NCM 117: Dynamics of Behavioral Pattern & Symptoms PDF

NCM 117: DYNAMICS OF BEHAVIORAL PATTERN & DISTURBANCES IN STREAM OF THOUGHT certain abnormalities may be observed in the manner SYMPTOMS...

NCM 117: DYNAMICS OF BEHAVIORAL PATTERN & DISTURBANCES IN STREAM OF THOUGHT certain abnormalities may be observed in the manner SYMPTOMS and rate of associative processes. I.DISTURBANCES OF THINKING NEOLOGISM NORMAL THOUGHT refers to the coinage of new words that have symbolic thought, or the cognitive, includes the processes of meaning, or the conferring of new meanings upon judgment, comprehension, memory, and reasoning. words that are commonly. Normal rational thinking consists of a goal-directed o coining of new words with distinct meaning to the pt. flow of ideas, & associations initiated by a problem or When the pt is detached from reality. task and leading to a reality-oriented conclusion. WORD SALAD DISTURBANCE OF THOUGHT OR ASSOCIATION a disconnected flow of communication made up of a the flow of thought may become seemingly mixture of words, phrases, and sentences which haphazard, purposeless, logical, confused, Incorrect, sound meaningless and as if the product of abrupt, and bizarre. This phenomenon is most dissociation and the pressure of Invading thoughts. conspicuous in schizophrenia. In fact, Bleuler regarded o no pattern but scattered words disturbance in association as one of the fundamental symptoms of that disease. INTELLECTUALIZATION a state of anxious pondering about abstract, SIDE theoretical or philosophical issues. It is a flight into DISTURBANCE OF THOUGHT AND ASSOCIATION intellectual concepts and words that are emotionally This could be observe in pt with schizophrenia neutral in order to avoid objectionable feelings or impulses. FUNDAMENTAL SYMPTOMS OF SCHIZOPHRENIA SIDE by Eugen Bleuler defense mechanism Bleuler has 4's in describing schizophrenia person doesn’t go down to emotional level but focuses Associative looseness on intellectual level because the emotional dimension is Autism not acceptable for the person Apathy it’s all about theories and concepts which is intellectual Ambivalence: The pt feels simultaneous things all at level without dragging his personal experiences ones like love and hate at the same time pt who intellectualize could not accept reality Ex: a politician campaigning against drug abuse, DISTURBANCE IN FORM OF THINKING explaining all facts without telling his experience that his under this category are included all deviations from son is also a drug addict (which is the emotional level) rational, logical, goal- directed thinking. CIRCUMSTANTIALITY DEREISM is a disorder of association in which too many or dereistic thinking, emphasizes the disconnections associated ideas come into consciousness because of that have taken place between the patient's mental too little selective suppression. The inclusion in processes and his ongoing actual experiences. The conversation by a highly anxious individual of many mental processes do not follow reality, logic, or unnecessary details, scattered thoughts and experience. explanations. The pressure of invading thought and o Example: The person is thinking that he is eating but in feelings tends to organize the communications and reality, he’s defecating. delays the reaching of the goal point of the conversation. AUTISM SIDE can occur as a character trait, referring to individuals beating around the bush interjecting unnecessary thoughts and ideas with the who are bashful, shy, retiring, shut in, inaccessible, or main resort of delaying the statement. introverted. Delaying the end goal of conversation but would still SIDE say it. One of Bleuler’s 4A’s TANGENTIALITY: too many associated ideas and so They create their own world many unnecessary details but the person failed to Schizophrenic person thinks world is hostile, convey his/her point. Did not reach the end goal of unpleasurable, unfavorable and as their defense mechanism they make their own world which is very conversation. opposite than their reality MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 5 2nd SEMESTER l PRELIM STEREOTYPE O word from previous statement will be used to the next is the constant repetition of any speech or action. sentence but has no connection. VERBIGERATION CLANG ASSOCIATION the continuous reiteration of a specific phrase. It may linkage of similar word sounds, such as seven, heaven, also occur in the form of writing a given word or eleven, to compensate for defects in memory and phrase over and over again, and it is most often seen communication which may be psychic or organic origin. in schizophrenia. o words that rhymes