TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

SIGNS AND SYMPTOMS

The major differences between signs and symptoms are described on the table below:

SIGNS SYMPTOMS
▪ Objective
▪ Based from clinician’s observation
▪ Subjective

▪ Subjective experiences of the patient

However, psychopathological signs and symptoms are not clearly differentiated, they often
overlap. A syndrome , or a constellation of signs and symptoms that make up a recognizable
condition, is often used to show the overlap of the two.

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

DISTURBANCES OF CONSCIOUSNESS

Consciousness - state of awareness ▪ Apperception: perception modified by one’s own

thoughts and emotions
▪ Sensorium : (sometimes used as another term for consciousness) refers to the state of
functioning of the special senses
1. Disorientation – disturbed orientation regarding time, place, or person.
2. Delirium – patient exhibits confusion, restlessness, bewilderment, and a disoriented reaction
that is usually associated with hallucinations and fear.
3. Clouding of consciousness – a state of perceptual and cognitive confusion.
4. Stupor – a general condition wherein the patient exhibits extreme unresponsiveness and loss
of orientation to the environment.
5. Twilight state – a disturbance in consciousness, with hallucinations.
6. Dreamlike state – another term for psychomotor epilepsy or complex partial seizure.
7. Somnolence – abnormal drowsiness, usually displayed in organic processes.
8. Coma vigil (akinetic mutism) – patient appears to be sleeping but is aroused easily.
9. Coma – profound level of consciousness, abnormal state of deep stupor that is accompanied
by a total loss of consciousness, loss of voluntary behavior and some reflexes.

DISTURBANCES OF ATTENTION
Attention – selective aspects of perception; quantity of effort given to focusing on parts of an
experience; ability to concentrate
1. Distractibility – the inability to concentrate or focus attention because patient is easily
drawn to irrelevant external stimuli.
2. Selective attention – blocking out of anxiety-causing stimuli.
3. Hyper vigilance – excessive focus and attention is given to all internal and external stimuli
due to paranoia.
DISTURBANCES IN SUGGESTIBILITY
Suggestibility - uncritical and compliant response to influence or an idea.
1. 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.
2. Hypnosis – artificially induced consciousness characterized by heightened suggestibility.

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

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 observable to others.

1. 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.
2. Inappropriate affect – inconsistency between the emotional tone and the idea, thought, or
speech accompanying it.
3. Blunted affect – characterized by a severe reduction in the intensity of the externalized
feeling tone.
4. Restricted or constricted affect – reduction in the intensity of feeling tone. It is less severe
than blunted affect.
5. 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.
6. Labile affect – rapid and abrupt changes in the emotional feeling tone which is unrelated to
an external stimuli.

Mood – the sustained and pervasive emotion subjectively experienced and reported by the
patient, and is observable to others.
1. Dysphoric Mood – unpleasant mood
2. Euthymic Mood – normal range of mood
3. Expansive Mood – the expression of one’s feelings without any restraint. It is frequently
and overestimation of one’s significance or importance.
4. Irritable Mood – the person is easily provoked to anger and is easily annoyed. 5. Mood
Swings (labile mood) – moving between euphoria and depression or anxiety. 6. Elevated
Mood – characterized by an air of enjoyment and confidence. A mood which is more
cheerful than normal but is not considered pathological.
5. Euphoria – intense elation with feelings of grandeur.
6. Ecstasy – feeling of intense rapture or delight.
7. Depression – the psychopathological feeling of sadness.
8. Anhedonia – loss of interest and withdrawal from all regular and pleasurable activities.
Often associated with depression.
9. Grief or Mourning – sadness that is appropriate to a real loss.
10. Alexithymia – the inability or difficulty in describing one’s moods or emotions.
Other Emotions
1. Anxiety – a feeling of apprehension that is caused by anticipation of internal or external
danger/threat.
2. Free-floating anxiety – unfocused and pervasive fear that is not attached to any idea.
3. Fear – anxiety caused by a consciously recognized and realistic danger.
4. Agitation – motor restlessness associated with severe anxiety.
5. Tension – unpleasant increased motor and psychological activity.
6. Panic – acute, episodic, intense anxiety attack associated with overwhelming feelings of
dread.
7. Apathy – dulled emotional tone associated with indifference or detachment.
8. Ambivalence – presence of two opposing impulses toward the same thing, in the same
person, at the same time.

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

a. Psychomotor Agitation – excessive motor and cognitive overactivity, usually nonproductive
and in response to inner tension.
b. Hyperactivity (Hyperkinesis) – restless, aggressive, and destructive activity, often associated
with some underlying organic pathology.
c. Tic – involuntary, spasmodic motor movement.
d. Sleepwalking (Somnambulism) – motor activity during sleep.
e. 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.
f. Compulsion – uncontrollable impulse to perform an act repetitively
i. Dipsomania – compulsion to drink alcohol.
ii. Kleptomania – compulsion to steal.
iii. Nymphomania – excessive and compulsive need for coitus in a woman.
iv. Satyriasis – excessive and compulsive need for coitus in a man.
v. Trichotillomania – compulsion to pull out one’s hair.
vi. Ritual – automatic activity compulsive in nature, anxiety-reducing in origin.

