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FEELING active experience of somatic sensation, touch.. passive subjective experience of emotion

Affect and emotional_disorders

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Page 1: Affect and emotional_disorders

FEELING

active experience of somatic sensation, touch.. passive subjective experience of emotion

Page 2: Affect and emotional_disorders

EMOTION

Memory & feeling intertwinedTransitory and spontaneous experience similar to but not identical to feeling

↓As it need not incorporate physical accompaniments of experience

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AFFECT

• Expression of emotion• Broad term covering mood, feeling,

attitude, preferences and evaluations

• External manifestations associate with specific feelings like laugh, cry, fear

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MOOD

• Prolonged prevailing state or disposition• State of self in relation to environment• Normal mood is an enormous range of

variation• Pathological mood- from which the

patient suffers or mood causing disturbance or suffering to others(is person suffering?), extent to which it is acceptable( is it appropriate?)

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Mood associated with physical constitution which creates tendecy(personality) for eg- cyclothymic personality is more prone to morbid elation, overactivity or tacitum dejection and retardation

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THEORIES OF EMOTION

• JAMES LANGE THEORY-Emotions are result of self awareness of physical and bodily changes in presence of stimulus

CAR HEART POUNDFEAR(EMOTION)

CANNAN BARD THEORY- visceral/behavioralChanges follows emotion CAR FEAR(EMOTION) HEART POUND

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SCHACHTER & SINGER’S 2 FACTOR THEORY• SOCIAL CONTEXT • PHYSIOLOGICAL AROUSAL COGNITION

FEAR FUNNY

THIS THEORY has implication for clinical evaluation of mood disorders

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BASIC EMOTIONS

According to ekman & colleagues(1971) there are 6 basic emotions1) Anger2) Disgust3) Fear4) Happiness5) Sadness6) SurpriseIn papua new guinea there was little distinction between surprise & fear( changes with location)Change also with culture but the general theme is universal.Eg- Ingesting something repulsive is a disgust everywhere

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MOOD COMMUNICATION

• NO MAN IS AN ISLAND, ENTIRE OF ITSELF- JOHN DONNE

• Our feelings affected by those around us, not accidental but signalled as non verbal message

• Affect itself is not directed but expression of affect is conveyed

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MIRROR NEURONS

“The most important scientific discovery since DNA?”

Found in primates & birds and later inferred in humans

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Non verbal message

• - through face(eyes mainly), gestures, posture, tone of voice, general appearance especially clothes

• Interviewer’s mood influences patient’s mood

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Mirror neurons are the source of empathy.

When we see a facial gesture, our brains automatically mirror the face and send a message to the limbic system. Once this emotional reaction has kicked in, we understand the other because we have become the other.

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Broca’s Area shows that gestures and language are simultaneous. When we hear a word our action neurons fire. This is called embodied semantics.

THE KISS OF DEATH

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Area F5 of the premotor cortex, similar to Broca’s Area in the human brain

• Also inferior parietal cortex

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Let’s replicate the experiments

WORK IN PAIRS THROUGHOUT1. Both grasp a small object, such as

a pen2. Now one of you grasp whilst the

other watches only3. Now just look at the object

without grasping it

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Around 20% of the neurons that fired when you grasped the object also fired when you watched your partner grasp that object. These are mirror neurons.

Some “logically related” mirror neurons, the same ones, will also have fired when you saw the object which may have been about to be grasped.

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And the conclusion to all this?

ACTIONPERCEPTIONINTENTION

are all the same thing as far as the brain is concerned.

It is holistic. This is how we empathise, by simulating others’ actions and their possible intentions.

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IMITATION

• Piaget suggested that babies learn to imitate

• Rizolatti & craighero said these mirror neurons important for culture and language acquisition

• Mirror neurons tell us that babies imitate to learn – from the first hour of their lives

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PATHOLOGICAL CHANGES IN BASIC EMOTIONS

• CHANGE IN EMOTION INTENSITY- dysphoria or euphoria

• Diminution of feeling

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• Anhedonia- loss of capacity to experience joy & pleasure

• Euphoria- state of excessive unreasonable cheerfulness

• Delayed grief- prolongation of initial numb phase

• Lability of mood- both heightening or an intensification of emotions with instability in persistence of emotions & inappropriate

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• Pathological laughter/crying unprovoked emotion not related to any identifiable social situation

• Cause- gelastic epilepsy, acquired brain injury

• Pathological crying occurs either discretely or together

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• Parathymia- reacts to bad news with cheerfulness

• Paramimia- lack of unity between various modes of expression of emotion

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• Blunting- lack of emotional sensitivity

• Flattening- limitation of usefull range of expressed emotion

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• Retardation- slowing down of ability to initiate thoughts or action

• Smiling depression- degree of depression concealed consciously due to habitual emotion masking or to avoid treatment

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• Diurnal variation seen in mood disorder- worse in morning

• Alexithymia- difficulty in identifying & describing their own feeling,measured by toronto alexithymia scale(4 factors) namely

1) Difficulty identifying feelings2) Externaay oriented thinking3) Difficulty expressing feelings4) Reduced daydreaming

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Localised &somatised affect• Vital feelings- make us aware of

our ‘vital self ’, feeling of mood that emanates from body- most commonly headache but also abdomen, chest, eyes

• Coenestopathic states- distressing feeling from one local part of the body leading to change in normal quality of physical feeling from certain body part without any local lesion

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• Free floating anxiety- powerfull affect seems to have no general goal & asso with no object. Patient describes of feeling generally anxious, not anxious about anything in particular but just anxious

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• Somatisation- selective perception & focus on somatic manifestations of disorders with denial or minimisation of affective & cognitive changes

• Prosopoaffectiveagnosia-selective deficiency in appreciating emotional experience displayed in face of others

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• Emotional dysprosody

Receptive ExpressiveSelective deficit impairment inIn recognising production ofEmotional tone emotional in speech tone in speech

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CYCLOTHYMIA

• Patient shows mood swings over many years in both directions that is gloom & elation but severity does not amount to that seen in manic- depressive illness

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MANIA

• Elation of mood, overactivity, acceleration of thinking

• Rarely patient complains• Early enjoyable and relief but later

on unplesant and even frightening