A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A
Abnormal Behavior                            
Patterns of emotion, thought, and action deemed pathological for one or more of the following reasons: infrequent occurrence, violation of norms, personal distress, disability or dysfunction, and unexpectedness.

Abuse, Substance
Impairment in social and occupational functioning resulting from the pathological and “compulsive” use of a substance. The concept is closely related to the definition of substance dependence, which has similar symptoms of impairment but may include evidence of physiological tolerance or withdrawal. Typical symptoms of abuse include failure to fulfill major role obligations at work, school, or home; recurrent use of the substance in situations where such use is physically hazardous; substance-related legal problems; and continued use even though it exaggerates interpersonal problems.

Acting Out
Expressions of unconscious emotional conflicts or feelings in actions rather than words. The person is not consciously aware of the meaning of such acts (see conscious). Acting out may be harmful or, in controlled situations, therapeutic (e.g., children’s play therapy).

Acute Confusional State
1. A form of delirium in which the most prominent symptoms are disorders of memory and orientation, usually with short-term memory deficit and both retrograde and anterograde amnesia and clouding of consciousness (i.e. reduced clarity of awareness of environment with reduced capacity to shift, focus, and sustain attention to environmental stimuli).     
2. An acute stress reaction to new surroundings or new demands, common in adolescence; it generally subsides as the person adjusts to the situation.

Addiction
Dependence on a chemical substance to the extent that a physiological and/or psychological need is established. This may be manifested by any combination of the following symptoms; tolerance, preoccupation with obtaining and using the substance, use of the substance despite anticipation of probable adverse consequences, repeated efforts to cut down or control substance use, and withdrawal symptoms when the substance is unavailable or not used.

Adjustment          
Often transitory functional alteration or accommodation by which one can better adapt oneself to the immediate environment and to one’s inner self.

Affect
Behavior that expresses a subjectively experienced feeling state (emotion); affect is responsive to changing emotional states, whereas mood refers to a pervasive and sustained emotion. Common affects are euphoria, anger, and sadness.

Affective Reaction              
Refers to a psychotic condition characterized by a severe disturbance in emotion or mood.

Aftercare              
Posthospitalization program of rehabilitation designed to reinforce the effects of therapy and to help the patient adjust to his or her environment and prevent relapse.

Aggression           
Forceful physical, verbal or symbolic action. May be appropriate and self-protective, including healthy self-assertiveness, or inappropriate as in hostile or destructive behavior. May also be directed toward the environment, toward another person, or toward the self, as in depression.

Aggressive
An interpersonal style where only the immediate needs of the self are considered rather than the needs of others.  (As opposed to passive or assertive)

Agitation
Excessive motor activity, usually non-purposeful and associated with internal tension. Examples include inability to sit still, fidgeting, pacing, wringing of hands, and pulling of the clothes.

Agoraphobia
A mental disorder characterized by fear of and avoidance of being alone in public places; this disorder is often accompanied by panic attacks.

Akinesia                
A state of motor inhibition; reduced voluntary movement.

Alcohol Abuse
Diagnosis given to someone who uses alcohol in dangerous situations, fails to meet obligations at work or at home due to alcohol use, and has recurrent legal or social problems as a result of alcohol use.

Alcohol Dependence
Dependence on alcohol characterized by either tolerance to the agent or development of withdrawal phenomena on cessation of, or reduction in, or intake. Other aspects of the syndrome are psychological dependence and impairment in social and/or vocational functioning. This is also called alcoholism.

Alcohol, Drug Abuse, and Mental Health Administration            
An agency in the US Department of Health and Human Services that was replaced in 1992 by the Substance Abuse and Mental Health Services Administration (SAMHSA). In reorganizing ADAMHA into SAMHSA, the three ADAMHA research institutes, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH), were moved to the National Institutes of Health. What remain in SAMHSA are the substance abuse and mental health services programs.

Alexithymia          
A disturbance in affective and cognitive function that overlaps diagnostic entities but is common is psychosomatic disorders, addictive disorders, and post traumatic stress disorder. The chief manifestations are difficulty in describing or recognizing one’s own emotions, a limited fantasy life, and general constriction in the affective life.

Alienation             
The estrangement felt in a setting one views as foreign, unpredictable, or unacceptable. For example, in depersonalization phenomena, feelings of unreality or strangeness produce a sense of alienation from one’s self or environment. In obsessions, which involve a fear of one’s emotions, avoidance of situations that arouse emotions, and continuing effort to keep feelings out of awareness, there is alienation of affect.

Allied Health Professional
A member of a nonmedical profession whose functions traditionally include involvement in the prevention, treatment, or rehabilitation process. In psychiatry, examples include the psychiatric nurse, psychiatric social worker, clinical psychologist, neuropsychologist, occupational therapist, and art therapist.

Ambiguous           
Unclear or not well structured.

Ambivalence
1. The coexistence of contradictory emotions, attitudes, ideas or desires with respect to a particular person, object or situation. Ordinarily, the ambivalence is not fully conscious and suggests psychopathology only when present in an extreme form.     
2. The simultaneous holding of strong positive and negative emotional attitudes toward the same situation or person.

Amnesia
Loss of memory.  Usually only a partial loss such as for a period of time or biographical information.

Amphetamine Use Disorders
In DSM-IV, this group includes amphetamine (or related substance) dependence, amphetamine abuse, amphetamine intoxication, amphetamine withdrawal, amphetamine withdrawal, amphetamine delirium, amphetamine psychotic disorder, amphetamine mood disorder, amphetamine anxiety disorder, amphetamine sexual dysfunction, and amphetamine sleep disorder.

Amphetamines
1. A group of chemicals that stimulate dopamine release in the central nervous system; often misused by adults and adolescents to control normal fatigue and to induce euphoria. Used clinically to treat hyperkinetic disorder and narcolepsy.  
2. A group of stimulating drugs that produce heightened levels of energy and, in large doses, nervousness, sleeplessness, and paranoid delusions.

Ancillary Care
Health services other than professional services or hospital room and board; these services may include drug and laboratory services.

Anesthesia
1. Absence of sensation; may result from nerve damage, anesthetic, drugs, or psychological processes such as hysterical neurosis, conversion type (see under neurosis) or hypnosis.  
2. An impairment or loss of sensation, usually of touch but sometimes of the other senses, that is often part of conversion disorder.

Anhedonia
Inability to experience pleasure from activities that usually produce pleasurable feelings.

Anniversary Reaction
An emotional response to a previous event occurring at the same time of year. Often the event involved a loss and the reaction involves a depressed state. The reaction can range from mild to severe and may occur at any time after the event.

Anomie
Apathy, alienation, and personal distress resulting from the loss of goals previously valued.

Antianxiety Drugs
Drugs used to treat anxiety-related disorders.

Anticipatory Anxiety
A fear of having a panic attack; may lead to the development of agoraphobia.

Antidepressant Drugs
Drugs used to treat depression.

Anxiety
A sense of apprehension or doom that is accompanied by many physiological reactions, such as accelerated heart rate, sweaty palms, and tightness in the stomach.

Anxiety Neurosis
A DSM-II term for what are now diagnosed as panic disorder, and generalized anxiety disorder.

Anxiety State                       
A neurosis characterized by severe and very sudden attacks of anxiety.

Anxiolytics
1. Drugs that have an antianxiety effect and are used widely to relieve emotional tension. The most commonly used antianxiety drugs are the benzodiazepines.
2. Tranquilizers; drugs that reduce anxiety.

Anxious-Fearful Personality Disorders
Category including avoidant, dependent, and obsessive-compulsive personality disorder that is characterized by a chronic sense of anxiety or fearfulness and behaviors intended to ward off feared situations.

Apathy
Lack of feeling, emotion, interest, or concern.

Apperception
Perception as modified and enhanced by one’s own emotions, memories, and biases.

Assessment                          
Process of gathering information about a person’s symptoms and their possible causes.

Assimilation
Incorporating objects, experiences, or information into existing schemas.

Ataque de Nervios
Attack of the nerves, syndrome in Hispanic cultures that closely resembles anxiety and depressive disorders, o El ataque de los nervios, síndrome en las culturas hispanas que se parece de cerca a la ansiedad y desórdenes depresivos.

Attention                              
Ability to sustain focus on one activity. A disturbance in attention may appear as having difficulty in finishing tasks that have been started, being easily distracted, or having difficulty in concentrating.

Attitude
A set or predisposition that determines the individual's reaction to a particular stimulus or set of stumuli.

Auditory Hallucination
Auditory perception of phenomena that is not real, such as hearing a voice when one is alone.

B
Barbiturate
A drug that causes sedation; one of several derivatives of barbituric acid.

