MOTOR OR MOVEMENT RELATED SYMPTOMS

1.      Abulia- reduced impulse to act and to think which is associated with indifference about consequences of action. Occurs as a result of neurological deficit, depression and schizophrenia.

2.      Adiadochokinesia- inability to perform rapid alternating movements. Occurs with neurological deficit and cerebellar lesions.

3.      Adynamia- weakness and fatigability, characteristic of neurasthenia and depression.

4.      Agitation- severe anxiety associated with motor restlessness.

5.      Akathisia- subjective feeling of motor restlessness manifested by a compelling need to be in constant movement. May be seen as an extrapyramidal adverse effect of antipsychotic medication. May be mistaken for psychotic agitation.

6.      Akinesia- lack of physical movement, as in extreme immobility of catatonic schizophrenia. It can also occur as an extrapyramidal effect of antipsychotic medication.

7.      Akinetic Mutism or Coma Vigil- absence of voluntary motor movement or speech in a patient who is apparently alert (as evidenced by eye movement). It is seen in psychotic depression and catatonic states.

8.      Apraxia- inability to perform a voluntary purposeful motor activity. It cannot be explained by paralysis or other motor or sensory impairment.

9.      Constructional Apraxia- patient cannot draw a 2 or 3 dimensional form (inability to copy a drawing).

10.   Astasia Abasia- inability to stand or walk in a normal manner, even though normal leg movements can be performed in a sitting or lying down position. It is seen in conversion disorder.

11.   Ataxia- lack of coordination, physical or mental. In neurology, refers to loss of muscular co-ordination. In psychiatry, the term intra-psychic ataxia refers to lack of co-ordination between feelings and thoughts. It is seen in schizophrenia and in severe OCD.

12.   Atonia- lack of muscle tone.

13.   Bradykinesia- slowness of motor activity, with a decrease in normal spontaneous movement.

14.   Catalepsy or Waxy flexibility or Cerea Flexibilitas- condition in which person maintains the body position into which they are placed. It is observed in severe cases of catatonic schizophrenia.

15.   Cataplexy- temporary sudden loss of muscle tone, causing weakness and immobilization. It can be precipitated by a variety of emotional states and is often followed by sleep. It is commonly seen in narcolepsy.

16.   Catatonic excitement- excited, uncontrolled motor activity seen in catatonic schizophrenia. Patients in catatonic state may suddenly erupt into an excited state and may be violent.

17.   Catatonic Posturing- voluntary assumption of an inappropriate or bizarre posture, generally maintained for long periods of time (may switch unexpectedly with catatonic excitement).

18.   Catatonic rigidity- fixed and sustained motoric position that is resistant to change.

19.   Catatonic stupor- stupor in which patients ordinarily are well aware of their surroundings.

20.   Chorea- movement disorder characterized by random and involuntary quick, jerky, purposeless movements. It is seen in Huntington’s disease.

21.   Command Automatism- condition associated with catalepsy in which suggestions are followed automatically.

22.   Cycloplegia- paralysis of the muscles of accommodation in the eye. It is observed at times, as an automatic adverse effect (anti-cholinergic effect) of antipsychotic or antidepressant medication.

23.   Dyskinesia- difficulty in performing movements. It is seen in extrapyramidal disorders.

24.   Dystonia- extrapyramidal motor disturbance consisting of slow, sustained contractions of the axial or appendicular musculature. One movement often predominates, leading to relatively sustained postural deviations. Acute dystonic reactions (facial grimacing and torticollis) are occasionally seen with the invitation of antipsychotic drug therapy.

25.   Hypoactivity or hypokinesis- decreased motor and cognitive activity, as in psychomotor retardation. Visible slowing of thought, speech and movement.

26.   Mannerism- ingrained, habitual involuntary movement.

27.   Muscle rigidity- state in which the muscles remain immovable. It is seen in schizophrenia.

28.   Mydriasis- dilation of the pupil. Sometimes occurs as an autonomic (anticholinergic) or atropine like adverse effect of some antipsychotic and antidepressant drugs.

