Typical Signs and Symptoms of Psychiatric Disorder PDF

Typical Signs and Symptoms of Psychiatric Disorder Dr. Mohammad Abu Mahfouz August 17, 2024 1  Teaching Methods Visual PPT Video Interactive discussion August 17, 2024...

Typical Signs and Symptoms of Psychiatric Disorder Dr. Mohammad Abu Mahfouz August 17, 2024 1  Teaching Methods Visual PPT Video Interactive discussion August 17, 2024 2  Outlines Disturbances of Consciousness. Disturbances of Attention. Disturbances in Suggestibility. Disturbances of Motor Behavior. Specific Disturbances in Form of Thought. Specific Disturbances in Content of Thought. Disturbances in Speech. Disturbances in Perception. Disturbances in Memory. 17 August 2024 3  Learning Objectives After ending this lecture, students will be able to: Differentiate between psychiatric signs and symptoms. Determine the signs and symptoms as presented by the service users. Record signs and symptoms in there nursing records accurately. 17 August 2024 4  Introduction Signs: are objective finding observed by the clinician (e.g., Psychomotor retardation and flat affect). Symptoms: are subjective experiences describe by the service user or patient ( e.g., Depressed mood and decreased angry). Psychopathological signs and symptoms are not clearly differentiated, they often overlap. A syndrome , or a constellation of signs and symptoms that make up a recognizable condition, is often used to show the overlap of the two. 17 August 2024 5  Introduction Syndrome: is a group of signs and symptoms that occur together as a recognizable condition that may be less than specific a clear-cut disorder or condition (e.g., Tourette's syndrome) 17 August 2024 6  Disturbances of Consciousness Consciousness: state of awareness. Apperception : perception modified by one’s own emotion and thoughts. Sensorium: state of cognitive functioning of the special sense. 17 August 2024 7  Disturbances of Consciousness Are most often associated with brain pathology Disorientation: disturbance of orientation in time, place, person, and situation. Clouding of consciousness: incomplete clear mindedness with disturbances in perception and attitudes. Stupor: lack of reaction to and unawareness of surrounding. 17 August 2024 8  Disturbances of Consciousness Delirium: Bewildered, restless, confused, disorientation reaction associated with fear and hallucination. Twilight state: disturbed consciousness with hallucinations. 17 August 2024 9  Disturbances of Consciousness Dreamlike state: often used as a synonym for complex partial seizure or psychomotor epilepsy. Somnolence: abnormal drowsiness. Coma: profound degree of unconsciousness. Coma vigil: coma in which the patient appears to be asleep but ready to be aroused also known as a Kinetic mutism. 17 August 2024 10  Disturbances of Attention Attention : is the amount of effort exerted in focusing on certain portion of an experience; ability to sustain a focus on one activity; ability to concentrate. 17 August 2024 11  Disturbances of Attention Distractibility: inability to concentrate attention. The attention is drawn to unimportant or irrelevant external or internal stimuli ✓Example: The patient diverts her attention away from the nurse with outside stimuli, such as the colorful bulletin boards in the street, and internal stimuli, such as her thoughts about the holidays. 17 August 2024 12  Disturbances of Attention Selective Inattention: blocking out only those things that generate anxiety ✓Example: the patient is focusing on watching television while his nurse is talking about his divorce. 17 August 2024 13  Disturbances of Attention Hypervigilance: Excessive attention and focus on all internal and external stimuli, usually secondary to delusion or paranoid state ✓Example: a patient with paranoid delusion believes that someone will kill him, so he keeps checking his surroundings. 17 August 2024 14  Disturbances of Attention Trance: focused attention and altered consciousness are usually seen in hypnosis and ecstatic religious experiences. 