PSYCHASTHENIA: CHARACTERISTICS, SYMPTOMS AND DIAGNOSIS - ECONOMÍA - 2024

The psicastenia is a psychological disorder characterized by the presentation of phobias, obsessions, compulsions and anxiety. This term was coined by Janet in 1903 with the aim of defining clinical pictures in which obsessions and compulsions were mainly present.

Although these two manifestations are the main ones of psychasthenia, the alteration includes other symptoms such as tics, phobia and depersonalization. This disorder is interpreted as a deficit in psychological tension, which can be chronic, degenerative and hereditary.

At present, psychasthenia is no longer part of the psychopathologies classified as psychological disorders, and does not appear in diagnostic manuals. However, it does continue to constitute one of the ten sub-scales of the Minnesota Multiphasic Personality Inventory (MMPI), one of the most widely used personality tests in the field of mental health.

Characteristics of psychasthenia

Psychasthenia is a term that comes from the Greek where "psyche" means soul and "asthenia" means weakness. From the most etymological point of view, psychasthenia could be defined as a picture of mental weakness.

The term was coined by Pierre Janet when analyzing and establishing one of the different emotional and mental disorders and disorders that he studied throughout his professional career.

Psychasthenia is a disorder that is usually included among personality disorders and that defines different forms of obsession, anxiety or phobia. People who suffer from it are characterized by having insufficient control over their conscious thinking and memory, a fact that leads them to wander aimlessly and forget what they were doing.

The thoughts of the subject with psychasthenia are often scattered and poorly organized. The individual usually constructs sentences that do not correspond to what he wants to say and are unintelligible to other people.

On the other hand, the subject suffering from psychasthenia may experience an intense and irrational fear of having problems concentrating, expressing inconveniences and acting without undue doubt, a fact that can cause a picture of intense stress and anxiety.

Historical evolution

The appearance of psychasthenia as a mental disorder dates back to 1903, when Janet developed a clinical picture characterized by the typical elements of this disorder. Psychasthenia is considered today as an ancient mental condition that appeared prior to the beginning of experimental psychology.

Pierre Janet based the conceptualization of psychasthenia on the division of neuroses between hysterias and psychasthenias, as well as discarding the term neurasthenia, since this alteration implied a neurological theory of the disease that was nonexistent.

The main difference that Janet made between hysterics and psychasthenias lies in the origin of both disorders. That is to say, hysterias present in their origin a narrowing of the field of consciousness, while psychasthenias start from a disorder in the sense of reality.

Therefore, psychasthenia defines a kind of weakness that reduces the individual's ability to attend to changing experiences, adjust to them, and gain a valid idea of ​​them.

Another author of reference of the time, the philosopher Karl Jasper, kept the term neurasthenia, defining it as an irritable weakness that originated manifestations such as irritability, susceptibility, painful hyperesthesia or a feeling of fatigue in the subject.

Similarly, Karl Jaspers defined psychasthenia, following the guidelines of Pierre Janet, as a variety of phenomena linked by the theoretical concept of a decrease in psychic energy.

According to the German philosopher, the person with psychasthenia lacks self-confidence, is prone to obsessive thoughts, unfounded fears, self-scrutiny and indecision.

On the other hand, psychasthenia decreases the ability of the person to integrate his life and elaborate his various experiences, thus being unable to constitute his personality and carry out firm personal processes.

Symptoms

Both the postulations of Pierre Janet and the views of Karl Jaspers on psychasthenia, define the alteration as a series of anxious and phobic conditions that characterize the way of being of the person.

Beyond the aspects that determine "the psychasthenic personality", this alteration is characterized by originating a series of symptoms and manifestations in the individual who suffers from it.

The symptoms of psychasthenia are mainly anxious, including manifestations such as phobia, obsession, compulsion, depersonalization or tics.

Symptoms related to psychasthenia are usually severe and intense, seriously affecting both the functioning and well-being of the individual.

Phobias

Phobia is a psychological disorder characterized by the experience of intense, disproportionate and irrational fear of specific objects or situations.

This fear leads to the experience of clinically significant anxiety every time the subject is exposed to its feared elements, as well as to a marked avoidance of phobic stimuli.

