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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Because of reduced levels of trust, there can be challenges in treating PPD. However, psychotherapy, antidepressants, antipsychotics and anti-anxiety medications can play a role when an individual is receptive to intervention.
Ideas of reference and delusions of reference describe the phenomenon of an individual's experiencing innocuous events or mere coincidences and believing they have strong personal significance. It is "the notion that everything one perceives in the world relates to one's own destiny".
In psychiatry, delusions of reference form part of the diagnostic criteria for psychotic illnesses such as schizophrenia, delusional disorder, bipolar disorder (during the elevated stages of mania), as well as schizotypal personality disorder. To a lesser extent, it can be a hallmark of paranoid personality disorder. Such symptoms can also be caused by intoxication, especially with hallucinogens or stimulants like methamphetamine.
Thought insertion is defined by the ICD-10 as feeling as if one's thoughts are not one's own, but rather belong to someone else and have been inserted into one's mind. The person experiencing thought insertion will not necessarily know where the thought is coming from, but is able to distinguish between their own thoughts and those inserted into their minds. However, patients do not experience all thoughts as inserted, only certain ones, normally following a similar content or pattern. This phenomenon is classified as a delusion. A person with this delusional belief is convinced of the veracity of their beliefs and is unwilling to accept such diagnosis.
Thought insertion is a common symptom of psychosis and occurs in many mental disorders and other medical conditions. However, thought insertion is most commonly associated with schizophrenia. Thought insertion, along with thought broadcasting, thought withdrawal, thought blocking and other first rank symptoms, is a primary symptom and should not be confused with the delusional explanation given by the respondent. Although normally associated with some form of psychopathology, thought insertion can also be experienced in those considered nonpathological, usually in spiritual contexts, but also in culturally influenced practices such as mediumship and automatic writing.
Examples of thought insertion:
"She said that sometimes it seemed to be her own thought 'but I don't get the feeling that it is'. She said her 'own thoughts might say the same thing', 'but the feeling isn't the same', 'the feeling is that it is somebody else's'"
"I look out the window and I think that the garden looks nice and the grass looks cool, but the thoughts of Eamonn Andrews come into my mind. There are no other thoughts there, only his. He treats my mind like a screen and flashes thoughts onto it like you flash a picture"
"The subject has thoughts that she thinks are the thoughts of other people, somehow occurring in her own mind. It is not that the subject thinks that other people are making her think certain thoughts as if by hypnosis or psychokinesis, but that other people think the thoughts using the subject's mind as a psychological medium."
Assessment of patients with DES can be difficult because traditional tests generally focus on one specific problem for a short period of time. People with DES can do fairly well on these tests because their problems are related to integrating individual skills into everyday tasks. The lack of everyday application of traditional tests is known as low ecological validity.
Most of the treatments for thought insertion are not specific to the symptom, but rather the symptom is treated through treatment of the psychopathology that causes it. However, one case report considers a way to manage thought insertion through performing thoughts as motor actions of speech. In other words, the patient would speak his thoughts out loud in order to re-give himself the feeling of agency as he could hear himself speaking and then contributing the thought to himself.
The verbal fluency test is a widely and commonly used test to assess for frontal lobe dysfunction in patients.
- Procedure:
Participants are asked to generate words beginning with letters that had previously been introduced to them (e.g.: generate a word beginning with 'A' or 'R'). They are given three 1-min trials (one trial per letter). The goal is to say as many different words possible that begin with the given letter.
- Results:
The Verbal fluency test can assess for damage in the prefrontal lobes, which has been associated with patients suffering from source amnesia. Patients with frontal lobe disorder have trouble putting verbal items into a proper sequential order, monitor personal behaviors as well as a deficient judgment in recency. All of these behaviors are required for the proper recall of the source of a memory.
Neurosis is a class of functional mental disorders involving chronic distress but neither delusions nor hallucinations. The term is no longer used by the professional psychiatric community in the United States, having been eliminated from the "Diagnostic and Statistical Manual of Mental Disorders" in 1980 with the publication of DSM III. It is still used in the .
Neurosis should not be mistaken for psychosis, which refers to a loss of touch with reality. Neither should it be mistaken for neuroticism, a fundamental personality trait proposed in the big Five personality traits theory.
The Wisconsin Card Sorting Test is widely used in clinical settings to test for cognitive impairments, such as frontal lobe disorder which has been associated with source amnesia.
- Procedure:
The visuo-spatial component of this test is devised of two sets of 12 identical cards. The figures on the cards differ with respect to color, quantity, and shape. The participants are then given a pile of additional cards and are asked to match each one to one of the previous cards.
- Results:
Patients suffering from frontal lobe dysfunction and ultimately source amnesia, will have much greater difficulty finishing this task successfully through method of strategy.
Thought disorder (TD) or formal thought disorder (FTD) refers to disorganized thinking as evidenced by disorganized speech. Specific thought disorders include derailment, poverty of speech, tangentiality, illogicality, perseveration, and thought blocking.