17 August 2024 15  Disturbances of Suggestibility Suggestibility: an inclination to readily and uncritically adopt the ideas, beliefs, attitudes, or actions of others. ✓Example: “Contagious Yawning" (multiple people begin to yawn after observing a person yawning) 17 August 2024 16  Disturbances of Suggestibility ‫ ﺑﻐﺾ اﻟﻨﻈﺮ‬،‫ ﯾﺸﯿﺮ ﻣﺼﻄﻠﺢ ﻗﺎﺑﻠﯿﺔ اﻟﺘﺄﺛﺮ إﻟﻰ ﻣﺪى ﺿﻌﻒ اﻟﻌﻤﯿﻞ ﻓﻲ ﻗﺒﻮل اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﻘﺪﻣﺔ ﻣﻦ طﺮف ﺛﺎﻟﺚ ﻋﻠﻰ أﻧﮭﺎ ﺻﺤﯿﺤﺔ‬،‫ﻓﻲ ﺳﯿﺎق ﻋﻼج اﻟﺼﺤﺔ اﻟﻌﻘﻠﯿﺔ‬.‫ﻋﻦ ﻣﺪى ﺻﺪﻗﮭﺎ‬ In the context of mental health treatment, Suggestibility refers to a client’s vulnerability to accepting information provided by a third party as true, regardless of its veracity. ‫ﻗﺎﺑﻠﯿﺔ اﻟﺘﺄﺛﺮ‬ Individuals with high suggestibility are more susceptible to changing their thoughts, feelings, or behaviors based on the counsel of others. 17 August 2024 17  Disturbances of Suggestibility Folie a deux (or folie a trois) – emotional/mental illness shared between two (or three) persons; also called shared psychosis between two (or three) persons ✓Example: let’s say a person has a psychotic disorder and, as part of that illness, believes aliens are spying on them. If his wife has a shared psychotic disorder, she will start to believe in the spying aliens. ‫ إذا ﻛﺎﻧﺖ‬.‫ ﯾﻌﺘﻘﺪ أن اﻟﻜﺎﺋﻨﺎت اﻟﻔﻀﺎﺋﯿﺔ ﺗﺘﺠﺴﺲ ﻋﻠﯿﮫ‬،‫ وﻛﺠﺰء ﻣﻦ ھﺬا اﻟﻤﺮض‬،‫ﺼﺎ ﻣﺎ ﯾﻌﺎﻧﻲ ﻣﻦ اﺿﻄﺮاب ذھﺎﻧﻲ‬ ً ‫ﻟﻨﻔﺘﺮض أن ﺷﺨ‬.‫ ﻓﺴﺘﺒﺪأ ﻓﻲ اﻹﯾﻤﺎن ﺑﺎﻟﻜﺎﺋﻨﺎت اﻟﻔﻀﺎﺋﯿﺔ اﻟﺘﻲ ﺗﺘﺠﺴﺲ ﻋﻠﯿﮫ‬،‫زوﺟﺘﮫ ﺗﻌﺎﻧﻲ ﻣﻦ اﺿﻄﺮاب ذھﺎﻧﻲ ﻣﺸﺘﺮك‬ 17 August 2024 18  Disturbances of Emotion Emotion: is a complex feeling state with a psychic, somatic, and behavioural component related to Mood and Affect. Mood: a pervasive and sustained emotion, subjectively experienced and reported by the service user and observed by others such as depression, elation, and anger. Affect: observed expression of emotion; may be inconsistent with service user’s description of emotion. 17 August 2024 19  Disturbances of Emotion Different descriptions of Mood include: ‫ﻣﺘﻘﻠﺐ اﻟﻤﺰاج‬ ❖ Dysphoric Mood: unpleasant mood. ‫ﻓﻄﺮي‬ ❖ Euthymic Mood: normal range of mood. ❖ Expansive Mood – the expression of one’s feelings without any restraint, and It is frequently and overestimation of one’s significance or importance. 17 August 2024 20  Disturbances of Emotion Different descriptions of Mood include: ❖ Elevated mood: a mood more cheerful than usual. ❖ Irritable mood: easily annoyed and provoked to anger. ❖ Euphoria: intense elation with feeling of grandeur. ❖ Labile mood( swings): oscillations between euphoria and depression or anxiety. ❖ Ecstasy: feeling of intense rapture..‫ ﺷﻌﻮر ﺑﺎﻟﻨﺸﻮة اﻟﺸﺪﯾﺪة‬:‫اﻟﻨﺸﻮة‬ 17 August 2024 21  Disturbances of Emotion Different descriptions of Mood include: ❖ Depression: psychopathological feeling of sadness. ‫اﻧﻌﺪام اﻟﻤﺘﻌﺔ‬ ❖ Anhedonia: loss of interest in and withdrawal from all regular and pleasurable activities, often associated with depression. ❖ Grief or mourning: sadness appropriate to real loss (e.g., death of father or mother). 17 August 2024 22  Disturbances of Emotion Other Physiological disturbances associated with mood: These refer to signs of somatic (usually autonomic) by dysfunction of the person, most often associated with depression. It include: ❖ Anorexia: loss of or decreased in appetite. ❖ Hyperphagia: increased in appetite and intake food. ❖ Diminished Libido: decreased sexual interest, drive, and performance (increased libido is often associated with manic state). 17 August 2024 23  Disturbances of Emotion Other Physiological disturbances associated with mood: ❖ Insomnia: lack of or diminished ability to sleep. ❖ Constipation: inability or difficulty in defecating. 