Inappropriate Affect Symptoms And Signs

By Sarah Fader

Updated December 17, 2018

Reviewer Kay Adkins, LPC



Affect itself is understood to show the internal state of an individual's emotions at any given time. Inappropriate affect is defined as displaying emotion, behavior, and/or demeanor that is not appropriate for the event, situation, or thought that is occurring or being expressed. Smiling when giving someone bad news is an example of inappropriate affect. There are many disorders in which inappropriate affect is a symptom itself.

Disorders in which inappropriate affect is a symptom include schizoid personality disorders and brain damage. The limbic system, anterior cingulate cortex, brainstem and the prefrontal cortex are areas that are involved with this disorder, and it is important that mental health care professional tests for brain damage and other physical conditions. It is important to rule out neurological conditions before treating inappropriate affect because inappropriate affect is a symptom as well as a disorder.

Blunted affect, constricted affect, labile affect, restricted affect, and flat affect are examples of an inappropriate affect. Blunted, constricted, labile, restricted, and flat affect explain symptoms in which the individual does not express emotion properly. These symptoms are common in those with schizoid disorders and brain damage. Conditions that can exhibit these symptoms include pseudobulbar affect, autism, PTSD, and depression among others.

Inappropriate affect, like other affect disorders, can be symptoms of dementia and Alzheimer's disease. It is important that a neurologist as well as a psychologist/psychiatrist, test for these conditions when a patient presents with affect problems. Expressing emotions properly becomes impaired with these conditions and proper treatment depends on a good diagnosis. History of mental illness, mood disorders, and head trauma are some of the triggers of inappropriate affect and other affect disorders.


Symptoms Of Inappropriate Affect

Expression of emotion varies among people, but emotions such as happiness, anger, love, and sadness, are common emotions we all share. For individuals with inappropriate affect, emotions expressed do not always represent the reality of event, situation, or thought. It is not always easy to differentiate between conditions that display the symptoms of inappropriate affect; sometimes it is a combination of problems that produce inappropriate affect.

Although there are several affect disorders in which people express emotions that are not harmonious with their reality, each one has particular symptoms and signs. These affect disorders all produce emotional reactions that are out of sync with reality, knowing the symptoms of inappropriate affect can help in diagnosing and treating the underlying condition.

Symptoms of Inappropriate Affect

  • Expressing emotions not congruous to reality
  • Expressing happiness or joy during times of sadness
  • Outbursts of anger without obvious provocation
  • Manic episodes
  • Depression
  • Irritability
  • Abnormal emotional responses such as crying, laughing or becoming angry when a situation, event, or thought does is not in agreement with the emotional response

Diagnosing Inappropriate Affect


A diagnosis of inappropriate affect requires the expertise of a qualified, licensed, mental health care professional. A psychologist or psychiatrist will use the symptoms of inappropriate affect to help diagnose the underlying condition.

Inappropriate affect can also occur without an underlying mental or physical condition, this is known as inappropriate affect syndrome. This syndrome is diagnosed when no other condition can be found, only the symptoms of inappropriate affect are present. In most cases, inappropriate affect is a symptom that indicates a more serious mental disorder.

Inappropriate affect can be seen in those with brain tumors, brain damage, and dementia. It is common for those with these conditions not to recognize their inappropriate reactions to situations and events. On the opposite side of the scale is pseudobulbar affect, those with this condition understand that they are not reacting appropriately in certain emotional situations. When an individual with pseudobulbar affect begins to cry uncontrollably during moments of joy, happiness, or anger, they know they are not responding properly.

Individuals who have been diagnosed with schizoaffective disorder are prone to hallucinations and delusions; emotions experienced during these hallucinations and delusions are not based in reality. It is easy to see how someone with this disorder would display emotions and behaviors that are not consistent with reality from moment to moment. Other disorders that trigger delusions and hallucinations also trigger inappropriate affect because these individuals are not always in touch with reality, they are reacting to delusions and hallucinations.