Basic Benefits
In insurance policies, the minimum set of benefits that must be made available to the insured.

Benzodiazepine
A class of drugs having anxiolytic ("tranquilizing") effects; examples are Librium and Valium.

Bereavement                       
Feelings of deprivation, desolation, and grief at the loss of a loved one. The grieving person does not need to seek professional help unless these feelings last for a long period of time or relief is sought for symptoms such as anorexia nervosa or insomnia.

Bipolar Disorders
1. In DSM-IV, a group of mood disorders that includes bipolar disorder, single episode; bipolar disorder recurrent; and cyclothymic disorder. A bipolar disorder includes a manic episode at some time during its course. In any particular patient, the bipolar disorder may take the form of a single manic episode (rare), or it may consist of recurrent episodes that are either manic or depressive in nature (but at least one must have been predominantly manic). Bipolar II is used on some classifications (including DSM-IV) to denote a mood disorder characterized by episodes of major depressive disorder and hypomania (rather than full mania). Other authorities prefer to call such a mood disorder “major depressive disorder with hypomanic episodes.”
2. A term applied to the disorder of cycles between manic episodes and depressive episodes. Also called manic-depression.
3. A term applied to the disorder of people who experience episodes of both mania and depression or of mania alone.

Bonding
The unity of two people whose identities are significantly affected by their mutual interactions.

Brief Psychotherapy
Any form of psychotherapy whose end point is defined either in terms of the number of sessions (generally not more than 15) or in terms of specified objectives; usually goal-oriented, circumscribed, active, focused, and directed toward a specific problem or symptom.

Brief Reactive Psychosis
A disorder in which a person has a sudden onset of psychotic symptoms -- incoherence, loose associations, delusions, hallucinations -- immediately after a severely disturbing event; the symptoms last more than a few hours but no more than two weeks.

Burnout
Changes in thoughts, emotions, and behavior as a result of extended job stress and unrewarded repetition of duties.  Burnout is seen as extreme dissatisfaction, pessimism, lowered job satisfaction, and a desire to quit.

Bystander Intervention
The intervention of a person in a situation that appears to require his or her aid.

C
Caregiver
Any person involved in the treatment or rehabilitation of a patient; includes the psychiatrist and other members of the traditional treatment team as well as community workers and other nonprofessionals.

Catalepsy
A generalized condition of diminished responsiveness shown by trancelike states, posturing, or maintenance of physical attitudes for a prolonged period of time. May occur in organic or psychological disorders, or under hypnosis.

Catatonic Stupor
Motionless, apathetic state in which one remains oblivious to external stimuli.

Catharsis
The healthful (therapeutic) release of ideas through “talking out” conscious material accompanied by an appropriate emotional reaction. Also, the release into awareness of repressed (“forgotten”) material from the unconscious.

Cathexis
Attachment, conscious or unconscious, of emotional feeling and significance to an idea, an object, or, most commonly, a person.

Chronic                 
Continuing over a long period of time or recurring frequently. Chronic conditions often begin inconspicuously, and symptoms may be less pronounced than in acute conditions.

Clinical Psychologist
An individual who has earned a Ph.D. degree in psychology, or a Psy.D. and whose training has included an internship in a mental hospital or clinic.

Clinical Social Worker
A social worker who applies the theory and methods of social work to the treatment and prevention of psychosocial dysfunction, disability, or impairment with individuals, families, and small groups. Many states require a license to practice clinical social work. Usually certification requires a master’s degree in social work, at least 2 years work experience, and the passing of an examination.

Clinician
A health professional authorized to provide services of people suffering from one or more pathologies.

Codependency
A popular term referring to all the effects that people who are dependent on alcohol or other substances have on those around them, including the attempts of those people to affect the dependent person. The term implies that codependence is a psychiatric disorder and hypothesizes that the family’s actions tend to perpetuate (enable) the person’s dependence. Empirical studies, however, support a stress and coping model for explanation of the family behavior.

Cognitions
Thoughts or beliefs

Cognitive Appraisal
One's perception of a stressful situation
Cohesive Self
The stable sense of one’s identity or core self, which develops through progressive consolidation of the grandiose self, the idealized parental imago, and the person’s talents and skills. Optimal development is promoted by a holding environment in which the child develops basic trust.

Community Mental Health
The delivery of services to needy, underserved groups through centers that offer outpatient therapy, short term inpatient care, day hospitalization, twenty-four hour emergency services, and consultation and education to other community agencies, such as the police.

Compulsion
An irresistible impulse to repeat some action over and over even though it serves no useful purpose.

Concrete Thinking
Thinking characterized by immediate experience, rather than abstractions. It may occur as a primary, developmental defect, or it may develop secondary to organic brain disease or schizophrenia.

Conditioned Avoidance Response
Type of behavior in which a person avoids stimuli that he or she associates with anxiety-provoking symptoms, reducing anxiety, which then becomes a positive reinforcer for continuing avoidance.

Conditioning
Establishing new behavior as a result of psychological modifications of responses to stimuli.

Confusion
Disturbed orientation in respect to time, place, or person.

Conscious
The content of mind or mental functioning of which one is aware. In neurology, awake, alert.

Conversion Reaction
A psychoneurosis characterized by physical symptoms that may involve paralysis, blindness, deafness, loss of sensation, and others. These may be differentiated from hypochondriacal reactions in that conversion symptoms are usually highly specific, whereas hypochondriacal symptoms tend to be more generalized and diffuse.

Coping Response
A response that permits an animal to escape, avoid, or minimize the stressful (harmful or painful) effects of an aversive stimulus.

Coping Strategy
A plan of action that a person follows to reduce the perceived level of stress, either in anticipation of a stressor or in response to its occurrence.

Counseling
A form of supportive psychotherapy in which one person, the advisor or counselor, offers guidance or advice to another based on their joint discussion of the other’s particular or general personal problems. The method is commonly used by psychiatrists, psychologists, social workers, and the clergy.

Counseling Psychologist
A doctoral level mental health professional whose training is similar to that of a clinical psychologist, though usually with less emphasis on research and serious psychopathology.

Crisis
A state of sudden psychological disequilibrium; turning point in a person’s life.

Crisis Intervention
A form of brief psychotherapy that emphasizes identification of the specific event precipitating the emotional trauma and uses methods to neutralize that trauma. Often used in hospital emergency rooms.

Culture
The sum of socially-transmitted knowledge, customs, and behavior patterns common to a particular group of people.

Cyclothymic Disorder
In DSM-IV. one of the bipolar disorders characterized by numerous hypomanic episodes and frequent periods of depressed mood or loss of interest or pleasure.
These episodes do not meet the criteria for a full manic episode or major depressive disorder. See depressive disorders.

D

Decompensation
The deterioration of existing defenses (see defense mechanism), leading to an exacerbation of pathological behavior.

Defense Mechanism
Unconscious intrapsychic processes serving to provide relief from emotional conflict and anxiety. Conscious efforts are frequently made for the same reasons, but true defense mechanisms are unconscious. Some of the common defense mechanisms defined in this glossary are compensation, conversion, denial, displacement, dissociation, idealization, identification, incorporation, interjection, projection, rationalization, reaction formation, regression, sublimation, substitution, symbolization, and undoing.

Delirium
A cognitive disorder characterized by impairment in consciousness, attention, and changes in cognition (e.g., memory deficit, disorientation, language or perceptual disturbance). The following types of delirium are recognized by DSM-IV; delirium due to a general medical condition, substance-induced delirium (in intoxication and withdrawal states), delirium due to multiple etiologies, and delirium of unknown etiology or not otherwise specified.

Delusion
A false belief based on an incorrect inference about external reality and firmly sustained despite clear evidence to the contrary. The belief is not part of a cultural tradition such as an article of religious faith.

Delusion of Reference                       
False belief that external events, such as people's actions or natural disasters, relate somehow to one's self.
Denial
A defense mechanism, operating unconsciously, used to resolve emotional conflict and allay anxiety by disavowing thoughts, feelings, wishes, needs, or external reality factors that are consciously tolerable.

Dependency Needs
Vital needs for mothering, love, affection, shelter, protection, security, food, and warmth. May be a manifestation of regression when they reappear openly in adults.

Depersonalization
Feelings of unreality or strangeness concerning either the environment, the self, or both. This is characteristic of depersonalization disorder and may also occur in schizotypal personality disorder, schizophrenia, and in those persons experiencing overwhelming anxiety, stress or fatigue.