17 August 2024 24  Disturbances of Emotion Different descriptions of Affect include: ❖ Appropriate affect: condition in which the emotional tone is in harmony with the accompanying idea, thought, and speech. ❖ Inappropriate affect: disharmony between the emotional feeling tone and the idea, thought or speech accompanying it. 17 August 2024 25  Disturbances of Emotion Different descriptions of Affect include: ❖ Blunted affect: a disturbance in affect manifested by a severe reduction in the intensity of externalized feeling tone. ❖ Restricted or constricted affect: reduction in intensity of feeling tone less severe than blunted affect but clearly reduced. 17 August 2024 26  Disturbances of Emotion Different descriptions of Affect include: ❖ Flat affect: absence or near absence of any signs of affective expression; voice, monotonous, and face immobile. ❖ Labile affect: rapid and abrupt changes in emotional feeling tone unrelated to external stimuli. 17 August 2024 27  Disturbances of Emotion Other descriptions of emotion: ‫اﻧﻌﺪام اﻟﻤﺘﻌﺔ‬ ❖ Anxiety: feeling of apprehension caused by anticipation of danger, which may be internal or external. ❖ Fear : anxiety caused by consciously recognized and realistic anger. ❖ Fear floating anxiety: pervasive, unfocused fear not attached to any idea ✓ Example: you are waiting in line at the cash register when suddenly you feel randomly nervous) 17 August 2024 28  Disturbances of Emotion Other descriptions of emotion: ❖ Tension: increased motor and psychological activity that is unpleasant. ❖ Panic: acute, episodic, intense attack of anxiety associated with over whelming feeling of dread autonomic discharge. 17 August 2024 29  Disturbances of Emotion Other descriptions of emotion: ❖ Agitation: severe anxiety associated with motor restlessness. ❖ Apathy: dulled emotional tone associated with detachment and indifference (I don’t Care). 17 August 2024 30  Disturbances of Emotion Other descriptions of emotion: ❖ Ambivalence: coexistence of two opposing impulses toward the same things in the person at the same time. ✓ Example: If you love your mom but find her totally embarrassing, you might feel ambivalent about having her give a presentation at your school.. 17 August 2024 31  Disturbances of Emotion Other descriptions of emotion: ❖ Abreaction: emotional release or discharge after recalling a painful experience. ❖ Shame: failure to live up to self expectation. ❖ Guilt: emotion secondary to doing that is perceived wrong. 17 August 2024 32  Disturbances of Motor Behavior Echopraxia: pathological imitation of movements of one person by another. Negativism: motiveless resistance to all attempts to be moved or to all instruction. ✓ Resistance to the suggestions ✓ Act in ways that are contrary to the commands of others.. 17 August 2024 33  Disturbances of Motor Behavior Cataplexy: temporary loss of muscle tone and weakness precipitated by a variety of emotional state. Stereotype: repetitive fixed pattern of physical action or speech. ✓ Example: hand waving, body rocking, head banging or hitting one's own body. 17 August 2024 34  Disturbances of Motor Behavior.‫ﺣﺮﻛﺔ ﻻ إرادﯾﺔ ﻣﺘﺄﺻﻠﺔ ﻋﺎدة‬ Mannerism: ingrained habitual involuntary movement. ✓ Example: a flip of the head/hair, a wiggling gait..‫اﻷداء اﻟﺘﻠﻘﺎﺋﻲ ﻟﻔﻌﻞ أو أﻓﻌﺎل ﺗﻤﺜﻞ ﻋﻤﻮًﻣﺎ ﻧﺸﺎطًﺎ رﻣﺰﯾًﺎ ﻻواﻋﯿًﺎ‬ Automatism: automatic performance of an act or acts generally representative of unconscious symbolic activity. ✓ Example: simple actions such as finger rubbing, lip smacking , or complex actions, such as sleepwalking behaviors. 17 August 2024 35  Disturbances of Motor Behavior Mutism: voice lessness without structural abnormalities. Catatonia: a neuropsychiatric syndrome characterized by abnormal movements, behaviors, and withdrawal. 17 August 2024 36  Disturbances of Motor Behavior Types of Catatonia: ❖ Catalepsy: general term for an immobile position that is constantly maintained. ❖ Catatonic excitement: agitated, purposeless motor activity, uninfluenced by external stimuli ❖ Catatonic stupor: markedly slowed motor activity often to a point of immobility and seeming unawareness of surrounding. 