Emotional Incontinence

Pseudobulbar affect
Other namesEmotional incontinence

Pseudobulbar affect (PBA), or emotional incontinence, is a type of emotional disturbance characterized by uncontrollable episodes of crying, laughinganger or other emotional displays. PBA occurs secondary to a neurologic disorder or brain injury. Patients may find themselves crying uncontrollably at something that is only moderately sad, being unable to stop themselves for several minutes. Episodes may also be mood-incongruent: a patient may laugh uncontrollably when angry or frustrated, for example. Sometimes, the episodes may switch between emotional states, resulting in the patient crying uncontrollably before dissolving into fits of laughter.

The pseudobulbar affect, also referred to as emotional lability, should not be confused with labile mood or labile emotions that stem from emotional instability – affective dysregulation – commonly seen in personality disorders.

Arthur Fleck, the central character of the 2019 film Joker, displays signs of pseudobulbar affect,[53] which are said to be what Joaquin Phoenix used as inspiration for his character’s signature laugh.

In the 2019 movie Parasite, the character Ki-woo suffers head trauma, and although it is not clearly mentioned that he’s affected by pseudobulbar affect, he mentions not being able to stop laughing when thinking about all the events that occur in the movie.

In the medical television show House, season 7, episode 8 (Small Sacrifices), the character Ramon Silva, played by Kuno Becker displays pseudobulbar affect, with uncontrollable incongruent laughter, while suffering from Marburg variety of Multiple sclerosis.

In season 3, episode 9 of The Good Fight, the character Brenda DeCarlo, an external auditor, displays pseudobulbar affect, with uncontrollable incongruent laughter.


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