Depression
When used to describe a mood, depression refers to feelings of sadness, despair, and discouragement. As such, depression may be a normal feeling state. The overt manifestations are highly variable and may be culture specific. Depression may be a symptom seen in a variety of mental or physical disorders, a syndrome of associated symptoms secondary to an underlying disorder, or a specific mental disorder. Slowed thinking, decreased pleasure, decreased purposeful physical activity, guilt, and hopelessness, and disorders of eating and sleeping may be seen in the depressive syndrome. DSM-IV classifies depression by severity, recurrence, and association with hypomania or mania. Other categorizations divide depression into reactive and endogenous depressions on the basis of precipitants or symptom clusters. Depression in children may be indicated by a refusal to go to school, anxiety, excessive reaction to separation from parental figures, antisocial behavior, and somatic complaints.

Derealization
A feeling of estrangement or detachment from one’s environment. My be accompanied by depersonalization.

Detachment
A behavior pattern characterized by general aloofness in interpersonal contact; may include intellectualization, denial, and superficiality.

Differentiation
The degree to which an individual identifies the self as separate or distinct from others.

Disorientation
Loss of awareness of the position of the self in relation to space, time or other persons; confusion.

Dissociation
The splitting off of clusters of mental contents from conscious awareness, a mechanism central to hysterical conversion and dissociative disorders; the separation of an idea from its emotional significance and affect as seen in the inappropriate affect of schizophrenic patients.

Dissociative Amnesia
A dissociative disorder in which the person suddenly becomes unable to recall important personal information to an extent that cannot be explained by ordinary forgetfulness. Loss of memory for important facts about a person's own life and personal identity, usually including the awareness of this memory loss. The normal integration of consciousness, memory, or identity is suddenly and temporarily altered.

Distractibility
Inability to maintain attention; shifting from one area or topic to another with minimal provocation. Distractibility may be a manifestation of organic impairment or it may be a part of a functional disorder such as an anxiety disorder, mania or schizophrenia.

Drug Dependence
Habituation to, abuse of, and/or addiction to a chemical substance. Largely because of psychological craving, the life of he drug-dependent person revolves around the need for the specific effect of one or more chemical agents on mood or state of consciousness. The term thus includes not only the addiction (which emphasizes the physiological dependence) but also drug abuse (in which the pathological craving for drugs seems unrelated to physical dependence). Examples include alcohol, opiates, synthetic analgesics with morphine-like effects, barbiturates, other hypnotics, sedatives, some antianxiety agents, cocaine, psychostimulants, marijuana, and psychotomimetic drugs.

Dysphoria
Unpleasant mood.

Dysthymic Disorder
One of the depressive disorders, characterized by a chronic course (i.e., seldom without symptoms), with lowered mood tone and a range of other symptoms that may include feelings of inadequacy, loss of self-esteem, or self-deprecation; feelings of hopelessness or despair; feelings of guilt, brooding about past events, or self-pity; low energy and chronic tiredness; being less active or talkative than usual; poor concentration and indecisiveness; and inability to enjoy pleasurable activities.

E

Eidetic Image
Unusually vivid and apparently exact mental image; may be a memory, fantasy, or dream.

Emotion
A state of arousal determined by a set of subjective feelings, often accompanied by physiological changes, that impels one toward action.  Examples are fear, anger, love, and hate.  See affect.

Empathy
1. Awareness and understanding of another's feelings and thoughts. See primary empathy and advanced accurate empathy.
2. Insightful awareness, including the meaning and significance of the feelings, emotions, and behavior of another person.  Contrast with sympathy.

Epidemiology
1. The study of the frequency and distribution of an illness in a population.
2. In psychiatry, the study of the incidence, distribution, prevalance, and control of mental disorders in a given population.

Euphoria
An exaggerated feeling of physical and emotional well-being, usually of psychological origin.  Also seen in organic mental disorders, and in toxic and drug-induced states.

Exogenous
Attributable to external causes.

F

Fear
Unpleasant emotional and physiological response to recognized sources of danger, to be distinguished from anxiety.

Fight-or-Flight Response
Physiological changes in the human body that occur in response to a perceived threat, including secretion of glucose, endorphins, and hormones as well as elevation of heart rate, metabolism, blood pressure, breathing and muscle tension.

Flat Affect
A deviation in emotional response wherein virtually no emotion is expressed whatever the stimuli, emotional expressiveness is blunted, or a lack of expression and muscle tone is noted in the face.

Flight of Ideas
1. A symptom of mania that involves a rapid shift in conversation from one subject to another with only superficial associative connections.
2. A nearly continuous flow of accelerated speech with abrupt changes from one topic to another, usually based on understandable associations, distracting stimuli, or playing on words.  When severe, however, this may lead to disorganized and incoherent speech.  Flight of ideas is characteristic of manic episodes, but it may occur also in organic mental disorders, schizophrenia, other psychoses, and, rarely, acute reactions to stress.

Follow-Up Examination
Clinical assessment, often repeated at specific intervals following discharge from inpatient or outpatient treatment.  Among its major purposes are to evaluate the need for adjustment of drug dosage, to detect signs of relapse, to measure improvement over time, and to identify (and, when possible, control) significant contributory factors to the maintenance or recurrence of symptoms

Fragmentation
Separation into different parts, or preventing their integration, or detaching one or more parts from the rest.  A fear of fragmentation of the personality, also known as disintegration anxiety, is often observed in patients whenever they are exposed to repetitions of earlier experiences that interfered with development of the self.  This fear may be expressed as feelings of falling apart, as a loss of identity, or as a fear of impending loss of one's vitality and of psychological depletion.

Frustration
A term used in two ways. In one sense, frustration refers to any interference with the satisfaction of a motive. In another sense, frustration refers to the consequences or internal state resulting from such interference with goal-directed behavior.

G

GAD
Generalized anxiety disorder.

General Medical Condition
Any condition or disorder that is listed outside the mental disorders section of the International Classification of Diseases (ICD).  The phrase is used in DSM-IV as a term of convenience only; it does not imply that there is any fundamental distinction between mental disorders and general medical conditions or that mental disorders are unrelated to physical or biological factors or processes.

Generalized Anxiety Disorder (GAD)
1. One of the anxiety disorders, where anxiety is so chronic, persistent, and pervasive that it seems free-floating. The individual is jittery and strained, distractible and apprehensive that something bad is about to happen. A pounding heart, fast pulse and breathing, sweating, flushing, muscle aches, a lump in the throat, and an upset gastrointestinal tract are some of the bodily indications of this extreme anxiety.
2. (GAD) Anxiety neurosis; characterized by unrealistic or excessive anxiety, apprehensive expectations, and worry about many life circumstances (e.g., academic, athletic, or social performance).  A mother may worry endlessly about her child, who is in no danger.  The worry is associated with symptoms such as trembling, muscle tension, restlessness, feelings of being smothered, lightheadedness, insomnia, exaggerated startle response, or difficulty in concentration.  The worrying is difficult to control, and with associated symptoms, often social or occupational functioning is impaired.  When id occurs in adolescence, generalized anxiety disorder is termed overanxious disorder by some.  Symptoms include multiple, unrealistic, anxieties concerning the quality of one's performance in school, at work, or in sports, and of one's health or appearance, accompanied by the need to be reassured.

Gerontology
The interdisciplinary study of aging and of the special problems of the elderly.

Global Assumptions
Fundamental beliefs that encompass all types of situations.

Grand Mal Epilepsy
The most severe form of epilepsy involving a loss of consciousness and violent convulsions. The French words grand mal mean "big sickness" (the final "d" in "grand" is not pronounced).

Grandiosity
Exaggerated belief or claims of one's importance or identity, often manifested by delusions of great wealth, power, or fame.

Grave Disability
Legal criterion for involuntary commitment that is met when a person is so incapacitated by a mental disorder that he or she cannot care for his or her own basic needs such as food, clothing, or shelter and his or her survival is threatened as a result.

Grief
Normal, appropriate emotional response to an external and consciously recognized loss; it is usually time-limited and subsides gradually.  To be distinguished from depression.

Group Home
Type of residence for people with mental disorders that serves as an alternative to hospitalization by providing resources and assistance in the least restrictive environment possible.

Group Practice
A formal association of three or more physicians, or other health professionals, organized to provide a continuum of broader-based care than is usually provided by a single practitioner.  Twenty-four-hour coverage by those within the group, different services, and different specialties make more services available, and management is less cumbersome and more patient-oriented than is possible in larger health care institutions.

Group Psychotherapy
Application of psychotherapeutic techniques by a therapist who uses the emotional interactions of members of the group to help them get relief from distress and possibly modify their behavior.  Typically, a group is composed of 4 to 12 persons who meet regularly with the therapist.

Guilt
Emotion resulting from doing what one conceives of as wrong, thereby violating superego precepts; results in feelings of worthlessness and at times the need for punishment.