17 August 2024 37  Disturbances of Motor Behavior Types of Catatonia: ❖ Catatonic rigidity: voluntary assumption of a rigid posture, held against all efforts to be moved. ❖ Waxy flexibility: the person can be molded into a position that is them maintained; when the examiner moves the person’s limb, the limb feel as if it made of wax. 17 August 2024 38  Disturbances of Motor Behavior Over Activity ❖ Psychomotor agitation: excessive motor and cognitive over activity; usually nonproductive and in response to inner tension. ‫ﻟﻠﺘﻮﺗﺮ اﻟﺪاﺧﻠﻲ‬ ❖ Hyperactivity (hyperkinesia) : restless, aggressive, destructive activity; often associated with underlying brain pathology. ❖ Tic: involuntary, spasmodic motor movement.. 17 August 2024 39  Disturbances of Motor Behavior Over Activity ❖ Sleepwalking: motor activity during sleep. ❖ Akathisia (an inability to remain still) or it is subjective feeling of muscular tension secondary to antipsychotic or other medication which can cause restlessness, pacing, repeated sitting and standing. ❖ Ataxia: failure of muscle coordination irregularity of muscle action. 17 August 2024 40  Disturbances of Motor Behavior Over Activity ❖ Compulsion: an uncontrolled impulse to perform an act repetitively. ✓ Dipsomania: a compulsion to drink alcohol. ✓ Kleptomania: a compulsion to steal. ✓ Trichotillomania: a compulsion to pull out one’s hair. 17 August 2024 41  Disturbances of Motor Behavior Hypoactivity (hypokinesis) ❖ Hypokinesis decreased motor activity and cognitive activity, as in psychomotor retardation; visible slowing of thought, speech and movements. ❖ Mimicry: the spontaneous imitation of an interaction partner ‫اﻟﺘﻘﻠﯿﺪ اﻟﺘﻠﻘﺎﺋﻲ ﻟﺸﺮﯾﻚ اﻟﺘﻔﺎﻋﻞ‬ ✓ Example: imitating verbally—such as using similar words, accent, echoing, intonation or speech rate—non-verbally, like mirroring facial expressions, postures or gestures 17 August 2024 42  Disturbances of Motor Behavior Hypoactivity (hypokinesis) ❖ Acting out: direct expression of an unconscious wish or impulse in action; unconscious fantasy is lived out impulsively in behavior. ✓ Example: Instead of saying, “I'm angry with you,” a person who acts out may instead throw a book at the person, or punch a hole through a wall. 17 August 2024 43  Specific Disturbances in form of Thought Neologism: new word created by the patient, often by combining syllables of other words for idiosyncratic psychological reasons. ✓ Example: “headshoe” to mean “hat”. Word Salad: incoherent mixture of words and phrases. ✓ Example: Bags stain purple vacuum. 17 August 2024 44  Specific Disturbances in form of Thought Circumstantiality: indirect speech that is delayed in reaching the point but eventually gets from original point to desired goal; characterized by an over inclusion of details and parenthetical remark. 17 August 2024 45  Specific Disturbances in form of Thought Tangentiality: in ability to have goal directed association of thought; patient never gets from desire from desired point to desired goal. ✓ Example: when a therapist poses the question, “How was your week?” a person may respond with, “When I was five, my cat was killed.” 17 August 2024 46  Specific Disturbances in form of Thought Incoherence: thought, that generally is not understandable; running together of thoughts or words with no logical or grammatical connection, resulting in disorganization. ✓ Example: "They're destroying too many cattle and oil just to make soap. If we need soap when you can jump into a pool of water, and then when you go to buy your gasoline, my folks always thought they should get pop but the best thing to get is motor oil, and, money..." 17 August 2024 47  Specific Disturbances in form of Thought Preservation : pathological repetition of the same response to different stimuli, as in a repetition of the same verbal response to different questions; persistent repetition of specific words or concepts in the process of speaking. ✓ Examples: Using the same answer to multiple questions in a row even if it doesn't make sense.... 