Synonyms
Apathy; Athymia; Loss of psychic self-activation; Psychic akinesia
Also spelled Aboulia
Definition
The term is derived from the Greek “boul” (will). Abulia is manifested by lack of motivation; lack of spontaneity in speech and action; deficiency in initiation, inertia, mental, and motor slowness; poor attention; and easy distractibility. Inactivity comes from an inability to select a course of action, although a wish to participate may be present. Some research indicates that abulia occurs due to malfunction of the brain’s dopamine-dependent circuitry. In neurologic diseases, it is associated with bilateral lesions in the medial or orbital frontal lobes. The following criteria have been suggested for the diagnosis of abulia: (i) decreased spontaneity in activity and speech; (ii) prolonged latency in responding to queries, directions, and other stimuli; and (iii) reduced ability to persist with a task.
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Further Reading
Berrios, G. E., & Grli, M. (1995). Abulia and impulsiveness revisited: A conceptual history. Acta Psychiatrica Scandinavica, 92(3), 161–167.
Caplan, L. R., Schmahmann, J. D., Kase, C. S., Feldmann, E., Baquis, G., Greenberg, J. P., et al. (1990). Caudate infarcts. Archives of Neurology, 47(2), 133–143.
Drubach, D. A., Zeilig, G., Perez, J., Peralta, L., & Makley, M. (1995). Treatment of abulia with carbidopa/levadopa. Journal of Neuroengineering and Rehabilitation, 9, 151–155.
Egnelborghs, S., Marien, M. A., Pickut, B. A., Verstraeten, M. A., & De Deyn, P. P. (2000). Loss of psychic self-activation after paramedian bithalamic infarction. Stroke, 31, 1762–1765.
Forstl, H., & Sahakian, B. A. (1991). A psychiatric presentation of abulia: Three cases of frontal lobe ischaemia and atrophy. Journal of the Royal Society of Medicine, 84, 89–91.
Kumral, E., Evyapan, D., & Balkir, K. (1999). Acute caudate vascular lesions. Stroke, 30, 100–108.
Laplande, D., Attal, N., Sauron, B., de Billy, A., & Dubois, B. (1992). Lesions of the basal ganglia due to disulfiram neurotoxicity. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 925–929.
Liddle, P. F. (1987). The symptoms of chronic schizophrenia. British Journal of Psychiatry, 151, 145–151.
Litvan, I., Paulsen, J. S., Mega, M. S., & Cummings, J. L. (1998). Neuropsychiatric assessment of patients with hyperkinetic and hypokinetic movement disorders. Archives of Neurology, 55, 1313–1319.
Powell, J. H., Al-Adawi, S., Morgan, J., & Greenwood, R. J. (1996). Motivation deficits after brain injury: Effects of bromocriptine in 11 patients. Journal of Neurology, Neurosurgery, and Psychiatry, 60, 416–421.
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Piryatinsky, I. (2017). Abulia. In: Kreutzer, J., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_1874-2
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DOI: https://doi.org/10.1007/978-3-319-56782-2_1874-2
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