Mar 28, 2024
Imagery
Synaesthesia
Form Constants
Abnormal Perception
Sensory Distortions
Spatial form (size)
Dysmegalopsia
Intensity
Quality
Spatial location
Uniqueness of experience
Intensity
Spatial position
Palinapti
Exosomesthesia
Alloaesthesia
Intensity
Quality
Splitting of Perception
False Perceptions/Sensory Distortions
Illusions
Completion illusion
Affect illusion
Pareidolia
Perceptual misinterpretation
Functional hallucinations
Fantastic interpretations/ Elaborate daydreaming
Trailing Phenomena
There are two categories of perceptual disorders: sensory distortions and sensory deceptions. Sensory distortions are actual objects perceived via a warped lens. A patient may perceive, for instance, that a pen is larger than it actually is. False perceptions are another name for sensory deceptions. These are fresh perspectives that an individual encounters, which might or might not be connected to actual items.
The first step in taking in information from the external environment is sensation. The sensory system provides us with information from the outside world through sensory pathways. Numerous sensory pathways consist of: The visual pathway, which transports data from the eyes to the central nervous system.
• The information is received by the ear through the auditory pathway.
• The tactile pathway via the touch sense.
• The sense of smell.
• Requiring in terms of flavor.
• Kinaesthetic through the perception of bodily position or motion
• Proprioceptive pathway, which is the ability to perceive joint position or motion and sense the body in space.
• The cerebral cortex or central nervous system receives this sensory raw data from peripheral receptors, where it is then transformed or sent upward.
Perception is the process by which unprocessed sensory inputs are converted into sensory information, which is then cortically decoded to provide a meaningful perception. For instance, someone is grasping a pen. Through tactile and visual pathways, among others, he receives information that is sent to the cortex level of the brain and given meaning, such as the act of holding a pen.
In essence, perception is the meaning provided at the cerebral level, whereas sensation is the raw data. A number of variables, including attention, affect, memory, and prior experiences, influence perception.
Perception is significantly influenced by attention. For instance, someone who isn't paying attention and is looking for a spectacle even when he is holding one.A pen gifted by a close friend or relative may be perceived differently depending on the effect, or feelings. It might also rely on recollections or prior encounters. Perception is an active process that relies on internal variables and involves the formation of the outside world.
Perception and sensation are not the same thing. In visual object agnosia, for instance, a patient may detect items in his range of vision but is unable to identify the object or its purpose. In a similar vein, a person can see an elephant's limbs, tail, teeth, or body but is unable to identify it as an elephant. Sensation is therefore unaffected, but perception is compromised.
Imagery, often known as "seeing with the eyes of the mind" or "hearing with the ears of the mind," is an internal mental image of the world that is actively pulled from memory. When asked to name any beach or hilly place you have visited, for instance, you conjure up an image of the location in your mind that is consistent with your recollection of the location.
We refer to this as imaging.Additionally, imagery is particularly helpful for doing crucial cognitive tasks like mental math, visualization, and place-imagining. Jasperes defined imagery in 1962. He endowed imagery with particular qualities that set it apart from ordinary perception.
Understanding perceptions, hallucinations, and pseudo-hallucinations is aided by imagery. It also aids in comprehending the brain substrate and mechanics of imagery, which may overlap with anomalous perception.
Normal Perception | Imagery(Jaspers 1962) |
Concrete reality | Figurative, have a character of subjectivity |
Occur in External | Occur in Inner |
Objective Space | Subjective Space |
Clearly Delineated | Incomplete & Poorly Delineated |
Sensory Elements: Full & Fresh | Relatively insufficient |
Constant, remain unaltered | Dissipate, have to be recreated |
Independent of our will | Dependent on our will |
Although it is an uncommon occurrence, it is not thought to be an unusual experience. The experience of an object displayed in one sensory modality simultaneously in another is known as synesthesia.
For instance, if someone claims to be able to see the color of the music they are listening to or the flavor of the food they are eating. People perceive the same thing in two different modalities in both situations. We refer it this as synesthesia. This phenomenon is not the same as what is perceived or imagined.
It is felt in close proximity to the body, or in peripersonal space, which is defined as within arm's reach. It resembles a place where people have hallucinations. Synesthesias are basic, recurring, and specialized in character. There is proof that the experiences associated with certain synesthesias are instances of form constants, or geometric patterns. Changes could be observed in terms of hue, form, dimensions, spin, etc.