29.   Overactivity- abnormality in motor behaviour that can manifest itself as psychomotor agitation, hyperactivity (hyperkinesis), tics, sleepwalking or compulsions.

30.   Paresis- weakness or partial paralysis of organic origin.

31.   Posturing or Catatonia- strange, fixed and bizarre bodily positions held by a patient for an extended time.

32.   Psychomotor Agitation- physical and mental over activity that is usually non-productive and is associated with a feeling of inner turmoil, as seen in agitated depression.

33.   Stupor- state of decreased reactivity to stimuli and less than full awareness of one’s surroundings; as a disturbance of consciousness, it indicates a condition of partial coma or semi-coma. In psychiatry, used synonymously with mutism and does not necessarily imply a disturbance of consciousness. In catatonic stupor, patients are ordinarily aware of their surroundings.

34.   Tic disorders- predominantly psychogenic disorders characterized by involuntary, spasmodic, stereotyped movement of small groups of muscles. It is seen most predominantly in moments of stress or anxiety, rarely as a result of organic disease.

35.   Tremor- rhythmical alteration in movement, which is usually faster than one beat a second. It typically decreases during periods of relaxation and sleep and increase during periods of anger and increased tension.

36.   Ideomotor Apraxia- often called IMA, is a neurological disorder characterized by the inability to correctly imitate hand gestures and voluntarily mime tool use, e.g.- pretend to brush one’s hair.

37.   Lesh- Nyhan Syndrome- impaired kidney function, acute gouty arthritis and self mutilating behaviours such as lip and finger biting and/or head banging. Additional symptoms include involuntary muscle movements, and neurological impairment.

38.   Stereotypy- repetitive, abnormal frequent, non-goal directed movements.

39.   Grimacing- an ugly, twisted expression on a person’s face, typically expressing disgust, pain or wry amusement.

SIGNS AND SYMPTOMS RELATED TO SPEECH AND LANGUAGE

1.    Acataphasia- Disordered speech in which statements are incorrectly formulated. Patients may express themselves with words that sound like the ones intended, but not appropriate to the thoughts or they may use totally inappropriate expression.

2.    Aculalia- nonsense speech associated with marked impairment of comprehension. Occurs in mania, schizophrenia and neurological deficit.

3.    Alogia- inability to speak because of a mental deficiency or an episode of dementia.

4.    Aphasia- any disturbance in the comprehension or expression of language caused by a brain lesion.

5.    Asyndesia- disorder of language in which the patient combines unconnected ideas and images. It is commonly seen in schizophrenia.

6.    Bradylalia- abnormally slow speech. Commonly seen in depression.

7.    Circumstantiality- disturbance in the associative thought and speech processes in which a patient digresses into unnecessary details and inappropriate thoughts before communicating the central idea. It is commonly observed in schizophrenia, obsessional disturbances and certain cases of dementia.

8.    Clang association- association or speech directed by the sound of a word rather than its meaning. The words have no logical connection. Punning and rhyming may dominate the verbal behaviour. It is seen most frequently in schizophrenia and mania.

9.    Cluttering- disturbance of fluency involving an abnormally rapid rate and erratic rhythm of speech that impedes unintelligibly. The affected individual is usually unaware of the communicative impairment.

10.  Copralalia- involuntary use of vulgar or obscene language. Observed in some cases of schizophrenia and Tourette’s syndrome.

11.  Cryptolalia- a private spoken language.

12.  Cryptographia- a private written language.

13.  Dysphasia- (Reception dysphasia) -difficulty in comprehending oral language. (Expressive Dysphasia)-difficulty in trying to express verbal language.

14.  Dysprosody- loss of normal speech prosody. It is commonly seen in depression.

15.  Echolalia- psychopathological repeating of words or phrases of one person by the other, tends to be repetitive and persistent. It is seen in certain kinds of schizophrenia, particularly the catatonic types.

