Psychological Signs and Symptoms - Diagnose of a Psychological Problem

Written by Dr. Sam Vaknin

Psychomotor Agitation

Mounting internal tension associated with excessive, non-productive (not goal orientated), and repeated motor activity (hand wringing, fidgeting, and similar gestures). Hyperactivity and motor restlessness which co-occur with anxiety and irritability.

Psychomotor Retardation

Visible slowing of speech or movements or both. Usually affects the entire range of performance (entire repertory). Typically involves poverty of speech, delayed response time (subjects answer questions after an inordinately long silence), monotonous and flat voice tone, and constant feelings of overwhelming fatigue.

Psychosis

Chaotic thinking that is the result of a severely impaired reality test ( the patient cannot tell inner fantasy from outside reality). Some psychotic states are short-lived and transient (microepisodes). These last from a few hours to a few days and are sometimes reactions to stress. Persistent psychoses are a fixture of the patient's mental life and manifest for months or years.

Psychotics are fully aware of events and people "out there". They cannot, however separate data and experiences originating in the outside world from information generated by internal mental processes. They confuse the external universe with their inner emotions, cognitions, preconceptions, fears, expectations, and representations.

Consequently, psychotics have a distorted view of reality and are not rational. No amount of objective evidence can cause them to doubt or reject their hypotheses and convictions. Full-fledged psychosis involves complex and ever more bizarre delusions and the unwillingness to confront and consider contrary data and information (preoccupation with the subjective rather than the objective). Thought becomes utterly disorganized and fantastic.

There is a thin line separating nonpsychotic from psychotic perception and ideation. On this spectrum we also find the schizotypal personality disorder.

Narcissism, Psychosis, and Delusions

Reality Sense

The way one thinks about, perceives, and feels reality.

Reality Testing

Comparing one's reality sense and one's hypotheses about the way things are and how things operate to objective, external cues from the environment.

Schneiderian First-rank Symptoms

A list of symptoms compiled by Kurt Schneider, a German psychiatrist, in 1957 and indicative of the presence of schizophrenia. Includes:

Auditory hallucinations

Hearing conversations between a few imaginary "interlocutors", or one's thoughts spoken out loud, or a running background commentary on one's actions and thoughts.

Somatic hallucinations

Experiencing imagined sexual acts couple with delusions attributed to forces, "energy", or hypnotic suggestion.

Thought withdrawal

The delusion that one's thoughts are taken over and controlled by others and then "drained" from one's brain.

Thought insertion

The delusion that thoughts are being implanted or inserted into one's mind involuntarily.

Thought broadcasting

The delusion that everyone can read one's mind, as though one's thoughts were being broadcast.

Delusional perception

Attaching unusual meanings and significance to genuine perceptions, usually with some kind of (paranoid or narcissistic) self-reference.