AbPsy Handout

REVIEW CENTER FOR ALLIED PROFESSIONALS

PSYCHOMETRICIAN BOARD EXAM REVIEW

ABNORMAL PSYCHOLOGY

I. Understanding Abnormality

Normal and Abnormal

Criteria for Normality Normality is average. This means that what is accepted by the majority is considered normal. The problem here is that majority behavior is not always acceptable.

Normality is Social Conformity. Anyone who conforms to social norms is normal.

Normality is Social Comfort. If a person feels comfort or pleasure, then it is normal

Normality is Ideal. What is good, what is socially acceptable and something that causes personal

comfort.

Normality is a Process. No one is instantly normal, we undergo certain processes and undergo adjustment. Example, coping

Cultural Relativism

-the view that there are no universal standards or rules for labeling a behavior as abnormal -behaviors can only be abnormal relative to cultural norms

1. Culture and gender can affect ways how people express their symptoms. 2. Culture and gender can influence peoples willingness to admit certain types of behavior. 3. Culture and gender can influence the types of treatments deemed acceptable or helpful for maladaptive behaviors

Unusualness- Behaviors that are deviant, or unusual, are considered abnormal Distress-behaviors should be considered abnormal only if the individual suffers distress and wishes

to be rid of the behaviors

Mental Illness -Behaviors are not abnormal unless a part of a mental illness.

The Four Ds of Abnormality Dysfunction

Distress

Deviance

Dangerousness

II. Recognizing Psychopathology

Typical Signs and Symptoms of Psychopathology

Sadock, B.J., & Sadock, V.A. (2007). Kaplan & Sadocks Synopsis of Psychiatry (10th ed.) Philadelphia, USA: Lippincott Williams & Wilkins

Sign- Objective; Based from a clinicians observation Symptom- Subjective; Experiences of the patient

SYNDROME- constellation of signs and symptoms that make up a recognizable condition, is often

used to show the overlap of the two

DISTURBANCES OF CONSCIOUSNESS

Consciousness- state of awareness

Apperception -perception modified by ones own thoughts and emotions Sensorium- sometimes used as another term for consciousness; refers to the state of functioning

of the special senses

Disorientation

disturbed orientation regarding time, place, or person.

Delirium

patient exhibits confusion, restlessness, bewilderment, and a disoriented reaction

that is usually associated with hallucinations and fear.

Clouding of consciousness

a state of perceptual and cognitive confusion.



ABNORMAL PSYCHOLOGY

Stupor

a general condition wherein the patient exhibits extreme unresponsiveness and loss

of orientation to the environment.

Twilight state

a disturbance in consciousness, with hallucinations.

Dreamlike state

another term for psychomotor epilepsy or complex partial seizure.

Distractibility

the inability to concentrate or focus attention because patient is easily drawn to

irrelevant external stimuli. Selective attention

blocking out of anxiety-causing stimuli.

Hyper vigilance

excessive focus and attention is given to all internal and external stimuli due to

paranoia.

DISTURBANCES OF SUGGESTIBILITY

Suggestibility - uncritical and compliant response to influence or an idea.

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.

Hypnosis

artificially induced consciousness characterized by heightened suggestibility

DISTURBANCES IN EMOTION

Emotion

a complex feeling or state related to mood and affect with psychic, somatic, and

behavioral components.

Affect

the expression or outward manifestation of emotion

Appropriate affect

a normal condition wherein emotional tone is in harmony or is consistent with the

accompanying thought, idea, or speech. It is also described as broad or full affect wherein

a full range of emotions is appropriately expressed.

Inappropriate affect

inconsistency between the emotional tone and the idea, thought, or speech accompanying

it.

Blunted affect

characterized by a severe reduction in the intensity of the externalized feeling tone.

Restricted or constricted affect

reduction in the intensity of feeling tone

It is less severe than blunted affect.

Flat affect

the absence or near absence of any signs of affective expression.

It can be characterized by an immobile face and a monotonous voice.

