FLAT AFFECT AS PHENOMENON AND PREDICTOR OF SHORT-TERM OUTCOME IN PSYCHOSIS: WORDS WITHOUT FEELINGS, FEELINGS WITHOUT WORDS.
Item
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Title
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FLAT AFFECT AS PHENOMENON AND PREDICTOR OF SHORT-TERM OUTCOME IN PSYCHOSIS: WORDS WITHOUT FEELINGS, FEELINGS WITHOUT WORDS.
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Identifier
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AAI8302505
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identifier
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8302505
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Creator
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FOSHA, DIANA.
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Contributor
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Harold Wilensky
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Date
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1982
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical
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Abstract
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A review of the literature on differential diagnosis and prognosis in the functional psychoses revealed that of all signs and symptoms in evidence during an acute psychotic episode, affect quality was the strongest predictor of outcome five, ten and twenty-two years later. This investigation addressed two questions: (1) What are flat and full affect states differentially associated with in the realms of psychotic symptomatology, formal thought disorder, verbal communication and kinesic activity; (2) Is flat affect also a predictor of short-term outcome, i.e., does flat affect on admission predict greater impairment at discharge? Twenty-two psychotic patients with few if any prior hospitalizations were evaluated on all measures twice, on admission when floridly psychotic and several weeks later, during partial remission.;The data suggest that phenomena in all four areas significantly differentiate the flat affect from the full affect state. Flat affect is accompanied by anergia, negative thought disorders, low verbal productivity, absence of communicative hand movements and an isolated impersonal discourse style. Full affect is associated with high verbal productivity, high rate of communicative hand movements, and an interpersonally-related discourse style. Positive symptoms (e.g., hallucinations), positive thought disorders (e.g., derailment), body-focused hand movements (i.e., self-stimulation) and syntactic complexity do not distinguish flat from full affect states. Flat affect on admission predicts significantly more anergia, negative thought disorders and low verbal productivity at discharge; counter to hypotheses, it does not predict prevalence of positive symptoms, positive thought disorders, self-stimulation rate or syntactic complexity.;It is noteworthy that only 50% of patients with flat affect on admission exhibited flat affect on discharge; the remaining 50%, who demonstrated a marked brightening of affect, were indistinguishable from the full affect group on most measures by discharge.;The adaptive value of flat affect was conceptualized in terms of its own arousal properties as well as the information-processing characteristics of the interpersonal interactions it makes more probable: it is a strategy used by psychotic individuals to reduce internal and external stimulation, and to enhance the predictability of their intrapsychic as well as interpersonal worlds.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
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Program
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Psychology