17 August 2024 48  Specific Disturbances in form of Thought Verbigeration : meaningless repetition of specific words or phrases. ✓ Examples: a person with schizophrenia may repeatedly say a nonsense syllable or a cluster of nonsense syllables. Echolalia: psychopathological repeating of words or phrases of one person by another; tends to be repetitive and persistent, may be spoken with mocking. ✓ Example: someone with echolalia might only be able to repeat a question rather than answer it. 17 August 2024 49  Specific Disturbances in form of Thought Loosening of associations: a thought disturbance demonstrated by speech that is disconnected and fragmented, with the individual jumping from one idea to another unrelated or indirectly related idea. ✓ Examples: A person with loose associations speaks sentences like these. “I like to dance, all people have hands.” “I like to play games because the river is flowing down a mountain.” 17 August 2024 50  Specific Disturbances in form of Thought Flight of idea: rapid, continuous verbalizations or plays on words produce constant shifting from one idea another. ✓ Example: A person experiencing flight of ideas, for example, might deliver a 10- minute monologue during which he or she jumps from talking about childhood, to a favorite advertisement, to a moment of distorted body image, to political ideology, concluding with a rant about his or her favorite flower. 17 August 2024 51  Specific Disturbances in form of Thought Clang association: association of word similar in sound but not in meaning; words have no logical connection may include rhyming and punning. ✓ Example: “I tied the rope soap the slope nope.” Blocking: abrupt interruption in train of thinking before a thought or idea is finished; after a brief pause; the person indicates no recall of what was being said or was going to be said..‫اﻧﻘﻄﺎع ﻣﻔﺎﺟﺊ ﻓﻲ ﺳﻠﺴﻠﺔ اﻟﺘﻔﻜﯿﺮ ﻗﺒﻞ اﻻﻧﺘﮭﺎء ﻣﻦ ﻓﻜﺮة أو ﻓﻜﺮة ﻣﻌﯿﻨﺔ؛ ﺑﻌﺪ ﺗﻮﻗﻒ ﻗﺼﯿﺮ؛ ﯾﺸﯿﺮ اﻟﺸﺨﺺ إﻟﻰ ﻋﺪم ﺗﺬﻛﺮ ﻣﺎ ﻗﯿﻞ أو ﻣﺎ ﻛﺎن ﺳﯿﻘﺎل‬ 17 August 2024 52  Specific Disturbances in form of Thought ‫ﻓﻜﺮة ﻣﺒﺎﻟﻎ ﻓﻲ ﻗﯿﻤﺘﮭﺎ‬ Over valued idea: unreasonable, sustained false belief maintained less firmly than delusion. Delusion: false fixed belief, based on incorrect inference about external reality, not consistent with service user's intelligence and cultural background that cannot be corrected by reasoning. 17 August 2024 53  Specific Disturbances in form of Thought Types of Delusion.(‫اﻋﺘﻘﺎد ﺧﺎطﺊ ﻏﺮﯾﺐ وﻏﯿﺮ ﻣﻌﻘﻮل ﻋﻠﻰ اﻹطﻼق )ﻏﯿﺮ ﻣﻨﻄﻘﻲ‬ ❖ Bizarre delusion: an absurd, totally implausible (illogical), strange false belief. ✓ Example: Invaders from space have implanted electrodes in the service user's brain. ❖ Systematized delusion: false belief or beliefs united by single events or theme. ✓ Example: a person grows older and starts to believe that family members are conspiring against them to get their money and possessions. 17 August 2024 54  Specific Disturbances in form of Thought Types of Delusion.‫اﻟﻮھﻢ ﻣﻊ اﻟﻤﺤﺘﻮى اﻟﻤﻨﺎﺳﺐ ﻟﻠﻤﺰاج‬ ❖ Mood congruent delusion: delusion with mood appropriate content. ✓ Example: A depressed patient believes that he or she is responsible for the destruction of the world. ❖ Mood in congruent delusion: delusion with content that has no association to mood. (‫ﯾﻌﺎﻧﻲ اﻟﻤﺮﯾﺾ اﻟﻤﻜﺘﺌﺐ ﻣﻦ وھﻢ اﻟﺘﺤﻜﻢ ﻓﻲ اﻷﻓﻜﺎر )إدﺧﺎل اﻷﻓﻜﺎر أو ﺳﺤﺒﮭﺎ‬ ✓ Example: A depressed patient has delusion of thought control (thought insertion or withdrawal) or thought broad casting (TV, media, newspaper... etc.). 17 August 2024 55  Specific Disturbances in form of Thought Types of Delusion ❖ Nihilistic delusion: false feeling that self, others, or the world is nonexistent or ending. ✓ Example: patient would verbalize that his internal organs not existing entirely as a human being, and his house has developed cracks and is going to fall down. ❖ Somatic delusion: false belief involving functioning of one's body ✓ Example: Belief that one's brain is rotting or melting. 