o They will continuously reiterate the word or phrase o they rhyme but don’t have connection even WITHOUT ASKING THEM QUESTIONS. Unlike in perseveration that when you asked them questions, APHASIA they will give the same answer even with different is a general term for all disturbances of language and questions. communication due to brain lesions but not as the result of faulty innervations of the speech muscles, PERSEVERATION involvement of the organs of articulation, or general psychopathological repetition of the same word or mental or Intellectual deficiency. Aphasia results in an idea in response to different questions. inability to pronounce words and names and to When a patient gives an answer that is in harmony indicate the use of common objects. with and appropriate to the questions, his answer is disturbance of speech due to organic brain MOTOR disorder in which understanding remains but said to be relevant. If it is out of harmony, it is said to APHASIA ability to speak is lost. be irrelevant. loss of ability to comprehend the meaning of o Giving the same response to different question. SENSORY words of use of objects. o Could be first response to the question is relevant but APHASIA speak remains but unable to understand succeeding questions are as the same response as the words first and are irrelevant NOMINAL difficulty in finding right name for an object. APHASIA Similar to having brain fog INCOHERENCE Inability to arrange words in proper is the result of disorderly thinking, thoughts do not SYNTACTICAL sequence. No proper sequence giving wrong meaning follow in logical sequence. Under such circumstances APHASIA making statements incomprehensible and the patient's verbalizations cannot be understood by unlogical the listener. A milder manifestation of incoherence is is the inability to recognize the full known as scattering. SEMANTIC significance of words, it is related to a loss in o Answer is really far from question APHASIA the capacity for abstract thinking. o Scattering: has an idea but the answer is still far from speech is reduced to a limited group of the question JARGON unintelligible neologisms (making their own APHASIA words), which the subject uses in a VOLUBILITY OR LOGORRHEA stereotyped fashion. is copious speech that may occur more or less within limits of normal and that coherent and logical. DISTURBANCES IN CONTENT OF THOUGHT o coherent and logical but not understandable FANTASY is a mental representation of a scene or occurrence PRESSURE OF SPEECH that is recognized as unreal but is either expected or is voluble speech that is difficult for the listener to hoped for. interrupt. which prepares for some later action. Ex. You will be attending the party, before CREATIVE FLIGHT OF IDEAS attending you think of how will you look, FANTASY a continuous stream of conversation with rapid shifts who will dance with you, literally every in topics owing to pressure of thoughts, sometimes details. characterized as topic jumping. An alert listener can DAY- which is the refuge for wishes that cannot DREAMING be fulfilled. detect connections to the fundamental topic of FANTASY conversation. Often the shifts can be traced to false logic of a fantastic nature that is stimulation of preceding statements as in the motivated by a low self- esteem and weak following: "Three ships sailed out of the harbor of superego. Impersonation of celebrities, Beirut. We are three brothers. I liked my older brother PSEUDOLOGICA pathological lying and the writing of false best. The best men in the service. Not a wedding FANTASTICA signatures are abnormal uses of the service in the ship's sail. Three ships. He was stationed mechanism of identification. It differs from normal day-dreaming in that the in Beirut." subject believes in the reality of his o has pattern MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 6 2nd SEMESTER l PRELIM  fantasies intermittently and for long false belief that the behavior of others enough intervals of time to act on them. DELUSION OF refers to oneself; derived from ideas of is a type of pathological liar who seeks to REFERENCE reference in which patient falsely feels he gain some advantage by imposing on is being talked about by others. IMPOSTER others various lies about his attainments, DELUSION OF false feeling of remorse. social position or worldly possessions. SELF- defense mechanism is interjection or Usually those with narcissistic personality ACCUSATION blaming self false feeling that one is being controlled by PHOBIA DELUSION OF others. CONTROL Ex. he believes he is being controlled by a an exaggerated end invariably pathological dread of computer or