H

Hallucinations*
False perceptions that occur in the absence of objective stimulation.

Health*
A general condition of soundness and vigor of body and mind; not simply the absence of illness or injury.

Health and Human Services
A federal department established in 1953 as the U.S. Department of Health, Education, and Welfare to supervise and coordinate the following agencies: Food and Drug Administration; Office of Human Development; Public Health Service; Social Security Administration; Substance Abuse and Mental Health Services Administration; National Institutes of Health; Centers for Disease Control; Health Care Financing Administration; Office of Children, Youth and Families; and Office of Smoking and Health.  In 1979, a separate Department of Education was established, and the remaining agencies became the Department of Health and Human Services.

Health Maintenance Organization (HMO)
(HMO) A form of group practice by physicians and supporting personnel to provide comprehensive health services to an enrolled group of subscribers who pay a fixed premium (capitation fee) to belong.  Emphasis is on maintaining the health of the enrollees as well as treating their illnesses.  HMOs must include psychiatric benefits to receive federal support.

Health Promotion*
The development and implementation of general strategies and specific tactics to eliminate or reduce the risk that people will become ill.

Health Psychology*
The field of psychology devoted to understanding the ways people stay healthy, the reasons they become ill, and the ways they respond when they become ill.

Hemophilia
An inherited blood disease in which the blood does not clot properly.

Hierarchy of Needs*
Maslow's view that basic human motives form a hierarchy and that the needs at each level of the hierarchy must be satisfied before the next level can be achieved; these needs progress from basic biological needs to the need for transcendence.

High-Risk Behavior
Actions that put one in danger or render one vulnerable to harmful consequences.  Needle sharing by addicts, for example, is high-risk behavior because of the likelihood of transmission of HIV and other pathogens.

HIV Dementia
Also, AIDS dementia complex (ADC); a rapidly progressive subcortical dementia characterized by 1) cognitive deficits such as inattentiveness, impaired concentration and problem solving, forgetfulness, and impaired reading; 2) motor abnormalities such as tremors, slurred speech, ataxia, and generalized hyperreflexia; and 3) behavioral changes such as sluggishness and social withdrawal.  CT and MRI usually indicate brain atrophy along with an enlargement of the ventricles.
HIV dementia characteristically begins with impaired concentration and mild memory loss.  Over a period of several weeks or months, the condition progresses to severe global cognitive impairment.

HIV Meningitis
An acute aseptic meningitis that occurs soon after infection with the virus.  Symptoms, which are usually mild and self limited, include headache, fever, painful sensitivity to light, and cranial neuropathy.  The symptoms typically disappear in 1 to 4 weeks.
Cryptococcal meningitis is a more serious form of meningitis that occurs in HIV-infected persons as a result of infection with the common soil fungus, Cryptococcus neoformans.  Symptoms include headache, stiff neck, fever, and painful sensitivity to light.

Holistic Approach
An approach in medicine that emphasizes all factors affecting the individual's health, both physical and psychological.

Hostility
Actual or threatened aggressive contact, destructive in intent.

Hotline
Telephone assistance service for crisis intervention, usually focused on topics such as alcoholic binges, suicide, drugs, and runaways.

Human Nature
An unscientific concept used by laymen to account for uniformities in behavior. Implicit in the concept human nature is the idea that uniformities observed among individuals in behavior must be the result of certain inborn characteristics common to all human beings.

Human-Potential Movement*
The therapy movement that encompasses all those practices and methods that release the potential of the average human being for greater levels of performance and greater richness of experience.

Humanistic and Existential Therapies
A generic term for insight psychotherapies that emphasize the individual's subjective experiences, free will, and ever-present ability to decide on a new life course.

Humanistic Perspective*
A psychological model that emphasizes an individual's phenomenal world and inherent capacity for making rational choices and developing to maximum potential.

Hyperactivity
Excessive motor activity that may be purposeful or aimless; movements and utterances are usually more rapid than normal.  Hyperactivity is a prominent feature of the attention-deficit disorder, so much so that in DSM-IV the latter is called attention-deficit/hyperactivity disorder.

Hypersomnia
1. Excessive sleeping.
2. A dyssomnia consisisting of prolonged or daytime sleep episodes occurring almost daily.  The hypersomnia is called primary if it is not related to another mental disorder, if it is not substance induced, and it is not due to a general medical condition.

Hypertension
Abnormally high arterial blood pressure, with or without known organic causes.

Hyperventilation
1. Very rapid and deep breathing associated with high levels of anxiety; causes the level of carbon dioxide in the blood to be lowered with possible loss of consciousness.
2. Overbreathing sometimes associated with anxiety and marked by reduction of blood carbon dioxide, producing complaints of light-headedness, faintness, tingling of the extremities, palpitations, and respiratory distress.

Hypochondriacal Reaction
A psychoneurosis characterized by varied and diffuse complaints of a physical nature with no basis in the organic functioning of the body.

Hypoglycemia
Abnormally low level of blood sugar.

Hypomania
1. An above-normal elevation of mood, but not as extreme as mania.
2. A psychopathological state and abnormality of mood falling somewhere between normal euphoria and mania.  It is characterized by unrealistic optimism, pressure of speech and activity, and a decreased need for sleep.  Some people show increased creativity during hypomanic states, whereas others show poor judgment and irritability.

Hysterics
Lay term for uncontrollable emotional outbursts.

I

Idealization
A mental mechanism in which the person attributes exaggeratedly positive qualities to the self or others.

Identification
1. Defense mechanism in which a person adopts the ideas, values, and tendencies of someone in a superior position in order to elevate self-worth.
2. A defense mechanism, operating unconsciously, by which one patterns oneself after some other person.  Identification plays a major role in the development of one's personality and specifically of the superego.  To be differentiated from imitation or role modeling, which is a conscious process.

Illusion
A misperception of a real external stimulus.

Immediate Memory
The recall of perceived material within a period of 30 seconds to 25 minutes after presentation.

Impulse
A desire or propensity to act in a certain way, typically in order to ease tension or gain pleasure.

Impulse Control Disorders
Failing to resist an impulse, drive, or temptation to perform some act that is harmful to oneself or to others.  The impulse may be resisted consciously, but it is consonant with the person's immediate, conscious wish.  The act may display regret or guilt for the action or its consequences.  In DSM-IV, this category includes pathological gambling, kleptomania, pyromania, intermittent explosive disorder, and trichotillomania.

Inappropriate Affect
1. Emotional responses that are out of context, such as laughter when hearing sad news.
2. A display of emotion that is out of harmony with reality or with reality or with the verbal or intellectual content that accompanies.

Incoherence  
Lacking in unity or consistence; often applied to speech or thinking that is not understandable owing to any of the following: lack of logical connection between words or phrases; excessive use of incomplete sentences, many irrelevancies or abrupt changes in subject matter; idiosyncratic word usages; or distorted grammar. 
Incompetency
Lack of the capacity to understand the nature of, to assess adequately, or to manage effectively a specified transaction or situation that the ordinary person could reasonably be expected to handle.  As used in the law, the term refers primarily to cognitive defects that interfere with judgment.

Individuation
A process of differentiation, the end result of which is development of the individual personality that is separate and distinct from all others.

Infectious Disease
An illness caused when a microorganism, such as a bacterium or a virus, invades the body, multiples, and attacks a specific organ or organ system. Pneumonia is one example.

Informally Organized Group
A group that possesses a set of status and role relations and norms that regulate the behavior of members. The status and role relations in such groups, as well as the norms, are not normally made explicit.

Informed Consent
1. Procedure (often legally required prior to treatment administration) in which a patient receives a full and understandable explanation of the treatment being offered and makes a decision about whether to accept or refuse the treatment. Also, the agreement of a person to serve as a research subject or to enter therapy after being told the possible outcomes, both benefits and risks.
2. Permission by the patient for a medical procedure based on understanding the nature of the procedure, the risks involved, the consequences of withholding permission, and alternative procedures.

Inhalants
Solvents such as gasoline, glue, or paint thinner that one inhales to produce a high and that can cause permanent central nervous system damage as well as hepatitis, liver disease and kidney disease.

Insanity
1. Legal term denoting a state of mental incapacitation during the time the crime was committed.
2. An obsolete term for psychosis.  Still used, however, in strictly legal contexts such as insanity defense.

Insecurity
A feeling of helplessness against anxiety arising from uncertainty about one's goals, ideals, abilities, and relationships.

Insight
1. Used in two ways. In one sense, it refers to a sudden grasp of the relationships in a problem or the sudden solution of a problem. In another sense, it refers to one's understanding of his personal problems and/or motives.
2. Self-understanding; the extent of a person's understanding of the origin, nature, and mechanisms of his or her maladaptive attitudes and behavior.