17 August 2024 56  Specific Disturbances in form of Thought Types of Delusion ❖ Paranoid delusion : also known as persecutory delusions, are fears, anxieties, and suspicions centered on perceived victimization or unwarranted feelings of being threatened by external forces such as individuals or government authorities. ✓ Example: They may say things like: "They are out to ruin my reputation." "They put tracking technologies in my medications." "I know my employer put a camera in my home." 17 August 2024 57  Specific Disturbances in form of Thought Types of Delusion ❖ Delusion of grandeur: exaggerated conception of one's important, power, or identity. ✓ Example: A person may believe that they are famous, can end world wars, or that they are immortal. ❖ Delusion of self accusation : false feeling of remorse and guilt. ✓ Example: A patient may believe that they are responsible for the occurrence of any disaster in the world. 17 August 2024 58  Specific Disturbances in form of Thought Types of Delusion ❖ Delusion of reference: false belief that the behavior of other refers to one self; that events, objects, or other people have a particular and unusual significance usually of a negative nature; derived from idea of reference in which one falsely feels that one is being talked about by others. ✓ Example: Belief that people on TV or radio are talking to or about the patient. 17 August 2024 59  Specific Disturbances in form of Thought Types of Delusion ❖ Delusion of control: false feeling that one's will thought, or feeling are being controlled by external forces. ✓ Example: a patient may believe that the government is controlling his move via radio waves. ❖ Thought withdrawal: delusion that one's thought are being removal from one's mind by other people or forces. ✓ Example: a patient may believe that the government is removing thoughts from his or her head. 17 August 2024 60  Specific Disturbances in form of Thought Types of Delusion ❖ Thought insertion: delusion that thoughts are being implanted in one's mind by other people or forces. ✓ Example: “My doctor is trying to plant thoughts inside my head.” ❖ Thought broadcasting: delusion that one's thoughts can be heard by others, as thought they were being broadcast into air. 17 August 2024 61  Specific Disturbances in form of Thought Egomania: pathological self-preoccupation ( self-importance) ✓ Example: a person might express egotism by constantly reminding his friends that he has a fantastic figure or a magnificent mind..‫اﻻﻧﺸﻐﺎل ﺑﻤﻮﺿﻮع أو ﻓﻜﺮة واﺣﺪة‬ Monomania: preoccupation with single object or idea. ✓ Example: He had a monomania for collecting antique dolls or His monomania for success drove him to work 18 hours a day. 17 August 2024 62  Specific Disturbances in form of Thought Hypochondria : exaggerated concern about one's health that is based not on real organic pathology but, rather on unrealistic interpretation of physical signs or sensation as abnormal. ✓ Example: a person who has a minor cough may think that they have tuberculosis. Obsession: pathological persistence of an irresistible thought or feeling that can not be eliminated from consciousness by logical effort. ✓ Example: a person may be obsessed with germs and cleanness 17 August 2024 63  Specific Disturbances in form of Thought Compulsion: pathological need to act an impulse that, if resisted, produces anxiety; repetitive behavior in response to an obsession or performed according to certain rules, with no true end in it self other than to prevent something from occurring in the future. ✓ Example: a person may be obsessed with germs and cleanness and he may counteract this obsession with continual hand washing. 17 August 2024 64  Specific Disturbances in form of Thought Phobia: persistent , irrational, exaggerated and in variably pathological dread of some specific type of stimulus or situation, result in a compelling desire to avoid the feared stimulus..‫ ﯾﺆدي إﻟﻰ رﻏﺒﺔ ﻣﻠﺤﺔ ﻓﻲ ﺗﺠﻨﺐ اﻟﻤﺤﻔﺰ اﻟﻤﺨﯿﻒ‬،‫اﻟﺨﻮف اﻟﻤﺴﺘﻤﺮ وﻏﯿﺮ اﻟﻌﻘﻼﻧﻲ واﻟﻤﺒﺎﻟﻎ ﻓﯿﮫ واﻟﻤﺮﺿﻲ ﻣﻦ ﻧﻮع ﻣﻌﯿﻦ ﻣﻦ اﻟﻤﺤﻔﺰات أو اﻟﻤﻮاﻗﻒ‬ Specific phobia: circumscribed dread of a discrete object or situation ( for ex., dread of spider or snakes). (‫ اﻟﺨﻮف ﻣﻦ اﻟﻌﻨﻜﺒﻮت أو اﻟﺜﻌﺎﺑﯿﻦ‬،‫ﺧﻮف ﻣﺤﺪد ﻣﻦ ﺷﻲء أو ﻣﻮﻗﻒ ﻣﺤﺪد )ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‬ Social phobia: dread of public humiliation, as in fear of public speaking, performing, or eating in public. Acrophobia: dread of high places. 