11. Hypoactivity (Hypokinesis) – decreased motor and cognitive activity, as in psychomotor

retardation; visible slowing of thought, speech and movements.
12. Mimicry – simple, imitative motor activity of childhood.
13. Aggression – forceful goal-directed action that may be verbal or physical; the motor
counterpart of the affect of rage, anger, or hostility.
14. Acting out – direct expression of an unconscious wish or impulse in action; unconscious
fantasy is lived out impulsively in behavior.

DISTURBANCES IN THINKING/THOUGHT
Thinking – the goal-directed flow of ideas. Symbols and associations initiated by problem or
task and leading toward a reality-oriented conclusion.
General disturbances in form or process of thinking
1. 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.
 2. Psychosis – inability to distinguish reality from fantasy. Impairment in reality testing,
with creation of a new reality.
3. Reality testing – the objective evaluation and judgment of the world outside the self.
4. 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.
5. 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.
6. Dereism – mental activity not concordant with logic experience.
7. 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.
8. 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., to cause or to prevent events).
9. Primary process thinking – general term for thinking that is dereistic; illogical and
magical; normally found in dreams, abnormally in psychotics.

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

Specific disturbances in form of thought
1. 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., headshoe to mean hat), but such
constructions are more properly referred to as word approximations.
2. Word Salad – incoherent, essentially incomprehensible, mixture of words and phrases
commonly seen in far-advanced cases of schizophrenia (See also incoherence.).
3. 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; observed in schizophrenia, obsessional disturbances, and certain cases of
dementia.
4. Tangentiality – oblique, digressive, or even irrelevant manner of speech in which the central
idea is not communicated.
5. Incoherence – thought that, generally is not understandable; patient never gets from desired
point to desired goal.
6. 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.
7. Verbigeration – meaningless and stereotyped repetition of words or phrases, as seen in
schizophrenia; also called cataphasia.
8. Echolalia – a person’s 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.
9. Condensation – mental process in which one symbol stands for a number of components.
10. Irrelevant answer – answer that is not in harmony with question asked.
11. 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.
12. Derailment – gradual or sudden deviation in train of thought without blocking; sometimes
used synonymously with loosening of association.
13. Flight of ideas – rapid succession of fragmentary thoughts or speech in which content
changes abruptly and speech may be incoherent.
14. 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.
15. 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.
16. Glossolalia – unintelligible jargon that has meaning to the speaker but not to the listener;
occurs in schizophrenia.

Specific disturbances in content of thought

1. Poverty of content – thought that gives little information because of vagueness, empty
repetitions, or obscure phrases.
2. Overvalued idea – 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.

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

8. Obsession – persistent and recurrent idea, thought, or impulse that cannot be
eliminated from consciousness by logic or reasoning; obsessions are involuntary and
ego-dystonic. See also compulsion.
9. 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.
10. Coprolalia – involuntary use of vulgar or obscene language. Observed in some cases of
schizophrenia and in Tourette's syndrome.
11. 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.
a. Simple phobia – circumscribed dread of a discrete object or situation.
b. Social phobia – fear of public humiliation, as in fear of public speaking, performing, or
eating in public.
c. Acrophobia – fear of high places.
d. Algophobia – fear of pain.
e. Claustrophobia – Abnormal fear of closed or confining spaces.
f. Xenophobia – Abnormal fear of strangers.
g. Zoophobia – Abnormal fear of animals.
12. Noesis – a revelation in which immense illumination occurs in association with a sense
that one has been chosen to lead and command.
13. Unio mystica – feeling of mystic unity with an infinite power.

DISTURBANCES IN SPEECH
Speech – ideas, thoughts, feelings as expressed through language; communication through the
use of words and language.
1. Pressure of Speech – rapid speech that is increased in amount difficult to interpret.
2. Volubility (logorrhea) – copious, coherent, logical speech; excessive talking observed in
manic episodes of bipolar disorder. (also known as tachylogia, verbomania)
3. Poverty of Speech – restriction in the amount of speech used; replies may be mono-syllabic.
4. Nonspontaneous speech – verbal responses given only when asked or spoken to directly; no
self initiation of speech.
5. Poverty of content of speech – speech that is adequate in amount but conveys little
information because of vagueness, emptiness or stereotyped phrases.
6. Dysprosod – loss of normal speech melody. (called prosody)
7. Dysarthria – difficulty in articulation, not in word finding or in grammar.
8. 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.
9. Stuttering – frequent repetition or prolongation of a sound or syllable, leading to markedly
impaired speech fluency.
10. Cluttering – erratic and dysrhythmic speech, consisting of rapid and jerky spurts.