Psychiatrists consider formal thought disorder as being one of two types of disordered thinking, with the other type being delusions. The latter involves "content" while the former involves "form". Although the term "thought disorder" can refer to either type, in common parlance it refers most often to a disorder of thought "form" also known as formal thought disorder.
Eugen Bleuler, who named schizophrenia, held that thought disorder was its defining characteristic. However, formal thought disorder is not unique to schizophrenia or psychosis. It is often a symptom of mania, and less often it can be present in other mental disorders such as depression. Clanging or echolalia may be present in Tourette syndrome. Patients with a clouded consciousness, like that found in delirium, also have a formal thought disorder.
However, there is a clinical difference between these two groups. Those with schizophrenia or psychosis are less likely to demonstrate awareness or concern about the disordered thinking. Clayton and Winokur have suggested that this results from a fundamental inability to use the same type of Aristotelian logic as others. On the other hand, patients with a clouded consciousness, referred to as "organic" patients, usually do demonstrate awareness and concern, and complain about being "confused" or "unable to think straight"; Clayton and Winokur suggest that this is because their thought disorder results, instead, from various cognitive deficits.
A monothematic delusion is a delusional state that concerns only one particular topic. This is contrasted by what is sometimes called "multi-thematic" or "polythematic" delusions where the person has a range of delusions (typically the case of schizophrenia). These disorders can occur within the context of schizophrenia or dementia or they can occur without any other signs of mental illness. When these disorders are found outside the context of mental illness, they are often caused by organic dysfunction as a result of traumatic brain injury, stroke, or neurological illness.
People who experience these delusions as a result of organic dysfunction often do not have any obvious intellectual deficiency nor do they have any other symptoms. Additionally, a few of these people even have some awareness that their beliefs are bizarre, yet they cannot be persuaded that their beliefs are false.
A self-disorder, also called ipseity disturbance, is a psychological phenomenon of disruption or diminishing of a person's sense of minimal (or basic) self. The sense of minimal self refers to the very basic sense of having experiences that are one's own; it has no properties, unlike the more extended sense of self, the narrative self, which is characterized by the person's reflections on themselves as a person, things they like, their identity, and other aspects that are the result of reflection on one's self. Disturbances in the sense of minimal self, as measured by the Examination of Anomalous Self-Experience (EASE), aggregate in the schizophrenia spectrum disorders, to include schizotypal personality disorder, and distinguish them from other conditions such as psychotic bipolar disorder and borderline personality disorder.
The Behavioural Assessment of the Dysexecutive Syndrome (BADS) was designed to address the problems of traditional tests and evaluate the everyday problems arising from DES. BADS is designed around six subtests and ends with the Dysexecutive Questionnaire (DEX). These tests assess executive functioning in more complex, real-life situations, which improves their ability to predict day-to-day difficulties of DES.
The Dysexecutive Questionnaire (DEX) is a 20-item questionnaire designed to sample emotional, motivational, behavioural and cognitive changes in a subject with DES. One version is designed for the subject to complete and another version is designed for someone who is close to the individual, such as a relative or caregiver. Instructions are given to the participant to read 20 statements describing common problems of everyday life and to rate them according to their personal experience. Each item is scored on a 5-point scale according to its frequency from "never" (0 point) to "very often" (4 points).
Treatment often involves the use of behavioral modification and anticonvulsants, antidepressants and anxiolytics.
An example of circumstantial speech is that when asked about the age of a person's mother at death, the speaker responds by talking at length about accidents and how too many people die in accidents, then eventually says what the mother's age was at death.
The delusions that fall under this category are:
- Capgras delusion: the belief that (usually) a close relative or spouse has been replaced by an identical-looking impostor.
- Fregoli delusion: the belief that various people whom the believer meets are actually the same person in disguise.
- Intermetamorphosis: the belief that people in one's environment swap identities with each other while maintaining the same appearance.
- Subjective doubles: a person believes there is a doppelgänger or double of him- or herself carrying out independent actions.
- Cotard delusion: the belief that oneself is dead or does not exist; sometimes coupled with the belief that one is putrefying or missing internal organs.
- Mirrored-self misidentification: the belief that one's reflection in a mirror is some other person.
- Reduplicative paramnesia: the belief that a familiar person, place, object, or body part has been duplicated. For example, a person may believe that they are, in fact, not in the hospital to which they were admitted, but in an identical-looking hospital in a different part of the country.
- Somatoparaphrenia: the delusion where one denies ownership of a limb or an entire side of one's body (often connected with stroke).
Note that some of these delusions are sometimes grouped under the umbrella term of delusional misidentification syndrome.
Some debates have pervaded the field of psychology since its genesis. Perhaps one of the most salient ones deals with the nature of personality. Personality psychology studies one's distinctive style of cognition, behavior, and affect. However, this concept elicits discord among psychologists as some have insisted that it does not exist, while others struggle with issues of measurement.