17 August 2024 65  Specific Disturbances in form of Thought Agoraphobia: dread of open places. Claustrophobia: dread of closed places. Algophobia: dread of pain. Ailurophobia: dread of cat. Erythrophobia: dread of red( refer to fear of blushing). Panphobia: dread of every thing. Xenophobia: dread of strangers. 17 August 2024 66  Disturbances in Speech Speech : ideas, thought, feeling as expressed through language, communication through the use of words and language. Disturbances in speech ❖ Pressure of speech: rapid speech that is increased in amount and difficult to interrupt. ❖ Poverty of speech: restriction in the amount of speech used; replies may be monosyllabic. 17 August 2024 67  Disturbances in Speech Disturbances in speech ❖ Non spontaneous speech : verbal responses given only when asked or spoken to directly; no self-initiation of speech. ❖ Poverty of content of speech : speech that is adequate in amount but conveys little information be cause of vagueness, emptiness, or stereotyped phrases. ❖ Dysprosody: loss of normal speech melody. 17 August 2024 68  Disturbances in Speech Disturbances in speech ❖ Dysarthria: difficult in articulation, not in word finding or in grammar. ❖ Excessively loud or soft speech: loss of modulation of normal speech volume, may reflect a variety of pathological conditions ranging from psychosis to depression to deafness. ❖ Stuttering: frequent repetition or prolongation of a sound or syllable, leading to markedly impaired speech fluency. 17 August 2024 69  Disturbances in Perception Perception: process of transferring physical stimulation in to psychological information; mental process by which sensory stimuli are brought to awareness. Hallucination: false sensory perception not associated with real external stimuli, there may or may not be a delusional interpretation of the hallucinatory experience. 17 August 2024 70  Disturbances in Perception Types of Hallucination ❖ Auditory hallucination: false perception of sound, usually voices/ commands but also other noises, such as music; most common hallucination in psychiatric disorder ❖ Visual hallucination: false perception involving sight consisting of both formed image ( ex. People,) and unformed images (ex. Flashes or light) most common in medically determined disorders. 17 August 2024 71  Disturbances in Perception Types of Hallucination ❖ Olfactory hallucination: false perception of smell, most common in medical disorder. ❖ Gustatory hallucination: false perception of taste, such as an pleasant taste caused by uncinate seizure, most common in medical disorder 17 August 2024 72  Disturbances in Perception Types of Hallucination ❖ Tactile hallucination: false perception of touch or surface sensation, as form an imputed limb ( phantom limb), crawling sensation on or under the skin( formication; insects crawling in, on or under your skin). 17 August 2024 73  Disturbances in Perception Illusion: misperception or misinterpretation of real external sensory stimuli. ✓ Example: a person who perceives tree branches at night as if they are goblins may be said to be having an illusion. 17 August 2024 74  Disturbances in Perception Depersonalization refers to feeling like you're outside of yourself watching your own thoughts or actions from a removed distance. 17 August 2024 75  Disturbances in Perception Derealization: refers to feeling like the world around you isn't real. People in this state often describe their external surroundings as unclear, lifeless, or foggy. 17 August 2024 76  Disturbances in Memory Memory : function by which information stored in the brain is later recalled to consciousness. 