Behavior or Psychomotor Activity

This category is concerned with physical movement. Client activity throughout the evaluation should be noted and recorded. Examiners watch for excessive or limited body movements as well as particular physical movements, such as absence of eye contact (keeping cultural differences in mind), grimacing, excessive eye movement (scanning), odd or repeated gestures, and posture. Clients may deny experiencing particular thoughts or emotions (e.g., paranoia or depression), although their body movements suggest otherwise (e.g., vigilant posturing and scanning or slowed psychomotor activity and lack of facial expression).

Excessive body movements may be associated with anxiety, drug reactions, or the manic phase of bipolar disorder. Reduced movements may represent organic brain dysfunction, catatonic schizophrenia, or drug-induced stupor. Depression can manifest either via agitation or psychomotor retardation. Sometimes, paranoid clients constantly scan their visual field in an effort to be on guard against external threat. Repeated motor movements (such as dusting off shoes) may signal the presence of obsessive-compulsive disorder. Similarly, repeated picking of imagined lint or dirt off clothing or skin is sometimes associated with delirium or toxic reactions to drugs/medications.

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