16.  Expressive aphasia or Broca’s Aphasia or Motor Aphasia or non-fluent aphasia- disturbance of speech in which understanding remains but ability to speak is grossly impaired, halting, laborious, inaccurate speech. People with this condition may know exactly what they want to say and understand what they hear others say, but they cannot control the actual production of their own words. Speech is halting and words are often mispronounced such as saying “cot” instead of “clock” or “non” instead of “nine”.

17.  Expressive dysphasia- difficulty in expressing verbal language, the ability to understand language in intact.

18.  Fluent aphasia or Wernicke’s aphasia or sensory aphasia or receptive aphasia- aphasia characterized by inability to understand the spoken word. Fluent but incoherent speech is present. A person with Wernicke’s aphasia would be able to speak fluently and pronounce words correctly, but the words would be the wrong one entirely. For example, “now get me some milk out of the air conditioner, woman!”

19.  Global aphasia- combination of grossly non-fluent aphasia and severe fluent aphasia.

20.  Glossolalia, it is also called “speaking in tongue”- unintelligible jargon that has meaning to the speaker but not to the listener. Commonly seen in schizophrenia.

21.  Holophrastic- using a single word to express a combination of ideas. It is seen in schizophrenia.

22.  Jargon aphasia- aphasia in which words produced are neologistic; that is nonsense words created by the patient.

23.  Metonymy- speech disturbance common in schizophrenia in which the affected persons use a word or phrase that is related to the proper one but is not the one ordinarily used. For example, the patient speaks of consuming a menu rather than a meal, or refers to losing the piece of string of the conversation, rather than the thread of the conversation.

24.  Mutism- organic or functional absence of faculty of speech.

25.  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., head-shoe to mean hat), but such constructions are more properly referred to as word approximations)

26.  Nominal aphasia or Anomia or Amnestic aphasia- aphasia characterized by difficulty in giving the correct name of an object.

27.  Poverty of speech or Laconia speech- condition characterized by a reduction in the quality of spontaneous speech. Replies to questions are brief and unelaborated, and little or no unprompted additional information is provided. It commonly occurs in schizophrenia, major depression and organic mental disorders.

28.  Lethologica- momentary forgetting of a name or proper noun.

29.  Poverty of speech content- speech that is adequate in amount, but conveys little information because of vagueness, emptiness or stereotyped phrases.

30.  Pressured speech- increase in the amount of spontaneous speech, rapid, loud, accelerated speech, as occurs in mania, schizophrenia and cognitive disorders.

31.  Receptive aphasia- organic loss of ability to comprehend the meaning of words, fluid and spontaneous but incoherent and nonsensical speech.

32.  Receptive dysphasia- difficulty in comprehending oral language, the impairment involves comprehension and production of language.

33.  Paraphasia- abnormal speech in which one word is substituted for another, the irrelevant word generally resembling the required one in form, meaning or phonetic composition. The inappropriate word may be a legitimate one used incorrectly, such as “clover” instead of hand, or a bizarre nonsense expression such as “treen” instead of “train”.

34.  Stereotypy- continuous mechanical repetition of speech or physical activities. It is observed in catatonic schizophrenia.

35.  Stuttering- frequent repetition or prolongation of a sound or syllable, leading to markedly impaired speech fluency.

36.  Syntactical aphasia- aphasia characterized by difficulty in understanding spoken speech. Associated with gross disorder of thought and expression.

37.  Tangentiality- oblique, digressive or even irrelevant manner of speech in which the central idea is not communicated.

38.  Verbigeration or Cataphasia- meaningless and stereotyped repetition of words or phrases as seen in schizophrenia.

39.  Word salad or incoherence- incoherent, essentially incomprehensible, mixture of words and phrases commonly seen in far advanced cases of schizophrenia.

