Mental Health and Psychology Dictionary
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C D E F G H I J K L M N O P Q R S T U V W X Y Z
Defense mechanism.
When an anxiogenic inner emotional conflict (a dissonance
most often experienced as frustration) is communicated via behavioral
aggression.
Acting out involves little or no insight,
foresight, impulse control, self-awareness (it is dissociative), or
self-reflection.
Sometimes intended to attract attention and disrupt
other people's lives.
Affect
Affect is how we express our innermost feelings and how other people observe
and interpret our expressions. Affect is characterized by the type of emotion
involved (sadness, happiness, anger, etc.) and by the intensity of its
expression.
Some people have flat
affect: they maintain "poker faces", monotonous, immobile, apparently
unmoved. This is typical of Schizoid Personality Disorder. Others have blunted,
constricted, or broad (healthy) affect. Patients with dramatic-erratic (Cluster
B) personality disorders - especially Histrionic and Borderline - have
exaggerate and labile (changeable) affect. They are "drama queens".
In certain mental health disorders, the affect is inappropriate. For instance:
such people laugh when they recount a sad or horrifying event or when they find
themselves in morbid settings (e.g., in a funeral).
Ambivalence
Possessing equipotent - but opposing and conflicting - emotions or ideas. In
someone with a permanent state of inner turmoil: her emotions come in mutually
exclusive pairs, her thoughts and conclusions arrayed in contradictory dyads.
The result is extreme
indecision, to the point of utter paralysis and inaction. Sufferers of
Obsessive-Compulsive Disorders and Obsessive-Compulsive Personality Disorder
are highly ambivalent.
Amnesia, Anterograde
Loss of memory pertaining
to events that occurred after the onset of the amnetic condition or agent.
Amnesia, Retrograde
Loss of memory pertaining
to events that occurred before the onset of the amnetic condition or agent.
Amok
Male-specific culture-bound syndrome: an alternating pattern of
dissociation, brooding, and violence directed at objects and people.
Provoked by real or imagined criticism or slights and accompanied by
persecutory ideation, amnesia, automatism, and extreme fatigue. Sometimes
co-occurs with a psychotic episode.
Common in Malaysia (where
it was discovered), Laos, Philippines, Polynesia (where it is called cafard or
cathard), Papua New Guinea, Puerto Rico (mal de pelea), and among the Navajo
Native-Americans (iich'aa).
Anhedonia
The loss of the urge to seek pleasure and the ability to experience it.
Major Depression and schizophrenia often involve anhedonia. The patient is unable to conjure sufficient mental energy to get off the couch and do something because s/he finds everything equally boring, tedious and unattractive.
Anorexia
Diminished appetite to the point of refraining from eating. Whether it is part
of a depressive illness or a body dysmorphic disorder (erroneous perception of
one's body as too fat) is still debated. Anorexia is one of a family of eating
disorders which also includes bulimia (compulsive gorging on food and then its
forced purging, usually by vomiting).
Antisocial
Personality Disorder (Psychopath)
APD or AsPD; Formerly
called "psychopathy" or, more colloquially, "sociopathy".
Some scholars, such as Robert Hare, still distinguish psychopathy from mere
antisocial behavior.
The disorder appears in
early adolescence but criminal behavior and substance
abuse often abate with age, usually by the fourth or fifth decade of
life. It may have a genetic or hereditary determinant and brain and
physiological abnormalities. It afflicts mainly men. The diagnosis is
controversial and regarded by some scholar as scientifically unfounded.
Psychopaths regard other
people as objects to be manipulated and instruments of gratification
and utility. They have no discernible conscience, are devoid of empathy,
and find it difficult to perceive other people's nonverbal cues, needs,
emotions, and preferences.
Consequently, the
psychopath rejects other people's rights and his commensurate obligations. He
is impulsive, reckless, irresponsible and unable to postpone gratification. He
often rationalizes his behavior showing an utter absence of remorse
for hurting or defrauding others.
Their (primitive) defence mechanisms include splitting or dichotomous
thinking (they view the world - and people in it - as "all good"
or "all evil"), projection (attribute their own shortcomings
unto others) and projective identification (force others to behave the way they
expect them to).
The psychopath fails to
comply with social norms. Hence the criminal acts, the deceitfulness and
identity theft, the use of aliases, the constant lying, and the conning of even
his nearest and dearest for gain or pleasure.
Psychopaths are
goal-oriented but unreliable and do not honor their undertakings, obligations,
contracts, and responsibilities. They rarely hold a job for long or repay their
debts. They are vindictive, remorseless, ruthless, driven, dangerous, aggressive,
violent, irritable, and, sometimes, prone to magical thinking. They seldom plan
for the long and medium terms, believing themselves to be immune to the
consequences of their own actions.
A kind of unpleasant
(dysphoric), mild fear, with no apparent external reason. Apprehension or dread
in anticipation of a future menace or an imminent but diffuse and unspecified
danger, usually imagined or exaggerated. The mental state of anxiety (and
the concomitant hypervigilance) has physiological complements. It is
accompanied by short-term dysphoria and physical symptoms of stress and
tension, such as sweating, palpitations, tachycardia, hyperventilation, angina,
tensed muscle tone, and elevated blood pressure (arousal).
APD, AsPD - Antisocial Personality Disorder
Aphonia
Inability to produce speech
(or sounds) through the larynx due to psychological, nonorganic, reasons.
Autistic or Dereistic
Thinking
Ways of relating to reality, experience, logic, and to other
people.
Fantasy-infused thoughts (dereism) or narcissistic and egocentric self-absorption (autistic).
These patients’s illogical and idiosyncratic cognitions derive from an overarching and all-pervasive daydreaming or fantasy life. They infuse people and events around them with completely subjective meanings.
They regard the external world as an extension or projection of the internal one.
Such patients often withdraw completely and retreat into their inner, private realm, unavailable to communicate and interact with others.
Automatic
obeisance or obedience
Automatic,
unquestioning, excessive, uncritical, mechanical, and immediate obeisance of
all commands, requests, and suggestions of others - even the most manifestly
absurd and dangerous ones. This suspension of critical judgment is sometimes an
indication of incipient catatonia.
Avoidant Personality Disorder
Social shyness and social
anxiety coupled with feelings of inadequacy, deformity, and dysfunction and
with hypersensitivity to criticism, real or imagined.
Sufferers of the disorder
avoid interpersonal contact because they dread rejection, embarrassment,
disagreement, and disapproval. They strive to ascertain that their
counterparty likes them and approves of their conduct, or their choices,
before they actually meet them.
They prefer solitary
occupations and are very restrained and "cold" in intimate
relationships. They constrict (limit) their world, evade challenges and risks
and stunt their personal growth and development by avoiding the new (e.g.,
unfamiliar people, novel activities, or pursuits).
They are mortified by shame and by the possibility of being mocked, criticized,
rejected, or ridiculed in public. They are prone to having ideas of reference
(see entry). They are perceived by others as reserved, timid, and inhibited
because they regard themselves as socially inept, repellent, unattractive,
inferior, inadequate, dysfunctional, defective, or deformed. Some Avoidants
develop Body Dysmorphic Disorders.
