VOLITION (will, willingness)

• Volition or will is the cognitive process by

which an individual decides on and
commits to a particular course of action. It
is defined as purposive striving and is one
of the primary human psychological
functions.
• Others include affection (affect or
feeling), motivation (goals and
expectations), and cognition (thinking).
Volitional processes can be applied
consciously or they can be automatized
as habits over time.
 The will is consciously directing psychic energy to specific
actions that aim to perform meaningful choice between multiple
targets and multiple motives.

It begins with the emergence of a conscious desire to do

something specific, and the desire is motivated by vital and
social motives.
When we will conclude that the desire is according to our
personal interests and socio-culture norms, desire is
transformed into intention and decision and its implementation
mobilize mental and physical powers.

If the desire is opposite with social interests or social norms,

than conflicts are raising and conscious "I" can rejected or
postponed decision, or to accept and implement.
Satisfyng needs
 Disorders of volition

1.Increasing or decreasing of volition

2. Ambitendency

3. Increased suggestibility –docility

4. Impulsive reactions

5. Compulsive reactions

6. Catatonic disorders

7. Stupor
I. Increasing or decreasing of volition

1. Hypobulia – lowered ability to make decisions or to act

abulia (anchormia)- an absence of willpower or an inability
to act decisively, as a symptom of mental illness (lack of
drive).
Affective disorders and sch
2. Anhedonia- inability to feel pleasure.
3. Avolition means a severe lack of initiative or motivation. A
psychological term used to describe the lack of interest or will
to become engaged in goal-oriented behavior,avolition is
found in schizophrenia
…

4. Agitation - overactive motor activity associated with

internal tension. The activity is unproductive and repetitive,
walking up and down, restless, breaking the hands, plucking
the clothes, inability to sit in place.
 II. AMBITENDENCY

Ambitendency is a tendency to act in opposite ways or

directions in situations of conflict and under the influence
of opposing motivational forces.
Inability to perform choice between different and conflicting
motives. Usually goes along with affective ambivalence.
Psychologist example Buridan donkey unable to decide which
layer of hay to eat, hungry and dropped dead ( "Buridan's
donkey ").
OCD and Sch
 III. Increased suggestibility - DOCILITY
• Suggestibility is the quality of being inclined to accept and act
on the suggestions of others; where false but plausible
information is given and one fills in the gaps in
certain memories with false information when recalling a
scenario or moment. Suggestibility uses cues to
distort recollection after persistently being told something
pertaining to a past event, one's memory of the event conforms
to what they've been told.[1]
• A person experiencing intense emotions tends to be more
receptive to ideas and therefore more suggestible. Generally,
suggestibility decreases as age increases.
However, psychologists have found that individual levels of self-
esteem and assertiveness can make some people more
suggestible than others, which has resulted in the concept of a
spectrum of suggestibility.
• Normally depends on the emotional state of the person,
the degree of disturbance of consciousness, intellectual
abilities and so on.
• Increase in fatigue, sleepiness, hunger, physical
exhaustion, advanced age (senium).
• In pathological cases to the level of blind obedience
(docility) -they all accept suggestions without the
possibility of their critical analysis.
• Mentally retarded persons (MMR) histeroid structure -
can be used by other entities for criminal acts.
• Subject expertise while signing wills -under suggestion to
change the will or under intimation to prescribe the
property of the one who suggests.
 IV. Impulsive reactions

• are characterized by the repeated inability to refrain

from performing a particular action that is harmful either
to oneself or others.
• The individual fails to resist performing a potentially
harmful act and it is usually accompanied by a sense of
tension or arousal before committing the act and a
sense of relief or pleasure when it is committed.
• - poriomania
• - kleptomania
• - pyromanya
• -koprolalia (pathological need to express indecent words
or sentences, profanity or insults directed to strangers.)
 ... Impulsive reactions

