Psychopathology

Henok A.K.
Mental Heath Professional Specialist
Department of Psychiatry, WKU

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 Objectives of the session
 Understand the concept of
psychopathology
 Describe signs and symptoms of mental
illness

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MEANING OF THE PSYCHOPATHOLOGY
Greek word:
psyche /soul or mind/
 Pathos /suffering or disease/
Logos /science or study /.

•Psychopathology:- is referred as study of

abnormal state of mind.

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General points

Signs: are objective findings observed by the

clinicians.
Example- constricted affect, and
psychomotor agitation or retardation.

Symptoms: are subjective experiences

described by the patient.
Example- depressed mood and decreased
energy

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 Syndrome: is a group of signs and
symptoms that occur together to
make up a recognizable condition

Eg. Schizophrenia

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Major groups of symptoms

1. Disturbance of perception
2. Disorder of thought
3. Disorder of Speech
4. Disturbance of affect/mood(Emotion)
5. Disturbance of motor behavior
6. Disturbance of consciousness

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 1.DISTURBANCE OF
PERCEPTION
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 Perception: the process of interpreting
sensory information to form a mental
representation of the world. It involves both the
physical sensation of stimuli and the cognitive
interpretation of those sensations.
 Occurs in all of our sensory domains

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Example:
 Locating a sound source
 Feeling temperature
 Recognizing objects by touch

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Disturbance of perception cont.

 Illusion
 Hallucination
 Depersonalization
 Derealization
 Dejavu,Jamais vu

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 Disturbance of perception cont.

 Illusion
 Misperception or misinterpretation of real
external sensory stimuli.

 can occur in normal persons and not

considered as a psychopathology

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 E.g. the normal person walking along a
dark lonely lane(narrow road) is mildly
frightened and cannot see clearly.

He is therefore likely to misinterpret,

harmlles shadows as threatening people.

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 Completion illusions
 our brain's tendency to perceive
patterns and complete incomplete
information.

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The Kanizsa triangle

 a white triangle appears to

exist, even though there are
no continuous lines forming
it.
 Our brain fills in the missing
information, creating a
perceived shape that isn't
physically present.
 This demonstrates our
brain's tendency to interpret
incomplete information and
perceive meaningful
patterns.

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Affective illusion
Arise in the context of particular mood state
Bereaved persons momentarily believe they see
the deceased person

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Hallucinations: False sensory perception
not associated with real external stimuli;

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True hallucinations
 Heard as if the come from outside the
head
Pseudo-hallucinations
 heard inwardly (inside the head, have
insight)
 may not indicate significant
psychopathology
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 Causes of hallucinations
 Intense emotions/Psychiatric disorder
– depression, schizophrenia
 Migraine, epilepsy, delirium –organic d/r
 Disorders of peripheral sense organs –
ears or eyes
 Sensory deprivation - deafness
 Disorders of the CNS – diencephalon &
cortical lesions

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 Hallucinations vary according to
 Sensory modality
 Degree of complexity of the hallucinated experience
 The level of conviction about their reality
 The clarity of their contents
 The location of their sources of origin
 The degree to which the hallucination influences the
person’s behavior

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Types of hallucination
1.Hearing/auditory hallucinations
 May be elementary & unformed
 simple noises, bells, undifferentiated whisper or voices
 can occur in organic states

 Delirium
 Complex partial seizures
 Toxic and metabolic hallucinations
 Well formed voices are characteristics of schizophrenia

May be commanding, commenting, arguing, abusive,

neutral or even helpful in tone
 Some pts are not troubled by them; others try to reply to them
or preoccupied with them & cannot function properly
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 Auditory hallucination is classically associated with
schizophrenia (60 - 90% of patients)
The are also seen in mood disorders
 20 % of manic patients
 10 % of depressed patients
 The type of auditory hallucinations commonly seen in
schizophrenia (which, however, are seen less commonly
in patients with major depression and mania)
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 Audible thoughts described as one hears one’s own
thought
 Voices running commentary on the patient’s actions
 Hearing two or more voices arguing with each other
often about patient, who is referred to in the third
person

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In command hallucinations voices command patients to do
things

Often the commands are benign reminders of the daily

task: “pick up your shoes” or “Clean off the table”