being controlled by God some type of stimulus or situation. false belief derived from pathological ACROPHOBIA dread of high places jealousy that one’s lover is unfaithful. AGORAPHOBIA dread of open places (Pathological jealousy-may occur in dread of pain marital settings in which a spouse has ALGOPHOBIA DELUSION OF algo means pain unconscious extramarital sexual impulses ASTRA(PO)PHOBIA dread of thunder and lightning INFIDELITY either heterosexual or homosexual, CLAUSTROPHOBIA dread of closed or confined places which are then projected onto the dread of excreta marital partner and emerge clinically as COPROPHOBIA copro means feces delusions of Infidelity.) HEMATOPHOBIA dread of sight of blood PARANOID oversuspiciousness leading to persecutory HYDROPHOBIA dread of water DELUSION delusions. LALOPHOBIA OR dread of speaking GLOSSOPHOBIA DISTURBANCES IN JUDGMENT MYSOPHOBIA dread of dirt or contamination NECROPHOBIA dread of dead bodles Judgment, from a psychiatric point of view, is the mental NYCTOPHOBIA dread of darkness, night act of comparing or evaluating alternatives within the PATHOPHOBIA OR framework of a given set for the purpose of deciding on a dread of disease, suffering NOSOPHOBIA course of action. The comparison may be in terms of PACCATOPHOBIA dread of sinning magnitude, rightness, goodness, beauty, or economic PHONOPHOBIA dread of speaking aloud worth. If the course of action decided on is constant with PHOTOPHOBIA dread of strong light reality as measured by mature adult standards, the SITOPHOBIA dread of eating judgment is intact, good, or normal. If, on the other hand, TAPHOPHOBIA dread of being buried alive. the course of action is inconsistent with reality, the TOXOPHOBIA dread of being poisoned. judgment is impaired, poor, or abnormal. XENOPHOBIA dread of strangers ZOOPHOBIA dread of animals II.DISTURBANCES OF CONSCIOUSNESS OBSESSION Consciousness is a faculty of perception that draws on is the pathological presence of a persistent and information from the outer world directly through the irresistible thought, feeling or impulse that cannot be sense organs and indirectly through stored memory traces. eliminated from consciousness by any logical effort. LEVELS OF CONSCIOUSNESS TREND OR PREOCCUPATION OF THOUGHT consciousness exists on a continuum, with maximum when thought content centers around a particular idea alertness at one extreme and absolute and is associated with strong affective tone. unconsciousness or coma on the other, in between are confusion, clouding of consciousness, delirium and DELUSION stupor. False belief, not consistent with patient's intelligence SIDE and cultural background that cannot be corrected by LEVELS OF CONSCIOUSNESS reasoning and even by presenting evidences. 1. Confusion DELUSION OF exaggerated perception of one's 2. Clouding Consciousness GRANDEUR importance. 3. Delirium false belief that one is being persecuted, 4. Stupor often found in litigious patients. 5. Coma (Litigious-is a pathological tendency to 6. Coma Vigil take legal action because of suspected DELUSION OF and imagined persecution. When these PERSECUTION imagined persecutions reach delusional CONFUSION proportions, we speak of delusion of there is disorientation as to time, place and person and persecution) a feeling of bewilderment. It is often accompanied by o could be combined with delusion of an impairment of consciousness and is encountered reference both in organic states and functional disorders. MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 7 2nd SEMESTER l PRELIM o Assess: ask the time, place, name in psychotic states as a result of delusions and in organic brain disease with sensory aphasia. CLOUDING OF CONSCIOUSNESS there is a disturbance in perception, attention and SUGGESTIBILITY thought and a subsequent amnesia. exists when a particular responds compliantly with unusual readiness. DELIRIUM o Whatever is commanded, without processing, the pt is a psychic state characterized by disorientation in all does it. spheres, confusion, clouding of consciousness and o Ex: Someone asked pt to punch the person beside bewilderment in association with anxiety, fear, him, so he immediately punched him. illusions, and hallucination, it is a result of an infection, tumor, hemorrhage, or toxic metabolic disorder and is NEGATIVE SUGGESTIBILITY classically associated with acute brain syndromes. in which the patient does the opposite of what is suggested, is seen normally in children and in catatonic STUPOR schizophrenia as negativism, which means the perverse is a state of relative non-responsiveness to the resistance to suggestion or advice. environment. FOLLE OR DEUX COMA a psychotic