Psychasthenia usually generates a high propensity in the individual to experience phobia towards different objects or situations, a fact that modifies their behavioral pattern and reduces their state of well-being.

Obsessions

Obsessions are mental disturbances produced by a fixed idea (obsession) that appears persistently in the person's mind.

Subjects with obsessions present persistent thoughts about specific items. These cognitions generate discomfort in the person, since they cannot get rid of the unwanted thoughts.

Individuals with psychasthenia tend to present obsessions of different kinds on a frequent basis, a fact that alters their normal cognitive process.

Compulsions

Compulsion is a symptom that is closely linked to obsession, and refers to the performance of a series of behaviors (physical or mental) continuously and persistently.

People with compulsions perform repetitive behaviors in order to mitigate the anxiety caused by the obsession. In this sense, compulsions are elements that allow us to live with the obsession and reduce the discomfort that they produce.

Both obsessions and compulsions are hallmarks of obsessive-compulsive disorder. However, psychasthenia postulates a pathological way of being that usually occurs with these two manifestations.

Anxiety

The main symptomatology of psychasthenia is anxiety. Subjects with psychasthenia usually present a permanently high state of anxiety and tension, a fact that leads them to be nervous and anxious on a regular basis.

Tics

Tics are involuntary movements without reason of different muscle groups. Convulsive, inopportune and excessive movements result.

The relationship between tics and psychasthenia seems somewhat more confused, however, Pierre Janet postulated these symptoms as manifestations that may appear in the alteration.

Depersonalization

Depersonalization is an alteration of the perception or experience of oneself in such a way that one feels "separated" from the mental processes or the body, as if they were an external observer to them.

The mental state that causes psychasthenia leads to the appearance of depersonalization in a frequent and transitory way.

Current situation

Considering the descriptive qualities and the defining elements of psychasthenia, today this alteration is interpreted as a personality disorder.

Psychasthenia defines a way of being anxious, passive, phobic and obsessive that is pathological and has a negative impact on the state and functioning of the individual.

In the current cataloging of personality disorders, psychasthenia does not appear as a diagnosis, mainly because it lacks scientific evidence to constitute a clinical picture.

However, the construct postulated by Janet is not totally obsolete today. Today, psychasthenia continues to be an assessment scale of the Minnesota Multiphasic Personality Inventory (MMPI), one of the most widely used personality assessment tests in mental health.

Psychasthenia at MMPI

Sub-scale 7 of the Minnesota Multiphasic Personality Inventory (MMPI) describes psychasthenia as a disorder related to obsessive-compulsive disorder.

Its main characteristics include excessive doubts, compulsions, obsessions and irrational fears. The person with psychasthenia is unable to resist certain actions or thoughts.

Likewise, the MMPI psychasthenia scale indicates the presence of abnormal fears, self-criticism, difficulties concentrating and recurrent feelings of guilt.

The scale of the instrument does not allow the elaboration of the diagnosis of psychasthenia but it works correctly as a determination of long-term trait anxiety. Likewise, it allows the establishment of the individual's stress response.

In general, the MMPI scale of psychasthenia allows the definition of a person with little control over conscious thought and memory, as well as a notable tendency to anxiety, fear, obsessions, recurrent feelings of guilt and concentration difficulties.

References

1. Jaspers, Karl (1990). General Psychopathology (7th ed.). Manchester: Manchester University Press. ISBN 0-7190-0236-2.
2. Janet, Pierre (1903). Les Obsessions et la Psychasthénie. Paris: Alcan.
3. Osberg, TM, Haseley, EN, & Kamas, MM (2008). The MMPI-2 Clinical Scales and Restructured Clinical (RC) Scales: Comparative psychometric properties and relative diagnostic efficiency in young adults. Journal of Personality Assessment. 90, 81-92.
4. Sellbom, M., Ben-Porath, YS, McNulty, JL, Arbisi, PA, & Graham, JR (2006). Elevation differences between MMPI-2 Clinical and Restructured Clinical (RC) Scales: Frequency, origins, and interpretative implications. Assessment, 13, 430-441.
5. Swedo, SE, Rapoport, JL, Leonard, HL, Lenane, M., et al. (1989). Obsessivecompulsive disorder in children and adolescents: Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, 46, 335-341.