Commands may be frightening or dangerous

commanding acts of violent toward the self or others

such as “Jump off the roof, you are not worth anything.” or
Pick up the knife and kill your mother.” may be examples of
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them
These command voices vary in insistence or persistence,

and patients vary in their capacity to ignore these commands

Patients with marked passivity may be helpless in the face of

command hallucinations and may feel impelled to carry out the

orders

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Auditory hallucinations are mood neutral in schizophrenia

The auditory hallucinations in mood disorders are, however,

characteristically consistent with the prevailing moods of patients

In psychotically depressed patients auditory hallucinatory voices

may be unbearably critical and sadistic

To the contrary in mania, the voices often refer to the patient’s

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 Mood congruent hallucination

 Hallucination in which the content is consistent with either depressed

or manic mood. Example, a depressed patient hears voices saying
that the patient is a bad person; a manic patient hears voices saying
that the patient is of inflated worth, power, and knowledge)

 Mood incongruent hallucination

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 Mood-incongruent hallucination: hallucination in
which the content is not consistent with either depression
or manic mood –

-example, 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
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2. Visual hallucination
 May be unformed/elementary- flashes of light,
geometric patterns
 Completely organized - people, objects, animals
 More common in acute organic states with
clouding of consciousness than functional
psychosis
 Lilliputian hallucination – see tiny/reduced size
people or objects
 Common in:
 Delirium tremens
 TLE

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Visual hallucinations

Visual hallucinations occur in wide variety of neurological and

psychiatric disorders, including
 Toxic disturbances
 Drug withdrawal syndromes
 Focal CNS lesions
 Migraine headaches

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  schizophrenia, and
 Psychotic mood disorders

Although visual hallucinations are generally assumed

to characteristically assumed to reflect organic
disorders, they are seen in one-fourth to one-half of
patients with schizophrenia, often but not always – in
conjunction with auditory hallucinations
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 Visual hallucinations may be simple and elemental, in which
hallucinations consist of
 flashes of light or
 geometrical figures, or
 elaborate visions such angels

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 In certain religious subcultures visual hallucinations
may be experienced as normal

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 In Lilliputian hallucinations an individual sees
figures in very reduced size, such as dwarfs
 They may be related to perceptual distortions of
macropsia and micropsia respectively, the
perception of objects as much bigger or smaller
than they actually are
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3.Smell(olfactory) hallucination
 Can occur in schizophrenia & organic
states, uncommonly in depressive
psychosis
 Foul body odor (Delusion vs. hallucination) -
emit smell, smell of poison
 As aura of TLE
4.Taste(gustatory)hallucination
 Occur in schizophrenia & acute organic
states

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5.Touch(tactile) hallucination
 Feeling of cold wind blowing on the body,
sensation of heat, electrical shocks & sexual
sensations
 The bugs crawling over the one’s skin (formication) are
common in alcohol withdrawal syndromes and in
cocaine intoxication
 Classified as
 superficial,
 kinaesthetic
 visceral
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Superficial
 Affects the skin; 4 types:
1)Thermic – cold/hot
2)Haptic – hand brushing against skin
3)Hygric – fluid flowing from head to
stomach
4)Paraesthetic – pins & needles

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Kinaesthetic
 Affect the muscles & joints
 limbs are twisted, pulled or moved

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Visceral hallucinations(Pain & deep
sensation arising from internal
organs)
 Explain as twisting & tearing pains
 Schizophrenia patient may report
cutting sensation in bone marrow

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 6.Hypnagogic & hypnopompic hallucination
***occur in narcolepsy or normal people
…not indicative of any psychopathology
40

hynagogic hypnopompic
 When falling asleep  When waking up
 Occur during  Persistent from sleep
drossiness while eyes are open
 Are 3x common than  Better indicative of
hypnompic(37%) narcolepsy
 Hearing one’s name  hearing the telephone
called ring even though it
has not

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Disturbance of perception cont.
Assessing Hallucinations

 Have you heard noises, or sounds, or voices

that other people didn’t hear?
If Yes: What did You hear?

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Disturbance of perception, assessing
Hallucination cont.

 Do the voices seem to come from inside

or outside your head?

 Are they male or Female?

 Do you recognize them?

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Disturbance of perception,
assessing Hallucination cont.
 Do You ever hear two or more voices
talking to each other?

 Do the voices ever talk about what you are

doing or thinking?

 How long ago did the voices start?

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Disturbance of perception,
assessing Hallucination cont.
 Do you hear them every day?

 How often during the day do you hear

them?

 Do they influence your behavior?

 Do they tell you to do things?