Avolition
Inability to initiate goals
and goal-directed activities – or to pursue them once initiated. Overpowering
and pervasive lack of "will", perseverance, and stamina in various
fields of life (work, self-care, intellectual tasks and interests, family life,
etc.)
Blocking
Halted, frequently interrupted speech to the point of incoherence indicates a
parallel disruption of thought processes. The patient appears to try hard to
remember what it was that he or she were saying or thinking (as if they
"lost the thread" of conversation).
Borderline
Personality Disorder
BPD;
A controversial mental health diagnosis in cluster B (erratic-dramatic).
Borderlines
are characterized by stormy, short-lived, and unstable relationships matched by
wildly fluctuating (labile) self-image and emotional expression (unstable
affect). Some scholars suggest that BPD is merely emotionally dysregulated
CPTSD.
Borderlines
are impulsive and reckless, their sexual conduct is frequently unsafe, they
binge eat, gamble, drive, and shop carelessly, or are substance abusers.
They
also display self-destructive and self-defeating behaviors, such as suicidal
ideation, suicide attempts, gestures, or threats, and self-mutilation or
self-injury.
The
specter of abandonment provokes anxiety in the Borderline as do the feelings of
engulfment or enmeshment. They make frantic - and, usually, counterproductive -
efforts to preempt or prevent both conditions.
Clinging,
codependent acts are followed by idealization and then by an abrupt devaluation
of the Borderline's partner (approach-avoidance repetition compulsion and
splitting).
Borderlines
have pronounced mood swings, shifting between dysphoria (sadness or depression)
and euphoria, manic self-confidence and paralyzing anxiety, irritability and
indifference. They are often angry and violent, usually getting into physical
fights, throw temper tantrums, and have frightening rage attacks.
Under
stress, some Borderlines become briefly psychotic, or develop transient
paranoid ideation and ideas of reference (the erroneous conviction that one is
the focus of derision and malicious gossip).
Dissociative
symptoms such as amnesia, derealization, and depersonalization are common
("losing" stretches of time, or objects, and forgetting events or
facts with emotional content).
Borderline
Personality Organization Scale (BPO)
Diagnostic test designed in
1985. It sorts the responses of respondents into 30 relevant scales. It
indicates the existence of identity disturbance, primitive defenses, and
deficient reality testing.
BPD - Borderline Personality Disorder
Catalepsy
The rigid maintenance of a
position of the entire body or of an organ over extended periods of time
("waxy flexibility"). "Human sculptures" are patients who
freeze in any posture and position that they are placed, no matter how painful
and unusual. Typical of catatonics. See: Cerea Flexibilitas
Catatonia
A syndrome comprised of various signs, amongst which
are: catalepsy, mutism, stereotypy, negativism, stupor, automatic obedience,
echolalia, and echopraxia. Until recently it was thought to be related to
schizophrenia, but this view has been discredited when the biochemical basis
for schizophrenia had been discovered. The current thinking is that catatonia
is an exaggerated form of mania (in other words: an affective disorder). It is
a feature of catatonic schizophrenia, though, and also appears in certain psychotic
states and mental disorders that have organic (medical) roots.
Catatonic Behavior
Severe motoric
abnormalities, including stupor or catalepsy (motoric immobility), or, at the
other end of the spectrum, agitated (excessive), purposeless,
repeated motoric activity, not in response to external stimuli or
triggers.
Also (apparently
motiveless) resistance or indifference to attempts to being moved or to being
communicated with (extreme negativism).
Catatonic behavior often
comprises mutism, posturing (stereotyped motion), echolalia, and echopraxia.
Chinese Classification of
Mental Disorders. The Chinese equivalent of the DSM. Currently in its third
edition (CCMD-3). Recognizes culture-bound syndromes
(e.g., Koro) as diagnosable and treatable mental health disorders.
Cerea Flexibilitas
Literally:
wax-like flexibility. In the common form of catalepsy, the patient offers no
resistance to the re-arrangement of his limbs or to the re-alignment of her
posture. In Cerea Flexibilitas, there is some resistance, though it is very
mild, much like the resistance a sculpture made of soft wax would offer.
Circumstantiality
When the
train of thought and speech is often derailed by unrelated digressions, based
on chaotic associations. The patient finally succeeds to express his or her
main idea but only after much effort and wandering. In extreme cases considered
to be a communication disorder.
Clang
Associations
Rhyming
or punning associations of words with no logical connection or any discernible
relationship between them. Typical of manic episodes,psychotic states, and
schizophrenia.
Clouding
(Also: Clouding of Consciousness)
The patient is wide awake but his or her awareness of
the environment is partial, distorted,or impaired. Clouding also occurs when
one gradually loses consciousness (for instance, as a result of intense pain or
lack of oxygen).
When
someone holds simultaneously two conflicting views, thoughts, values, or bits
of information which call for diametrically opposed decisions or actions.
This
state of things generates an inner conflict and triggers several primitive
(infantile) defense mechanisms such as denial, splitting, projection, and
reaction formation.
Involuntary
repetition of a stereotyped and ritualistic action or movement, usually in
connection with a wish or a fear. The patient is aware of the irrationality of
the compulsive act (in other words: she knows that there is no real connection
between her fears and wishes and what she is repeatedly compelled to do).
Most compulsive patients find their compulsions tedious, bothersome,
distressing, and unpleasant - but resisting the urge results in mounting
anxiety from which only the compulsive act provides much needed relief.
Compulsions are common in obsessive-compulsive disorders, the
Obsessive-Compulsive Personality Disorder (OCPD), and in certain types of
schizophrenia.
Concrete
Thinking
Inability
or diminished capacity to form abstractions or to think using abstract
categories. The patient is unable to consider and formulate hypotheses or to
grasp and apply metaphors. Only one layer of meaning is attributed to each word
or phrase and figures of speech are taken literally. Consequently,
nuances are not detected or appreciated. A common feature of
schizophrenia, autism spectrum disorders, and certain organic
disorders.
The
constant and unnecessary fabrication of information or events to fill in gaps
in the patient’s memory, biography or knowledge, or to substitute for
unacceptable reality. Common in schizophrenia, Cluster B personality disorders
(narcissistic, histrionic, borderline, and antisocial), in organic memory
impairment (such as Korsakoff Syndrome, dementias), and in the amnestic
syndrome (amnesia).
Conflict Tactics
Scale (CTS)
Diagnostic test invented in
1979. It is a standardized scale of the frequency and intensity of conflict
resolution tactics – especially abusive stratagems – used by members of a dyad
(couple).
Confusion
Complete (though often momentary) loss of orientation
in relation to one's location, time, and to other people. Usually the result of
impaired memory (often occurs in dementia) or attention deficit (for instance,
in delirium). Also see: Disorientation.
Recurrent dysfunctional
behavior linked to troubling experiences regarded, in a specific
locale by its native denizens, or in a specific culture, as aberrant or
sick.
