Abnormal Emotional Reaction
An abnormal emotional reaction is an emotional response to a real event or situation that is recognisable as the same kind of feeling anyone might have, but which is excessive in degree, disproportionate to what actually happened, or persists for longer than the situation reasonably warrants. Unlike the more severe disturbances of mood seen in established mental illness, this is the mildest and most clinically ambiguous rung of disordered emotion: a reaction the patient themselves can usually still recognise as connected to a real trigger, just markedly out of scale with it.
This has traditionally been placed as the first and least severe of several recognised levels of disturbed emotion, distinguished from the normal emotional reactions either side of it mainly by degree and duration rather than by any difference in kind, which is precisely what makes the boundary between a normal and an abnormal reaction a matter of clinical judgement rather than a fixed threshold.
Recognition features
- The emotion itself (fear, sadness, anger and so on) is a recognisable, ordinary human feeling rather than something bizarre or alien
- Its intensity, duration, or persistence is out of proportion to the triggering event
- The patient can usually still identify the real event or situation that set the reaction off
- Sits at the mild end of a spectrum, distinguished from more severe morbid disorders of emotion mainly by degree
Eliciting it at interview
- Ask what happened before the feeling started, and compare the scale of the person's reaction with what most people would experience in the same circumstances
- Ask how long the reaction has lasted, since duration out of proportion to the trigger is often as telling as intensity
- Explore whether the person themselves feels their reaction has been excessive, which many with an abnormal but not yet morbid reaction are able to recognise
Distinguishing features
- Differs from a normal emotional reaction only by degree and duration, not by the type of feeling involved
- Differs from a morbid disorder of emotion, which is a more severe, sustained, and often less clearly reactive disturbance
- Differs from an abnormal expression of emotion, which concerns how a feeling is shown or communicated rather than its intensity or proportionality
Common misconceptions
- That any strong emotional reaction to a difficult event is automatically abnormal; intensity has to be weighed against the scale of the trigger and how long the reaction persists
- That this is simply an early or mild form of clinical depression or anxiety disorder; it may resolve on its own and does not always progress further
Related phenomena
Anxiety · Phobia · Anxious Foreboding · Reactivity of Mood · Demoralization · Morbid Disorder of Emotion
Practice this
After a minor disagreement with a colleague, a man remains intensely angry and preoccupied with the incident for several days, an ordinary feeling of anger but clearly out of proportion to the minor trigger, though he can still readily identify what set it off. What is this? · A patient has felt persistently low in mood for several months, with the low mood present most days regardless of what is actually happening in her life, worsening steadily despite generally positive circumstances. Before revealing the answer: is this an abnormal emotional reaction? · A patient's emotional response seems disproportionate. Before revealing the answer, decide what distinguishes an abnormal emotional reaction from a morbid disorder of emotion. · A patient's emotional feeling seems to differ from how it is being shown. Before revealing the answer, decide what distinguishes an abnormal expression of emotion from an abnormal emotional reaction. · You are assessing whether a patient's emotional response is an abnormal emotional reaction. Before revealing the answer, decide how you would assess for this. · Explain why an abnormal emotional reaction is described as the mildest and most clinically ambiguous rung of disordered emotion.
Illustration
After a minor disagreement with a colleague over a scheduling mix-up, a 38-year-old man finds himself unable to stop replaying the conversation and feeling unusually on edge for several days, far longer and more intensely than the incident itself would seem to warrant, though he is clear in his own mind about exactly what triggered it.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 6, 'Disorders of Emotion'.