Labile affect

rapid and abrupt changes in the emotional feeling tone which is unrelated to an

external stimuli



ABNORMAL PSYCHOLOGY

Euphoria

intense elation with feelings of grandeur.

Ecstasy

feeling of intense rapture or delight.

Depression

the psychopathological feeling of sadness.

Anhedonia

loss of interest and withdrawal from all regular and pleasurable activities. Often

associated with depression. Grief or Mourning

sadness that is appropriate to a real loss.

Alexithymia

the inability or difficulty in describing ones moods or emotions.

Anhedonia

loss of interest and withdrawal from all regular and pleasurable activities. Often

associated with depression.

Grief or Mourning

sadness that is appropriate to a real loss.

Alexithymia

the inability or difficulty in describing ones moods or emotions.

Agitation

motor restlessness associated with severe anxiety.

Tension

unpleasant increased motor and psychological activity.

Panic

acute, episodic, intense anxiety attack associated with overwhelming feelings of

dread.

Apathy

dulled emotional tone associated with indifference or detachment

Ambivalence

presence of two opposing impulses toward the same thing, in the same person, at

the same time.

PHYSIOLOGICAL DISTRUBANCES ASSOCIATED WITH MOOD

Physiological disturbances associated with mood

Signs that refer to the somatic (usually autonomic) dysfunction of a person, which are

most often associated with depression; also known as vegetative signs.

Anorexia

loss of or decrease in appetite.

Hyperphagia

increase in appetite and food intake.

Hypersomnia

excessive sleeping.

Insomnia

difficulty or lack the lack of ability to fall asleep.

Initial

difficulty in falling asleep. (early onset)

Middle



ABNORMAL PSYCHOLOGY

difficulty in sleeping through the night without waking up; difficulty in going back to

sleep if awaken in the middle of the night. (middle onset)

Terminal

early morning awakening. (late onset)

Diurnal variation

mood is regularly worst in morning, immediately after awakening, and improves as

the day progresses.

Diminished libido decreased sexual interest, drive, and performance.

Increased libido is usually associated with manic states.

Constipation

inability or difficulty in defecating

DISTURBANCES IN MOTOR FUNCTIONING

Echopraxia

the persons pathological imitation of movements of another person. Catatonia

motor anomalies in non-organic disorders (as opposed to disturbances of

consciousness and motor activity secondary to organic pathology)

Negativism

motiveless resistance to all instructions or to all attempts to be moved.

Catalepsy

general term used to describe an immobile position that is constantly maintained.

Catatonic Excitement

agitated, purposeless motor activity that is uninfluenced by external stimuli.

Catatonic Stupor

noticeable slowed motor activity, often to a point of immobility and seeming

unawareness of surroundings.

Catatonic Rigidity

voluntary assumption of a rigid posture, held against all efforts to be moved.

Catatonic Posturing voluntary assumption of an inappropriate or bizarre posture which is generally

maintained for long periods of time.

Cerea Flexibilitas (Waxy Flexibility)

a condition wherein the person can be molded into a position that is then

maintained. When the examiner moves the persons limb, the limb feels as if it were made of wax.

Cataplexy

temporary muscle weakness and loss of muscle tone precipitated by a variety of

emotional states.

Stereotypy

repetitive fixed pattern of physical action or speech.

Mannerism

deep-seated/ingrained and habitual involuntary movement.



ABNORMAL PSYCHOLOGY

Automatism

automatic performance of an act or acts generally representative of unconscious

symbolic activity.

Command Automatism

automatic following of suggestions. (automatic obedience)

Mutism

voicelessness that is not caused by structural abnormalities or physical conditions.

Overactivity

abnormality in motor behavior that can manifest itself as psychomotor agitation, hyperactivity, tic, sleepwalking, or compulsions

Psychomotor Agitation

excessive motor and cognitive overactivity, usually nonproductive and in response to inner

tension.

Hyperactivity (Hyperkinesis)

restless, aggressive, and destructive activity, often associated with some underlying organic

pathology.

Tic

involuntary, spasmodic motor movement.