reaction in which two closely related and is the term describing the most profound degree of associated Individual's simultaneously show the same unconsciousness, in which there is no detectable symptoms and one member seems to have influence evidence of responsiveness. the other. COMA VIGIL FOLLE A TRIOS is a coma in which the eyes remain open. This also, a communicated insanity, this time it affects three condition may occur in a variety of acute organic brain members of the family. disorders, particularly when the diencephalon is affected. HYPNOSIS this is an artificially Induced disturbance of ATTENTION consciousness that may superficially resemble sleep is an aspect of consciousness that relates to the amount of but is physiologically distinct from it. It is characterized effort exerted in focusing on a certain portion of an by heightened suggestibility. As a result, variety of experience so that they become relatively more vivid. sensory, motor, and memory abnormalities may be induced by the hypnotist. DISTRACTIBILITY an aspect of attention is too easily drawn from a given SLEEP content by extraneous or distracting stimuli. is a complex state of altered consciousness consisting o Easily distracted of a least four separate stages of varying depth, sensory and motor activity and responsivity. SELECTIVE INATTENTION an aspect of attentiveness that generates anxiety, guilt, INSOMNIA and other unpleasant feelings. is a pathological inability to sleep. o select only things they want to focus, only focus on o assess the cause of insomnia those nice to hear o if the stimulus is anxiety provoking, the pt won't listen HYPERSOMNIA to it is often seen in depressive reactions occurring in psychoneurotic. In those instances, sleep is a retreat BLUNTING OF ATTENTION from painful encounters with the real world. in an extreme form of inattention in which responses o pt would just sleep and sleep to noxious stimuli are reduced. REVERSAL OF SLEEP HABIT APPERCEPTION is a common accompaniment of hypersomnia. In these or comprehension, implies the correct and clear recognition instances, the patient tends to sleep soundly through of the meaning of the data of perception. When a mental the early morning hours, wakes up gradually in the image is clearly perceived but is falsely interpreted or early afternoon and achieves full wakefulness at a time understood, one speaks of abnormal apperception. This when most people are going to bed. may occur in psychoneurosis in relation to severe anxiety, MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 8 2nd SEMESTER l PRELIM DROWSINESS CONFABULATION is a state of consciousness that intervenes normally there is an unconscious filling in of gaps in memory by between sleep and walking and is characterized by a imagined experience that the patient believes, general slowing up of the thought processes, with a although they have no basis in fact. tendency to concreteness in thinking, diminished perception and clumsiness in motor responses. PSEUDO REMINISCENCE incorporates both confabulation and retrospective falsification. III.DISTURBANCES OF ORIENTATION Orientation may be defined as the ability to recognize DÉJÀ VU one's surroundings and their temporal and spatial an illusion of recognition in which a new situation is relationships to oneself or to appreciate one's relations incorrectly regarded as repetition of a previous to the social environment. memory. Disorientation for time, place, and person. JAMAIS VU IV.DISTURBANCES OF MEMORY there is a false feeling of unfamiliarity with a real situation that one has experienced. o Opposite of deja vu AMNESIA is the partial or total inability to recall past DÉJÀ ENTENDU experiences. in which a comment never heard before is incorrectly regarded as a repetition of previous conversation. RETROGRADE AMNESIA there is amnesia for a period prior to the traumatic DÉJÀ PENSE event. in which a thought never entertained before is incorrectly regarded as repetition of a previous HYSTERICAL AMNESIA thought. is a loss of memory for a particular period of past life or for certain situations associated with great fear, rage, HYPERMNESIA or shameful humiliation. is an exaggerated degree of retention and recall, it can be elicited at times in a hypnotic trance. It is seen in HYSTERICAL FUGUE STATE certain prodigies, obsessive compulsive neurosis, a form of amnesia that sets in following a severe paranoia, and mania. emotional trauma. PARAMNESIA V.DISTURBANCES OF PERCEPTION is a distortion of recall usually associated with the MACROPSIA inclusion of false details or wrong temporal is a condition characteristic of hysteria in which objects