Behavioral science

02.04.2013

 Compulsion: Irresistible impulse to

perform and irrational act; seen in
impulse-control and obsessive-compulsive
disorders.

 Coprolalia: Involuntary utterance of

vulgar or obscene words; seen in Tourette
disorder.

 Depression: Feeling tone characterized

by sadness, apathy, pessimism, and a
sense of loneliness; part of major
depressive and other mood disorders.

 Disorientation: Loss of awareness of

position of self in relation to space, time,
or other persons; confusion.

 Distractibility: Condition in which the

patient changes from topic to topic in
accordance with stimuli from within and
from without; seen in mania.

 Dysarthria: Difficulty in speech production

due to incoordination of speech
apparatus.

 Dyskinesia: Any disturbance of

movement

 Echolalia: Imitative repetition of speech of

another; seen in schizophrenia.

 Echopraxia: Imitative repetition of

movements of another; sometimes seen in
catatonic schizophrenia.

Orientation
This is assessed by asking about the
patients awareness of time, place, and
person. If the question of orientation is
kept in mind throughout the interview, it
may not be necessary to ask specific
questions at this stage of the examination
because the interviewer will already know
the answers.

 Specific questions begin with the day, month, year, and

season. In assessing the replies, it is important to
remember that many healthy people do not know the
exact date and that, understandably, patients in hospital
may be uncertain about the day of the week, particularly
if the ward has the same routine every day. When
enquiring about orientation in place, the interviewer asks
what sort of place the patient is in (such as a hospital
ward or an old peoples home). Questions are then
asked about other people such as the spouse or the
ward staff; for example who they are and what their
relationship to the patient is. If the patient cannot answer
these questions correctly, he should be asked about his
own identity.

Attention and concentration

Attention is the ability to focus on the matter in hand. Concentration

is the ability to sustain that focus. Whilst taking the history, the
interviewer should look out for evidence of attention and
concentration. In this way he will already have formed a judgement
about these abilities before reaching the mental state examination.
Formal tests add to this information and provide a semi-quantitative
indication of changes as illness progresses. It is usual to begin with
the serial sevens test. The patient is asked to subtract seven from
100 and then subtract seven from the remainder repeatedly until this
is less than seven. The time taken is recorded, together with the
number of errors. If poor performance seems to be due to lack of
skill in arithmetic, the patient should be asked to do a simpler
subtraction or to say the months of the year in reverse order. If
mistakes are made with these, he can be asked to give the days of
the week in reverse order.

 Formal tests add to this information and provide a semiquantitative indication of changes as illness progresses.
It is usual to begin with the serial sevens test.
The patient is asked to subtract seven from 100 and then
subtract seven from the remainder repeatedly until this is
less than seven.
The time taken is recorded, together with the number of
errors. If poor performance seems to be due to lack of
skill in arithmetic, the patient should be asked to do a
simpler subtraction or to say the months of the year in
reverse order.
If mistakes are made with these, he can be asked to
give the days of the week in reverse order.

 Memory
Whilst taking the history, questions will have
been asked about everyday difficulties in
remembering. During the examination of mental
state, tests are given of immediate, recent, and
remote memory. None is wholly satisfactory, and
the results should be assessed alongside other
information about the patients ability to
remember and, if there is doubt, supplemented
by standardized psychological tests.

Short-term memory in the psychologists sense (see p. 21) is assessed by

asking the patient to repeat sequences of digits that have been spoken
slowly enough for him reasonably to be expected to register them. An easy
short sequence is given first to make sure that the patient understands the
task. Then five different digits are presented. If the patient can repeat five
correctly, six are given and then seven; if he cannot repeat five digits, the
test is repeated with a different sequence of five. A normal response from a
person of average intelligence is to repeat seven digits correctly. The test
also involves concentration, and so it cannot be used to assess memory if
tests of concentration are definitely abnormal. Short-term memory in the
clinicians sense of the memory over a few minutes is assessed by asking
the patient to memorize a name and a simple address, to repeat it
immediately (to make sure it has been registered correctly), and to retain it.
The interview continues on other topics for 5 minutes before recall is
tested. A healthy person of average intelligence should make only minor
errors.

 Memory for recent events is assessed by

asking about news items from the last day or
two, or about events in the patients life that are
known to the interviewer (such as the ward
menus on the previous day). Questions about
news items should be adapted to the patients
interests, and should have been widely reported
in the media.

 Remote memory can be assessed by asking

the patient to recall personal events or wellknown public items from some years before,
such as the birth of his children or grandchildren
(provided of course that the latter are known to
the interviewer), or the names of earlier political
leaders. Awareness of the sequence of events
is as important as the recall of individual items

life cycles
-biological bases of behavior, biological mediators,
-psychological bases of behavior, activity/behavior / motivation/
volition-Factors involved in taking decision, -developement in life
cycles.
-psychopatology of social behavior, Communication, culture, body
image, sexuality, violence, disturbance of the physical, emotional
and social well-being determined by the use and abuse of
substances
-doctor- pacient relationship, communication skills, personality
disorder- overview, introduction in psychosomatic medicine.
-providing medical services; physical restraint, ethical and legal
issues.

 When a patient is in hospital, important

information about memory is available from
observations made by nurses and occupational
therapists. These observations include how fast
the patient learns the daily routine and the
names of staff and other patients, and whether
he forgets where he has put things, or where to
find his bed, the sitting room, and so on.

 For elderly patients the questions about

memory in the clinical interview
discriminate poorly between those who
have a cerebral pathology and those who
do not. For these patients it is more
informative to use a standard set of
questions that lead to a rating. One widely
used rating, the Mini-Mental State
Examination, is reproduced in the
appendix to this chapter.

