Description and categorization of abnormal experiences as reported by the patient and observed from his behaviour is known as:
B. Psychopathology is the systematic study of abnormal experience, cognition, and behaviour. It consists of two major divisions:
A 55-year-old man with chronic schizophrenia resists any passive limb movements attempted during a neurological examination, in spite of being asked not to do so.
Which of the following symptom is he exhibiting?
B. This patient is exhibiting a catatonic symptom called negativism. Patients with negativism resist or oppose all passive movements attempted by the examiner. A mild form of such resistance is called Gegenhalten or opposition. In extreme forms it is called negativism, where apparently motiveless resistance to all interference is found. Negativism can be a frustrating symptom, especially for carers involved in offering nursing assistance to the patient. The catatonic symptom of blocking or obstruction (or Sperrung) refers to a phenomenon similar to thought blocking but occurs while carrying out motor acts. A patient with obstruction suddenly stops a motor act for no reason, without any warning. This may be demonstrated by asking the patient to move a part of his body; the movement is generally well begun, but then stops halfway without any indication. In ambitendency the patient makes a series of tentative, opposing, alternate movements that do not reach the intended goal. This becomes evident when the patient is asked to carry out a motor act, for example asking the patient to show his tongue will elicit repeated protrusion and retraction of tongue as if the patient is undecided about showing his tongue.
According to Jaspers, the most important component of psychiatric assessment is:
A. While humour may facilitate the process of clinical interview on certain occasions, it is not a necessary component of descriptive psychopathology. There are two essential components of descriptive psychopathology:
The latter was referred to by Jaspers as phenomenology and implies that the patient is able to introspect and describe his internal experiences and the doctor recognizes and understands the description. To describe a phenomenon, it is important to appreciate the phenomenon from the beholder’s point of view. This attempt to ‘feel like how your patient might feel’ is very different from feeling sorry or pity for your patient. The former is called empathy while the latter is called sympathy. Empathy is an essential component to learn further about the pathological processes taking place in a patient.
The concept of symptoms assessed by descriptive psychopathology has both form and content as its components.
Which of the following, with regard to this statement, is true?
D. The patient usually presents with loss or impairment of functions, the reasons for which will reveal the contents of the patient’s thoughts and feelings. Form is the technical term (e.g. phobia, obsession, or delusion) used to identify a recurring pattern of experience or behaviour and so helps in diagnosing the psychiatric disorder. Content is essential for decisions about the management of the patient and family (suicidal content, admission, etc.), and is an important aspect of the severity of the disorder. A symptom described using descriptive psychopathology has both form and content as equally important components. The same content can occur in different forms, for example the content ‘I’m too fat’ can occur as an obsession, delusion, overvalued idea, or even hallucination.
A patient is experiencing increased brightness and acuity of visual objects. Intense perceptions occur in all of the following EXCEPT:
E. Stimulus may be perceived as corresponding object but not as accurate as the real object. This is a perceptual error (sensory distortion), and can be associated with changes in physical properties, for example size, shape, intensity, and colour. In depression and hypoactive delirium there is dulled perception. Intense perceptions can occur in mania, hyperactive delirium, and drug-induced states (hallucinogens). Hyperacusis is especially seen in migraine and alcohol hangover.
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