Page 65 - LECTURETTE TOPICS eBOOK

as evidenced by the occurrence of undue emotionalism as a child or of any

previous nervous illness or breakdown. The presence of stammering, tic, nail
biting, excessive hyperhydrosis or restlessness during examination could be
indicative of emotional instability.

Psychosis. All candidates who are suffering from psychosis are to be
rejected. Drug dependence in any form will also be a cause for rejection.

Psychoneurosis. Mentally unstable and neurotic individuals are unfit for

commissioning. Juvenile and adult delinquency, history of nervous
breakdown or chronic ill health are causes for rejection. Particular attention

should be paid to such factors as unhappy childhood, poor family
background, truancy, juvenile and adult delinquency, poor employment and

social maladjustment records, history of nervous break down or chronic ill-
health, particularly if these have interfered with employment in the past.

Organic Nervous Conditions. Any evident neurological deficit should call

for rejection.

Tremors. Tremors are rhythmic oscillatory movements of reciprocally
innervated muscle groups. Two categories are recognized: normal or

physiologic and abnormal or pathologic. Fine tremor is present in all
contracting muscle groups, it persists throughout the waking state, the

movement is fine between 8 to 13 Hz. Pathologic tremor is coarse, between
4 to 7 Hz and usually affects the distal part of limbs. Gross tremors are

generally due to enhanced physiological causes where, at the same
frequency, the amplitude of the tremor is grossly enhanced and is elicited by

outstretching the arms and fingers which are spread apart. This occurs in
cases of excessive fright, anger, anxiety, intense physical exertion, metabolic

disturbances including hyperthyroidism, alcohol withdrawal and toxic effects
of lithium, smoking (nicotine) and excessive tea, coffee. Other causes of

coarse tremor are parkinsonism, cerebellar (intention) tremor, essential
(familial) tremor, tremors of neuropathy and postural or action tremors.

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