Stereotypies

STEREOTYPIES, mechanical repetitions of the same movements, gestures, postures, words, and turns of speech, observed predominantly in psychiatric diseases as one of the manifestations of catatonic (see Catatonia) states. In their form, stereotypies can be very diverse: in some patients, these are peculiar grimaces (pursing the mouth into a snout, wrinkling the forehead and eyebrows, causeless smiling, etc.); in others, various movements with the hands (stroking the face, waving, patting, etc.); in others, movements associated with peculiar postures or gait (swaying of the torso, circling in one place, etc.); and in others, the stereotypical repetition of certain turns of speech, as well as speech consisting of a collection of meaningless words and phrases (see Verbigeration). Stereotypies of thought are also described: a tendency to constantly return to the same thoughts and ideas, which differs from obsessive thinking by the mechanical nature of its emergence and the absence of an accompanying unpleasant emotional experience and internal struggle. The psychological condition for the emergence of stereotypies is a lowering of attention and mental activity: in the presence of this condition, the motor manifestations of healthy people can also become stereotypical (e.g., the unconscious repetition of the same habitual gesture, word, or the drawing of monotonous figures when attention is distracted). A feature of true stereotypies, however, is that they are not eliminated by fixing the patient's attention on them, as is the case with the stereotypical movements of normal people. Bleuler and Kläsi insist that the source of stereotypies is motor manifestations of affective experiences associated with one or another mental complex, which often have a symbolic meaning. At least in some cases, stereotypies indeed develop from acts that previously had a definite meaning, but later became mechanized, habitual, and escaped from the control of consciousness and will. In such cases, stereotypies in their gradual development undergo a series of contractions and simplifications, which make their original meaning unrecognizable and give them an imprint of absurdity and meaninglessness. In a number of cases, Kläsi succeeded in getting old schizophrenics to return to consciousness the experience that served as the original source of the stereotypy, after which the stereotypy disappeared. Kleist considers stereotypies to be one of the forms of iterative disorders (organically conditioned repetitions) and seeks their anatomical basis in a lesion of the striatal region. However, stereotypies have significantly more complex conditions of origin than phenomena such as the rhythmically repeating movements of idiots, to which Kläsi and Boström assign the name of monotypies, or the palilalia of encephalitics. The presence of stereotypies has significant differential diagnostic value, as in a sharply expressed form they are observed almost exclusively in the terminal states of schizophrenia (see).