Sleepwalking (Somnambulism)

motor activity during sleep.

Akathisia

subjective feeling of muscular tension secondary to antipsychotic or other medication,

which can cause restlessness, pacing, repeated sitting and standing; can be mistaken for

psychotic agitation.

Compulsion

uncontrollable impulse to perform an act repetitively

Dipsomania compulsion to drink alcohol.

Kleptomania compulsion to steal.

Nymphomania excessive and compulsive need for coitus in a woman.

Satyriasis excessive and compulsive need for coitus in a man. Trichotillomania compulsion to pull out ones hair.

Ritual automatic activity compulsive in nature, anxiety-reducing in origin.

Hypoactivity (Hypokinesis)

decreased motor and cognitive activity, as in psychomotor retardation; visible

slowing of thought, speech and movements.

Mimicry

simple, imitative motor activity of childhood.

Aggression

forceful goal-directed action that may be verbal or physical; the motor counterpart

of the affect of rage, anger, or hostility.

Acting out

direct expression of an unconscious wish or impulse in action; unconscious fantasy is

lived out impulsively in behavior.

DISTURBANCES IN THINKING

Thinking

the goal-directed flow of ideas.



ABNORMAL PSYCHOLOGY

Symbols and associations initiated by problem or task and leading toward a reality-

oriented conclusion.

GENERAL DISTURBANCES IN THE FORM OF THINKING

Mental disorder

clinically significant behavioral or psychological syndrome that is associated with

distress or disability, and not just an expected response to a particular event.

Psychosis

inability to distinguish reality from fantasy. Impairment in reality testing, with creation of a new reality.

Reality testing

the objective evaluation and judgment of the world outside the self.

Formal though disorder

disturbance in the form of thought instead of the content of thought.

Thinking is characterized by loosened associations, neologisms, and illogical

constructs.

Thought process is disordered and the person defined psychotic.

Illogical thinking

thinking containing erroneous conclusions or internal contradictions. It is considered

psychopathological only when it is marked and when not caused by cultural values or

intellectual deficit.

Dereism

mental activity not concordant with logic experience.

SPECIFIC DISTURBANCES IN THE FORM OF THOUGHT

Autistic Thinking

thinking that gratifies unfulfilled desires but has no regard for reality

a preoccupation phase in children in which thoughts, words, or actions assume

power.

Magical thinking

a form of dereistic thought; thinking similar to that of the preoperational phase in

children (Jean Piaget), in which thoughts, words, or actions assume power (e.g., to

cause or to prevent events). Primary process thinking

general term for thinking that is dereistic

illogical and magical

normally found in dreams, abnormally in psychotics.

GENERAL DISTURBANCES IN THE FORM OR PROCESS OF THINKING

Neologism new word or phrase whose derivation cannot be understood often seen in schizophrenia it has also been used to mean a word that has been incorrectly constructed but

whose origins are nonetheless understandable (e.g., headshoe to mean hat), but

such constructions are more properly referred to as word approximations.

Word Salad

incoherent, essentially incomprehensible, mixture of words and phrases commonly

seen in far-advanced cases of schizophrenia (See also incoherence.).

Circumstantiality



ABNORMAL PSYCHOLOGY

disturbance in the associative thought and speech processes in which a patient

digresses into unnecessary details and inappropriate thoughts before communicating

the central idea

observed in schizophrenia, obsessional disturbances, and certain cases of dementia.

Tangentiality

oblique, digressive, or even irrelevant manner of speech in which the central idea is

not communicated.

Incoherence

thought that, generally is not understandable

patient never gets from desired point to desired goal. Perseveration

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.

Seen in cognitive disorders, schizophrenia, and other mental illness.

Verbigeration

meaningless and stereotyped repetition of words or phrases, as seen in

schizophrenia

also called cataphasia.

Echolalia

a persons psychopathological repeating of words or phrases of by another tends to be repetitive and persistent

Seen in certain kinds of schizophrenia, particularly the catatonic types.