1. Poriomania -
A morbid impulse to wander or journey away from home.
PYROMANIA
 Pyromania
• Pyromania is the recurrent, deliberate, and purposeful
setting of fires. Associated features include tension or
affective arousal before setting the fires; fascination with,
interest in, curiosity about, or attraction to fire and the
activities and equipment associated with firefighting; and
pleasure, gratification, or relief when setting fires or when
witnessing or participating in their aftermath.
• The diagnosis of pyromania necessitates the occurrence of
more than one occasion during which the patient attempts
deliberately setting fire. Moreover, the patient usually feels
stressed before setting the fire and relieved after
performing the act.
• Pyromania is extremely rare and literature data is rather
scarce.
• Incidence <1%, M>F
 Facts and Figures
• Age factors: although fire setting is a major problem
in childhood and adolescence, pyromania is rare;
juvenile fire setting is usually associated with ADHD,
Conduct Disorder, or Adjustment Disorder
• Prevalence: rare
• Gender differences: more common in males
• Typical age of onset: unknown
• Course: episodic; fire setting incidents may wax and
wane in frequency
• Cultural: primarily Caucasian
KLEPTOMANIA
 Kleptomania
• Kleptomania is the irresistible urge to steal items that you
generally don't really need and that usually have little value.
• The essential feature of kleptomania is a recurrent failure to
resist impulses to steal objects, not needed for personal use or
for monetary value. The objects taken are often given away,
returned surreptitiously, or kept and hidden. Kleptomanics
usually have the money to pay for the objects they impulsively
steal.
• It is crucial to differentiate kleptomania from common theft. In
kleptomania, the patient steals items that aren’t needed in
terms of use and/or their financial value. The shoplifting
behavior is neither a response to anger or revenge nor
triggered by hallucinations or delusions. Similarly to other forms
of impulse control disorders, patients with kleptomania feel
tensioned prior to performing the act of and relieved afterwards.
 Kleptomania - Case
Presentation
• A 24 years old female, highly successful, single
executive from a wealthy background. She
was brought to the psychiatrist ward by the police
officer. She was accused of stealing several times
from the same shop in the same month.
She further states that the items she had stolen were
hair-chips and that she have kept them in a box at
home.
NB:
Although the thefts do not occur when immediate arrest
is probable, persons with kleptomania do not always
consider their chances of being apprehended,
although repeated arrests lead to pain and
humiliation.
 Facts and Figures
• Gender: 66% to 80% are female
• Prevalence: occurs in less than 5% of
identified shoplifters; prevalence in general
population is rare and unknown
• Course:
– Sporadic with brief episodes & long periods
of remissions;
– Episodic with protracted periods of stealing
and periods of remission;
– Chronic with some degree of fluctuation
• Onset: variable; earlier onset and treatment
for women
TRICHOTILLOMANIA
 Trichotillomania
• Trichotillomania is hair loss from repeated urges to pull
or twist the hair until it breaks off. Patients are unable to
stop this behavior, even as their hair becomes thinner.
• The criteria for the diagnosis of trichotillomania are
generally similar to obsessive compulsive disorders, with
an associated heightened tension immediately before
doing the act and a sense of gratification and/or relief of
tension after committing the act. It has been proposed that
trichotillomania should be categorized under the new
group of disorders; the obsessive compulsive related
disorders for DSM-V. Nevertheless, some evidence
denotes that trichotillomania is not simply a form of an
obsessive compulsive disorder.
V. compulsive reactions

Compulsive actions take place as a pressing and

forced a desire to perform an activity for which
the person is aware that it is no meaningful and
logical, but there is no strength and the will to
resist.
VI. Catatonic disorders (catatonia sch symptomatic psychoses)
1. Catalepsy-specific stiffness and capability of muscle power to
keep part of the body or limbs in an unnatural position without
feeling tired (sleep with head raised as a pillow, standing on
one foot long)

2. Waxy Flexibilty (flexibilitas cerea) - segment of the previous

disorder. Able to modulate limbs (or parts) in unnatural
position (bent like wax)
• During reposturing of patient, he offers initial resistance before
allowing himself to be repositioned, similar to that of a bending
candle.
VI. Catatonic disorders

3. Negativism - Apparantly motiveless resistance to

instructions or attempts to move/examine patient.
Contrary behaviour, does exact opposite of instruction.
It can be active or passive.
4. Withdrawal
• Refusal to eat, drink and/or make eye contact.
5. Stereotypy
•Repetitive, non goal-directed action that is carried out in a
uniform way.
…VI. Catatonic disorders

6. Mannerisms
• Unusual repetitive performances of a goal directed motor
action or the maintenance of an unusual modification of an
adaptive posture.
• Example:-hopping or walking tip toe,saluting
passersby,pecularities of hair styles etc.
• BIZARRERIES

7. Grimacing
•Maintenance of odd facial expressions.
8. Echopraxia/echolalia
•Mimicking of examiner’s movements/speech.
…VI. Catatonic disorders

9. Mutism - termination of verbal contact.

10. Excitement (rage)

• The patient displays excessive, purposeless motor activity
that is not influenced by external stimuli.
VII. Stupor
•Stupor is the classic and most striking
catatonic sign. It is a combination of
immobility and mutism, although the two
can also occur independently.
•The loss of any psychomotor activity.
•Affective syndrome (depressive) disorder,
or a disorder dissociation organic
psychosyndrome.