Premorbid Personality
This section probes into the patient's personality and day to day functioning before the onset of the illness. The history so far should have already given you some idea about this. It may be that due to the chronic nature of the illness the patient cant recall how they where before becoming ill (see tips below)
Personality consists of enduring characteristics of the patients these should include.
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Cognitions (ways of thinking)
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Affectivity (emotions and feelings)
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Behaviour (interpersonal, reaction, self control)
Before you began experiencing these symptoms / this happened ...
… how did you get along with other people?
… how did you cope when something when wrong?
… what was your temperament like?
… what activities did you do, what interest did you have?
In some psychiatric illnesses e.g. dementia, psychoses this section of the history has to be obtained from family, friends, cares, GPs, colleuges.
| Example. Jasmine |
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| 'Before she started making herself vomit after meals and obsessing about her body image Jasmine was a slightly overweight 17 year old college student who followed 'gothic youth culture'. She had a small circle of friends. She never really grew that close to any particular one of them always having "...felt different to that lot". Since they found out about her eating disorder she no longer "...hangs out with that crew".
Even before becoming ill she always had a very tense relationship with her mother and father. She has always got on well with her sisters.
Jasmine had an unassuming personality and was never the centre of attention. She seems to reflect on herself as having been very emotional. She would tend to cry or seek out her sister when something went wrong.
She was often impulsive for example after a major argument at home when she was 15 she disappeared with her sister for three days, they caught a train to London and had sleep rough and beg "I now know it was dumb, it just felt right at the time... if something felt right I would just go for it"
Her mother concurred that Jasmines' relationship with her had been tense and "reserved". She didn't feel that her daughter ever opened up to her the way she wanted. |
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