Orientation

ORIENTATION, a complex psychic function that determines the clear, distinct processing of the immediate situation, spatial localization, and current chronological data. Disorders of orientation are not in themselves a direct symptom of disease that cannot be broken down into individual components, but are formed as a result of the interaction of various pathological disturbances: disorders of consciousness, attention, memory, changes in affectivity, and hallucinatory-delusional experiences influence the quality of orientation. Spatial-situational (allopsychic) orientation consists of the knowledge and understanding of information about one's personal location and the relationship of the latter to the further environment, in the knowledge and understanding of individual circumstances of the environment, persons, their behavior, and their relationship to one's own personality. Orientation in time refers to the knowledge of the time of day, the name of the day, the month, the date of the year, and the season. Past chronological information has a closer relationship to autopsychic orientation. The most complete disorder of orientation is observed during clouding of consciousness, characterized mainly by a disorder of perception. Apathetic disorder of orientation is based on the lack of motivation in patients to account for the passage of time, who is surrounding them, and what they see and hear. Inhibited, depressed patients with an affect of confusion exhibit a disorder of orientation that arises from the impossibility for such patients (due to difficulty in thinking) of forming a holistic picture of their situation while correctly evaluating individual circumstances. Disorientation during acute manic excitement has a similar character, associated with significant difficulty in understanding and processing external impressions. Delirious disorders of orientation arise from a change in the quality of consciousness, a lack of clarity in understanding the environment, and sensory deceptions. While in stupor there is a loss of orientation (apathetic disorientation), in hallucinatory states the matter consists of the perversion of the environment by sensory deceptions, in the distortion of all material for orientation, leading to hallucinatory disorientation. It goes without saying that in various syndromes, several of the listed psychopathological factors can influence orientation, an example of which is delirium tremens with its combination of changes in consciousness and an influx of hallucinations. In the sense of a consequence, but not in the sense of a mechanism, delusional ideas act on orientation similarly to sensory deceptions (delusional disorientation). Incorrect processing of a correctly perceived and registered environment leads to a false assessment of time and the environment, often creating so-called double orientation. Memory disorders (in particular Korsakoff's syndrome) sometimes form amnestic disorientation, based mainly on the inability to retain and reproduce information about time and localization.

Ya. Frumkin.