Condensation

mental process in which one symbol stands for a number of components.

Irrelevant answer

answer that is not in harmony with question asked.

Loosening of associations

characteristic schizophrenic thinking or speech disturbance involving a disorder in

the logical progression of thoughts

manifested as a failure to communicate verbally adequately

unrelated and unconnected ideas shift from one subject to another.

Derailment

gradual or sudden deviation in train of thought without blocking

sometimes used synonymously with loosening of association.

Flight of ideas

rapid succession of fragmentary thoughts or speech in which content changes

abruptly and speech may be incoherent.

Clang association

association or speech directed by the sound of a word rather than by its meaning

words have no logical connection

punning and rhyming may dominate the verbal behavior.

Seen most frequently in schizophrenia or mania.

Blocking

abrupt interaction in train of thinking before a thought or idea is finished after brief

pause, person indicates no recall of what was being said or was going to be said.

Glossolalia

unintelligible jargon that has meaning to the speaker but not to the listener

occurs in schizophrenia.

Poverty of content thought that gives little information because of vagueness, empty repetitions, or

obscure phrases.

Overvalued idea



ABNORMAL PSYCHOLOGY

false or unreasonable belief or idea that is sustained beyond the bounds of

reason; it is held with less intensity or duration than a delusion, but is usually

associated with mental illness.

Delusion false belief, based on incorrect inference about external reality, not consistent

with patients intelligence and cultural background that cannot be corrected by reasoning

SPECIFIC DISTURBANCES IN THE CONTENT OF THOUGHT

Bizarre delusion

false belief that is patently absurd or fantastic (e.g., invaders from space have

implanted electrodes in a person's brain), common in schizophrenia.

Systematized delusion

group of elaborate delusions related to a single event or theme.

Mood-congruent delusion

delusion with content that is mood appropriate (e.g., depressed patients who believe

that they are responsible for the destruction of the world).

Mood-incongruent delusion

delusion with content that has no association to mood or is mood-neutral. Nihilistic delusion

depressive delusion that the world and everything related to it have ceased to exist.

Delusion of poverty

false belief that one is bereft or will be deprived of all material possessions

Somatic Delusion

delusion pertaining to the functioning of one's body.

Paranoid delusions

includes persecutory delusions and delusions of reference, control, and grandeur

Delusion of persecution Delusion of grandeur Delusion of reference

Delusion of self-accusation

false feeling of remorse and guilt. Seen in depression with psychotic features.

Delusion of control

false belief that a person's will, thoughts, or feelings are being controlled by external

forces.

Thought withdrawal

Thought insertion

Thought broadcasting

Delusion of infidelity

false belief that one's lover is unfaithful. Sometimes called pathological jealousy.

Erotomania delusional belief, more common in women than in men, that someone is deeply in

love with them (also known as de Clrembault syndrome).

Pseudologia fantastica

a type of lying, in which the person appears to believe in the reality of his or her

fantasies and acts on them.

Preoccupation of thought

centering of thought content on a particular idea, associated with a strong affective

tone, such as a paranoid trend or a suicidal or homicidal preoccupation.

Egomania

morbid self-preoccupation or self-centeredness.

Monomania



ABNORMAL PSYCHOLOGY

mental state characterized by preoccupation with one subject.

Hypochondria

exaggerated concern about health that is based not on real medical pathology, but

on unrealistic interpretations of physical signs or sensations as abnormal.

Obsession

persistent and recurrent idea, thought, or impulse that cannot be eliminated from

consciousness by logic or reasoning

obsessions are involuntary and ego-dystonic.

Compulsion

pathological need to act on 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 itself other than to prevent something from occurring in

the future.

Coprolalia

involuntary use of vulgar or obscene language. Observed in some cases of

schizophrenia and in Tourette's syndrome.

Phobia

persistent, pathological, unrealistic, intense fear of an object or situation

the phobic person may realize that the fear is irrational but, nonetheless, cannot

dispel it.