Defense Mechanism
A psychological process
that protects or isolates a person from the effects of anxiety, internal and
external stressors, and perceived or real dangers, usually by reducing,
altering, or blocking his or her awareness of them. Defense
mechanisms mediate the individual's reactions to emotional and physical hurt,
inner conflicts, and stressors of all kinds. Most defense mechanisms are
adaptive when first formed but later become maladaptive (e.g., splitting,
acting out, projective identification, projection, intellectualization). Others
- such as suppression or denial - can be adaptive in certain circumstances and
if they are flexibly applied, are not severe, and are safely reversible.
Defense mechanisms are measured and evaluated using the Defensive Functioning
Scale.
Delirium
is a syndrome which involves clouding, confusion, restlessness, psychomotor
disorders (retardation or, on the opposite pole, agitation), and mood and
affective disturbances (lability). Delirium is not a constant state. It waxes
and wanes and its onset is sudden, usually the result of some organic
affliction of the brain.
A belief, idea, or conviction firmly held despite
abundant information to the contrary. The partial or complete loss of reality
test is the first indication of a psychotic state or episode. Beliefs,
ideas, or convictions shared by other people, members of the same
collective, are not, strictly speaking, delusions, although they may be
hallmarks of shared psychosis. There are many types of delusions:
I. Paranoid
The belief that one is being controlled or
persecuted by stealth powers and conspiracies.
2. Grandiose-magical
The conviction that one is important, omnipotent,
possessed of occult powers, or a historic figure.
3. Referential (ideas of reference)
The belief that external, objective events carry
hidden or coded messages or that one is the subject of discussion, derision, or
opprobrium, even by total strangers.
The counterfactual conviction
that unrelated events and people are somehow specifically meaningful to the
person and intentionally effected. A patient with delusions of
reference is convinced that he is the topic of malicious gossip,
the victim of pranks, or the recipient of messages (for instance, through the
media). See also: idea of reference, persecutory delusion.
Dementia
Simultaneous impairment of various mental faculties,
especially the intellect, memory, judgment, abstract thinking, and impulse
control due to brain damage, usually as an outcome of organic illness. Dementia
ultimately leads to the transformation of the patient's whole personality.
Dementia does not involve clouding and can have acute or slow (insidious)
onset. Some dementia states are reversible.
Defense mechanism. Ignoring
unpleasant facts, filtering out data and content that contravene one's
self-image, prejudices, and preconceived notions of others and of the world.
Dependent Personality Disorder
DPD; A compulsive,
pervasive, and excessive craving to be attended to and taken care of
that leads to clinging, stifling, and humiliating or submissive behaviors.
Codependents are paralyzed by their anxiety of being abandoned.
They are indecisive and demand constant and repeated reassurances and advice
from a myriad sources, thereby "transferring" responsibility for
their decisions to others. Codependents rarely initiate, though
they often harbor repressed ambition, energy, and imagination. They lack
self-confidence and distrust their own abilities and judgment.
This reliance on others leads to self-negating behavior. The codependent never
disagrees with meaningful others or criticizes them, lest s/he loses the
support and emotional nurturance they do or could provide. The codependent
molds himself/herself and bends over backward to cater to the needs of his
nearest and dearest and satisfy their every whim, wish, expectation, and
demand. Nothing is too unpleasant or unacceptable if it serves to secure the
uninterrupted presence of the codependent's family and friends and the
emotional sustenance s/he can extract (or extort) from them.
The codependent feels helpless, threatened, ill-at-ease, child-like, and
not fully-alive when alone. This acute discomfort drives the codependent to hop
from one relationship to another. The sources of nurturance are
interchangeable. To the codependent, being with someone, with anyone, no matter
whom - is always preferable to being alone.
Feeling that one's body has changed shape or that
specific organs have become elastic and are not under one's control. Usually
coupled with "out of body" experiences. Common in a variety of mental
health and physiological disorders: depression, anxiety, epilepsy,
schizophrenia, and hypnagogic states. Often observed in adolescents. See: Derealization.
Derailment
A loosening of
associations. A pattern of speech in which unrelated or loosely-related ideas
are expressed hurriedly and forcefully, with frequent topical shifts and with
no apparent internal logic or reason. See: incoherence.
A dissociative disorder or defense. Feeling that one's immediate environment is unreal,
dream-like, or somehow altered. See: Depersonalization.
Dereistic
Thinking
Inability to incorporate reality-based facts and
logical inference into one's thinking. Fantasy-based thoughts.
Devaluation
Defense mechanism.
Attributing negative or inferior traits or qualifiers to self or others. This
is done in order to punish the person devalued and to mitigate his or her
impact on and importance to the devaluer. When the self is devalued, it is a
self-defeating and self-destructive act.
Dhat
Culture-bound
syndrome in India which includes incapacitating anxiety attacks,
hypochondriasis associated with self-reported painful ejaculation of sperm,
discharge of foggy white urine, and overwhelming fatigue. Also see: Jiryan,
Sukra Prameha, and Shen-k'uei.
Disorientation
A state of confusion about
the date, place, time of day, or one's personal identity. One of the signs of delirium.
Displacement
Defense mechanism.
Confronting someone weaker or irrelevant and, thus, less menacing when one
cannot confront the real sources of one's frustration, pain, and envy.
Dissociation
Sudden or gradual
perturbance in the continuous operation of high-level integrated
functions, such as consciousness, memory, perception, and identity. Most
dissociative disorders are transient, but some - such as the Dissociative
Identity Disorder (q.v.) are chronic. Also see: Dissociative Amnesia,
Dissociative Fugue, Dissociative Identity Disorder, Dissociative Trance
Disorder.
DSM - Diagnostic and Statistical
Manual
Diagnostic and Statistical
Manual, currently at its fourth edition (text revision, also shortened as
DSM-IV-TR). First published by the American Psychiatric Association in 1952,
based on the sixth edition of the World Health Organizagtion's ICD. Contains a
classification of all mental health disorders, organized into 17
diagnostic classes and based on literature reviews, data analyses, and
field trials. Compiled by more than 1000 mental health professionals, working
in committees. A fifth edition is expected in 2010.
Dyssomnia
Primary disorder of the
amount, quality, or timing of sleep and wakefulness. Insomnias and
hypersomnias are dyssomnias.
Imitation by way of exactly repeating another
person's speech. Involuntary, semiautomatic, uncontrollable, and repeated
imitation of the speech of others. Observed in organic mental disorders,
pervasive developmental disorders, psychosis, and catatonia. See: Echopraxia.
Involuntary, semiautomatic,
uncontrollable, and repeated imitation of the movements of others. Observed in organic
mental disorders, pervasive developmental disorders, psychosis, and catatonia.
See: Echolalia.
Defense mechanism. Seeking
gratification - the satisfaction of drives or desires - by constructing
imaginary worlds that, gradually, are preferred to reality.
Flashback
A vivid recurrence
of past experiences, memories, or emotions, often triggered by specific
events, words, or sensory cues. Common in Post Traumatic Stress Disorder
(PTSD).
Rapidly
verbalized train of unrelated thoughts or of thoughts related only via
relatively-coherent associations. Still, in its extreme forms, flight of
ideas involves cognitive incoherence and disorganization. Appears as a
sign of mania, certain organic mental health disorders, schizophrenia, and
psychotic states. Also see: Pressure of Speech and Loosening of Associations.