Insight
When insight is assessed, it is important to keep in mind
the complexity of the concept (see Chapter 1). By the
end of the mental state examination, the interviewer
should have a provisional estimate of how far the patient
is aware of the morbid nature of his experiences.
Direct questions should then be asked to assess this
awareness further.
These questions are concerned with the patients opinion
about the nature of his individual symptoms, for example
whether he believes that his extreme feelings of guilt are
justified or not.

 The interviewer should also find out whether the

patient believes himself to be ill (rather than, say,
persecuted by his enemies) and, if so, whether
he thinks that the illness is physical or mental,
and whether he sees himself as needing
treatment.
The answers to these questions are important
because they determine, in part, how far the
patient is likely to collaborate with treatment. A
note that merely records insight present or no
insight is of little value.

Theoretical bases of the tridimensional

equation. Relational determination of
behavioral reactions

Paul Fraisse: Today we cannot study human other than related to

his behavior. Even elementary declarations or expressions, phrases
of a subject represent a part of his behavior. Nobody can infirme the
concept of Watson.
In fact, Watsons behavioral mechanism stimulus- reaction(S-R),
which seems today so natural and simple, same with Pavlovs
reflexology, is a result of clasical research methods insufficiency
(based on introspection).( Psychology must became experimental,
repeatable, objective).
Acording humans life complexity ,grown-up, the watsonian couple
stimulus-reaction(S-R) is obvious, stable in real life( the subtle
aspect being miss, overlooked).

S-P-R
That in why the study of human behavior is including the
notion of personality in the formula, between stimulus
and reaction
S means not only stimulus but also situation, complex of
stimuli.
S, Situation is related to an specific subject, and his acts,
conduct, reaction R-> are related to his personality P, his
body, experience, temperament, needs.
R=f(S P)
-
That means continuous interactions between complexlife
situationsS and human personality P, draw as an arrow
with to directions.

R.B. Catell formula ,used in evaluating

personality in experimental psychology
laboratories
Equation of ergic tension
E=S[C+H(P-aG)]-bG.
E- erg, innate tendency, generated by the drives,
found in all evoluated mammals, determinative
for goal oriented behavior and attitudes. This
tendency stop to act immediate after achieve a
level of accomplishment or completion,fulfilment.
/-any drive (sexual, feeding..).
Any erg have a need strenght that will develop
drive strenght under the influence of stimulus
strenght.

Need strenght: C+H(P-aG)

Increased or decreased related to the amount of
goal satisfaction, gratification.
Ex. After a good meal is a significant decrease of
the level of ergic tension.
C- body constitution, genetical determined
component of personality (drive strenght)
Need strenght depends also on H history; innate
tendencies stimulated or inhibited accordig to
the persons experiences and life style.
After you eat comes the appetite

C+H(P-aG)
P- PHYSIOLOGICAL component
Ex. Degree of functioning of secretory glands of
gastric secretion, accompanied by the
perception of hunger.
Correction mean deviation of the quantity of
accomplishment of goal satisfaction, gratification
G.
A second correction, -bG, decreased of
psychological tension related to the gratification
of the need.

life cycles
-biological bases of behavior, biological mediators,
-psychological bases of behavior, activity/behavior / motivation/
volition-Factors involved in taking decision, -developement in life
cycles.
-psychopatology of social behavior, Communication, culture, body
image, sexuality, violence, disturbance of the physical, emotional
and social well-being determined by the use and abuse of
substances
-doctor- pacient relationship, communication skills, personality
disorder- overview, introduction in psychosomatic medicine.
-providing medical services; physical restraint, ethical and legal
issues.

1. Bruno Wicker; Pierre Fonlupt; Benedicte Hubert; Carole Tardif, Bruno Gepner; Christine Deruelle,
Abnormal Cerebral Effective Connectivity During Explicit Emotional Processing in Adults With Autism
Spectrum Disorder, posted 10/24/2008, Soc. Cogn Affect Neurosci. 2008, 3(2);135-143, 2008, Oxford
University Press

The multifacetated non-verbal information

comunicated by faces is crucial to social
and communicative competence and
contributes to our ability to regulate social
interactions. Autism is a pervasive
developemental disorder with a unique
profile of impairments in social comunication
and interactions( Hobson,1986), leading to a
dramatic inability for adaptive social
behaviour.(1).

Recent data however suggest that the problem in autism may be

more due to the abnormal connectivity patterns in the brain rather
than to local deficits in a specific region (Belmonte et al., 2004;
Courchesne and Pierce, 2005; Wickelgren, 2005).
This hypothesis appeard as early as 1988 (Horwits et al., 1988), but
has received support only recently.
Abnormal correlation of activation between extrastriate and superior
temporal cortices was observed during attribution of mental states
from movements of animates shapes ( Castelli et al.,2002).
Similarly, decreased functional connectivity between Wernickes and
Brocas areas during language processing (Just et al., 2004) and
reduced functional connectivity between V1 and inferior frontal
cortex in a visuo-motor task (Vilalobos et al., 2005) have been
described.

 Other examples of reduced functional

connectivity have been observed , e.g.
in an executive functioning task (Just et al.,
2007),
an imagery task (Kana et al.,2007),
an inhibition task (Kana et al ., 2007) and
in a fixation resting state( Cherkassky et al.,
2006).
Thus, a number of functional neuroimaging
studies suggest that there is a lower level of
coordination among brain areas in autism.(1).