Insomnia
1. The state of being unable to sleep.
2. A dyssomnia consisting of difficulty initiating or maintaining sleep, or of nonrestorative sleep (i.e., sleep is adequate in amount but unrefreshing), associated with daytime fatigue or impaired daytime functioning.  The insomnia is called primary if it is not related to another mental disorder, if it is not substance induced, and if it is not due to a general medical condition.

Intake
The initial interview between a patient and a member of a psychiatric team in a mental health facility

Integration
The useful organization and incorporation of both new and old data, experience, and emotional capacities into the personality.  Also refers to the organization and amalgamation of functions at various levels of psychosexual development.

Intellectualization
1. Defense mechanism in which a person adopts a cold, distanced perspective on a matter that actually creates strong unpleasant feelings.
2. A mental mechanism in which the person engages in excessive abstract thinking to avoid confrontation with conflicts or disturbing feelings.

Intelligence
1. Often defined as the aggregate or global ability to act purposefully, think rationally, and deal effectively with one's environment.
2. Capacity to learn and to utilize appropriately what one has learned.  May be affected by emotions.

Intelligence Test
A standardized means of assessing a person's current mental ability, for example, the Stanford-Binet and the Wechsler Adult Intelligence Scale.

Interdisciplinary Approach
An approach to psychological problems that stresses the necessity of using data from a number of different but related disciplines - for example, sociology, anthropology, political science, and economics.

Intoxication
Poisoning; especially the acute effects of overdosage with chemical substances.  Characteristically, intoxication with substances of abuse produces behavioral or psychological changes because of their effects on the central nervous system.  Such changes may be expressed as belligerence, differences in mood, or impaired judgment.
* alcohol - Typical symptoms include maladaptive behavioral changes such as inappropriate aggressive or sexual behavior, lability of mood, and impaired judgment.  The accompanying physical signs include slurred speech, incoordination, unsteady gait, and flushed face.
* amphetamine - Typical symptoms include maladaptive psychological or behavioral changes such as euphoria with enhanced vigor and alertness or grandiosity; affective blunting with fatigue or sadness; changes is sociability ranging from gregariousness to social withdrawal; hypervigilance and sensitivity, sometimes leading to fighting; anxiety, tension, or anger; stereotyped, repetitive behavior; and impaired judgment.  Perceptual disturbances may also occur.  Accompanying physical signs may include very rapid or very slow heartbeat, elevated or lowered blood pressure, perspiration or chills, nausea, evidence of weight loss, muscular weakness, chest pain, and confusion. 
* caffeine - Consumption of caffeine, generally more than 250 mg. produces signs including restlessness, nervousness, excitement, insomnia, flushed face, muscle twitching, rambling speech, and psychomotor agitation.
* cannabis - Within 2 hours of cannabis use, the subject shows maladaptive behavioral or psychological changes such as impaired motor coordination, euphoria, anxiety, suspiciousness, sensation of slowed time, impaired judgment, and social withdrawal.  Physical signs may include increased appetite, dry mouth, and very rapid heartbeat.
* cocaine - Signs and symptoms are the same as in amphetamine intoxication (see above).
* hallucinogen - The syndrome includes maladaptive behavioral or psychological changes such as marked anxiety or depression, fear of losing one's mind, paranoid ideation, and impaired judgment.  Also, perceptual changes such as intensified perceptions, illusions, hallucinations, derealization, and depersonalization occur in a state of full wakefulness.  Some physical signs include sweating, very rapid heartbeat, blurring of vision, tremors, and incoordination.
* inhalant - Recent use or short-term, high-dose exposure to volatile inhalants often leads to maladaptive behavioral or psychological changes such as belligerence, assaultiveness, apathy, and impaired judgment.  The accompanying physical signs include dizziness, incoordination, slurred speech, unsteady gait, euphoria, lethargy, psychomotor retardation, and blurred vision.
* opioid - Signs of this syndrome include initial euphoria followed by apathy, psychomotor agitation or retardation, and impaired judgment.  Diminished pupil size in the eyes, drowsiness, slurred speech, and impairment in attention or memory are some of the physical indicators.
* phencyclidine - Recent use of phencyclidine or a related substance may induce belligerence, assaultiveness, impulsiveness, unpredictability, and impaired judgment.  The physical signs may include hypertension or a very rapid heartbeat, numbness or diminished responsiveness to pain, ataxia, muscle rigidity, or seizures.
* sedative - Effects of sedative intoxication are similar to those of alcohol intoxication.  Signs include inappropriate sexual or aggressive behavior, swings in mood, and impaired judgment.  Associated physical signs may include slurred speech, incoordination, unsteady gait, and impairment in attention or memory.

Introspection
1. The method used by Structuralists to investigate the nature of consciousness. Introspection involves the subject's reporting on his own conscious experience.
2. Self-observation; examination of one's feelings, often as a result of psychotherapy.

IQ
Intelligence quotient.

Isolation
A defense mechanism operating unconsciously (see unconscious) central to obsessive-compulsive phenomena in which the affect is detached from an idea and rendered unconscious, leaving the conscious idea colorless and emotionally neutral.

J

Joint Commission on Accreditation of Healthcare Organizations
(JCAHO) Formerly Joint Commission on Accreditation of Hospitals (JCAH); the agency that surveys hospitals and other health facilities and programs and certifies that they have met the standards set by the Joint Commission.

Judgment
Mental act of comparing choices between a given set of values in order to select a course of action.

K

Kinesics
The study of body posture, movement, and facial expressions.

Kinesthesis
The sense of muscle movement or equilibrium.

Kleptomania
An impulse control disorder consisting of episodes of stealing objects that are not needed for personal use or for their monetary value.  As in other disorders of impulse control, an increasing sense of tension or affective arousal immediately precedes the action, and the completion of the action brings a sense of pleasure or relief.

L

Labile
1. Easily moved or changed, quickly shifting from one emotion to another, or easily aroused.
2. Rapidly shifting (as applied to emotions); unstable.

Laceration
A jagged wound.

Language Disorder
Difficulties understanding spoken language (receptive) or expressing thoughts verbally (expressive).

Latency
The time between stimulus and response. A measure of habit strength.

Latitude of Acceptance
Refers to the tolerance an individual has for positions on a particular issue other than his own.

Leadership
The position at the top of the status hierarchy of a group.

Learned Helplessness
1. General expectation that one cannot control important events, leading to lowered persistence, motivation, self-esteem, and initiative.
2. A condition in which a person attempts to establish and maintain contact with another by adopting a helpless, powerless stance.
Learned Helplessness Theory
View that exposure to uncontrollable negative events leads to a belief in one's inability to control important outcomes, and a subsequent loss of motivation, indecisiveness with failure to action, and depression. An individual's passivity and sense of being unable to act and to control his or her life, acquired through unpleasant experiences and traumata in which efforts made were ineffective; according to Seligman, this brings on depression.

Learning
Any modification in behavior that can be attributed to experience but not to other factors, such as fatigue, the effects of drugs, or maturation.

Learning Disabilities
General term for learning disorders, communication disorders, and motor skills disorder.

Learning Disorders
A set of developmental disorders encompassing dyslexia, mathematics disorder, and disorder of written expression, and characterized by failure to develop in a specific academic area to the degree expected the child's intellectual level. It is unknown if the disorder is due to a sensory deficit.

Lethologica
Temporary inability to remember a proper noun or name.

Level of Aspiration
A goal that the individual sets for himself and that he strives to achieve.

Liaison Nursing
Consultation by clinical specialists in psychiatric nursing to nursing colleagues on issues of patient management in medical-surgical, parent-child, or geriatric settings.

Limbic System
1. Part of the brain that relays information from the primitive brain stem about changes in bodily functions to the cortex where the information is interpreted. The lower parts of the cerebrum, made up of primitive cortex; controls visceral and bodily changes associated with emotion and regulates drive-motivated behavior.
2. Visceral brain; a group of brain structures - including the amygdala, hippocampus, septum, cingulate gyrus, and subcallosal gyrus - that work to help regulate emotion, memory, and certain aspects of movement.

Lithium
Drug that reduces levels of certain neurotransmitters and decreases the strength of neuronal firing. This drug is the most common treatment for bipolar disorder and is useful in treating both manic and depressive episodes. Also known as Lithium carbonate.

Living Will
One type of advanced directive; a competent person gives instructions for medical care, indicating the kind of care that will be consented to or refused.

Logorrhea
Uncontrollable, excessive talking.

Long-Term Memory
The final phase of memory in which information storage may last from hours to a lifetime.