These synesthesias can manifest as spirals, honeycombs, tunnels, loans, etc. for the patient.
Form constants appear to be a feature of the visual brain; individuals report experiencing them during sensory deprivation episodes and migraine auras.Understanding synesthesia facilitates our understanding of significant aberrant perception in peripersonal space.
These are not images or everyday experiences. Experiences such as synesthesia, which are not abnormal, might take place in a third space.A person may not always suffer aberrant perceptions; rather, the shapes of these abnormal perceptions may be determined by a neurological substrate of perception.
Syntactical hallucinations are those that arise during auditory hallucinations. This indicates that they are not just a collection of words. For instance, second- or third-person hallucinations and command hallucinations.
Vygotsky's developmental model of thought and speech is a key hypothesis concerning auditory hallucination. He postulated that internalized external discourse results in private speech, which is then transformed into inner speech and ultimately causes hallucinations.
Two categories of abnormal perceptions are sensory distortions and sensory deception, also known as false perceptions.Real eternal objects are distortedly fooled in sensory distortions. Sensory deception, also known as false perception, is the creation of new perceptions that may or may not be a result of external stimuli. An example of this would be a patient perceiving a pen to be larger or different in shape than it actually is. Examples of sensory deceptions include illusions, hallucinations, and pseudohallucinations. Let's say that you are not wielding a knife, but someone believes you are.
Mental state disorders with or without organic brain illness can result in sensory distortions.Any of the fundamental components of perception could be affected by these shifts in perception. For instance, the perception's quality, intensity, or spatial form change.Additionally, it can be comprehended by looking at the fundamental elements of the modality—such as tactile, auditory, or visual—through which we are experiencing the item.When there are sensory aberrations, the seen item is accurately identified. An object deviates from its usual appearance without changing our understanding of what kind of object it is.
The individual perceives the object as being bigger. This is referred to as megalopsia, or macrospia, whereas micropsia is the appearance of a smaller object. This phenomenon manifests as smaller-than-life objects or people in dreams or hallucinations, such as Lilliputian hallucinations.
One side of the eyesight is smaller than the other in hemimicropsia. Patients suffering from temporal lobe epilepsy frequently exhibit these abnormalities.Metamorphopsia is a type of visual distortion in which an individual perceives changes in an object's shape. For instance, everything appears to be upside down or an object appears to have an odd shape. Metamorphopsia is a condition that affects the face in paraprosopia. People's faces appear deformed to the observer.
The most prevalent cause of this dysmegalopsia is temporal and parietal lobe lesions, especially in posterior temporal lobe causes such as during seizures the person suffers dysmegalopsia. Dysmegalopsia can be macrospia, micropsia, or metamorphopsia. Dysmegalopsia can also result from retinal diseases, including those affecting convergence and accommodation.
The visual constituents on the retina are divided if there is retinal edema. As a result, the picture is focused on the retina's functionally smaller region, which causes micropsia, or smaller image creation.
Retraction-induced retinal scarring may result in macropsia. Scarring typically results in irregular distortion, or metamorphopsia.
Macropsia can happen when there is total paralysis of accommodation or overactivity of accommodation during close vision. Micropsia, on the other hand, might happen if there is partial paralysis of accommodation during close vision. Micropsia is caused by damage to the nerves governing accommodation and convergence in arachnoiditis patients.
If a person has normal accommodation but weak convergence, macropsia may happen and objects will appear larger. Micropsia, on the other hand, could happen if accommodation is poor with normal convergence. Atropine or hyoscine poisoning, schizophrenia, and high altitude pilots due to hypoxia, high motion causing changes in accommodation and convergence are other less prevalent causes of dysmegalopsia.
Intensity is another sensory distortion that affects basic features of visual perception. The perception object's intensity can change.
Hyperesthesia is present if the intensity is high. This could be the result of a drop in the physiological threshold or strong emotions. There is an increase in color intensity in visual hyperaesthesia. For instance, colors appear brighter in mania, hypomania, and LSD users. These can occasionally also happen with typical strong emotions.
The apparent intensity of color is reduced in visual hypoaesthesia. A person suffering from illnesses like schizophrenia and depression may perceive things as being ancient, empty, or black.
Quality of perception may change in toxicities like digitalis and mescaline poisoning. Perception quality may change in visual perception. Things seem to have a more yellow hue in xanthopsia. In chloropsia, objects seem more green, while in erythopsia, objects appear redder.
