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Burns
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Established psychiatric disturbances may have led to the initial burn injury, e.g. suicide attempt, or altered perception due to substance abuse or withdrawal may have contributed to the injury. In addition, delirium may be a psychological reaction to injury or a manifestation of metabolic derangement, e.g. hypoglycaemia, hypoxia, sepsis or pain. The following problems have been described: Psychosis, delusions, hallucinations or paranoia (rare in children)Post-traumatic stress syndromePoor sleep, hypervigilance, flashbacks, nightmaresDepression, panic attacks, guilt (e.g. sole survivor)Longer-term problems Self-consciousness and poor self-esteemPhobias and anxiety
A short walk around the subject
Published in Derek Steinberg, Consciousness Reconnected, 2018
By consciousness I mean self-consciousness; not ‘shyness’, of course, but consciousness of self, the inner and ultimate ‘I’. Just about all definitions of consciousness are tautological, in other words defining self-consciousness in terms of itself (e.g. ‘self-awareness’). In one sense this is unsatisfactory, but it also provides us with a clue, and the first step in that clue is, again, the circular nature of the phenomenon we are pursuing. We will come back to this point, several times. A persisting problem with defining consciousness is that however industriously we try to define ‘I-ness’ in a complete and watertight way, there always seems to be another ‘I’ standing one step back, as if involved, interested, but ‘outside the frame’. This is described, sometimes despairingly, as the ‘law of infinite regression’; rather like pursuing a rainbow – it is always further away. Again, a rainbow is both in the sky and in your head at the same time: a crowd may contemplate a rainbow, but in optical terms each individual in the crowd has one of their own.
Case 35: My nose is too big and ugly
Published in Barry Wright, Subodh Dave, Nisha Dogra, 100 Cases in Psychiatry, 2017
Barry Wright, Subodh Dave, Nisha Dogra
There are preoccupations and ruminations about a perceived defect in appearance, which sometimes lead to obsessive or compulsive behaviours. Such behaviours might include regular checking of the relevant body part or checking in the mirror, intense avoidance of mirrors or images of themselves, attempts to hide the area of concern with makeup and clothing and prolonged grooming. All of these would be to an intense degree. Some will withdraw from family or social life, becoming intensely self-conscious, and they often develop low self-esteem. In some instances mental health symptoms become more severe. Self-consciousness may become paranoia. Low mood and low self-esteem may develop into clinical depression and/or thoughts of self-harm. These persons may seek regular reassurance from those close to them, regularly comparing themselves to others. Relationships and work can suffer, and it may lead to major depression, generalized anxiety or alcohol or drug abuse.
Differences in metacognitive beliefs among patients with bipolar disorder with or without previous suicide attempts
Published in Nordic Journal of Psychiatry, 2019
Ender Cesur, Özge Şahmelikoğlu Onur, Evrim Erten
Our findings indicated that the ‘cognitive self-consciousness’ subscale scores of BPDI− patients were significantly higher than those of both the BPDI+ group and the control group, but did not differ between the BPDI+ and the control group. As Wells [17] pointed out, the elevation in ‘cognitive self-consciousness scores’ was an indication of the excessive and dysfunctional monitoring of one’s thought processes. In Wells’ model of depression [6], dysfunctional metacognitive beliefs increase depressive symptoms. According to this, in our study, it seems contradictory that the ‘cognitive self-consciousness’ scores in the group without previous suicide attempts (considered as a symptom), were higher than those of the BPDI+ group and the control group. Using multiple logistic regression analyses, we found that the increase in ‘cognitive self-consciousness’ scores decreased suicide risk. ‘Cognitive self-consciousness’ means being aware of and monitoring one’s own thoughts and cognitive processes (for example, ‘I am constantly aware of my thinking’ and ‘I monitor my thoughts’). BPD patients with high ‘cognitive self-consciousness’ scores may feel the need to constantly review their thoughts because of the increased suicide risk of the illness. In this way, patients may be aware of suicidal ideation and may seek help to prevent suicide [38].