Loosening of Associations
A disturbance of thinking shown by speech in which ideas shift from one subject to another that is unrelated or minimally related to the first.  Statements that lack a meaningful relationship may be juxtaposed, or speech may shift suddenly from one frame of reference to another.  The speaker gives no indication of being aware of the disconnectedness, contraindications, or illogicality of speech.

Loss of Control
Failure to restrain impulses, functions, or actions that ordinarily can be regulated consciously (e.g., aggressive actions, sexual impulses, bladder and bowel emptying).  In relation to alcohol and other substances, loss of control refers to an impaired ability to modulate the amount or frequency of substance intake once any amount of the substance has been administered.  Such loss of control, or impaired control, is regarded as one sign of dependence on the substance used.

LSD
(lysergic acid diethylamide) A potent hallucinogen that produces psychotic symptoms and behavior such as hallucinations, illusions, body and time-space distortions, and, less commonly, intense panic or mystical experiences.

M

Magical Thinking
1. The conviction of the individual that his or her thoughts, words, and actions, may in some manner cause or prevent outcomes in a way that defies the normal laws of cause and effect.
2. A conviction that thinking equates with doing.  Occurs in dreams in children, in primitive peoples, and in patients under a variety of conditions.  Characterized by lack of realistic relationship between cause and effect.

Magnetic Resonance Imaging (MRI)
(MRI) A technique for showing anatomic structures that involves placing subjects in a strong magnetic field and then, by use of magnetic gradients and brief radio frequency pulses determining the resonance characteristics at each point in the area to be studied.  Used to detect structural or anatomic abnormalities; it is better able to differentiate between gray and white matter than is computed tomography.

Maintenance Dose
An amount of a drug designed to enable a patient to continue to benefit from a therapeutically effective regimen of medication. It is often less that the dose required to bring about the positive change in the first place.

Maintenance Drug Therapy
Continuing a therapeutic drug after it has reached its maximum efficacy and at a minimum effective level to prevent an early relapse or a later recurrence of illness.

Major Depression
Disorder involving a sad mood or anhedonia, plus four or more of the following symptoms; weight loss or a decrease in appetite, weight gain, insomnia or hypersomnia, fatigue, feelings of worthlessness or severe guilt, , trouble concentrating, and suicidal ideation. These symptoms must be present for at least two weeks and must produce marked impairments in normal functioning. The individual experiences episodes of depression, but not of mania. Also called unipolar depression.

Maladaptive
Term referring to behaviors that cause people to who have them physical or emotional harm, prevent them from functioning in daily life, and/or indicate that they have lost touch with reality and/or cannot control their thoughts and behavior. Also called dysfunctional.

Maladjustment
Unsuccessful attempts at adaptation.

Malingering
1. Faking a physical or psychological incapacity in order to avoid a responsibility or gain an end. The goal is readily recognized from the individual's circumstances. To be distinguished from conversion disorder, in which the incapacity is assumed to be beyond voluntary control. Feigning of a symptom or disorder for the purpose of avoiding an unwanted situation, such as military service.
2. Intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding onerous duties, obtaining financial compensation, evading criminal prosecution, or obtaining drugs.  There is often marked discrepancy between the person's claimed disability and objective findings.  The person may be uncooperative during the diagnostic evaluation or fail to comply with the prescribed treatment.

Managed Care
A system(s) organized to create a balance between use of health care resources, control of health costs, and enhancement of the quality of care.  Aiming to provide care in the most cost-effective manner, each managed care system closely monitors the intensity and duration of treatment as well as the settings in which it is provided.  It adds third parties to the providers-consumers dyad to share control of the treatment process.  It organizes physicians and other providers into coordinated networks of care to ensure that those who enroll in the system receive all medically necessary care.  Wide arrays of mechanisms are used to control utilization and reduce costs.
Currently, health maintenance organizations (HMOs) are the most frequently used management system for managed care.  In 1993, 56% of all Americans working for middle-sized and large firms were enrolled in HMOs.

Mania
Bipolar disorder; a mood disorder characterized by excessive elation, inflated self-esteem and grandiosity, hyperactivity, agitation, and accelerated thinking and speaking.  Flight of ideas may be present.  A manic syndrome may also occur in organic mental disorders.

Manic Episode
A distinct period of time (usually lasting at least 1 week) of abnormally and persistently elevated, expansive, or irritable mood accompanies by such symptoms as inflated self-esteem or grandiosity, decreased need for sleep, over talkativeness or pressured speech, flight of ideas or feeling that thoughts are racing, inattentiveness and distractibility, increased goal-directed activity (e.g., at work or school, socially or sexually), and involvement in pleasurable activities with high potential for painful consequences (e.g., buying sprees, sexual indiscretions, foolish business ventures).

Manipulation
A behavior pattern characterized by attempts to exploit interpersonal contact.

Abraham Harold Maslow                   
Humanistic psychologist whose theory proposed that humans have a hierarchy of needs and that self-actualization (the highest level of the hierarchy) can only occur when the lower-order needs have been met.

Masochism
Pleasure derived from physical or psychological pain inflicted on oneself either by oneself or by others.  It is called sexual masochism and classified as a paraphilia when it is consciously sought as a part of the sexual act or as prerequisite to sexual gratification.  It is the converse of sadism, although the two tend to coexist in the same person.

Maturation
As used in psychology, the term refers to the development of certain behavior as a result of underlying physical growth, rather than learning.

MDMA
This is is a synthetic, psychoactive (mind-altering) drug with amphetamine-like and hallucinogenic properties. Its chemical structure is similar to two other synthetic drugs, MDA and methamphetamine, which are known to cause brain damage. On the street it is called Adam, ecstasy, or XTC.

Medicaid
A means-tested entitlement program, financed jointly by the state and federal governments, that provides medical services to people with low incomes.  States must offer certain services, including inpatient and outpatient hospital services, physicians' (including psychiatrists') services, clinical laboratory and X-ray services, and home health services.  Additional coverage of persons with mental illnesses is limited.  For example, states must cover short-term acute care for mental illness in general hospitals; they may cover services for persons with mental illness in institutes for mental diseases for those over 65 or in psychiatric hospitals for those under 21.  Institutionalized people between the ages of 21 and 65 are excluded from coverage.

Medical Ethics
The moral code adopted by health professionals in assigning primary value to their patients' needs and interests

Medical Power of Attorney
The legal authority given by a competent person to a proxy or stand-in decision-maker to serve in the event of the subject's incapacity.  This is one type of advance directive.  See also living will.

Medical Record
A written document that contains sufficient information to identify the patient clearly, to justify the diagnosis and treatment, and to document the results accurately.

Medical Review
Examination by a team composed of physicians and other appropriate health personnel of the conditions and need for care, including a medical evaluation.

Medicare
An entitlement program of health insurance for the elderly and for qualified disabled persons enacted in 1965.  Part A, or hospital insurance, usually is earned through employment covered by Social Security.  Part B, or supplementary medical insurance, is elected and paid for through a heavily subsidized premium.  Covered services include inpatient hospital care, hospital outpatient services, skilled nursing facility care, physicians' (including psychiatrists') services, laboratory and other diagnostic tests, and hospice care.

Megalomania
A paranoid delusion of grandeur in which an individual believes that he or she is an important person or is carrying out great plans.

Melancholia
1. A vernacular diagnosis of several millenniums' standing for profound sadness and depression. In major depression with melancholia the individual is unable to feel better even momentarily when something good happens, regularly feels worse in the morning and awakens early, and suffers a deepening of other symptoms of depression.
2. Depression, typically endogenous rather than reactive, and of severe degree.  Some authorities use melancholia as equivalent to depression with psychotic features.  In DSM-IV (as in DSM-III and DSM-III-R), melancholia is used as a descriptor of a major depressive episode.  In addition to exhibiting loss of pleasure in activities (pervasive anhedonia) and lack of reaction to stimuli that would ordinarily be pleasurable, the patient often shows psychomotor retardation or agitation, depression that is worse in the morning, early morning awakening, anorexia nervosa and weight loss, and excessive or inappropriate guilt.

Memory
The ability, process, or act of remembering or recalling; especially the ability to reproduce what has been learned or explained.

Mendacity
Pathological lying.

Meningitis
An inflammation of the meninges through infection, usually by a bacterium, or through irritation.

Mental Age
1. The numerical index of an individual's cognitive development determined by standardized intelligence tests.
2. (MA) A measure of mental ability as determined by psychological tests.

