The document discusses the psychological concepts of affect and mood, detailing their characteristics, evaluation parameters, and interrelationships. It outlines the types of affect, such as happiness and sadness, and assesses their range, intensity, stability, and appropriateness. Additionally, it addresses how affect can present differently in various psychiatric conditions, emphasizing the importance of congruence between mood and affect.

1. Made by
Psychologist
Stella

2. Affect:
 Visible external, objective manifestation of
emotional state.
 Dynamic changes in the expression of emotional
responses.
 Both internal stimuli (eg. Memories, ideas,
preoccupation) and external events (eg. Changes in
the environment) can after affect.
 ‘Emotional foreground’

3. Mood
 Subjective (described by patient) internal
feeling state or emotional tone over an
extended period of time.
 Less connected to internal stimuli or external
events.
 ‘Emotional background’

4. DescribingAffect
Affect can be evaluated along the following parameters:
 Type/Quality
 Range/Variability
 Degree/Intensity
 Stability/Mobility
 Appropriateness
 Congruence

5. 1. Type/ Quality
Type or quality is the predominant emotion expressed.
There are nine principal types of affect:
 Happiness
 Sadness
 Fear/anxiety
 Surprise  Shame
 Anger
 Interest
 Disgust
 Contentment

6. 2. Range/Variability
 The degree to which visible emotions vary.
 The patient would be expected to display various types of
affect (eg. Smile, frown, appear interested, sad, or
anxious.
 No standard degree of affect
 Terms used is ‘the patient showed an adequate range of
affect.?
 ‘Narrow/Restricted Range: Expression of only one or
two emotional states (eg. Mania, schiz paranoid disorders,
OCD).
 Wide Range or Expanded range: Several emotions are
displayed, eg. Cluster B PDs, dementia, delerium and
intoxication or withdrawal.

7. 3. Degree/Intensity (also called amplitude)

8. 3. Degree/Intensity (also called amplitude) contd……. .
 The ‘force of the expression’ eg. the good actor...
 Measure of the energy expended in Conveying the
feeling.
 Emotional expression is on continuum.
 Intense affect may go with narrow range eg. mania or
depn.
 Low intensity may go with wide range. eg. histrionic
personalities, delirium.

9. 3. Degree/Intensity (also called amplitude) contd……. .
 Blunting: lack of emotional sensitivity to other.
 Flattening: Limitation of useful intensity of emotion (as
in Schiz, conversion– la belle indifferénce, and OC and
schiz personalities.
 Heightened: seen in mania, narcisstic and borderline
personalities.
 Depressives conveny
 Either intense distress.
 Or are muted and apathetic

10. 4. Stability/Reactivity
 Duration of an affective response. eg. As brief as a
facial expression, or a tear shed; other may be more
pervasive.
 During an interview, for eg. There may be shifts
anxiety at the beginning, sadness when discussing a
loss, anger at the husband’s infidelity, happiness at
the son’s academic achievement.
 These periods (shifts) may be for some moments and
are appropriate to the context.

11. 4. Stability/Reactivity contd...
 If shifts in affect are small or non-existent, are
considered fixed or immobile and are more referable
to mood.
 Labile : rapid and frequent changes in affect.
 Changes could be either in intensity or range. eg.
Happy  tearful, low irritations  high irritation
(mania)

13. Inappropriate affect is seen in:
 Malingering- the emotional component of a
patient’s presentation doesn’t “add up” to the
verbalized problems.
 Substance use – introxication or withdrawal
can cause patients to be inappropriately jovial
or unconcerned with medical problems,
criminal charges, etc.
 Conversion disorder – la belle indiference
describes a distinct lack of concern for
reported neurologic deficits

14. Inappropriate affect is seen in contd…
 Depression- when patients have decided to
attempt suicide, they can become
unconcerned or untroubled by their pre-
existing problems
 Delirious or demented patients can seem to
be unusually concerned about trivial matters
(or the converse)
 Antipsychotic use – affective flattening can
occur through the parkinsonian side-effects
of these medications.

15. 6. Congruence
 Mood : Affect may not be congruent to mood state described by the Incongruity
may mean
 Malingering
 Two or more condition (mood & personality disorder)
 Substance use
 Schizoaffective disorder
 Schizophrenia
 Psychotic mood disorder.

16.  Appearance:
 Patient have little time or interest
 Grooming & Attire – Depressed patients neglect self care  disheveled.
 Manic patients dress flamboyantly (often in red) and use poor judgement
in picking new looks or styles.
 Schizophrenic patients may make bizarre alterations and become
unkempt.
 Facial expression –
 Unvarying movements are seen in depression and schizophrenia
 In mania and personality disorders: dramatic and exaggerated.
 Behaviour
 Posture
 Body movement/gesticulation
 Speech
 Inflection provides Modulation and emphasis in speech
 Makes speech interesting
 Reduced in depression, schizopohrenia or OC personalities.
 Enhanced in mania and cluster B personality disorders.

17. Affect has 3 functions
 Self perception – providing an emotional value
judgement.
 Communication – expression of feelings is made known
to others.
 Motivation –affect is one of the key elements leading to
the initiation of action.

18. Describing Mood
 Reactivity
 Intensity same as in affect
 Stability/Duration
 Pattern
 Type/Quality

19. Type/Quality
 Quality of mood is the patient’s self report on
emotional state.
 DSM includes
 Depressed Mood
 Euphoric Mood
 Angry / Irritable Mood
 Anxious Mood

20.  Depressed Mood:
 Less energetic, less hopeful, less worthy or less
capable than what is usual for them.
• Dysphoria: a state of unhappiness, or feeling ill at ease.

21. • Double Depression: Depressive episode on dysthymia

23. Euphoric Mood
 Patient feel energized, elated or ecstatic.
 Of a greater degree than what is experienced when patients are ‘up’
or in a ‘good mood.”

24. Euphoric mood often occurs with changes in:
 Appearance (unusual or bizarre changes).
 Behavior (move rapidly and continuously).
 Speech (speak loudly and have a lot to say).
 Affect (expanded range; labile, intense).
 Thought content (grandiose themes).
 Thought form (flight of ideas; pressure of speech).
 Cognitive functioning (creativity and word
association) may be enhanced or diminished because
of distractibility.

25. Angry/Irritable Mood
 Irritability: is being easily provoked to anger.
 Is one of the three mood states in mania or hypomania.
 Irritability is usually seen as the mood disorder increases in severity.
 Anger or irritability: seen in any condition and, in isolation, is not of significance.

27. Anxious Mood
 Can be normal
 Anxiety: is pathological when it is pervasive or to a degree,
interferes with social or occupational functioning.
 To distinguish anxiety from that seen in anxiety disorders,
this mood state is frequently referred to as apprehension.

29. Stability
 Describes the length of time a mood disturbance exists
without significant variation.
 Rapid Cycling Subtype: Four or more cycles
 Mixed State: Mania and depression coexist.

32.  Mood-incogruent psychotic features (MIPF)
 Four possibilities:
 Do not denote a specific subtype of illness.
 MIPF indicate a distinct subtype of mood disorder.
 MIPF denote a form of schizoaffective disorder.
 MIPF are a type of schizophrenia.
 The strongest evidence was for the second possibility,
with some support for the third.