NP5

• Illusion


  Misinterpretation of EXTERNAL stimulus
• Hallucination


  Misinterpretation of SENSORY stimulus
• Types of hallucinations

  • Visual (psychedelics - marijuana use)
  • Tactile (formication - alcohol withdrawal)
  • Olfactory (phantosmia - post traumatic stress disorder)
  • Gustatory (spontaneous dysgeusia - epilepsy [aura of seizure])
  • Auditory (command auditory - paranoid schizophrenia)
• Management of hallucinations

  1. Recognize hallucination

  2. Assess the content

  3. Reality presentation

  4. Divert the attention

  5. Engage in reality-based activity

  6. Reintegrate with the milieu

  7. Talk back to the voices
• Synesthesia


  Mixing of senses (hears the color, sees the sound, tastes the words)
• Delusion


  False belief
• Types of delusions


  • Grandiose - superiority or invulnerability
  • Persecutory - "to be harmed by others"
  • Somatic - bodily functions are abnormal
  • Nihilistic - a part of the body is missing
  • Erotomanic - "a person is in love with her/him"
  • Ideas of Reference / Referential delusion - giving meaning to events or actions of others
• Management of delusions


  1. Clarify the meaning

  2. Acknowledge the feelings, but NOT the delusion

  3. Voice doubt, but DO NOT CHALLENGE

  4. Engage in reality-based activities
• Circumstantiality


  Fullness of detail, answer the question
• Tangentiality


  Lack of focus, answer the question
• Looseness of Association (derailment)

  Fragmented ideas
• Flight of Ideas


  Rapid speech, jumping from one topic to another
• Unusual speech patterns


  • Neologisms - coining of new words
  • Schizophasia - word salad, mixing of words without rhyme
  • Clang associations - rhyming of words
  • Echolalia - repeating the words of others
  • Palilalia - repeating own words (fast and decreasing audibility)
  • Verbigeration - repeating phrases
  • Stilted language - use of flowery words
  • Perseveration - adherence to a single topic
• Disturbances in affect


  • Flat - no emotion response (Withdrawn)
  • Blunt - minimal emotional response (Major Depression)
  • Inappropriate - emotions are opposite to the context of the situation (Schizophrenia)
  • Restrictive - single emotional response (Paranoid)
  • La bile - sudden shift of emotions (Bipolar disorder)
• Disturbances in memory


  • Amnesia - loss of memory
  • Retrograde - inability to recall memories formed before a traumatic event (Reminiscence therapy)
  • Anterograde - inability to make new memories after a traumatic event (Reorient the client)
  • Confabulation - making stories that are not true to fill the gap between memory loss