Achromatopsia is characterized by the total lack of color. Certain organic disorders, such unilateral or bilateral occipital lesions, may cause this.On the other hand, a person suffering from dyschromatopsia is unable of identifying colors. Unilateral posterior occipital lesions may present with this. Derealization also has an impact on perceptual quality. Derealization is characterized by a sense of unreality in the perceptual field, a disconnection from reality, or a change in the emotions connected to observed items. When a patient is in mania, objects around them may appear flawless and lovely.
Another common visual perception error is spatial location distortion, which causes an object to appear to be in a different location than it actually is. In pelopsia, items appear closer than they actually are, while in telopsia, objects appear farther away. Alloaesthesia denotes that the observed object is not where one would expect it to be. The individual in front of him, for instance, appears to have moved to the right.
The impairment of visual sense of motion is known as akinetopsia. It can happen in cases of bilateral post-cortical injury and is uncommon. For instance, when someone pours water into a glass, they may continue to pour even after the glass is filled because they are unable to sense the motion of the water in the glass.
In palinacousis, sounds are seen as continuing, auditory perception lasts longer than expected, and the individuality of the perceptual experience is warped. For instance, a person might be fiddling with his phone, and after a while, the phone does ring.
The degree of auditory perception might fluctuate in strength. When someone has hyperacuosis, everything sounds unnaturally loud, and they close their ears because they can't handle the noise. This happens because the point at which noise becomes intolerable is being lowered. This is evident in alcohol toxicity, anxiety, migraines, depression, and so forth. Hypoacuosis is characterized by a low intensity and an elevated threshold of feeling.
Even if the voice is loud, the person cannot hear. This could manifest as delirium. Additionally, it can be observed in a number of disorders where attention declines, including ADHD in children and depression. As a result, speaking with these patients should be done louder and more slowly.
The place from which the sound is occurring may appear nearer, further, or displaced in position.
The sensation of tactile sensation that lasts longer than the stimuli is known as palinaptia. Even though the person has kept the object on the table, it looks as though it is in their hand. Conditions like bilateral parietal lesions are examples of this. We can think of these as intricate haptic hallucinations.
The displacement of cutaneous sensation into an extrapersonal space is known as exosomesthesia. For instance, when someone touches your hand while you are carrying a pen, it appears as though they have touched the pen.
Exosomesthesia experimentation demonstrates that the feeling extends to an external item instead of the body. As an illustration, the right hand is placed beneath the table, and simultaneously the table and the right hand beneath the table are tapped. The table seems to be a part of the person's body once they continue tapping, and they feel something coming from it.
Alloaesthesia is the perception of a sensory stimuli on one side of the body on the other. Someone touches his hand, but he thinks it's his left hand. Multiple sclerosis, cervical tumors, and cervical disc herniation are examples of spinal cord lesions that exhibit this, as might lesions of the putamen on the right side.
There may be a decrease in the intensity of flavor perception. A person experiencing depression could think that food tastes the same or has no flavor at all.
There can be a shift in how well taste is perceived. For instance, someone taking lithium could taste metallic.
There are two ways in which time is experienced in psychiatry: personally and physically. Whereas personal time is established by an individual's assessment of the passage of time, physical time is the real time.Different psychiatric conditions might have an impact on personal time. Time may pass differently depending on one's mood. When you're pleased or having a wonderful day, for instance, time seems to go by very quickly. However, there are moments when people are depressed and keep their eyes on the time, and time seems to go by very slowly. In people with psychotic depression, this is more pronounced. However, manic patients experience a rapid sense of time.
The ability to judge time is compromised in schizophrenia. People see time differently. The patient might feel as though their time is being reduced or extended. Chronic cases may cause confusion about one's age. A sixty-year-old person, for instance, might think of themselves as thirty years old. Time dizziness occurs in several acute pathological conditions, such as delirium. Patients with temporal lobe lesions may complain of time going slowly or fast. For instance, the patient may say it is evening when it is actually morning.
This is not very common. This is observed in schizophrenia as well as in a number of biological disorders.The patient experiencing splitting of perception is unable to establish the typical anticipated connection between two or more perceptions. A person may perceive sounds and visuals as coming from multiple sources, for instance, if they are watching television and the voice is coming from the TV. Patients frequently perceive these two perspectives to be providing contradicting information.It happens when connections are not established between various sensory modalities. There seems to be a clash between the sensations.