relationships. appear larger that they really are. They may assume o you thought all the while that what you thought is terrifying proportion. correct but there’s distortion already cause there’s o Usually happens to those hysterical or in delirium false details included state FAUSSE RECONNAISSANCE MICROPSIA or false recognition, is the feeling of certainty that one is a condition in which objects appear smaller than is recalling accurately something that is patently they really are. It may alternate with macropsia in inaccurate. hysteria, but it has also been described as an aura in some cases epilepsy. RETROSPECTIVE FALSIFICATION a type of paramnesia, sometimes called illusions of HYPOCHONDRIASIS memory, false details, meanings, and recollections is the unshakable belief that physical disease is ofreal memory are created in response to emotional present, in the face of all evidence to the contrary needs. A patient may recall a past true event but distort it in accordance with a present need to support ILLUSIONS a symptom. there is perceptual misinterpretation of a real external sensory experience. MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 9 2nd SEMESTER l PRELIM o Ex. At night, you look outside your window and ATTITUDE thought there was a ghost but in reality, it’s only the refers to the effective state with which a person habitually shadow of you mango tree. confronts his environment. o It has stimulus compared to hallucination has no stimulus PLEASURABLE AFFECTS Euphoria → Elation → Exaltation → Ecstasy HALLUCINATIONS is the apparent perception of an external object with EUPHORIA no corresponding real object exists. refers to the first, moderate level in the scale of pleasurable affects. It is a feeling of emotional and HYPNAGOGIC HALLUCINATION physical well-being. When it occurs in a manifestly false memory perception occurring midway between inappropriate setting, it is indicative of mental falling asleep and being awake disorder. o Euphoria is normal but should be in an appropriate AUDITORY HALLUCINATION setting. false auditory perception ELATION VISUAL HALLUCINATION may be thought of as a second level in the scale of false visual perception pleasurable affects. It is characterized by a definite affect of gladness in which there is an air of OLFACTORY HALLUCINATION enjoyment and self- confidence, and motor activity is false perception of smell increased. This affect belongs within the limits of normal life experience. Yet, it may be indicative of GUSTATORY HALLUCINATION mental disorder when it occurs in a manifestly false perception of taste inappropriate setting. o They would even jump from excitement. TACTILE HAPTIC HALLUCINATION False perception of touch, such as feeling of worms EXALTATION under the skin extreme elation and is usually associated with delusions of grandeur. KINESTHETIC HALLUCINATION false perception of movement or sensation, as ECSTASY amputated limb (phantom limb) feeling of intense rapture LILLIPUTIAN HALLUCINATION MOOD SWINGS the hallucination objects, usually people, appear greatly refer to the oscillations between periods of euphoria reduced in size. and feelings of depression and anxiety. o Micropsia: reduced in size. o The difference is micropsia HAS STIMULUS but AMBIVALENCE lilliputian DO NOT have stimulus. refers to the co-existence of antithetical emotions, attitudes, ideas or wishes towards a given object or situation at the same time. VI.DISTURBANCES OF AFFECT Affect is the feeling tone, pleasurable or unpleasurable, DEPERSONALIZATION that accompanies an idea. a mental phenomenon characterized by a feeling of unreality and strangeness about oneself. The patient SHALLOW OR INADEQUATE AFFECT says, in effect, "This experience does not hurt me emotional flatness because I am not me." INAPPROPRIATE AFFECT DEREALIZATION when the emotion does not correlate with the stimulus a mental phenomenon characterized by the loss of the sense of reality concerning one's LABILE environment/surroundings. The patient says in effect, Changeable "This environment is not dangerous to me because this environment does not really exist." o Depersonalization is to own self but derealization is to their environment. MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 10 2nd SEMESTER l PRELIM  VII.DISTURBANCES IN MOTOR ASPECTS OF BEHAVIOR PYROMANIA the morbid compulsion to set fire. CONATION or the conative aspect of mental functioning, refers to TRICHOTILLOMANIA the capacity to initiate action or motor discharge and the compulsive pulling out of one's hair. concerns the basic strivings of an individual as expressed through his behavior. TIC an intermittent spasmodic twitching