The
sharing of delusional (often persecutory) ideas and beliefs by two or more
(folie a plusieurs) persons who cohabitate or form a social unit (e.g., a
family, a cult, or an organization). One of the members in each
of these groups is dominant and is the source of the delusional content
and the instigator of the idiosyncratic behaviors that accompany the delusions.
Formication - See Hallucination
Fugue
Vanishing act. A sudden flight or wandering away
and disappearance from home or work, followed by the assumption of a new
identity and the commencement of a new life in a new place. The previous life
is completely erased from memory (amnesia). When the fugue is over, it is also
forgotten as is the new life adopted by the patient.
The aversion to and
rejection of one's gender identity and biological sex, their physical
attributes and the social roles attendant to them. Often leads to attempts to
change one's sex through hormone therapy and surgery.
Gender Identity
The inner conviction that
one is either a male or a female.
Gender Role
Masculine or feminine
behavior patterns, attitudes, preferences, and personality traits within a
given culture.
Delusional or
non-delusional inflated evaluation of one's knowledge, power, worth,
importance, identity, accomplishments, rights, assets, or prospects. Typical of
certain personality disorders, such as the Narcissistic.
False perceptions based on false sensa (sensory input)
not triggered by any external event or entity. The patient is usually not
psychotic - he is aware that he what he sees, smells, feels, or hears is not
there. Still, some psychotic states are accompanied by hallucinations (e.g.,
formication - the feeling that bugs are crawling over or under one's
skin).
There are a few classes of hallucinations:
Auditory - The false perception of voices
and sounds (such as buzzing, humming, radio transmissions, whispering, motor
noises, and so on).
Gustatory - The false perception of tastes
Olfactory - The false perception of smells
and scents (e.g., burning flesh, candles)
Somatic - The false perception of processes
and events that are happening inside the body or to the body (e.g., piercing
objects, electricity running through one's extremities). Usually supported by
an appropriate and relevant delusional content.
Tactile - The false sensation of being
touched, or crawled upon or that events and processes are taking place under
one's skin. Usually supported by an appropriate and relevant delusional
content.
Visual - The false perception of objects,
people, or events in broad daylight or in an illuminated environment with eyes
wide open.
Hypnagogic and Hypnopompic -
Images and trains of events experienced while falling asleep or when waking up.
Not hallucinations in the strict sense of the word.
Hallucinations are common in schizophrenia, affective
disorders, and mental health disorders with organic origins. Hallucinations are
also common in drug and alcohol withdrawal and among substance abusers.
Histrionic
Personality Disorder
HPD; Histrionics - mostly
women - resemble narcissists in their attention seeking behaviors and
marked discomfort when not at the center of attention. Yet, unlike narcissists,
histrionics are empathic, sentimental, and overly emotional. They are sexually
seductive and provocative and people often find them embarrassing,
annoying, or outright repulsive.
The histrionic glides from one relationship to the next, constantly
experiencing shallow emotions and commitments. The Histrionic's speech is
impressionistic, disjointed, and generalized. She uses her physical
appearance and attire as bait. Histrionics often mistake the depth,
durability, and intimacy of their relationships and are devastated by their
inevitable premature termination.
Histrionics are the quintessential drama queens. They are theatrical, their
emotions exaggerated to the point of a caricature, their gestures sweeping,
disproportional, and inappropriate. They are easily suggestible and
over-reactive.
HPD - Histrionic Personality Disorder
Hwa-byung
Culture-bound
syndrome in Korea, attributed to suppressed anger (roughly translated as
"anger illness"). Symptoms include extreme fatigue coupled with sleep
disorder (mainly insomnia), panic, terror of imminent doom or death, dysphoria,
anhedonia, indigestion, anorexia, dyspnea, diffuse pains, palpitations, and a
feeling of congestion or mass in the epigastrium. See: panic
attack..
Hyperacusis
Painful hypersensitivity to
sounds, noises, and voices.
Hypersomnia
Pronounced tendency to
oversleep at night coupled with a difficulty to remain alert or awake during
the day and undesired, abrupt, and uncontrolled diurnal episodes of sleep.
Hypnagogic and
Hypnopompic
- See Hallucination
Weak delusions of
reference, devoid of inner conviction and with a stronger reality test. The
counterfactual feeling that unrelated events and people are somehow
specifically meaningful to the person and intentionally
effected. A patient with ideas of reference may feel
that he is the topic of malicious gossip, the victim of pranks, or the
recipient of messages (for instance, through the media). Ideas of reference are
common in some personality disorders. See also: delusion, persecutory delusion.
Defense mechanism. The
attribution of positive, glowing, and superior traits to self and (more
commonly) to others.
Illusion
The misperception or
misinterpretaion of real external - visual or auditory - stimuli, attributing
them to non-existent events and actions. Incorrect perception of a
material object. See: Hallucination.
A loosening of associations.
A pattern of speech in which unrelated or loosely-related ideas are expressed
hurriedly and forcefully, using broken, ungrammatical, non-syntactical
sentences, an idiosyncratic vocabulary ("private language"), topical
shifts, and inane juxtapositions ("word salad"). Incomprehensible
speech, rife with severely loose associations, distorted grammar, tortured
syntax, and idiosyncratic definitions of the words used by the patient
("private language"). See: Loosening of
Associations; Flight of Ideas;
Tangentiality.
Insomnia
Sleep disorder or disturbance involving difficulties
to either fall asleep ("initial insomnia") or to remain asleep
("middle insomnia"). Waking up early and being unable to resume sleep
is also a form of insomnia ("terminal insomnia").
Isolation of Affect
Defense mechanism. Avoiding
conflict and anxiety by separating the cognitive content (for instance, a
disturbing or depressing idea) from its emotional correlate and, thus, casting
away threatening and discomfiting feelings.
Intellectualization - see: Rationalization
Intersex Condition
Androgyny. The appearance
and manifestation, in one individual, of the characteristics of both sexes,
male and female: reproductive organs, physical form, and sexual behavior.
Culture-bound
syndrome in south and east Asia (and, more rarely, in the West, especially
among immigrant communities). Episodic abrupt and overwhelming anxiety that
one's sex organs (penis, vulva, nipples) will recede into one's body and cause
death. Recognized as a valid mental health diagnosis by the Chinese (in the
Chinese Classification of Mental Disorders - Second Edition - the CCMD-2). See also: Shuk yang, Shook yong, Suo yang, Jinjinia
bemar, Rok-joo.
Lability
Abnormal, repetitive, rapid, and
sudden fluctuations in both affect and affective expression. Characterizes
certain personality disorders, such as the Borderline.
Latah
Term used in Asia to
describe a syndrome of reactions to sudden fright which include echopraxia,
echolalia, command obedience, and dissociation in a trance-like state. Mainly
found among middle-aged women. Also called amurakh, irkunii, ikota, olan,
myriachit, menkeiti (in Siberia), bah tschi, bah-tsi, baah-ji (Thailand), imu
(Sakhalin, Japan), mali-mali and silok (Philippines).
