Disorders of affect and anosognosia Flashcards

(33 cards)

1
Q

Synonyms for apathy

A

initiation deficit, amotivation syndrome, avolition (lack of motivation), abulia (lack of willpower), anergia (lack of energy)

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2
Q

Characteristics of apathy

A

diminished goal-directed behavior; dependency on prompts from others; lack of interest in new experiences; loss of motivation or energy; lack of concern about personal problems; flat affect

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3
Q

3 brain systems involved in apathy

A

valuation, mediating, and motor systems

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4
Q

Valuation system

A

evaluation of the costs and benefits of a task based on the effort required to initiate and accomplish it

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5
Q

Mediating system

A

integrates information about the costs and benefits, and activates the motor system toward particular goals

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6
Q

Motor system

A

ACC transmits a go signal to supplementary motor areas for the execution of volitional behavior

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7
Q

Neurological conditions with apathy

A

stroke (ACA or basal ganglia), TBI, frontotemporal dementia (mild-moderate), alzheimer’s (moderate-severe), parkinsons

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8
Q

Treatments for apathy

A

methylphenidate; atypical antipsychotics; bromocriptine and amantadine (TBI); donepezil, galantamine, and memantine (AD); modafinil

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9
Q

Affect in apathy vs depression

A

just flat; flat, sad, or tearful

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10
Q

Mood in apathy vs depression

A

indifferent; sad

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11
Q

Thought content in apathy vs depression

A

neutral; pessimistic and self-critical

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12
Q

Response to prompting in apathy vs depression

A

comply; decline

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13
Q

Synonyms for emotionalism

A

emotional incontinence, emotional lability, pseudobulbar affect, pathological laughing and crying, involuntary emotional expression disorder

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14
Q

Pseudobulbar affect

A

uncontrolled or inappropriate episodes of laughing or crying

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15
Q

Characteristics of laughing/crying episodes in emotionalism

A

rapid-onset, brief, intense, involuntary, can be emotionally congruent or incongruent, and typically provoked by a seemingly trivial event

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16
Q

Affect in emotionalism vs depression

A

`incongruent or congruent (but exaggerated); congruent

17
Q

Onset in emotionalism vs depression

A

rapid; gradual

18
Q

Duration in emotionalism vs depression

A

typically seconds; hours to days

19
Q

Control in in emotionalism vs depression

A

involuntary; can be modulated

20
Q

Mood in emotionalism vs depression

A

normal range; sad

21
Q

Thought content in emotionalism vs depression

A

self-conscious of crying; pessimistic, self-critical

22
Q

Neurological conditions with emotionalism

A

amyotrophic lateral sclerosis (ALS), multiple sclerosis, stroke (brainstem or cerebellum)

23
Q

Treatments for emotionalism

A

distraction, explaining the condition to others, SSRIs, dextromethorphan/quinidine (DM/Q) or cough syrup

24
Q

Anosognosia

A

“without knowledge of disease”

25
Range of anosognosia
from mild (underestimate degree of impairment) to severe (completely unaware); can be general or domain-specific
26
Brain regions damaged in anosognosia
more damage in the right hemisphere and frontal cortex (especially ACC)
27
Other explanations for having no knowledge of one's disease
lack of feedback from others and psychological denial
28
3 levels of awareness in Crosson's hierarchical model
intellectual awareness, emergent awareness, anticipatory awareness
29
Intellectual awareness
can accurately predict what's safe and what's not safe before doing a task
30
Emergent awareness
can recognize trouble doing a task in the moment
31
Anticipatory awareness
the patient can say that something is wrong with them (full awareness)
32
Consequences of anosognosia
lack of concern or indifference; low engagement with rehabilitation; medication non-compliance; may require a supervised living arrangement; poor compensatory strategy use; euthymic (stable) or irritable but not dysphoric (unease)
33
Treatments for anosognosia
education, experiential functional exercises guided by therapists, feedback on performance, positive reinforcement