Those with schizoid personality disorders display a lack of interest in relationships both social and family; they suffer from a disconnect from reality due to paranoia and other symptoms. Paranoia itself can trigger inappropriate affect because the individual has assumed reasons for others behavior without knowing the truth. Individuals with schizoid and schizophrenia disorders are prone to inappropriate affect, and the cause can be due to paranoid delusions and hallucinations.

Anyone suffering from head trauma, brain injury, brain tumor, or brain damage may experience inappropriate affect. Depending on what part of the brain has been affected, the disconnect between reality and appropriate emotions and delusions can be from slight to severe. Mental health professionals use interviews and various testing methods to help them in understanding the causes of inappropriate affect behaviors.

Diagnosing inappropriate affect allows a psychologist/psychiatrist to further their diagnosis of the underlying condition. Inappropriate affect is a symptom itself, and all the symptoms of inappropriate affect are behaviors and reactions that indicate a mental health condition is present. When inappropriate affect is noted, it is understood to represent an underlying condition/disorder. When there is no underlying condition/disorder, it may be diagnosed with a syndrome, but, most syndrome diagnosis will eventually give way to another disorder.

A mental status examination is used by clinicians to ascertain the mental status of an individual. During an MSE or mental status examination, the psychologist/psychiatrist will examine the mood and affect of the individual. During this examination, the individual's affect will be described as inappropriate or appropriate to current reality and congruent or incongruent with current thought content.

The MSE will help the clinician make a diagnosis as to the mental stability of the individual; mood and affect are only one phase of the examination. If an individual's mood and affect show inappropriate and incongruous traits, further examination will be done to narrow down the reason for these reactions. For the most part, inappropriate affect is a symptom, not an actual diagnosis itself.

Treatment For Inappropriate Affect

Treatment for inappropriate affect depends on the mental or physical disorder that is causing the symptom. Most disorders with symptoms such as inappropriate affect are treated with medications. The medications will vary depending on the diagnosis, and it takes time for the symptoms to subside. Symptom severity is also considered when medications are used; only a licensed professional can diagnose and treat the conditions that trigger inappropriate affect.

Most individuals who display inappropriate affect do not rely on therapy to treat the symptom because the conditions that cause this disorder usually require medication. Therapy may be used along with medications to lessen the severity in some cases, but the therapy is only effective if medications are used in conjunction with the disorder. Schizoaffective disorders and schizoid personality disorders, two of most frequently diagnosed disorders with symptoms of inappropriate affect, require medication to control symptoms effectively.

There are many reasons why medications are needed to help control inappropriate affect. Inappropriate affect problems do not respond well to common therapies such as talk therapy or behavioral therapies because the conditions that cause inappropriate affect do not respond well to these therapies. Another reason for drug therapy is the fact that inappropriate affect can be due to an individual's inability to recognize reality from fantasy.

Research is ongoing, and new drugs for these disorders and symptoms are always being improved, and new ones are being introduced. As research into the causes and effects of inappropriate affect improves, so will treatment methods. Some modern research suggests that reducing stress levels may be helpful in controlling the onset of symptoms; this may lead to therapies that reduce stress, making drug treatments more effective.

It is important for family members and friends to seek therapy for dealing with a loved one who is affected by inappropriate affect. Learning how to manage how family members feel when dealing with someone with inappropriate affect can help to lower stress levels for both the family and the patient. Those who have the symptoms of inappropriate affect do not want to be hurtful or behave inappropriately and reacting negatively and defensively to their behavior can make the problem worse.


Finding a licensed mental health professional is the first step to getting treatment for yourself or someone you love. It is important to find a clinician that is qualified and accessible; the effectiveness of any treatment for disorders like this relies on observation and feedback. The easier it is to talk to a doctor, the easier it is to build trust.

It is difficult for anyone suffering from a schizoaffective disorder or any of the disorders that cause inappropriate affect. Trust in a clinician is the most important part of mental health care. When there is trust, the patient will be more honest about symptoms, stress levels are lower, and this makes treatment more effective. Take your time when searching for mental health care provider, a little research can make a big difference in prognosis and treatment.

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