Locura
Term
used in Latin America (and among Latino immigrants in the USA) to describe
severe and chronic psychosis, usually inherited, and induced by difficulties
and crises in the patient's life. The syndrome includes agitation, incoherence, hallucinations (both auditory and visual),
unpredictable (typically violent) beahvior, and inability to interact socially.
Thought and speech disorder which involves the
translocation of the focus of attention from one subject to another
for no apparent reason. The patient is usually unaware of the fact that his
train of thoughts and his speech are incongruous and incoherent. A sign of
schizophrenia and some psychotic states. See: Incoherence;
Flight of Ideas; Tangentiality.
Visual misperception of
objects as larger than they are. See: Micropsia.
Magical Thinking
The mistaken conviction
that effects and events in the external world are caused or prevented by one's
thoughts, words, or actions - frequently in defiance of the laws of physics and
formal logic. It is normal in early childhood but pathological thereafter when
it forms part of personality and other mental health disorders.
Visual misperception of
objects as smaller than they are. See: Macropsia.
Millon Clinical Multiaxial
Inventory. Diagnostic test composed of 157 true-or-false items.
The MCMI-III consists of 24
clinical scales and 3 modifier scales. The modifier scales serve to identify
Disclosure (a tendency to hide a pathology or to exaggerate it), Desirability
(a bias towards socially desirable responses), and Debasement (endorsing only
responses that are highly suggestive of pathology). Next, the Clinical
Personality Patterns (scales) which represent mild to moderate pathologies of
personality, are: Schizoid, Avoidant, Depressive, Dependent, Histrionic,
Narcissistic, Antisocial, Aggressive (Sadistic), Compulsive, Negativistic, and
Masochistic. Millon considers only the Schizotypal, Borderline, and Paranoid to
be severe personality pathologies and dedicates the next three scales to them.
The last ten scales are
dedicated to Axis I and other clinical syndromes: Anxiety Disorder, Somatoform
Disorder, Bipolar Manic Disorder, Dysthymic Disorder, Alcohol Dependence, Drug
Dependence, Posttraumatic Stress, Thought Disorder, Major Depression, and
Delusional Disorder.
Scoring is easy and runs
from 0 to 115 per each scale, with 85 and above signifying a pathology. The
configuration of the results of all 24 scales provides serious and reliable
insights into the tested subject.
Minnesota Multiphasic
Personality Inventory. Diagnostic test composed of 567 true-or-false questions
arranged in three validity scales and ten dimensional clinical scales. The
latter
measure hypochondriasis,
depression, hysteria, psychopathic deviation, masculinity-femininity, paranoia,
psychasthenia, schizophrenia, hypomania, and social introversion. There are
also scales for alcoholism, post-traumatic stress disorder, and personality
disorders.
The interpretation of the
MMPI-II is now fully computerized. The computer is fed with the patients' age,
sex, educational level, and marital status and does the rest.
Mood
Pervasive
and sustained feelings and emotions as subjectively described by the patient.
The same phenomena observed by the clinician are called affect. Mood can be
either dysphoric (unpleasant) or euphoric (elevated, expansive, "good
mood"). Dysphoric moods are characterized by a reduced sense of
well-being, depleted energy, and negative self-regard or sense of self-worth.
Euphoric moods typically involve an increased sense of well-being, ample
energy, and a stable sense of self-worth and self-esteem. Also see: Affect.
Mood
Congruence and Incongruence
The contents of mood-congruent hallucinations and
delusions are consistent and compatible with the patient's mood. During
the manic phase of the Bipolar Disorder, for instance, such hallucinations and
delusions involve grandiosity, omnipotence, personal identification with great
personalities in history or with deities, and magical thinking. In depression,
mood-congruent hallucinations and delusions revolve around themes like the
patient's self-misperceived faults, shortcomings, failures, worthlessness, guilt
- or the patient's impending doom, death, and "well-deserved"
sadistic punishment.
The contents of mood-incongruent hallucinations and
delusions are inconsistent and incompatible with the patient's mood. Most
persecutory delusions and delusions and ideas of reference, as well as
phenomena such as control "freakery" and Schneiderian First-rank
Symptoms are mood-incongruent. Mood incongruence is especially prevalent in
schizophrenia, psychosis, mania, and depression.
Multidimensional
Anger Inventory (MAI)
Diagnostic test invented in
1986. Assesses the frequency of angry responses, their duration, magnitude,
mode of expression, hostile outlook, and anger-provoking triggers.
Pathological narcissism is
a pattern of traits and behaviors which signify infatuation and obsession with
one's self to the exclusion of all others and the egotistic and ruthless
pursuit of one's gratification, dominance and ambition. Most narcissists (50-75%,
according to the DSM IV-TR) are men. See: Narcissistic Personality Disorder
(NPD).
Narcissistic Personality Disorder
NPD; one of a "family" of
personality disorders ("Cluster B"), which includes the Borderline
PD, Antisocial PD and Histrionic Personality Disorders. It is often diagnosed
with other mental health disorders ("co-morbidity") - or with
substance abuse and impulsive and reckless behaviors ("dual
diagnosis").
It is estimated that 0.7-1%
of the general population suffer from NPD. The onset of narcissism is in
infancy, childhood and early adolescence. It is commonly attributed to
childhood abuse and trauma inflicted by parents, authority figures, or even
peers.
NPD is treated in talk
therapy (psychodynamic or cognitive-behavioral). The prognosis for an adult
narcissist is poor, though adaptation to life and to others can improve with
treatment. Medication is applied to side-effects and behaviors (such as mood or
affect disorders and obsession-compulsion) - usually with some success.
The Diagnostic and
Statistical Manual of Mental Disorders, fourth edition, Text Revision
(DSM-IV-TR), 2000 (The American Psychiatric Association, Washington D.C.)
defines NPD as "an all-pervasive pattern of grandiosity (in fantasy or
behavior), need for admiration or adulation and lack of empathy, usually
beginning by early adulthood and present in various contexts."
The Narcissist feels
grandiose and self-important (e.g., exaggerates accomplishments, talents,
skills, contacts, and personality traits to the point of lying, demand to be
recognized as superior without commensurate achievements). Is obsessed with
fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled
brilliance (the cerebral narcissist), bodily beauty or sexual performance (the
somatic narcissist), or ideal, everlasting, all-conquering love or passion. He
is firmly convinced that he or she is unique and, being special, can only be
understood by, should only be treated by, or associate with, other special or
unique, or high-status people (or institutions).
The narcissist requires
excessive admiration, adulation, attention and affirmation - or, failing that,
wishes to be feared and to be notorious (Narcissistic Supply). He feels
entitled. Demands automatic and full compliance with his or her unreasonable expectations
for special and favorable priority treatment.
The narcissist is
"interpersonally exploitative", i.e., uses others to achieve his or
her own ends. He is devoid of empathy. Is unable or unwilling to identify with,
acknowledge, or accept the feelings, needs, preferences, priorities, and choices
of others. He is constantly envious of others and seeks to hurt or destroy the
objects of his or her frustration. Suffers from persecutory (paranoid)
delusions as he or she believes that they feel the same about him or her and
are likely to act similarly.
The narcissist behaves
arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible,
immune, "above the law", and omnipresent (magical thinking). Rages
when frustrated, contradicted, or confronted by people he or she considers inferior
to him or her and unworthy.
