The Japanese journal of neuropsychology

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ArticleTitle	Subjective Expreriences in Psychiatric and Neuropsychiatric Compulsive Symptoms
Language	J
AuthorList	Nishikawa Takashi, Tokunaga Hiromasa, Takeda Masatoshi
Affiliation	Department of Clinical Neuroscience, Psychiatry, Osaka University Graduate School of Medicine
Publication	Japanese Journal of Neuropsychology: 16 (2), 99-109, 2000
Received
Accepted
Abstract	The term 'compulsion' seems to have led to some confusion in the neuropsychological field. The concept accepted in the domain of neuropsychology differs in certain important aspects from that of 'obsession' or 'compulsion' according to orthodox psychiatry. This confusion may result from several factors; 1) The original concept of 'Zwang' was differentiated into 'subjektive Zwang' and 'objektive Zwang' in German neurology during the first decade of 1900s. 2) These two concepts were rapidly assigned different terms in English, namely, 'obsession/compulsion' and 'forced movement' respectively. However, equivalent Japanese terms for them were not clearly defined until the later 1980s. 3) The neuropsychological 'compulsion' includes some symptomatological features that cannot be simply attributed to either of the two concepts. The concept of the psychiatric 'obsession/compulsion' requires four essential factors; 1) recurrence or persistence, 2) involuntariness, 3) awareness of unreasonableness for the self (ego-dystonicity), 4) awareness of the thought or actions belonging to the self. The former two factors refer to objective phenomena and the latter three refer to subjective experience. The neuropsychological 'compulsion' is based on the objective factors attributable to the internally generated repetitive behavior (stereotypy) and the stimulus-bound behavior (environment-dependent symptome). It does not take subjective experiences into account, although they are necessary to the original concept of 'obsession/compulsion' in psychiatry. The authors emphasize that neuropsychology should learn to deal with the human subjective experience in earnest in the future.
Keywords	compulsion, obsession, forced, stimulus bound, stereotyped behavior, subjective experience