Descriptive Psychopathology: The Signs and Symptoms of ...

82 Section 1: Present, past, and futureassume that other humans have minds similar to theirs and therefore they canunderstand and predict each other’s behavior. Persons with persecutory delusionsare said to have a deficit in this construct because they do not perform well ontasks concerning the “mental state” of others. 174 These studies, however, are weakand do not account for the effect of other features of schizophrenia influencingperformance (e.g. poor executive function and other cognitive impairment).ConclusionsDespite advances in neuroscience and countless efforts to correlate brain functionand psychopathology, the specificity of the findings is extremely limited.Perturbations in prefrontal circuitry are associated with catatonia. Basal gangliadysfunction is found in patients with OCD. Manic-depression is associated with anabnormal stress response and temporal–limbic dysfunction. The pathophysiologiccascades of these relationships, however, are mostly unknown.Brain–psychopathology relationships are modestly helpful in delineatingbehavioral syndromes due to specific neurologic causes. Motor psychopathologyassists in localization of brain disease. Avolition and apathy signal prefrontalcircuitry dysfunction. Visual hallucinations and distortions suggest a lesion inthe visual system. Misidentification and passivity delusions are associatedwith non-dominant hemisphere disease. Sudden and transient abnormal emotionalexpression is associated with subcortical and limbic lesions. Subsequentchapters detail the associations of specific psychopathologic phenomena anddifferential diagnosis.NOTES1 The quote is the opening paragraph from the author’s preface of Theodor Meynert’s 1885text book in which he defined psychiatry as the clinical study of “the diseases of the forebrain”(Meynert, 1968). Meynert was a world-renowned neuropathologist making lastingcontributions to that discipline, and the first professor of nervous diseases at the Universityof Vienna, where he was also the chief of their psychiatric clinic. Meynert’s work andunderstanding that psychological events were epiphenomena of neurophysiologic eventsthat were in turn dependent on specific neuroanatomic structures influenced many wellknownneurologists of his day, including Wernicke. Freud studied under him and creditedMeynert with shaping some psychoanalytic concepts.2 Shorter (2005), pages 109–110.3 FromThe Complete Works of Sigmond Freud (James Strachey, ed., The Hogarth Press, London1966) cited in Koehler (2003).