Negativism
In
catatonia, complete opposition and resistance to suggestion.
Neologism
In schizophrenia and other psychotic disorders, the
invention of new "words" which are meaningful to the patient but
meaningless to everyone else. To form the neologisms, the
patient fuses together and combines syllables or other elements from
existing words.
NOS - (abbr.) Not Otherwise Specified
NPD - (abrr.) Narcissistic
Personality Disorder
Obsession
Recurring and intrusive images, thoughts, ideas, or wishes
that dominate and exclude other cognitions. The patient often finds the
contents of his obsessions unacceptable or even repulsive and actively resists
them, but to no avail. Common in schizophrenia and obsessive-compulsive
disorder.
Obsessive-Compulsive Personality
Disorder
OCPD; The
Obsessive-compulsive are concerned with control, both mental (self) and
interpersonal (others) and with its symbolic representations. They are
perfectionists and rigidly orderly or organized. According to the DSM, such
people lack flexibility, openness and efficiency.
Obsessive-Compulsives are preoccupied with lists, rules, rituals,
organization, perfection, and details. As a result, they are indecisive
and unable to prioritize. They are constantly worried that something is or
may go wrong and value their rigid schedules and checklists more
than the activities they relate to or the goals they are supposed to
help to achieve.
OCPDs are workaholics. They sacrifice family life, leisure, and friendships on
the altar of productivity and output. Yet, they are not very efficient or
productive.
Some OCPDs are self-righteous or even bigots. Their excessive conscientiousness
and scrupulous, unempathic and inflexible tyrannical
conduct precludes having meaningful, compromise-based, long-term
relationships. They regard their impossibly high work ethic and moral
standards as universal and binding. They are unable to delegate tasks to
others, unless they can micromanage the situation to fit their unrealistic
expectations. Consequently, they trust no one, are stubborn, and difficult to
deal with.
Some OCPDs are so terrified of change that they rarely discard acquired but now
useless objects, change the outlay of furniture at home, relocate, deviate from
the familiar route to work, tweak an itinerary, or embark on anything
spontaneous. They also find it difficult to spend money even on essentials.
This tallies with their view of the world as hostile, unpredictable, and
"bad".
OCD - Obsessive-Compulsive Disorder
OCPD - Obsessive-Compulsive Personality
Disorder
Omnipotence
Feeling or acting as though
one possesses special or magical powers or faculties, far superior to his
peers. As part of the defense mechanism of (pathological) narcissism, it serves
to ameliorate or sublimate emotional conflict and cope with internal or
external stressors. Often co-occurs with omniscience, magical thinking, ideas
of reference, and persecutory (paranoid) delusions.
Overvalued Idea or
Person
An unreasonable and
sustained belief in the value or veracity of an idea (overvalued idea) or a
person (idealization) that is not supported by other observers or by the
believer's culture or society. As opposed to a delusion, overvalued ideas are
sometimes reversed in the face of evidence to the contrary.
A form of severe anxiety attack accompanied by a sense
of losing control and of an impending and imminent life-threatening danger
(where there is none). Physiological markers of panic attacks include
palpitation, sweating, tachycardia (rapid heart beats), dyspnea or apnea (chest
tightening and difficulties breathing), hyperventilation, light-headedness or
dizziness, nausea, and peripheral paresthesias (an abnormal sensation of
burining, prickling, tingling, or tickling). In normal people it is a reaction
to sustained and extreme stress. Common in many mental health disorders.
Sudden, overpowering
feelings of imminent threat and apprehension, bordering on fear and terror.
There usually is no external cause for alarm (the attacks are uncued or
unexpected, with no situational trigger) - though some panic attacks are
situationally-bound (reactive) and follow exposure to "cues"
(potentially or actually dangerous events or circumstances). Most patients
display a mixture of both types of attacks (they are situationally
predisposed).
Bodily manifestations
include shortness of breath, sweating, pounding heart and increased pulse as
well as palpitations, chest pain, overall discomfort, and choking. Sufferers
often describe their experience as being smothered or suffocated. They are afraid
that they may be going crazy or about to lose control.
Paranoia
Psychotic grandiose and persecutory delusions.
Paranoids are characterized by a paranoid style: they are rigid,
sullen, suspicious, hypervigilant, hypersensitive, envious, guarded, resentful,
humorless, and litigious. Paranoids often suffer from paranoid ideation - they
believe (though not firmly) that they are being stalked or followed, plotted
against, or maliciously slandered. They constantly gather information to prove
their "case" that they are the objects of conspiracies against
them. Paranoia is not the same as Paranoid Schizophrenia, which is a subtype of
schizophrenia.
Paranoid Ideation
Ideas (usually, not
entirely delusional) that involve suspicions or beliefs that one is being
singled out for persecution, harassment, unfair treatment, or elimination. When
more severe, known as persecutory delusions (see Paranoid Personality
Disorder).
The paranoid firmly
believes that the world is malevolent, hostile, ominous,
and unpredictable. He distrusts others and suspects them of harboring
ulterior motives and sadistic or self-interested wickedness. People are out to
exploit, harm, get, or deceive him or her - even without good or
sufficient cause. Such convictions usually extend to the paranoid's family
members, friends, coworkers, and neighbors. The paranoid doubts their
loyalty. But many paranoids are also besieged by persecutory delusions which
place the paranoid at the center of conspiracies and collusions involving
various organizations and institutions.
They cower at home, planning their defenses, plotting and
counter-plotting, weary of any attempt to communicate with him. To them, any
information, even the most trivial, is a potential future weapon.
Moreover, even the most benign gestures, comments, or events assume threatening
proportions, nefarious meanings, malicious intent, and occult and debasing
outcomes (see: Ideas of Reference). Paranoids are hypersensitive and
unforgiving. Every remark is automatically and immediately interpreted as an
insult, injury, attack, or slight directed at the paranoid, his personality, or
reputation - and provokes aggression. Inevitably, paranoids are socially
isolated and appear to be eccentric.
Parasomnia
Abnormality of conduct or
unusual physiological reactions during sleep or in the transitions between
sleep and waking (for instance, hypnagogia, hypnopompia, sleep paralysis,
and night terrors).
Parorexia
Eating disorder. Having an
unnatural appetite or lack thereof (e.g., in anorexia).
Passive Aggression
The expression of indirect
and unassertive aggression
towards others as a way to relieve stressors (both internal and external) or to
cope with emotional conflicts. Overt compliance or even obsequiousness masks
covert hostility, resentment, resistance, and sabotage. Often occurs when the
individual's hidden wishes are not gratified or when independent action or
performance is demanded without the granting or acquisition of commensurate
autonomy, authority, skills, or powers.
Perseveration
Repeating the same gesture, behavior, concept, idea,
phrase, or word in speech. Common in schizophrenia, organic mental disorders,
and psychotic disorders.
Deeply ingrained, stable,
maladaptive, all-pervasive, lifelong behavior patterns manifested from early
adolescence and affecting all the dimensions of the patient's life: career,
interpersonal relationships, and social functioning.