Mental Disorder
A behavioral or psychological syndrome that causes significant distress (a painful symptom) or disability (impairment in one or more important areas of functioning), or a significantly increased risk of suffering death, pain, or an important loss of freedom.  The syndrome is considered to be a manifestation of some behavioral, psychological, or biological dysfunction in the person (and in some cases it is clearly secondary to or due to a general medical condition).  The term is not applied to behavior or conflicts that arise between the person and society (e.g., political, religious, or sexual preference) unless such conflicts are clearly an outgrowth of a dysfunction within that person.  In lay usage, "emotional illness" serves as a term for mental disorder, although it may imply a lesser degree of dysfunction, whereas the term "mental disorder" may be reserved for more severe disturbances.

Mental Health
A state of being that is relative rather than absolute.  The best indices of mental health are simultaneous success at working, loving, and creating, with the capacity for mature and flexible resolution of conflicts between instincts, conscience, important other people, and reality.

Mental Retardation
Developmental disorder marked by significantly subaverage intellectual functioning, as well as deficits (relative to other children) in life skill areas such as communication, self-care, work, and interpersonal relationships. Subnormal intellectual functioning associated with impairment in social adjustment an identified at an early age.

Mentally Ill
Legal description of an individual who purportedly suffers from a mental illness, which is analogous (in this view) to suffering from a medical disease.

Metabolism
From the Greek word meaning "change." The sum of the intercellular processes by which large molecules are broken down into smaller ones, releasing energy and wastes, and by which small molecules are built up into new living matter by consuming energy.

Metacognition
The knowledge people have about the way they know their world, such as recognizing the usefulness of a map in finding one's way in a new city.

Methadone
1. Opioid that is less potent and that is longer lasting than heroin, taken by heroin users to decrease their cravings and help them cope with negative withdrawal symptoms. A synthetic addictive heroin substitute for treating heroin addicts that acts as a substitute for heroin by eliminating its effects and the craving for it.
2. A synthetic narcotic.  It may be used as a substitute for heroin, producing a less socially disabling addiction or aiding in the withdrawal from heroin.  It may be abused.

Middle age
Conventionally considered to occur between 40 and 60-65 years of age and primarily defined by psychosocial rather than by physiological events.

Migraine Headaches
Extremely debilitating headaches caused by sustained dilation of the extracranial arteries, the temporal artery in particular. The dilated arteries trigger pain-sensitive nerve fibers in the scalp.

Mild Mental Retardation
A limitation in mental development measured on IQ tests at between 50-55 and 70. Children with such a limitation are considered the educable mentally retarded and are placed in special classes.

Modeling
Process of learning behaviors by observing and imitating others, especially authority figures or those like oneself.

Moderate Mental Retardation
A limitation in mental development measured on IQ tests between 35-40 and 50-55. Children with this degree of retardation are often institutionalized, and their training is focused on self-care rather than development of intellectual skills.

Monoamine Oxidase Inhibitors (MAOI)
(MAOI) An enzyme that deactivates catecholamines and indoleamines within the presynaptic neuron, and indoleamines in the synapse. Treatments for depression that inhibit monoamine oxidase, an enzyme that breaks down monoamines, in the synapse, thereby yielding more monoamines.

Mood Disorders
Disorders in which there are disabling disturbances in emotion.

Moral Anxiety
In psychoanalytic theory, the ego's fear of punishment for failure to adhere to the superego's standards of proper conduct.

Morbidity Risk
The probability that an individual will develop a particular disorder.
Mutism
The inability or refusal to speak.

N

Narcotics
Addictive sedative drugs, for example, morphine and heroin, that in moderate doses relieve pain and induce sleep.

Natural Environmental Type Phobia
Extreme fear of events or situations in the natural environment that causes impairment to one's ability to function normally.

Need for Treatment
Legal criterion operationalized as a signed certificate by two physicians stating that a person requires treatment but will not agree to it voluntarily; formerly a sufficient cause to hospitalize the person involuntarily and force him or her to undergo treatment.

Negativism
A tendency to behave in a manner opposite to the desires of others or to what is expected or requested.

Neonate
An infant.

Nervous System
General term referring to one or more of the following: autonomic nervous system, central nervous system, parasympathetic nervous system, somatic nervous system, and sympathetic nervous system.

Neurologist
A person who studies the nervous system, especially its structure, functions, and abnormalities.

Neuropsychologist
A psychologist concerned with the relationships among cognition, affect, and behavior on the one hand, and brain function on the other.

Neuroses
A large group of non-psychotic disorders characterized by unrealistic anxiety and other associated problems, for example, phobic avoidances, obsessions, and compulsions.

Neurosis
(psychoneurosis) A behavioral disturbance manifested in a variety of symptoms. These are less severe disturbances than the psychoses and apparently are precipitated by environmental rather than biological factors.

Neurotic Paradox
Situation of a person developing a means of avoiding anxiety that is itself maladaptive.

Nicotine
The principal alkaloid of tobacco (its addicting agent).

Nomenclature
A system or set of names or designations used in a particular discipline, such as the DSM-IV.

Nonadaptive Reaction
A reaction to frustration that is not reality oriented - that is, not oriented toward removing the source of the frustration. Defense mechanisms are examples of nonadaptive reaction.

Norms
Accepted ways of behaving that are developed in group settings.

O

Objective Anxiety
The ego's reaction to danger in the external world; realistic fear. Also referred to as realistic anxiety.

Observational Learning
Learning that occurs when a person observes the rewards and punishments of another's behavior and then behaves in accordance with the same rewards and punishments.

Obsessions
Uncontrollable intrusive recurring thoughts, images, ideas or impulses that an individual feels intrude upon his or her consciousness, and that cause significant anxiety or distress because of the irrational nature of the obsessions.

Obsessive-Compulsive Disorder (OCD)
An anxiety disorder in which the mind is flooded with persistent and uncontrollable thoughts (obsessions), or the individual is compelled to repeat certain acts again and again in a ritualistic fashion (compulsions), causing significant distress and interference with everyday functioning.

Opioids
Substances, including morphine and heroin, that produce euphoria followed by a tranquil state. Severe intoxication can lead to unconsciousness, coma, and seizures. The withdrawal symptoms after severe intoxication are symptoms of emotional distress, severe nausea, sweating, diarrhea, and fever.

Oppositional Defiant Disorder (ODD)
Syndrome of chronic misbehavior in childhood, marked by belligerence, irritability, and defiance, although not to the extent found in a diagnosis of conduct disorder.

Organic Psychosis
A severe behavioral disturbance usually requiring hospitalization and resulting from some organic malfunctioning of the body.

P

Pain Disorder
A somatoform disorder in which the person complains of severe and prolonged pain that is not explainable by organic pathology. It tends to be stress related or permits the patient to avoid an aversive activity or to gain attention and sympathy.

Panic Attacks
Short, intense periods during which an individual experiences physiological and cognitive symptoms of anxiety, characterized by intense fear or discomfort.

Panic Disorder
An anxiety disorder in which the individual has sudden and inexplicable attacks of jarring symptoms, such as difficulty breathing, heart palpitations, dizziness, trembling, terror, and feelings of impending doom. In DSM-IV, said to occur with or without agoraphobia.

Paranoid Disorder
A disorder in which the individual has persistent persecutory delusions or delusional jealousy, and is very often contentious but has no thought disease or hallucinations.

Paranoid Personality
This person, expecting to be mistreated by others, becomes suspicious, secretive, jealous, and argumentative. He or she will not accept blame, and appears cold and unemotional.

Paraprofessional
In clinical psychology, an individual lacking a doctoral degree but trained to perform certain functions usually reserved for clinicians. For example, a college student trained and supervised by a behavioral therapist to shape the behavior of autistic children through contingent reinforcers.

Passive Learning
Learning in which the learner does not take an active part. For example, the passive learner may do no more than simply read material.

Pathology
The anatomical, physiological, and psychological deviations of a disease or disorder. The study of these abnormalities.

Pedigree
As used in genetics, another word for family tree.

Perception
A bipolar process that involves the meaningful organization of stimuli.

Perceptual Defense
A term used to refer to the fact that the perception of some stimuli requires a longer exposure than perception of other stimuli. In other words, the thresholds for recognition of certain stimuli are higher than the thresholds of recognition for other stimuli.

Perceptual Selectivity
Refers to the fact that we do not attend to everything impinging on senses at the same time. We respond selectively - that is, if we are hungry, we are more likely to be aware of and respond to food related items.

Persecutory Delusion
False, persistent belief that one is being pursued by other people.

Personality Disorder
Chronic pattern of maladaptive cognition, emotion, and behavior that begins in adolescence or early adulthood and continues into later life.

Phobia
An unrealistic but very severe fear of any object or environment; for example, claustrophobia (a fear of enclosed spaces).

Physiology
The study of the functions and activities of living cells, tissues, and organs, and of the physical and chemical phenomena involved.