Simple phobia Social phobia Acrophobia Algophobia Claustrophobia Xenophobia Zoophobia

Noesis

a revelation in which immense illumination occurs in association with a sense that

one has been chosen to lead and command.

Unio mystica

feeling of mystic unity with an infinite power.

DISTURBANCE IN SPEECH

Speech

ideas, thoughts, feelings as expressed through language; communication through the

use of words and language.

Pressure of Speech

rapid speech that is increased in amount difficult to interpret.

Volubility (logorrhea)

copious, coherent, logical speech

excessive talking observed in manic episodes of bipolar disorder.

(also known as tachylogia, verbomania)

Poverty of Speech

restriction in the amount of speech used; replies may be mono-syllabic.

Dysarthria

difficulty in articulation, not in word finding or in grammar.

Excessively loud or soft speech loss of modulation of normal speech volume



ABNORMAL PSYCHOLOGY

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.

Cluttering

erratic and dysrhythmic speech, consisting of rapid and jerky spurts.

APHASIC DISTURBANCES

Dysarthria

difficulty 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.

Cluttering

erratic and dysrhythmic speech, consisting of rapid and jerky spurts.

Syntactical Aphasia inability to arrange words in proper sequence.

Jargon Aphasia words produced are totally neologistic nonsense words repeated with various intonations and inflections.

Global Aphasia combination of a grossly non-fluent aphasia and a severe fluent aphasia.

DISTURBANCES OF PERCEPTION

Perception

process of transferring physical stimulation into psychological information; the mental

process by which sensory stimuli are brought into awareness.

Illusion

misperception or misinterpretation of real external sensory stimuli.

Hallucination

false sensory perception not associated with real external stimuli

there may or may not be a delusional interpretation of the hallucinatory experience

hallucinations indicate a psychotic disturbance only when associated with impairment in reality testing

Hypnagogic Hallucination

false sensory perception occurring while falling asleep; generally considered a non-

pathological phenomenon.

Hypnopompic Hallucination

false perception occurring while awakening from sleep

generally considered non-pathological.

Auditory Hallucination

false perception of sound, usually voices but also other noises such as music; most

common hallucination in psychiatric disorders.

Visual Hallucination



ABNORMAL PSYCHOLOGY

false perception involving sight consisting of both formed images(e.g. people) and

unformed images (e.g. flashes of light)

most common in organically determined disorders.

Olfactory Hallucination

false perception in smell

most common in organic disorders.

Gustatory Hallucination

false perception of taste, such as unpleasant taste caused by an uncinate seizure

most common in organic disorders.

Tactile (Haptic) Hallucination false perception of touch or surface sensation, as from an amputated limb (phantom

limb), crawling sensation on or under the skin (formication).

Somatic Hallucination

false sensation of things occurring in or to the body, most often visceral in origin

(also known as cenesthetsic hallucination).

Lilliputian Hallucination

false perception in which objects are seen as reduced in size (also termed

micropsia).

Mood-congruent Hallucination

a kind of hallucination wherein the content of which is consistent with either a

depressed or manic mood (e.g. a depressed patient hears voices saying that the

patient is a bad person

a manic patient hears voices saying that the patient is inflated of worth, power,

knowledge, etc.)

Mood-incongruent Hallucination

Hallucination whose content is not consistent with either depressed or manic mood

(e.g. in depression, hallucinations not involving such themes as guilt, deserved

punishment, or inadequacy

in mania, hallucinations not involving such themes as inflated worth or power)

Hallucinosis

Hallucinations, most often auditory, that are associated with chronic alcohol abuse

and that occur within a clear sensorium.

Trailing Phenomenon

perceptual abnormality associated with hallucinogenic drugs in which moving object

are seen as a series of discrete and discontinuous stages.

DISTURBANCES ASSOCIATED WITH ORGANIC MENTAL DISORDER

Anosognosia

inability to recognize illness as occurring to oneself.

Autotopagnosia

inability to recognize a body part as ones own. Visual Agnosia

inability to recognize objects or persons.

Astereognosia

inability to recognize objects by touch.

