8) Other terms used to describe the symptoms associated with PBA include pathological crying/laughing, emotional incontinence, affective lability
, and involuntary emotional expression disorder.
Table 1 The study of PBA has yielded a long list of descriptive terms Affective lability
Emotional dyscontrol Emotional dysregulation Emotional incontinence Emotional lability Emotionalism Excessive emotionality Forced laughter or crying Inappropriate hilarity Involuntary emotional expression disorder Labile affect Pathological affect Pathological laughter and crying Pathological weeping Pseudobulbar crying PBA: pseudobulbar affect Source: Reference 4 Table 2 Prevalence of PBA in the 6 most common underlying disease states CNS-LS [greater than or equal CNS-LS [greater to] 21 (%) than or equal [consistent with to] 13 (%) moderate or [consistent with severe PBA] symptoms of PBA] N Traumatic brain 16.
Both groups were evaluated for BPD symptoms, depressive symptoms, impulsivity, affective lability
, and other potential psychiatric comorbidities.
Researchers have noted that poor ER is related to impulsivity, difficulty delaying gratification, and affective lability
(rapid changes in emotion).
Some individuals may present for hypnotherapy following a failure of previous treatment regimes to remedy ongoing affective lability
In 4 patients psychopathy-like states with acute curbing of interests and inactivity were registered, affective lability
being represented by dysphoria both on the subsidence of intoxication and out of it.
The items include 18 dimensions or traits of pathological personality: submissiveness, affective lability
, anxiousness, insecure attachment, cognitive dysregulation, identity problems, social avoidance, oppositionality, narcissism, stimulus seeking, callousness, rejectionality, conduct problems, restricted expression, intimacy problems, compulsivity, suspiciousness, and self-harm.
The researchers administered standardized scales for impulsivity, hostility, anger, anxiety, depression, and affective lability
and reported that impulsivity was reduced by 23%, hostility by 24%, lability by 37%, anger by 37%, anxiety by 31%, and depression by 62%.
Premenstrual dysphoric disorder (PMDD) is defined rather strictly in DSMIV: five or more symptoms during the luteal phase (one of which must be depressed mood, anxiety or tension, affective lability
, or anger or irritability) severe enough to markedly interfere with work, school, social activities, or personal relationships.
Symptoms of this disorder can include fatigue, disordered sleep, headaches, dizziness, irritability or aggression, anxiety, depression, affective lability
Even the Bottom Line stated that URC "has not been validated as a distinct clinical entity," but "careful evaluation" is recommended "to differentiate URC from affective lability
seen in other conditions," thus implicitly validating using the term as a diagnostic entity.
The differential diagnosis should also include affective lability
, essential crying, and witzelsucht.