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Disturbance of perception,
assessing Hallucination cont.
 Do you ever notice strange sensations in
your body or on your skin?

 Do you ever feel something creeping or

crawling on your body, or something push
or punch you but no one is there?

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Disturbance of perception,
assessing Hallucination cont.

 Have you seen visions or other things that

other people didn’t see?

 What about smells that other people don’t

notice, or strange tastes in your mouth?

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Disturbance of perception cont.
 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

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Disturbance of perception cont.
 Jamaias vu: The feeling of unfamiliarity
with familiar situations

 Déjà vu: The feeling that one has already

experienced a particular moment
(The feeling that an experience, occurring for the first time, has been
experienced before .)

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 2. DISTURBANCE OF
THOUGHT
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 Thinking is the capacity to understand,
process and interpret information and
understanding of a person to himself or
others.

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 Classification of Disorders of
Thinking

 Disturbance of thought form

 Disturbance of thought content

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Disturbance of thought form
 Thought form is how the thoughts are
formulated, organized, and expressed.
 Circumstantiality
 Tangentially
 Perseveration
 Clang association
 Neologism
 Thought blocking, loosening of association
 Flight of ideas, word salad
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Disturbance of thought form
cont.
Circumstantiality :Over inclusion of unnecessary
details in speech. Goal of thinking is not
completely lost(delayed in reaching the point but
eventually gets from original point to desired goal

Tangentiality:
Patient always seems to get near to the matter in
hand but never reaches it.
Goal of thinking is lost

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Disturbance of thought form cont.
 Perseveration: persisting response to a
prior stimulus after a new stimulus has
been presented (persistence repetition
of a word, phrase, or gesture despite
stopping of the stimulus),
 Commonly seen in organic brain
lesions
 verbigeration: meaningless repetition
of specific words or phrases(repeat words
with out prior stimulus)
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Disturbance of thought form cont
 Echolalia: repeating of words or phrases
of one person by another, tends to be
repetitive and persistent.

 Clang association: association of

words similar in sound but not in meaning;
words have no logical connection.

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Disturbance of thought form cont


Neologism: new word created by the
patient


Word salad: incoherent/meaningless
mixture of words and phrases

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Disturbance of thought form cont.
 Incoherence: thought that, generally,
is not understandable

 running together of thoughts or words

with no logical or grammatical
connection, resulting in disorganization .

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Disturbance of thought form cont.
 Loosening of
association/drailment: flow of thought
in which ideas shift from one subject to
another in a completely unrelated way;

• when severe, speech may be incoherent.

 classically a hallmark feature of

schizophrenia
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Disturbance of thought form cont
 Flights of ideas: rapid, continuous
verbalizations or plays on words
 constant shifting from one idea to another,
the ideas tend to be connected, and in
the less severe from a listener may to
follow them.
 found in:
 Mania,
 Hypomania (ordered FOIs/prolixity),
 Schizophrenia (occasionally),
 Lesions of the hypothalamus
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 Inhibition or slowing of thinking (thought
retardation)
The train of thought is slowed down & the number
of ideas & mental images is decreased
 ↓decision-making, concentration/attn, clarity
of thinking
 May lead to a mistaken dx of dementia
 Seen in: depression, manic stupor

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Thought blocking
 A sudden arrest of the train of
thought, leaving a ‘blank’
 An entirely new thought may then
begin
 Seen in: schizophrenia, Exhausted &
anxious pts

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Disorders of thought
content

 Thought content is essentially

what thoughts are occurring to the
patient

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 Disturbance of thought
Content cont.
1. Obsession/rumination
 a thought that persists & dominates a pt’s
thinking despite their awareness that the thought
is either entirely w/o purpose or else has
persisted & dominated their thinking beyond the
point of relevance or usefulness
 Cause the sufferer great anxiety & even guilt
 E.g. a religious person obsessed by
blasphemous thoughts

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2. Compulsions
Compulsions are merely obsessional
motor acts
 E.g. obsessional fear of contamination leading
to compulsive washing
 Contrast thinking – pt is compelled to think
the opposite of what is said
found in:
 OCD, depression, schizophrenia, organic states
Compulsions are common in post-
encephalitic parkinsonism
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Disturbance of thought Content
cont.

3. Overvalued idea – a thought that

takes precedence/dominate over all
other ideas for a long period of time
 less fixed, some degree of basis in reality

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Disturbance of Thought Content
cont.