Hallucinations are not triggered by external stimuli, whereas illusions are false perceptions that arise in reaction to external stimuli. • A new perception may arise in erroneous perception or sensory distortions, which may or may not be in response to external stimuli.
False perceptions brought on by outside stimuli are known as illusions. These are also erroneous interpretations of inputs originating from an outside source. A mistake is created when stimuli from a viewed item are coupled with an idea in the mind.
• Example 1: A person discovers a snake under a bed when they wake up in the middle of the night. However, upon turning on the lights, it was discovered to be a rope. The serpent represented a false impression of the rope, which was a real object.
• Example 2: It's a common misunderstanding that curtains move when someone wakes up in the middle of the night and perceives someone standing behind the window.
Perceptions that disagree with physical stimuli are sometimes referred to as illusions. An example of this is the Muller-Lieber illusion, which illustrates how two identical lines with arrows pointing in different directions appear to be of different lengths. Delirium, where the threshold for perception is elevated, and fear can also result in illusions.
Visual illusions are the most frequent type of illusion.
Patients may occasionally experience a remarkable illusion in which they perceive astonishing changes to their surroundings. For instance, when someone looks in the mirror, they see the face of a dog rather than themselves. SIMS (2003) distinguishes between three different kinds of illusions. Pareidolic illusion; completion illusion; affect illusion; and so on
In a newspaper, the word "DOK" is not printed correctly; someone interested in cooking may read it as COOK; if you read it carefully or pay more attention, the word is actually TOOK. Completion illusion depends on inattention to the occurrence.
As soon as attention is given, the perception changes. For example, you are reading a magazine with a misprinted word, but you still read it as it is written correctly based on your past experience.
Effect is what gives rise to this illusion. These illusions are transient and typically go away when severe anxiety is distracted from. They can be understood in the context of dominant mood states. When someone is delirious, they are confused or extremely complex. He or she might believe that other people are innocent. A person might feel as though they are being stabbed from behind when they are, for instance, patted on the back.
Patients suffering from depression who have guilt delusions may also experience affect illusions. For instance, because of his emotional state, he might hear others discussing killing him. Completion and affect illusion can occasionally happen simultaneously. For instance, when someone experiences sadness over the loss of a loved one, they may momentarily identify the deceased in a crowd as a result of illusions as well as fulfilment. However, upon closer inspection, the sense of familiarity becomes clear, and he determines that the individual is someone else.
Normal individuals may experience pareidolia frequently. Pareidolia causes visuals to be perceived as forms. These are made by combining sensory perceptions with creativity, and the result is a fully realized, detailed appearance. Psychomimetic medications may elicit it.
For instance, someone may unintentionally or against their will see clear images of fire or clouds. Duck faces could be visible in the clouds. Pareidolia is what this is. When more attention is paid here, more intricate objects become visible. This contrasts with illusions of feeling and fulfillment.
If someone pays more attention, pareidolia gets more complex and detailed; in other words, its intensity rises. Children are more likely than adults to experience it. Distinguishing illusions from functional hallucinations, fantastic interpretation, perceptual misinterpretation, and trailing phenomena is important.
Making an error with fantasy that isn't impacted by emotion is known as perceptual misinterpretation. For instance, ignorance leads people to mistake marijuana for an extremely valuable herb.
An external stimulus causes a new perception in a functional hallucination. In this instance, the perception and the hallucination are different, distinct, and occur simultaneously.
For instance, when someone turns on the lights, what they initially perceive to be a snake turns out to be a rope. Either a rope or a snake is visible to the person. But when someone has a functional hallucination, he sees a snake every time he sees a rope. At the same time, he sees the snake and the rope.
These may resemble illusions of pareidolic shapes. It mostly happens when fantasy is mixed in with these illusions; for example, a person may daydream in great detail as a result of fantasies.
Trailing phenomena are perceptual irregularities in which moving objects are perceived as a sequence of discrete and discontinuous pictures; it is not strictly an illusion. When a ball is tossed, for instance, the recipient may perceive it as distinct things at various points in space. When someone waves, the hand could be perceived as a distinct, discontinuous perception. When using hallucinogenic substances like LSD, trailing phenomena can be observed.
Hope you found this blog helpful for your Psychiatry residency Neurology and General Medicine preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.
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