17 August 2024 77  Disturbances in Memory Disturbances in Memory ❖ Amnesia: partial or total inability to recall past experiences, may be organic or emotional in origin. ✓ Anterograde: amnesia for events occurring after a point in time ( a person can’t remember new information but can remember events from before the onset of amnesia). ✓ Retrograde: amnesia prior to a point in time (a person can remember new information but cannot remember events from before the onset of amnesia.) 17 August 2024 78  Disturbances in Memory Disturbances in Memory ❖ Hyperamnesia: exaggerated degree of retention and recall. ✓ Example: delirious people who would speak fluently in a language they had not had occasion to use for up to 50 or more years and apparently had forgotten ❖ Déjà vu: illusion of visual recognition in which a new situation is in correctly regarded as a repetition of a previous memory. 17 August 2024 79  Disturbances in Memory Disturbances in Memory ❖ Confabulation: unconscious filing of gaps in memory by imagined or untrue experiences that service user believes but that have no bases in fact, most often associated with organic pathology. ❖ An example of confabulation is when a person with gaps in their memory is asked to remember and describe the details of a past event. Rather than responding that they do not know, the person's mind fills in missing details with confabulated memories of the event. 17 August 2024 80  Disturbances in Memory Memory Levels ✓ Immediate memory: reproduction or recall of perceived material within second to minutes. ✓ Recent memory: recall of events over past few days. ✓ Recent past: recall of events over past few months. ✓ Remote: recall of event in distant past. 17 August 2024 81  Disturbances in Memory Types of thinking ❖ Concrete thinking: literal thinking, limited use of metaphor without an understanding of nuances of meaning, one-dimensional thought. ✓ Example : When looking at photos of a wheelbarrow, a rake, and a hoe, a concrete thinker might point to a shared characteristic instead of describing the general function, “They all have wooden handles,” rather than, “You can use them all in the garden.” 17 August 2024 82  Disturbances in Memory Types of thinking ❖ Abstract thinking: the ability to appreciate nuances of meaning; multidimensional thinking with ability to use metaphors and hypotheses appropriately ✓ Example : if a person is given an equation to solve, abstract thinking allows them to think about what the solution might be, before attempting to solve it. 17 August 2024 83  Disturbances in Memory Levels of Insight Insight: ability of service use to understand the true cause and meaning of situation ( such as a set of symptoms). Intellectual insight : awareness that there is a mental illness without applying this knowledge to future experiences. True insight: awareness that there is a mental illness with applying this knowledge to control the situation. Impaired insight: diminished ability to understanding the objective the reality of a situation and illness. 17 August 2024 84  Disturbances in Memory Levels of Insight Judgment : ability to assess the situation correctly and at appropriately within that situation. Critical judgment: ability to assess, discern, and chooses among various options in a situation. Automatic judgment: reflex performance of an action. Impaired judgment: diminished ability to understand a situation correctly and to act appropriately 17 August 2024 85  References Halter, M. J. (2017). Varcarolis' Foundations of Psychiatric Mental Health Nursing- E-Book: A Clinical Approach. Elsevier Health Sciences. Sadock, B., & Sadock, V. (2007). Kaplan & Sadock’s Synopsis of Psychiatry (10th ed.) Philadelphia, USA: Lippincott Williams & Wilkins Varcarolis, E. M. (2014). Manual of Psychiatric Nursing Care Planning-E-Book: Assessment Guides, Diagnoses, Psychopharmacology. Elsevier Health Sciences. Varcarolis, E. M. (2016). Essentials of Psychiatric Mental Health Nursing-E-Book: A Communication Approach to EvidenceBased Care. Elsevier Health Sciences August 17, 2024 86  Abu Ma hfo uz, 17 August 2024 87 RN, MS