4.Delusion
 False belief/fixed belief
 Incorrigible - by reason, logic, or
proof
 Immense(huge) preoccupying
power
 Not shared by his cultural group

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Disturbance of thought Content
cont.
 Types of delusion
 Non-bizarre delusions
 Persecutory/paranoid,
 Delusion of reference ,
 Grandiose delusion,
 Somatic delusion,
 Delusion of love(erotomania),
 Delusion of jealousy

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Disturbance of thought content
cont.

Persecutory delusion:– most common

 Believe that being conspired against,
cheated, followed, poisoned/drugged,
harassed, etc

Is any body against you, following you,

giving you a hard time, or trying to hurt
you?

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Disturbance of thought
Content cont.

 If Yes: tell me about it

Do you feel like there’s a plot(plan) to

hurt you?
If yes: who is involved?
why would they want to hurt you?

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Disturbance of thought Content
cont.
 Delusion of reference: False belief
that ordinary, insignificant comments,
objects, or events refer to or have special
meaning for the patient..
(for example, belief that people on
television or radio are talking about
the patient).

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Disturbance of thought
Content cont.
 When watching TV, listening to the radio or
reading the paper do you notice that they
are referring to you?

 or that there are special messages

intended specifically for you?

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Disturbance of thought
Content cont.
 Does it seem like strangers on the street
are taking special notice of you or talking
about you?

 If yes is it a feeling you have, or are you

pretty sure that they are talking
about/referring to you?

 How do you know?

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Disturbance of thought Content
cont.
 Delusion of grandeur: patient may
believe himself to be a famous celebrity or
to have supernatural powers
 Claims special powers, talents, wealth,
ability, invention

Individual may Believe that he is

Christ
Patient may believe that he is investor
of ------
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Disturbance of thought
Content cont.
 Do you think you had special talents
abilities, or powers?

If yes: Like What?

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Disturbance of thought content
cont.

 Somatic Delusion: central theme of the

delusion involves bodily functions or
sensations
 conviction of having a disease, halitosis,
infestation, misshapenness
(for example, belief that one’s brain is
rotting or melting).

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Disturbance of thought
Content cont.
 Are you concerned that you have a serious
physical illness that a doctor hasn‘t found,

 or that something is wrong with your body?

If yes: what do you think is wrong?
Why do you think that?
Are you sure?

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Disturbance of thought content
cont.
 Delusion of infidelity (delusional
jealousy): false belief derived from
pathological jealousy that one’s lover is
unfaithful (central theme of the delusion is that
his/her spouse/lover is unfaithful)

 Erotomania/delusion of love:
delusional belief, more common in women than
in men, that someone is deeply in love with
them (a high status one/who has no r/ship
with her)
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Disturbance of thought
Content cont.
Delusions of guilt
 Belief of being worthless & only deserved
to die
 sinfulness

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Disturbance of thought Content
cont.
 Bizarre delusions :-Beliefs that something
that could never happen in real life
 Nihilistic delusion
 Thought alienation(The pt. has the
experience that their thoughts are under the
control of an outside agency or that others are
participating in their thinking)
 Thought insertion, thought withdrawal

 thought broadcasting, thought reading

 delusion of control – passivity phenomena

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Disturbance of thought content
cont.
 BIZZARE
 Nihilistic delusion: false belief that
self, others, or the world is nonexistent
or ending./the pt denies the existence of
their body, their mind, their loved ones &
the world around them eg. Lost one’s own
internal organ or non-exist
 In depression
 In schizophrenia
 In Delirium
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Disturbance of thought
Content cont.
 Thought insertion: delusion that
thoughts are being implanted in
one’s mind by other people or
forces

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Disturbance of thought
Content cont.

 Are there ever thoughts in your head that

have been put in there from the outside?

 If yes: Tell me about it.

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Disturbance of thought content
cont.
 Thought withdrawal: delusion that
one’s thought are being removed from
one’s mind by other people or forces

Does someone or some force reach into

your head and steal or remove your
thoughts? If yes; tell me about it.

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Disturbance of thought content
cont.
 Thought broadcasting: delusion that
one’s thoughts can be heard by others, as
though they were being broadcast into the
air.

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Disturbance of perception cont.
 Thought reading: delusional belief
that people can read one’s mind or know
one’s thought.

Are people able to read your mind and

know what you are thinking?

