Maladaptive behavior Psychiatry

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1. Maladaptive behavior of individuals and groups: stress, crisis and disaster

2. All living organisms have a tendency to maintain themselves in a state of relative constancy called as Homeostasis. Adaptation occurs when there is a threat to this homeostasis. Adaptive responses occurs when a stimulus from the internal or external environment causes a departure from the balanced state of organism.

3. Group adaptation is a process by which the group maintains a balance so that it can promote growth of individual and group members. For group to adapt successfully there must be: Good communication skills. Mutual respect for each other Adequate resources available for adaptation Previous experience with stressors

4. The word “Stress” was derived from Latin word “Stringere” which means “to draw tight”. Change in the internal/ external environment causes stress and an organism has to adapt to it to survive. The stimulus preceding or precipitating the changes are called stressors.

5. Crisis is a disturbance caused by a stressful event or a perceived threat. The person usual way of coping becomes ineffective in dealing with the threat, causing anxiety. Disaster is defined by the WHO as “A severe disruption, ecological and psychological, which greatly exceeds the coping capacity of the affected community. It can be natural and man made, psychological reaction may be either adaptive or maladaptive.

6. Etiology: bio-psycho-social factors

7. Previously, cause of mental illness was explained through humoral , demonic and physical theories. However, over the last few decades, a number of theories have been elaborated to explain psychiatric disorders on a scientific basis: Some of these are: Genetic theories Biochemical theories Psychological theories Behavioral and cognitive theories Social theories

8. Cause of mental illness can be chronologically divided into 3 groups: Pre- disposing Factors: These occurs before the onset of the disease or before psychopathology have appeared. Genetic Factors Biological Factors Psychological Factors

9. Precipitating Factors: These are events that occur shortly before the onset of disorders and appear to have induced it. Physical Factors Physiological Factors Psychological Factors Social factors

10. Perpetuating Factors: These are factors that prolong the course of a disorder after it has been provoked. It is extremely vital to consider these factors while planning treatment.

11. Psychopathology of mental disorders

12. Meaning of Psychopathology: Psychopathology is the systematic study of abnormal experience, cognition and behavior. It involves the observation and categorization of abnormal psychic events, internal experiences of the patient and his consequent behavior. Disorder may be due to disorder of personality, activity, perception, thinking, affect, attention, consciousness, memory and structural disturbances in the brain

13. 1. Disorders of personality

14. Cyclothymic Personality (Alternating Mood) Hypomanic Personality (Cheerful, enjoyer of life, energetic, confident, aggressive, pleasure loving) Melancholic Personality (kindly, sympathetic, quiet, good tempered, easily depressed, helplessness) Paranoid Personality (suspicious, stubborn, lonely, insecured , unhappy, sarcastic, argumentative) Schizoid Personality (loneliness, isolation, shyness, quiet and asocial, good at school work)

15. Obsessive Compulsive Personality (rigid, punctual, cannot work under pressure, do not relax, cannot make decisions) Hysterical Personality (self- centered dramatization, labile affect, emotional out burst, attention seeking) Passive- Aggressive Personality (Manifest by 3 ways: (Passive- dependent, Passive- aggressive, Aggressive type) Explosive Personality (friendly, happy, likeable, outgoing suddenly displayed guilt and anxiety)

16. 2. Disorders of motor behavior

17. Over Activity (seen in mania, can be goal directed but goal keeps changing) Decreased Activity (takes long time to start activity, once started it is done very slowly) Stereotypy (persistent, constant repetition of activities, that involve position, movement or speech) ( e.g : catalepsy, waxy- flexibility, mannerisms, verbigeration ) Repetitious Activities (activity is initiated, there is tendency to repeat)

18. Automatic Behavior (echolalia, echopraxia ) Negativism (manifested by opposition and resistance to what is suggested) Compulsion (morbid and irresistible urges to perform purposeless acts repetitiously) Violence (expression of aggressiveness in the form of murders, assaults, rape, damaging self) Suicide (means self- destruction, feel rejected and unloved, commonly seen recovery depression, acute schizophrenia and delirium)

19. 3. Disorders of perception

20. Illusion (misinterpretation of sense impression) Hallucination (perception occurs in the absence of the object, not related to external stimuli) Types : (auditory, visual, olfactory, gustatory, tactile and kinesthetic hallucination)

21. 4. Disorders of thinking

22. Disorders of Form of Thought (thinking is the response to a stimulus. This stimulus can be from unconscious or external environment, autistic thinking) Disorders in Progression of Thought (flight of ideas, retardation, perseveration, circumstantiality , incoherence, tangentiality , blocking) Disorders of Content of Thought (overvalued ideas, delusion) Hypochondriacal Delusion (exaggerated concern over physical health)

23. Obsession (persistent , irresistible thoughts) Phobias (irrational fear)

24. 5. Disturbances of affect

25. Pleasurable Affects (euphoria, elation, exhilaration, ecstasy) Depression (feeling of sadness) Anxiety (free- floating anxiety, agitation, tension, panic) Inadequate affect (emotionally dull o detached, indifferent and apathetic) Inappropriate Affect ( disharmony of affect ans situation) Ambivalence (contradictory feeling and attitude) Depersonalization (feeling of unreality and loss of self identity)

26. 6. Disturbances of attention

27. Disordered attention (conation, affect and associations, fatigue, toxic states and organic lesion interfere and lowered attention) Distractibility (inability to hold attention for sufficient length of time)

28. 7. Disorders of consciousness

29. Confusion (bewilderment, disorientation, disturbances of associative function and poverty of ideas) Clouding of Consciousness (due to physical or chemical disturbances producing functional impairment of the cerebrum) Delirium (acute brain syndrome) Dream State (twilight state, person is unaware of his surroundings, may last for several minutes to few days) Stupor (motionless, mute, movement of eyes and respiration occur)

30. 8. Disorders of memory

31. Memory is a function when information is acquired, presented to the consciousness, store and later recalled. There are three processes: Registration Retention Recall

32. There are several disorders of memory: Hyperamnesia (exaggerated degree of retention and recall) Amnesia (intergraded amnesia, retrograde amnesia) Paramnesia (confabulation, retrospective falsification)

33. 9. Deja vu

34. Is a French term meaning, “Already seen”. It is an experience of seeing with the feeling that one has seen it before but does not know when and where.

35. 10. dementia

36. Is a permanent, irreversible loss of intellectual efficiency, it occurs due to structural disturbances or degeneration of the higher cortical neurons of the brain due to prolonged toxication or malnutrition.

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