Prosopagnosia

inability to recognize faces.



ABNORMAL PSYCHOLOGY

Apraxia

inability to carry out specific tasks.

DISTURBANCES ASSOCIATED WITH CONVERSION AND ASSOCIATIVE

DISSOCIATION

Astereognosia

-inability to recognize objects by touch.

Prosopagnosia- inability to recognize faces.

Apraxia- inability to carry out specific tasks.

Somatization of repressed material or the development of physical symptoms and

distortions involving the voluntary muscle or special sense organs

not under voluntary control and not explained by any physical disorder

DISTURBANCES ASSOCIATED WITH CONVERSION AND DISSOCIATIVE PHENOMENA

Hysterical Anesthesia

loss of sensory modalities resulting from emotional conflicts.

Macropsia

state in which objects seem larger than they are.

Micropsia

state in which objects seem smaller than they are (both macropsia and micropsia can

also be associated with clear organic conditions such as complex partial seizures).

Depersonalization

a subjective sense of being unreal, strange, or unfamiliar to oneself.

Derealization

a subjective sense that the environment is strange or unreal

a feeling of changed reality.

Fugue

taking on a new identity with amnesia for the old identity

often involves travel or wandering to new environments.

Multiple personality

one person who appears at different times to be in possession of an entirely

different personality and character.

DISTURBANCES OF MEMORY

Memory

function by which information stored in the brain is later recalled to consciousness

Amnesia

partial or total inability to recall past experiences; may be organic or emotional in origin.

Paramnesia

falsification of memory by distortion of recall.

Fausse reconnaissance

false recognition.

Retrospective falsification



ABNORMAL PSYCHOLOGY

memory becomes unintentionally (unconsciously) distorted by being filtered through

patients present emotional, cognitive, and experiential state.

Confabulation

unconscious filling of gaps in memory by imagined or untrue experiences that patient

believes but that have no basis in fact; most often associated with organic pathology.

Dj vu

illusion of visual recognition in which a new situation is correctly regarded as a

repetition of a previous memory.

Dj entendu

illusion of auditory recognition.

Dj pense

illusion that a new thought is recognized as a thought previously felt or expressed.

Jamias vu

false feeling of unfamiliarity with a real situation one has experienced.

False memory

a persons recollection and belief by the patient of an event that did not actually occur.

Hypermnesia

exaggerated degree of retention and recall.

Eidetic image

visual memory of almost hallucinatory vividness.

Screen memory

a consciously tolerable memory covering for a painful memory.

Repression

a defense mechanism characterized by unconscious forgetting of unacceptable ideas

or impulses.

Lethologica

temporary inability to remember a name or a proper noun.

Blackout amnesia experienced by alcoholics about behavior during drinking bouts

usually indicates that reversible brain damage has occurred.

LEVELS OF MEMORY

Immediate

reproduction or recall of perceived material within seconds to minutes.

Recent

recall of events over past few days.

Recent past

recall of events over past few months.

Remote

recall of events in distant past.



ABNORMAL PSYCHOLOGY

DISTURBANCES OF INTELLIGENCE

Intelligence

the ability to understand, recall, mobilized, and constructively integrates previous

learning in meeting new situations.

Mental Retardation

Lack of intelligence to a degree in which there is interference with social and

vocational performance

Mild

I.Q. of 50 or 55 to approximately 70

Moderate

I.Q. of 35 or 40 to 50 or 55

Severe

I.Q. of 20 or 25 to 35 or 40

Profound

I.Q. below 20 or 25

Dementia

organic and global deterioration of intellectual functioning without clouding of

consciousness

Pseudodementia

clinical features resembling a dementia not caused by an organic mental dysfunction

most often caused by depression.

Concrete thinking

literal thinking

limited use of metaphor without understanding of nuances of meaning

one dimensional thought.

Abstract thinking

ability to appreciate nuances of meaning

multidimensional thinking with ability to use metaphors and hypotheses

appropriately.

AbPsy Handout

Documents

Transcript of AbPsy Handout