intelligence

• Mental Retardation: Lack of intelligence interferes with social and vocational performance.
• Dementia: Deterioration of intellectual functioning.

Insight

• Ability to understand the true cause and meaning of a situation.
  • Intellectual, true, or impaired.

Judgment

• Ability to assess a situation correctly and act appropriately.
  • Critical, automatic, or impaired.

Personality Disorders

• Personality Disorders: Enduring patterns of inner experience and behavior that deviate from cultural expectations, are inflexible, and lead to distress or impairment.

General Criteria

• Manifested in cognition, affectivity, interpersonal functioning, or impulse control; inflexible, pervasive, stable, and traced back to adolescence/early adulthood.

Clusters

• Cluster A (Odd/Eccentric):
  • Paranoid, Schizoid, and Schizotypal Personality Disorders.
• Cluster B (Dramatic/Emotional/Erratic):
  • Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders.
• Cluster C (Anxious/Fearful):
  • Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders.

Paranoid Personality Disorder

• Distrust and suspiciousness of others.
  • Suspects exploitation, unjustified doubts about loyalty, reluctance to confide, reads hidden meanings, bears grudges.

Schizoid Personality Disorder (“SIR SAFE”)

• Detachment from social relationships and restricted range of emotions.
  • Solitary lifestyle, indifferent to praise/criticism, relationships of no interest, sexual experiences not of interest, activities not enjoyed, lacking friends/emotionally cold.

Schizotypal Personality Disorder (“UFO AIDER”)

• Social and interpersonal deficits with discomfort, reduced capacity for relationships, cognitive/perceptual distortions, and eccentricities.
  • Unusual perceptions, friendless, odd thinking/speech, inappropriate affect, ideas of reference, doubts others, eccentric appearance, reluctant in social situations.

Antisocial Personality Disorder

• Disregard for and violation of the rights of others since age 15.
  • Failure to conform to social norms, deceitfulness, impulsivity, irritability, reckless disregard, irresponsibility, lack of remorse.

Borderline Personality Disorder

• Instability of interpersonal relationships, self-image, affects, and impulsivity.
  • Frantic efforts to avoid abandonment, unstable relationships, identity disturbance, impulsivity, suicidal behavior, affective instability.

Histrionic Personality Disorder

• Excessive emotionality and attention-seeking.
  • Uncomfortable when not the center of attention, sexually seductive behavior, rapidly shifting emotions, uses physical appearance for attention, impressionistic speech, self-dramatization, suggestible.

Narcissistic Personality Disorder

• Grandiosity, need for admiration, and lack of empathy.
  • Grandiose sense of self, fantasies of unlimited success, belief of being special, needs admiration, sense of entitlement, interpersonally exploitative, lacks empathy.

Avoidant Personality Disorder

• Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
  • Avoids interpersonal contact due to criticism fears, unwilling to get involved unless liked, restraint in relationships, preoccupied with criticism, inhibited in new situations, views self as inferior, reluctant to take risks.

Dependent Personality Disorder

• Excessive need to be taken care of, leading to submissive behavior and fears of separation.
  • Difficulty making decisions without advice, needs others to assume responsibility, difficulty expressing disagreement, difficulty initiating projects, goes to excessive lengths for support, uncomfortable when alone, urgently seeks another relationship, preoccupied with fears of self-care.

Obsessive-Compulsive Personality Disorder

• Preoccupation with orderliness, perfectionism, and control. Is preoccupied with details, rules, lists, or schedules to the extent that the major point of the activity is lost.
• Perfectionism shown to interfere task completion (ex. unable to complete a project because his or her own overly strict standards are not met).

Substance-Related Disorders

• Encompasses substance use, intoxication, and withdrawal, leading to various psychological and behavioral disturbances

Substance Use Disorders

Involves maladaptive substance use leading to impairment/distress

Terms

• Substance Dependence:
  • Tolerance
  • withdrawal.
    • Larger amounts/longer periods than intended
    • Persistent desire/unsuccessful efforts to control use.
    • Time spent obtaining/using/recovering from the substance.
    • Activities given up due to substance use
    • Continued use despite knowledge of substance-related problems.
• Substance Abuse:
  • Failure to fulfill obligations
  • Use in hazardous situations
  • Legal problems, social problems

Substance Induced Disorders

Includes:

• Intoxication
• Withdrawal
• Delirium
• Persisting Dementia
• Amnestic
• Psychotic
• Mood disorders