40.  Dysarthria- difficulty in articulation, the motor activity of shaping phonated sounds into speech, not in word finding or in grammar.

41.  Dyslalia- faulty articulation caused by structural abnormalities of the organs required for articulation or impaired hearing.

42.  Logorrhoea or Tachylogia or Verbomania or Volubility- copious, pressured, coherent speech, uncontrollable, excessive talking. It is observed in manic episodes of bipolar disorder.

43.  Hypergraphia- writing style that are unusual, excessive and preoccupied with selected themes.

TYPES OF RESEARCH

1.Descriptive Research – to portray accurately the characteristics of particular individual, situation or a group.

·        it includes surveys and fact-finding enquiries of different kind.

·        major purpose – description of the state of affairs as it exists at present.

·        sometimes also called “ex post facto research”

·        main characteristics – the researcher has no control over the variables, only what is happening or what has happened can be reported.

·        the researcher attempts to discover causes even when they cannot control the variables.

·        methods used – survey methods of all kinds (including comparative and correlational methods).

2. Analytical Research – the researcher uses facts or information already available and analyse these to make a critical evaluation of the material.

3. Exploratory or Formulative Research – the research objective is to gain familiarity with a phenomenon or to achieve new insights into it.

4. Diagnostic Research – the objective is to determine the frequency with which something occurs or with which it is associated with something else.

5. Hypothesis-Testing Research – to objective is to test a hypothesis of a causal relationship between variables.

6. Applied Research – it aims at finding a solution for an immediate problem facing a society or an industrial/business organisation

examples – research to identify social, economic or political trends that may affect a particular institution,

marketing research,

evaluation research.

7. Fundamental Research – it is mainly concerned with generalizations and with the formulation of a theory.

examples – research concerning some natural phenomenon or relating to pure mathematics.

8. Quantitative Research – it is based on the quantitative measurements of some characteristics (it is applicable to phenomena that can be expressed in terms of quantities).

9. Qualitative research- it is concerned with qualitative phenomenon i.e., phenomena relating to or involving quality or kind (it is especially important in the behavioral sciences where the aim is to discover the underlying motives of human behavior)

10. Conceptual research- is related to some abstract idea or ideas or theory. It is generally used by philosophers and thinkers to develop new concepts or to reinterpret existing ones.

11. Empirical research- it relies on experience or observation alone, often without due regard for system and theory. It is data based research, coming up with conclusions which are capable of being verified by observation or experiment.

MORAL DEVELOPMENT

PIAGET’S STAGES IN MORAL DEVELOPMENT:

STAGE 1: “stage of moral realism” or “morality by constraint”

-Automatic obedience to rules without reasoning or judgment.

-Children judge right or wrong in terms of their consequences.

STAGE 2: “stage of autonomous morality” or “morality by co-operation or reciprocity”

-The rigid and inflexible notions of right and wrong, learned from parents, are gradually modified.

-This enables children to look at their problems from different points of view and to take many factors into consideration in solving them.

- “Lying is not always necessarily bad.”

KOHLBERG’S STAGE IN MORAL DEVELOPMENT:

LEVEL1: “PRECONVENTIONAL MORALITY”

1^st stage – the child is obedience and punishment oriented and the morality of an act is judged in terms of its physical consequences.

2^nd stage – children conform to social expectations to gain rewards.

LEVEL 2: “CONVENTIONAL MORALITY”

1^st stage – the child conforms to rules to win the approval of others and to maintain good relations with them.

2^nd stage – children believe that if the social group accepts rules as appropriate for all group members, they should conform to them to avoid social disapproval.

LEVEL 3: “POST CONVENTIONAL MORALITY “

1^st stage – the child believes that there should be flexibility in moral beliefs that make it possible to modify and change moral standards if this will prove to be advantageous to group members as a whole.

2^nd stage – people conform to social standards and to internalized ideals to avoid self -condemnation rather than to avoid social censure.

