Quote:
Originally Posted by starkind
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So it's like forensic profiling, which isn't always accurate. That's a pretty bunk science.
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I’ll give some examples. Kids often try to claim hearing voices or seeing things, but schizophrenia comes out almost always at the end of puberty, so around 18-20 for girls and a few years older than that for boys. A psychiatrist who hears an 11 year old claim to be hearing voices is obviously going to be extremely skeptical that this child has schizophrenia rather than maybe a trauma response or simply their imagination. And a big indicator of this other than their age is their facial expressions
But let’s say it’s an adult or a child saying this. Adults often confuse their own inner monologue with auditory hallucinations, so let’s assume an adult claims to be hearing voices saying they are no good and should kill themself. A good follow up question is to ask where these voices are coming from. For a schizophrenic person with auditory hallucinations, they will almost always claim it to be from an outside source, such as behind a wall, from the tv, from the vents, etc, rather than within their own head. To go back to facial expressions, someone experiencing psychosis without mania will often have a flat emotionless affect, or a very labile (all over the place) affect, or sometimes an affect incongruent to what they are saying. So if a doctor is evaluating a man who has already smiled when he shook the doctor’s hand, frowned when relating a negative thing, and said he hears a voice in his head telling him he is no good and should kill himself is not going to get a schizophrenia diagnosis. His affect is context-appropriate, he doesn’t display disorganized speech or thoughts, and he is claiming the voice is coming from his own head, meaning it is his own internal monologue
That’s an example of how facial expressions matter. They are a part of evaluation, never the entire evalustion
09-15-2021, 03:27 PM
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