MOOD & AFFECT

affect
•Behavior that expresses a subjectively
experienced feeling state (emotion);
•affect is responsive to changing emotional
states,
•whereas mood refers to a pervasive and
sustained emotion.
•Common affects are euphoria, anger, and
sadness.
Some types of affect disturbance are
• blunted Severe reduction in the intensity
of affective expression.
• flat Absence or near absence of any signs
of affective expression such as a
monotonous voice and an immobile face.
• labile Abnormal variability, with repeated,
rapid, and abrupt shifts in affective
expression.
• restricted or constricted Reduction in the
expressive range and intensity of affects
• inappropriate Discordance of voice and
movements with the content of the
person’s speech or ideation.

• inappropriate affect A display of

emotion that is out of harmony with reality
or with the verbal or intellectual content
that it accompanies.

• Glossary DSM IV TR
• inappropriate affect Emotional tone
out of harmony with the idea, thought,
or speech accompanying it. Seen in
schizophrenia
• Flat affect virtually no signs of
affective expression should be present;
the patient's voice should be
monotonous and the face should be
immobile. Note the patient's difficulty in
initiating, sustaining, or terminating an
emotional response.
• restricted affect Reduction in intensity of
feeling tone, which is less severe than in
blunted affect, but clearly reduced.
• constricted affect Reduction in intensity
of feeling tone that is less severe than that
of blunted affect.
• blunted affect Disturbance of affect
manifested by a severe reduction in the
intensity of externalized feeling tone; one
of the fundamental symptoms of
schizophrenia, as outlined by Eugen
Bleuler.
Affect can be defined as the patient's present
emotional responsiveness, inferred from the
patient's facial expression, including the
amount and the range of expressive behavior.
Affect may or may not be congruent with mood.
Affect can be described as within normal
range, constricted, blunted, or flat.
In the normal range of affect can be variation
in facial expression, tone of voice, use of
hands, and body movements.
 mood
• Pervasive and sustained feeling tone that
is experienced internally and that, in the
extreme, can markedly influence virtually
all aspects of a person's behavior and
perception of the world. Distinguished from
affect, the external expression of the
internal feeling tone
Mood is defined as a pervasive and sustained
emotion that colors the person's perception of the
world.
The psychiatrist is interested in whether the patient
remarks voluntarily about feelings or whether it is
necessary to ask the patient how he or she feels.
Statements about the patient's mood should include
depth, intensity, duration, and fluctuations.
Common adjectives used to describe mood include
depressed, despairing, irritable, anxious, angry,
expansive, euphoric, empty, guilty, hopeless, futile,
self-contemptuous, frightened, and perplexed. Mood
can be labile, fluctuating or alternating rapidly between
extremes (e.g., laughing loudly and expansively one
moment, tearful and despairing the next).
 mood-congruent delusion
• Delusion with content that is mood
appropriate (e.g., depressed patients who
believe that they are responsible for the
destruction of the world).
mood-congruent hallucination
• Hallucination with content that is
consistent with a depressed or manic
mood (e.g., depressed patients hearing
voices telling them that they are bad
persons and manic patients hearing voices
telling them that they have inflated worth,
power, or knowledge).
 mood-incongruent delusion
• Delusion based on incorrect reference
about external reality, with content that
has no association to mood or is mood
inappropriate (e.g., depressed patients
who believe that they are the new
Messiah).
mood-incongruent hallucination
• Hallucination not associated with real
external stimuli, with content that is not
consistent with depressed or manic mood
(e.g., in depression, hallucinations not
involving such themes as guilt, deserved
punishment, or inadequacy; in mania, not
involving such themes as inflated worth or
power).
• mood swings Oscillation of a person's
emotional feeling tone between periods of
elation and periods of depression.
• labile mood Oscillations in mood between
euphoria and depression or anxiety.
• labile affect Affective expression
characterized by rapid and abrupt changes,
unrelated to external stimuli.
Appropriateness of Affect
The psychiatrist can consider the appropriateness of
the patient's emotional responses in the context of the
subject the patient is discussing.
Delusional patients who are describing a delusion of
persecution should be angry or frightened about the
experiences they believe are happening to them. Anger
or fear in this context is an appropriate expression.
Psychiatrists use the term inappropriate affect for a
quality of response found in some schizophrenia
patients, in which the patient's affect is incongruent with
what the patient is saying (e.g., flattened affect when
speaking about murderous impulses).
Synopsis Kaplan 2007
Mood has commonly been described as the
prevailing emotional state, and affect as the
expression and expressivity of a patient's emotions.
The term affect derives from the psychoanalytical
literature and was originally intended to describe the
feeling tone accompanying ideas or mental
representations of external objects.
Mood in turn was believed to derive from the
summation of affects.
By definition, affect would fluctuate with an
individual's changing thoughts. Mood was more
constant over time
affect The subjective and immediate
experience of emotion attached to ideas or
mental representations of objects. Affect has
outward manifestations that may be
classified as restricted, blunted, flattened,
broad, labile, appropriate, or inappropriate
• mood Pervasive and sustained feeling tone that is experienced internally and that, in
the extreme, can markedly influence virtually all aspects of a person's behavior and
perception of the world. Distinguished from affect, the external expression of the
internal feeling tone. For types of mood, see the specific term.
• mood-congruent delusion Delusion with content that is mood appropriate (e.g.,
depressed patients who believe they are responsible for the destruction of the world).
• mood-congruent hallucination Hallucination with content that is consistent with either
a depressed or manic mood (e.g., depressed patients hearing voices telling them that
they are bad persons; manic patients hearing voices telling them that they have
inflated worth, power, or knowledge).
• mood-incongruent delusion Delusion based on incorrect reference about external
reality, with content that has no association to mood or is mood inappropriate (e.g.,
depressed patients who believe that they are the new Messiah).
• mood-incongruent hallucination Hallucination not associated with real external
stimuli, with content that is not consistent with either depressed or manic mood (e.g.,
in depression, hallucinations not involving such themes as guilt, deserved
punishment, or inadequacy; in mania, not involving such themes as inflated worth or
power).
• mood swings Oscillation of a person's emotional feeling tone between periods of
elation and periods of depression.