PPD occurs in about 0.5%–2.5% of the general population. It is seen in 2%–10% of psychiatric outpatients. It is more common in males.
The concept of thought disorder has been criticized as being based on circular or incoherent definitions. For example, thought disorder is inferred from disordered speech, based on the assumption that disordered speech arises because of disordered thought. Incoherence, or word salad, refers to speech that is unconnected and conveys no meaning to the listener.
Furthermore, although thought disorder is typically associated with psychosis, similar phenomena can appear in different disorders, potentially leading to misdiagnosis—for example, in the case of incomplete yet potentially fruitful thought processes.
It has been suggested that individuals with autism spectrum disorders (ASD) display language disturbances like those found in schizophrenia; a 2008 study found that children and adolescents with ASD showed significantly more illogical thinking and loose associations than control subjects. The illogical thinking was related to cognitive functioning and executive control; the loose associations were related to communication symptoms and to parent reports of stress and anxiety.
Treatment for perfectionism can be approached from many therapeutic directions. Some examples of psychotherapy include: cognitive-behavioral therapy (the challenging of irrational thoughts and formation of alternative ways of coping and thinking), psychoanalytic therapy (an analysis of underlying motives and issues), group therapy (where two or more clients work with one or more therapists about a specific issue, this is beneficial for those who feel as if they are the only one experiencing a certain problem), humanistic therapy (person-centered therapy where the positive aspects are highlighted), and self-therapy (personal time for the person where journaling, self-discipline, self-monitoring, and honesty with self are essential). Cognitive-behavioral therapy has been shown to successfully help perfectionists in reducing social anxiety, public self-consciousness, and perfectionism. By using this approach, a person can begin to recognize his or her irrational thinking and find an alternative way to approach situations. Cognitive-behavioral therapy is intended to help the person understand that it is okay to make mistakes sometimes and that those mistakes can become lessons learned.
There are many different neuroses: obsessive–compulsive disorder, obsessive–compulsive personality disorder, impulse control disorder, anxiety disorder, hysteria, and a great variety of phobias.
According to C. George Boeree, professor emeritus at Shippensburg University, the symptoms of neurosis may involve:
Neurosis may be defined simply as a "poor ability to adapt to one's environment, an inability to change one's life patterns, and the inability to develop a richer, more complex, more satisfying personality."
Low frustration tolerance (LFT), or "short-term hedonism" is a concept utilized to describe the inability to tolerate unpleasant feelings or stressful situations. It stems from the feeling that reality should be as wished, and that any frustration should be resolved quickly and easily. People with low frustration tolerance experience emotional disturbance when frustrations are not quickly resolved. Behaviors are then directed towards avoiding frustrating events which, paradoxically, leads to increased frustration and even greater mental stress.
In REBT the opposite construct is "high frustration tolerance".
In psychology and psychiatry, clanging refers to a mode of speech characterized by association of words based upon sound rather than concepts. For example, this may include compulsive rhyming or alliteration without apparent logical connection between words. This is associated with the irregular thinking apparent in psychotic mental illnesses (e.g. mania and schizophrenia). Gustav Aschaffenburg found that manic individuals generated these "clang-associations" roughly 10-50 times more than non-manic individuals. Aschaffenburg also found that the frequency of these associations increased for all individuals as they became more fatigued.
Clanging refers specifically to behavior that is situationally inappropriate. While a poet rhyming is not evidence of mental illness, disorganized speech that impedes the patient's ability to communicate is a disorder in itself, often seen in schizophrenia.
The minimal self has been likened to a "flame that enlightens its surroundings and thereby itself." Unlike the extended self, which is composed of properties such as the person's identity, the person's narrative, and other aspects that can be gleaned from reflection, the minimal self has no properties, but refers to the "mine-ness" "given-ness" of experience, that the experiences are that of the person having them in that person's stream of consciousness. These experiences that are part of the minimal self are normally "tacit" and implied, requiring no reflection on the part of the person experiencing to know that the experience is theirs. The minimal self cannot be further elaborated and normally one cannot grasp it upon reflection. The minimal self goes hand-in-hand with immersion in the shared social world, such that "[t]he world is always pregiven, ie, tacitly grasped as a self-evident background of all experiencing and meaning." This is the self-world structure.
De Warren gives an example of the minimal self combined with immersion in the shared social world: "When looking at this tree in my backyard, my consciousness is directed toward the tree and not toward my own act of perception. I am, however, aware of myself as perceiving this tree, yet this self-awareness (or self-consciousness) is not itself thematic." The focus is normally on the tree itself, not on the person's own act of seeing the tree: to know that one is seeing the tree does not require an act of reflection.
Mathematical anxiety is anxiety about one's ability to do mathematics. It is a phenomenon that is often considered when examining students' problems in mathematics.
There are several measures that can be employed to assess the executive functioning capabilities of an individual. Although a trained non-professional working outside of an institutionalized setting can legally and competently perform many of these measures, a trained professional administering the test in a standardized setting will yield the most accurate results.