APHASIC DISTURBANCES (disturbances in language output)

1. Motor Aphasia – disturbance of speech caused by an organic mental disorder in which
understanding remains but ability to speak is grossly impaired; speech is halting laborious, and
inaccurate. (also known as Broca’s, non-fluent, or expressive aphasia)
2. Sensory Aphasia – organic loss of ability to comprehend the meaning of words; speech is
fluid and spontaneous, but incoherent and nonsensical. (also known as Wernicke’s, fluent, or
receptive aphasia)

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

3. Nominal Aphasia – difficulty in finding correct name for an object. (also termed anomia)
4. Syntactical Aphasia – inability to arrange words in proper sequence.
5. Jargon Aphasia – words produced are totally neologistic; nonsense words repeated
with various intonations and inflections.
6. 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.
1. 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
a. Hypnagogic Hallucination – false sensory perception occurring while falling asleep; generally
considered a non-pathological phenomenon.
b. Hypnopompic Hallucination – false perception occurring while awakening from sleep;
generally considered non-pathological.
c. Auditory Hallucination – false perception of sound, usually voices but also other noises such
as music; most common hallucination in psychiatric disorders.
d. Visual Hallucination – false perception involving sight consisting of both formed images(e.
people) and unformed images (e. flashes of light); most common in organically determined
disorders.
e. Olfactory Hallucination – false perception in smell; most common in organic disorders.
f. Gustatory Hallucination – false perception of taste, such as unpleasant taste caused by an
uncinate seizure; most common in organic disorders.
g. 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).
h. Somatic Hallucination – false sensation of things occurring in or to the body, most often
visceral in origin (also known as cenesthetsic hallucination).
i. Lilliputian Hallucination – false perception in which objects are seen as reduced in size (also
termed micropsia).
j. Mood-congruent Hallucination – a kind of hallucination wherein the content of which is
consistent with either a depressed or manic mood (e. 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.)
k. Mood-incongruent Hallucination – Hallucination whose content is not consistent with either
depressed or manic mood (e. 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)
l. Hallucinosis – Hallucinations, most often auditory, that are associated with chronic alcohol
abuse and that occur within a clear sensorium.
m. Trailing Phenomenon – perceptual abnormality associated with hallucinogenic drugs in
which moving object are seen as a series of discrete and discontinuous stages.

2. Illusion – misperception or misinterpretation of real external sensory stimuli.

DISTURBANCES ASSOCIATED WITH ORGANIC MENTAL DISORDER

Agnosia – an inability to recognize and interpret the significance of sensory impressions.

1. Anosognosia – inability to recognize illness as occurring to oneself.

TYPICAL SIGNS AND SYMPTOMS IN PSYCHOPATHOLOGY

8. Blackout – amnesia experienced by alcoholics about behavior during drinking bouts;
usually indicates that reversible brain damage has occurred.
Levels of Memory
a. Immediate – reproduction or recall of perceived material within seconds to minutes.
b. Recent – recall of events over past few days.
c. Recent past – recall of events over past few months.
d. Remote – recall of events in distant past.

DISTURBANCES OF INTELLIGENCE
Intelligence – the ability to understand, recall, mobilized, and constructively integrates previous
learning in meeting new situations.
1. Mental Retardation : Lack of intelligence to a degree in which there is interference with social
and vocational performance:
a. Mild (I. of 50 or 55 to approximately 70)
b. Moderate (I. of 35 or 40 to 50 or 55)
c. Severe (I. of 20 or 25 to 35 or 40)
d. Profound (I. below 20 or 25) Obsolete terms are “idiot” (mental age less than 3 years),
“imbecile” (mental age of 3 to 7 years), and “moron” (mental age of about 8)

2. Dementia – organic and global deterioration of intellectual functioning without clouding of

consciousness
a. Dyscalculia – loss of ability to do calculations not caused by anxiety or impairment in
concentration.
b. Dysgraphia – loss of ability to write in cursive style; loss of word structure.

3. Pseudodementia – clinical features resembling a dementia not caused by an organic mental

dysfunction; most often caused by depression.

4. Concrete thinking – literal thinking; limited use of metaphor without understanding of

nuances of meaning; one dimensional thought.

5. Abstract thinking – ability to appreciate nuances of meaning; multidimensional thinking with

ability to use metaphors and hypotheses appropriately.

REFERENCE: Sadock, B., & Sadock, V. (2007). Kaplan & Sadock’s Synopsis of Psychiatry (10th
ed.) Philadelphia, USA: Lippincott Williams & Wilkins