Patients with personality
disorders - except those suffering from the Schizoid or the Avoidant
Personality Disorders - expect preferential and privileged treatment, present
with numerous symptoms, frequently second guess the diagnosis and disobey the
physician. Such patients feel unique, are self-preoccupied, and suffer from
grandiosity and a diminished capacity for empathy. They are socially
maladaptive, emotionally labile, manipulative and exploitative, trust no one
and find it difficult to love or share.
Personality disorders are
often comorbid with other personality disorders, with Axis I disorders, with
mood and affective disorders and with anxiety disorders and are characterized
by a host of defenses - splitting, projection, projective identification,
denial, intellectualization. The
patient does not, on the
whole, find his personality traits or behavior objectionable, unacceptable,
disagreeable, or alien to his self (he or she is ego-syntonic, not
ego-dystonic). Substance abuse and reckless behaviors are also common
("dual diagnosis").
The patient tends to blame
others or "the world" for misfortunes and failures. Thus, under
stress, he or she tries to preempt (real or imaginary) threats by influencing
the environment to conform to his or her needs.
Personality disorders are
not psychoses and do not involve hallucinations, delusions or thought disorders
(though psychotic "microepisodes", mostly during treatment, occur in
the Borderline and Narcissistic Personality Disorders). The patients are fully
oriented, with clear senses (sensorium), good memory and a general fund of
knowledge.
Phobia
A persistent, unfounded,
and irrational fear or dread of one or more classes of objects,
activities, situations, or locations (the phobic stimuli) and the resulting
overwhelming and compulsive desire to avoid them.
Dread of
a particular object or situation, acknowledged by the patient to
be irrational or excessive. Leads to all-pervasive avoidance behavior
(attempts to avoid the feared object or situation). See: Anxiety.
Posturing
Assuming
and remaining in abnormal and contorted bodily positions for prolonged periods
of time. Typical of catatonic states.
Poverty
of Content (of Speech)
Persistently vague, overly abstract or concrete,
repetitive, or stereotyped speech.
Poverty of Speech
Reactive, non-spontaneous, extremely brief,
intermittent, and halting speech. Such patients often remain silent for days on
end unless and until spoken to.
PPD - Paranoid Personality Disorder
Pressure of Speech
Rapid, condensed, unstoppable and "driven"
speech. The patient dominates the conversation, speaks loudly
and emphatically, ignores attempted interruptions, and doesn't care
if anyone is listening or responding to him or her. Seen in manic states,
psychotic or organic mental disorders, and conditions associated with stress.
See: Flight of Ideas.
Prodrome
Early symptom or sign of a
disorder (mainly a mental health disorder).
Projection
A defense mechanism to cope
with internal or external stressors and emotional conflict by attributing to
another person - usually falsely - thoughts, feelings, wishes, impulses, needs,
and hopes deemed forbidden or unacceptable by the projecting party.
Projective
Identification
A defense mechanism to cope
with internal or external stressors and emotional conflict by casting
thoughts, feelings, wishes, impulses, needs, and hopes deemed forbidden or
unacceptable by the projecting party - as justifiable and predictable reactions
to another person's actions or words ("triggers"). The projecting
party sometimes induces in that other person the triggering behavior so as to
justify his or her reactions.
Psychomotor Agitation
Mounting internal tension associated with
excessive, nonproductive (not goal orientated), and repeated motor
activity (hand wringing, fidgeting, and similar gestures). Hyperactivity and
motor restlessness which co-occur with anxiety and irritability.
Psychomotor
Retardation
Visible slowing of speech
or movements or both. Usually affects the entire range of performance (entire
repertory). Typically involves poverty of speech, delayed response time
(subjects answer questions after an inordinately long silence), monotonous and
flat voice tone, and constant feelings of overwhelming fatigue.
Psychopath - See Antisocial
Personality Disorder
Psychosis
Chaotic thinking that is
the result of a severely impaired reality test ( the patient cannot tell
inner fantasy from outside reality). Some psychotic states are
short-lived and transient (microepisodes). These last from a few hours to a few
days and are sometimes reactions to stress. Persistent psychoses are a fixture
of the patient's mental life and manifest for months or years.
Psychotics are fully aware
of events and people "out there". They cannot, however separate data
and experiences originating in the outside world from information generated by
internal mental processes. They confuse the external universe with their
inner emotions, cognitions, preconceptions, fears, expectations, and
representations.
Consequently, psychotics
have a distorted view of reality and are not rational. No amount of objective
evidence can cause them to doubt or reject their hypotheses and convictions.
Full-fledged psychosis involves complex and ever more bizarre delusions and the
unwillingness to confront and consider contrary data and information
(preoccupation with the subjective rather than the objective). Thought becomes
utterly disorganized and fantastic.
There is a thin line
separating nonpsychotic from psychotic perception and ideation. On this
spectrum we also find the schizotypal personality disorder.
Qi-gong Psychotic
Reaction
Acute, transient psychotic
episode or microepisode, also involving dissociative, paranoid, and
nonpsychotic symptoms. Often occurs after participation in the Chinese practice
of qi-gong ("exercise of vital energy"). Included as an official diagnosis
in the second edition of the Chinese Classification of Mental Disorders
(CCMD-2).
Rationalization
The elaboration of
incorrect but reassuring, coherent, self-serving and "rational"
explanations (narratives) to conceal the true motivations for one's thoughts,
actions, or emotions. Used to avoid emotional conflict or to cope with
stressors (both external and internal).
Reaction Formation
The repression of one's
unacceptable behavior, thoughts, or feelings and their replacement with
diametrically opposed behavior, thoughts, or feelings as a way to manage
emotional conflict and cope with stressors (both external and internal).
Reality Sense
The way one thinks about, perceives, and
feels reality.
Reality Testing
Comparing one's reality sense and one's hypotheses
about the way things are and how things operate to objective, external cues
from the environment.
Relationship Styles
Questionnaire (RSQ)
Diagnostic test invented in
1994. Contains 30 self-reported items and identifies distinct attachment styles
(secure, fearful, preoccupied, and dismissing).
Repression
The exclusion from
conscious awareness of disturbing memories, thoughts, ideas, and wishes in
order to manage emotional conflict and cope with stressors (both external and
internal). The emotions associated with the excluded content usually remain
conscious.
Residual (Phase)
The final phase of an
illness. Occurs after remission of the main symptoms or the full syndrome.
Rorschach Inkblot
Test
Diagnostic test comprised of 10 ambiguous inkblots
printed on 18X24 cm. cards, in both black and white and color. The cards
and the diagnostician's questions provoke free associations in the test
subject. These are recorded verbatim together with the inkblot's spatial
position and orientation. The patient can then add details and comment on his
choices.
Scoring is based on the parts of the cards referred to
in the subject's responses (location), the correspondence between the blot and
the answers provided (determinant), the content of the responses, how unique or
common they are (popularity), how coherent are the patient's narratives
(organizational activity), and how well does the patient's percept fit the card
(form quality).
The interpretation of the test relies on both the
scores obtained and on what we know about mental health disorders. The test
teaches the skilled diagnostician how the subject processes information and
what is the structure and content of his internal world. These provide
meaningful insights into the patient's defenses, reality test, intelligence,
fantasy life, and psychosexual make-up.