of the face or ECHOLALIA other body part, repeated at frequent Intervals and is the pathological repetition by imitation of the without external stimulus. Tics occur automatically speech of another person. and are not under conscious control. ECHOPRAXIA VIII. OTHER BEHAVIOR PATTERNS Is the pathological repetition by imitation of the DREAMY STATE (TWILIGHT) - disturbed consciousness movements of another person. with hallucination WAXY FLEXIBILITY (CEREA FLEXIBILITY) DEPRESSION-psychopathological feeling of sadness. Is the maintenance by the patient imposed postures with increased muscle tone, as when a limb remain GRIEF OR MOURNING-sadness appropriate to real loss. passively in the position in which it is placed, however long and uncomfortable. ANXIETY- feeling of apprehension due to unconscious o A symptom of catatonia conflict. o The stimulus is still not present AGITATION Is a state of chronic restless motor activity that is FEAR- anxiety due consciously recognized and realistic manifestation of emotional tension danger. o Objective danger, the stimulus is happening or already SLEEP-WALKING (SOMNAMBULISM) in front of the person. is a motor disturbance that occurs primarily during childhood and tends to occur more often in individuals TENSION- increased motor and psychological activity that prone to hysterical symptom formation. It is also is unpleasant commonly associated with enuresis. PANIC- acute intense attack of anxiety associated with COMPULSION personality disorientation. uncontrollable impulse to perform an act repetitively. FREE-FLOATING ANXIETY- pervasive fear not attached to DIPSOMANIA any idea. the compulsion to drink alcohol excessively. o There’s no stimulus but you just feel anxious for no reason EGOMANIA the pathological preoccupation with self. APATHY- dulled emotional tone associated with detachment or indifference. KLEPTOMANIA compulsive stealing. AGGRESSION- forceful goal-directed action that may be verbal, physical and that is motor counterpart of the effect MEGALOMANIA of rage, anger or hostility. preoccupation with delusions of great power. PATHOLOGICAL LIMB RIGIDITY- state of unconsciousness in which immobile position is constantly maintained MONOMANIA the preoccupation with a single idea. COMMAND AUTOMATISM- automatic following of suggestion. NYMPHOMANIA excessive sexual desire in female. AUTOMATISM- automatic performance of act SATYRIASIS representative of unconscious symbolic activity. excessive sexual desire in male. MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 11 2nd SEMESTER l PRELIM NEGATIVISM- frequent opposition to suggestions. CONCRETE THINKING - the psychotic person has difficulty thinking on the abstract level and may use literal MANNERISM- stereotyped involuntary movements. translations concerning aspects of the environment. HYPERACTIVITY (HYPERKINESIS)- restless, aggressive, RELIGIOSITY - the psychotic person becomes preoccupied destructive activity with religious ideas, a defense mechanism thought to be used in an attempt to stabilize and provide structure to EROTHAMANIA- pathological preoccupation with sex. disorganized thoughts and behaviors. RITUAL- automatic activity compulsive in nature emotional in origin. HYPOACTIVITY- decreased activity or retardation, as in psychomotor retardation, allowing of psychological and physical functioning. MIMICRY- simple, imitative motion activity of childhood. TANGENTIALITY- inability to have a goal-directed associations of thought. Goal is never reached. CONDENSATION- fusion of various concepts into one. PUNNING- injecting witty remarks. HYSTERICAL ANESTHESIA- loss of sensory modalities resulting from emotional conflicts. COSMIC IDENTIFICATION- expressing the delusion that one has abilities which may be likened to the powers of a supreme being. LABILITY- sometimes characterized as emotional instability. Patient manifests quick shifts in his emotional responses, as if gliding from one into another affect INSIGHT - being able to recognized and accept the fact that one is ill even though the dynamics of the illness are not understood. o Example: Pt knew that he is in a mental health hospital because he stabbed his wife because he thought she was having an affair (Good insight) o Pt told nurse that he is in a mental health hospital because he’s on a vacation (Bad insight) ALIEN CONTROL- a belief held that one is under the stronger influence of another person or force. LA BELLE INDIFFERENCE- a relative lack of concern regarding the severity of symptoms (e.g., person is suddenly blind but shows no anxiety over the situation). MRPP © 2022 l NOTES BY: JAN FAITH RAMOS & JARETH PANGANTIHON 12 2nd SEMESTER l PRELIM