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Disturbance of perception cont.
 If Yes: How can they do this?
Can anyone do it ,or just some
people? Who?

Do they literally read your thoughts or

do they read your facial expression to know
what you are thinking?

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Disturbance of thought content
cont.

 Thought Control: delusional belief that

one’s actions, behavior, or feelings are not
under personal control or own doing, but are
imposed by an external force.

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Disturbance of thought
Content cont.
 Do you ever get the feeling that you’re
being controlled by some force or power
from the outside?

If Yes: What’s that like?

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Disturbance of thought
Content cont.
 At times, does it seem like you’re not in
control of your body, almost like you are a
puppet and something from the outside
pulls the strings?

 If I asked you to raise your hand or stand

up now would you be able to do it

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Disturbance of thought
Content cont.
 Systematized delusion: a false irrational belief that is
highly developed and organized, with multiple
elaborations that are coherent, consistent, and logically
related(group of delusion that are organized around a
common theme)
 Mood-congruent delusion: delusion with mood-
appropriate content (for example, a depressed patient
believes that he or she is responsible for the destruction
of the world).
 Mood-incongruent Delusion: delusion with content
that has no association to mood or is mood-neutral (for
example, a depressed patient has delusions of thought
control or thought broadcasting).

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10’ break

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 . disturbances of
emotion

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 Emotion is a complex feeling state with
psychic, somatic and behavior component
that is related to affect and mood

 Emotion has 2 parts

 Mood is the inside feeling of a person and is
relatively long lasting
 Affect is the outward and observed expression
of emotion and is mostly short lived

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Affect

Is the observed emotional state during

the evaluation
 Inferred from the patient's facial
expression
 The amount and the range of expressive
behavior
 May or may not be congruent with mood

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Affect
 Affect should be assessed in terms
of:-
 Stability (stable, fixed , labile)
 Range (constricted, full)
 Appropriateness (to the content of
speech and circumstances)
 Intensity (flat, blunted, exaggerated)
 Quality (depressed, sad, happy,
euphoric, irritable, anxious, neutral,
fearful, angry, apathetic, pleasant)
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Affect
 Appropriate affect
 Condition in which the emotional tone is
in harmony with the accompanying idea,
thought or speech

 It is also described as broad or full

affect in which a full range of emotions is
appropriately expressed

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Affect
 Inappropriate affect
 Disharmony between the emotional feeling
tone and the idea, thought or speech

 E.g. laughing when discussing the death of

a loved one

 Mostly seen in severe psychiatric disorder

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Affect
 Blunted affect
 Disturbance in affect manifested by severe
reduction in intensity of externalized feeling
tone
 Minimal expression in intensity of emotion
 The individual’s facial expression varies little
 There are few physical gestures of emotion
 Eye contact is either minimal or the patient
seems to stare at the interviewer
 The patient speaks in monotonous tone with
little vocal inflection
 The person’s face seems to have little muscle
tone

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Affect
 Restricted or constricted affect
 Reduction in intensity of feeling tone
 Less severe than blunted affect but
clearly reduced
 Limited range of expressed emotion
 Little variability of expression during the
interview

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Affect
 Flat affect
 Is more severe form of blunted affect
with essentially no affective expression
 The interviewer may feel as if he is
conversing with inanimate object
 If he is told that his mother died or if he
is told that he win lottery the response
will be the same
 No expression of sadness at the news of
the death of his mother
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Affect
 Labile affect
 Refer to abrupt, rapid and repeated
shifts of type and intensity of emotion
 Unrelated to external stimuli
 Individual’s emotional response is
exaggerated
 It is not proportionate to the expected
response
 There is emotional incontinence

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Mood
 Mood - a pervasive and sustained
emotion subjectively experienced and
reported by the patient
 Patient remarks voluntarily about
feelings OR
 By asking the patient how he or she
feels? Described as having:-
 E.g. depression, elation/cheerful,
anger/irritable, guilty etc..
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Mood
 Euthymic mood:- normal range of
mood, implying absence of depression
or elevated mood

 La belle indifference:- inappropriate

attitude of calm or lack of concern about
one’s disability

 Alexythymia:- a person’s inability to

describe or difficulty in describing or
being aware of emotions or mood
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Mood
 Irritable mood:- a state in which a person is
easily annoyed and provoked to anger

 Mood swings (labile mood):- oscillations

between euphoria and depression or anxiety

 Expansive mood:- a person’s expression of

feeling without restraint, frequently with an
overestimation of their significance or
importance