Schizoids are often act as automata ("robots"). They
appear cold and stunted, flat, and "zombie"-like.
Schizoids are uninterested in social relationships or interactions
and have a very limited emotional repertoire. Their affect - the
expression of whatever emotions they do possess - is poor and
intermittent.
Schizoids are loners. They confide only in first-degree relatives -
but maintain no close bonds or associations, not even with their immediate
family. They gravitate into solitary activities. Their sexual experiences are
sporadic and limited and, finally, they cease altogether.
Schizoids are anhedonic - find nothing pleasurable and attractive - but not
necessarily dysphoric (sad or depressed). They pretend to be indifferent to
praise, criticism, disagreement, and corrective advice (though, deep inside, they
are not). They are creatures of habit, frequently succumbing to rigid,
predictable, and narrowly restricted routines.
Schneiderian First-rank Symptoms
A list of symptoms compiled by Kurt Schneider, a
German psychiatrist, in 1957 and indicative of the presence of schizophrenia.
Includes:
Auditory hallucinations
Hearing conversations between a few imaginary
"interlocutors", or one's thoughts spoken out loud, or a running
background commentary on one's actions and thoughts.
Somatic hallucinations
Experiencing imagined sexual acts couple with
delusions attributed to forces, "energy", or hypnotic suggestion.
Thought withdrawal
The delusion that one's thoughts are taken over and
controlled by others and then "drained" from one's brain.
Thought insertion
The delusion that thoughts are being implanted or
inserted into one's mind involuntarily.
Thought broadcasting
The delusion that everyone can read one's mind,
as though one's thoughts were being broadcast.
Delusional perception
Attaching unusual meanings and significance to
genuine perceptions, usually with some kind of (paranoid or narcissistic)
self-reference.
Delusion of control
The delusion that one's acts, thoughts, feelings,
perceptions, and impulses are directed or influenced by other people.
The Structured Clinical
Interview (SCID-II) was formulated in 1997 by First, Gibbon, Spitzer, Williams,
and Benjamin. It is based on the language of criteria for personality disorders
in the the DSM-IV. Its 12 groups of questions correspond to the 12 personality
disorders. The scoring is simple: either the trait is absent, subthreshold,
true, or there is "inadequate information to code".
The SCID-II can be
administered to third parties (a spouse, an informant, a colleague) or
self-administered (in a reduced format with 119 questions).
The set of genetic and
physiological traits that define a person as male, female, or uncertain (androgynous). Usually
consist of external genitalia, internal and external sex organs, secondary sex
signs (such as quantity and distribution of body hair and size and shape of
breasts), and karyotype.
Shared Psychosis - See Folie
a Deux
Shenjing shuairuo
(Literally,
"neurasthenia" in Chinese). A form of mood or anxiety disorder that
manifests as overpowering physical and mental fatigue coupled with dizziness,
headaches or migraine, diffuse pain, difficulty to concentrate and perform
tasks, sleep disorders, and memory loss. Usually co-morbid with
gastrointestinal dysfunction, irritability, excitability, lability, and
disturbances of the autonomic nervous system. Included as an official diagnosis
in the second edition of the Chinese Classification of Mental Disorders
(CCMD-2).
Shin-byung
Culture-bound
syndrome in Korea. The illness progresses from general unease, anxiety,
somatic complaints (weakness, dizziness, fear, parorexia, insomnia, and
gasrointestinal problems) to dissociation (expressed as possession by ancestral
spirits).
The Structured Interview
for Disorders of Personality (SIDP-IV) was composed by Pfohl, Blum and
Zimmerman in 1997. It also covers the self-defeating personality disorder from
the DSM-III. It is conversational and the questions are grouped into 10 topics such
as Emotions or Interests and Activities. There is a version of the SIDP-IV in
which the questions are grouped by personality disorder. The scoring classifies
items as present, subthreshold, present, or strongly present.
Sociopath - See Antisocial
Personality Disorder
Splitting
"Primitive"
defense mechanism, which begins to operate in very early infancy. It involves
the inability to integrate contradictory qualities of the same object into a
coherent picture. This leads to cycles of idealization and devaluation of the
unintegrated object.
Stereotyped Movement
(or Motion)
Repetitive, urgent, compulsive, purposeless, and
non-functional movements, such as head banging, waving, rocking, biting, or
picking at one's nose or skin.Common in catatonia, amphetamine poisoning, and
schizophrenia.
Stressor
Event or change in life
which precipitates or coincides with the onset or exacerbation of a mental
health problem or a dysfunctional behavior.
Stupor
Restricted and constricted consciousness akin in some
respects to coma. Activity, both mental and physical, is limited. Some
patients in stupor are unresponsive and seem to be unaware of the
environment. Others sit motionless and frozen but are clearly cognizant of
their surroundings. Often the result of an organic impairment. Common in
catatonia, schizophrenia, and extreme depressive states.
Sublimation
The conversion and
channeling of unacceptable emotions into socially-condoned behavior.
Tangentiality
Inability or unwillingness to focus on an idea, issue,
question, or theme of conversation. The patient "takes off on a
tangent" and hops from one topic to another in accordance with his own
coherent inner agenda, frequently changing subjects, and ignoring any attempts
to restore "discipline" to the communication. Often co-occurs with
speech derailment. As distinct from loosening of associations,
tangential thinking and speech are coherent and logical but they seek to evade the
issue, problem, question, or theme raised by the other interlocutor.
Thematic
Appereption Test (TAT)
Diagnostic test comprised of
31 cards. One card is blank and the other thirty include blurred but
emotionally powerful (or even disturbing) photographs and drawings. Subjects
are asked to tell a story based on the content of the cards. The TAT was
developed in 1935 by Morgan and Murray.
The patient's reactions (in
the form of brief narratives) are recorded by the tester verbatim. Some
examiners prompt the patient to describe the aftermath or outcomes of the
stories, but this is a controversial practice.
The TAT is scored and interpreted simultaneously. Murray suggested to identify
the hero of each narrative (the figure representing the patient); the inner
states and needs of the patient, derived from his or her choices of activities
or gratifications; what Murray calls the "press", the hero's
environment which imposes constraints on the hero's needs and operations; and
the thema, or the motivations developed by the hero in response to all of the
above.
Thought Broadcasting, Though Insertion, Thought
Withdrawal
See: Schneiderian First-rank Symptoms
Thought
Disorder
A consistent disturbance that affects the process or
content of thinking, the use of language, and, consequently, the ability to
communicate effectively. An all-pervasive failure to observe semantic, logical,
or even syntactical rules and forms. A fundamental feature of schizophrenia.
Gender
dysphoria which involves an overwhelming desire to assume the physiological
characteristics and social roles of the opposite sex.
Undoing
Trying to rid oneself of
gnawing feelings of guilt by compensating the injured party either symbolically
or actually.
Vegetative Signs
A set of signs in depression which includes loss of
appetite, sleep disorder, loss of sexual drive, loss of weight, and
constipation. May also indicate an eating disorder.
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Malignant
Self Love - Narcissism Revisited
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