SIGMUND FREUD'S STRUCTURE OF PERSONALITY

It’s the first comprehensive theory of personality.

The structure of personality:

Id-

·         the original system of personality

·         the matrix within which the ego and the superego become differentiated

·         consists of everything psychological that is inherited and present at birth

·         reservoir of psychic energy

·         it is in the close touch from bodily processes

·         Freud called the id the “true psychic reality” because it represents the inner world of subjective experience and has no knowledge of objective reality

·         It cannot tolerate increases of energy that are experienced as uncomfortable states of tension

·         Consequently, when tension increases through external or internal stimulation, the id functions to discharge the tension immediately- THIS IS CALLED PLEASURE PRINCIPLE

·         To accomplish its aim, id uses 2 processes:

1.   Reflex actions:  It is inborn

          They are automatic reactions

          They reduce tension immediately

2.   Primary processes:It forms an image of the object that will remove the tension

e.g.- nocturnal dream

note- the hallucinatory experience in which the desired object is present in the form of a memory image is called wish-fulfillment.

Ego-

·         Comes into existence because the needs of the organism require appropriate transactions within the objective world of reality

·         The basic distinction between the id and the ego is that the id knows only the subjective reality of the mind whereas the ego distinguishes between things in the mind and things in the external world.

·         Obeys the reality principle, the aim of reality principle is to prevent the discharge of tension until an object that is appropriate for the satisfaction of the need has been discovered.

·         Operates by the means of secondary process, the ego formulates a plan for the satisfaction of the need and then tests the plan, usually by some kind of action, to see whether or not it will work.

Superego-

·         It is the internal representative of the traditional values and ideals of society as interpreted to the child by its parents and enforced by means of a system of rewards and punishments imposed upon the child.

·         The moral arm of personality

·         Represents the ideal rather than the real or the desire

·         There are 2 subsystems of superego:

1.   Conscience- whatever parents say is improper and punish the child for doing tends to become incorporated into conscience. It punishes the person by making him feel guilty.

2.   Ego-ideal- whatever parents approve of and reward the child for doing tends to become incorporated into its ego-ideal. It reward the person by making him or her feel proud.

This incorporation happens through introjection.

On the development of superego the self-control is substituted for parental-control.

SUBSTANCE ABUSE EXPLAINED

Any abused substance produce some form of intoxication that alters –

·         Judgment

·         Perception

·          Attention or

·         Physical control.

Many substances may bring on withdrawal- an effect caused by cessation or reduction in the amount of the substance used. Withdrawal can range from mild anxiety to seizures and hallucinations.

Drug overuse may cause death.

Tolerance- increasingly larger amount of the drug is required to produce the same level of intoxication.

TOBACCO

According to WHO, tobacco use is one of the biggest public health threats the world has ever faced.

Reasons for using tobacco: a. pleasure

      b. improved performance

      c. vigilance

     d. relief of depression

      e. curbing hunger

      f. weight control

The addicting substance in cigarettes is nicotine:

It changes how the brain and body function.

It can both invigorate and relax a smoker, depending on how much and how often they smoke.

It causes a rapid release of adrenaline which causes:  

·         rapid heartbeat

·         increased blood pressure

·         rapid and shallow breathing

v  Adrenaline causes the release of glucose in blood and nicotine blocks the release of insulin therefore making people hyperglycemic (having more sugar than usual in their blood). Therefore, people eat less (they think it curbs their appetite)

v  Nicotine increases the basal metabolic rate slightly (therefore weight lose takes place but it is not as healthy as exercising)

v  Overtime nicotine can increase the level of LDL cholesterol that damages the arteries and causes a heart attack or stroke.

Cigarette smoke- contains thousands of other chemicals that also damage health.

Health hazards- heart disease, lung cancer and emphysema, peptide ulcer and stroke.

Withdrawal symptoms of smoking-

·         anxiety

·         hunger

·         sleep deprivation

·         depression