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Mood
 Elevated mood:- confidence and enjoyment, a
mood more cheerful than usual

 Euphoria:- intense elation with feeling of

grandeur

 Ecstasy:- Feeling of intense rapture (delight)

 Elation:- feeling of joy, euphoria, intense self-

satisfaction or optimism

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Mood
 Melancholia:- severe depressive state

 Anhedonia : loss of interest in, and withdrawal from all

regular and pleasurable activities, usually associated with
depression
 Grief or mourning : appropriate sadness to a real
loss, also called bereavement
 Depressed mood refers to unusual and persistent sadness or
unhappiness as in depressive illness or Dysphoric mood:- an
unpleasant mood
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Other Emotions
 Anxiety:- feeling of apprehension
caused by anticipation of danger,
which may be internal or external
 Fear:- anxiety caused by consciously
recognized and realistic danger
 Agitation:- severe anxiety associated
with motor restlessness
 Tension:- increased and unpleasant
motor and psychological activity
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 Apathy:- dulled emotional tone
associated with detachment or
indifference

 Shame :- failure to live up to self

expectations

 Guilt:- emotion secondary to doing

what is perceived as wrong
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Disorders of emotion cont..
 How is your mood?
 Have you been feeling sad, blue, down or
depressed?
 If yes for how long have you been feeling
depressed?
 Do you feel this way nearly every day?
 How much of the day does it last?
 How bad is the feeling?

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Disorders of speech
 Speech is the way we put together our
taught in words, either orally or in
writings. Our speech tells other people
about our inner world.
1-Stammering: In stammering the normal
flow of speech is interrupted by
pauses/gap/silence the repetition of
fragment of the word eg. Nervous
2-Stuttering: frequent repetition or
prolongation of a sound or a syllable,
leading to markedly impaired speech
fluency/flow of speech
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3-Mutism: complete loss of speech or whispered
speech and

-may occur in children with range of emotional or

psychiatric disorders and

-in adult with hysteria, depression, schizophrenia

or organic brain disorders

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4. Pressure of speech: rapid speech that is
increased in amount and difficult to
interrupt
5. Nonspontaneous speech: verbal
responses given only when asked or
spoken to directly; no self-initiation of
speech

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6. Poverty of content of speech: speech that is
adequate in amount but conveys little information
because of vagueness, emptiness, or stereotyped
phrases
7. Dysprosody: loss of normal speech melody (called
prosody)
8. Dysarthria: difficulty in articulation, not in word finding
or in grammar
9. 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

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Speech described as :
Rate or speed of speech- slow,
hesitant, long pauses before
answering, pressurized speech

 Rhythm- monotonous, exaggerated

inflection

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 Volume of voice: soft, barely audible, loud

 Amount: monosyllabic,hypertalkative,mute

 Articulation: clear,mumbled ,slurred,dysarthric,

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MOTOR/ BEHAVIOR
ABNORMALITIES

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• Tics - irregular, involuntary & repeated
movements involving a group of muscles. Eg.
Shrugging
• Mannerism - repeated movements that
appear to have some functional significance to
a given person, but used out of context &
inappropriately e.g. saluting

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• Stereotypes - repeated movements that

are regular and without obvious

significance e.g. rocking to and fro

• Posturing - adoption of unusual body

posture for a long period of time E.g.

standing on one leg

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 Negativism – doing the opposite of
what was asked to do
 Echopraxia – imitation of the others act
 Echolalia – imitation of others speech
 Ambitendence/ambivalence –
alternation between opposite
movements
 Waxy flexibility – maintenance of a
position for a long time (can be molded
like a wax, slight resistance)
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 Psychomotor agitation – excessive
motor activity associated with feelings of
inner tension
 Catatonic excitement – agitated &
purposeless activity, uninfluenced by
external stimuli
 Catatonic rigidity – maintenance of a
rigid posture against all efforts to be
moved
 Akinesia – lack of physical movement
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 Catalepsy – a general term for an immobile position
(position induced by examiner maintained) eg. Waxy
flexablity
 Cataplexy – sudden loss of motor tone, associated
with narcolepsy
 Akathisia – subjective desire to be in constant motion
 Automatism – automatic repetition of acts (e.g. post
ictal state)
 Automatic obedience – the opposite of negativism,
to give in for all demands even if it is self damaging
 Mutism - speechlessness without structural
abnormalities

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