Placebo
Any inactive therapy or chemical agent, or any attribute or component of such a therapy or chemical, that affects a person's behavior for reasons related to his or her expectation of change.

Play Therapy
The use of play as a means of uncovering what is troubling a child and of establishing rapport.

Polygraph
Also called the lie detector, this device measures a number of physiological changes regulated by the the autonomic nervous system.

Polysubstance Abuse
The misuse of more than one drug at a time, such as drinking heavily and using cocaine.

Positive Reinforcement
The strengthening of a tendency to behave by virtue of the fact that previous responses in that situation have been followed by presentation of a desired reward.

Post-Traumatic Stress Disorder (PTSD)
An anxiety disorder in which a particularly stressful event, such as military combat, rape, or a natural disaster, brings in its aftermath intrusive mental images of experiencing a traumatic event, emotional numbness and detachment, estrangement from others, a tendency to be easily startled (hyperviligilance), nightmares, recurrent dreams, and otherwise disturbed sleep.

Predisposition
Tendency to develop a disorder which must interact with other biological, psychological, or environmental factors for the disorder to develop. An inclination or diathesis to respond in a certain way, either inborn or acquired. In abnormal psychology, a factor that lowers the ability to withstand stress and inclines the individual toward pathology.

Prevention
Divided into 3 subcategories of primary, secondary and tertiary, In primary prevention, the efforts in community psychology to reduce the incidence of new cases of psychological disorder by such means as altering stressful living conditions and genetic counseling. In secondary prevention, the efforts to detect disorders early, so that they will not develop into full blown, perhaps chronic, disabilities, In tertiary prevention, the efforts to reduce the long-term consequences of having a disorder, equivalent in most respects to therapy.

Primitivization
A defense mechanism that is a form of regression and involves manifesting a type of behavior that is inappropriate for a person of this age but that is appropriate to a much younger person. Primitivization involves immature behavior the person had not manifested at an earlier age.
Privileged Communication
The communication between parties in a confidential relation that is protected by statute. A spouse, doctor, lawyer, pastor, psychologist, or psychiatrist cannot be forced, except under unusual circumstances, to disclose such information.

Profound Mental Retardation
A limitation in mental development measured on IQ tests at less that 20-25. Children with this degree of retardation require total supervision of all their activities.

Prognosis
A prediction of the likely course and outcome of an illness.

Projection
A defense mechanism whereby unacceptable motives, characteristics, or desires unacceptable to the ego are attributed to someone else.

Psyche
The soul, spirit, or mind as distinguished from the body.

Psychiatric Social Worker
A mental health professional who holds a Master of Social Work (M.S.W.) degree.

Psychiatrist
A physician (M.D.) who has taken specialized postdoctoral training, called a residency, in the diagnosis, treatment, and prevention of mental and emotional disorders.

Psychiatry
A medical specialty concerned primarily with diagnosis and treatment of mental illness.

Psychoactive
Affecting perceptions, thoughts, emotions and/or behaviors.

Psychoactive Drugs
Chemical compounds having a psychological effect that alters mood or thought process. Valium is an example of a psychoactive drug.

Psychoanalysis
A theory of personality as well as a set of treatment methods used with the mentally ill.

Psychoanalyst
(analyst) A therapist who has taken specialized postdoctoral training in psychoanalysis after earning either an M.D. or a Ph.D.

Psychogenesis
Development from psychological origins as distinguished from somatic origins.

Psychogram
A graph used to depict an individual's relative standing on a number of different characteristics or traits.

Psychological Deficit
The term used to indicate that performance of a pertinent psychological process is below that expected of a normal person.

Psychological Dependency
The term sometimes applied as the reason for substance abuse. The reliance on, not physiological addiction to, a drug because its effects make stressful situations more bearable.

Psychological Factor Influencing a Medical Condition
An indication in DSM-IV that a physical illness is caused (in part) or exacerbated by psychological states.

Psychology
The science of behavior.

Psychomotor Epilepsy
A form of epileptic seizure in which the individual loses contact with the environment but appears conscious and performs some routine, repetitive act, or engages in more complex activity.

Psychopathologists
Mental health professionals who conduct research into the nature and development of mental and emotional disorders. Their academic backgrounds can differ, some having been trained as experimental psychologists, others as psychiatrists, and still others as biochemists.

Psychopathology
The field concerned with the nature and development of mental disorders.

Psychophysiological Disorders
Disorders with physical symptoms that may involve actual tissue damage, usually in one organ system, and that are produced, in part, by continued mobilization of the autonomic nervous system under stress. Hives and ulcers are examples. No longer listed in DSM-IV in a separate category, such disorders are now diagnosed on axis I as psychological factor influencing a medical condition. On axis III the specific physical condition is given.

Psychophysiology
The discipline concerned with the bodily changes that accompany psychological events.

Psychosis
A severe psychological disturbance that generally requires hospitalization of the person.

Psychosocial Approach
View that psychological characteristics and social events cause abnormality.

Psychosomatic Disorders
Syndromes marked by identifiable physical illness or defect caused at least partly by psychological factors.

Psychosomatic Hypertension
A condition of chronic high blood pressure that is aggravated by, or due to, emotional disturbances.

Psychotherapy
A verbal method of treatment of mental illness. Various types include directive counseling, client-centered therapy, and psychoanalysis.

Psychotic Depression
A profound sadness and unjustified feelings of unworthiness in which there are also delusions.

Psychotic Symptoms
Experiences that involve a loss of contact with reality as well as an inability to differentiate between reality and one's subjective state.

Q

Quality Assurance
Activities and programs intended to assure the standard of care in a defined medical setting or program.  Such programs must include educational components intended to remedy identified deficiencies in quality.

R

Rapid Cycling Bipolar Disorder
Diagnosis given when a person has four or more cycles of mania and depression within a single year.

Rapport
A close, trusting relationship, believed to be essential for effective psychotherapy.

Rationalization
A defense mechanism in which a plausible reason is unconsciously invented by the ego to protect itself from confronting the real reason for an action, thought, or emotion. For example, a person invents an acceptable motive to explain unacceptably motivated behavior.

Reaction Formation
A defense mechanism whereby an unconscious and unacceptable impulse or feeling that would cause anxiety is converted into its opposite so it can become conscious and be expressed. For example, a person adopts a set of attitudes and behaviors that are the opposite of his or her true dispositions.

Receptor
Proteins embedded in the membrane covering a neural cell that interact with one or more neurotransmitters.

Receptors
Specialized nerve cells that convert various forms of physical energy into neural energy.

Recovery Time
The period it takes for a physiological process to return to the baseline after the body has responded to a stimulus.

Reference Group
Any group with which the individual relates psychologically. He may or may not be a member of such a group, but the norms in the reference group influence his behavior nonetheless.

Reference Scales
Internal scales we use to evaluate or judge stimuli in the environment.

Reformulated Learned Helplessness Theory
View that people who attribute negative events to internal, stable, and global causes are more likely than other people to experience learned helplessness deficits following such events and are thus predisposed to depression.

Regression
Defense mechanism in which a person retreats to a behavior of an earlier developmental period in order to prevent anxiety and satisfy current needs. Anxiety is avoided by retreating to the behavior patterns of an earlier psychosexual stage.

Relapse Prevention Programs
Treatments that seek to offset continued alcohol use by identifying high-risk situations for those attempting to stop or cut down on drinking and teaching them either to avoid those situations or to use assertiveness skills when in them, while viewing setbacks as temporary.

Release Therapy
A type of psychotherapy used with children that puts the primary emphasis on providing the child with an opportunity to vent unconscious or suppressed and generally hostile feelings.

Repression
A defense mechanism that involves the unconscious exclusion of certain thoughts or feelings from conscious awareness.

Resistance
Refers to blocks that occur in psychoanalysis during free association in which the patient reports he cannot think of anything to say. Freud believed such resistance is caused by unconscious forces designed to keep repressed material from gaining conscious awareness.

Respondent Behavior
Behavior that appears to be clearly dependent upon a specific stimulus and elicited by that stimulus.

Resting Potential
The amount of electrical energy stored up by a nerve cell that can be discharged in a short burst.

Retroactive Inhibition
Occurs when learning one piece of material has a negative effect on the retention of something learned previously.

Retrograde Amnesia
Deficit in the ability to recall previously learned information or past events.

Retrogression
A defense mechanism that is actually a form of regression in which the person manifests a type of behavior inappropriate for his particular age but characteristic of this person at an earlier age.

Reuptake
Process in which the sending neuron reabsorbs some of the neurotransmitter in the synapse, decreasing the amount left in the synapse.

Right to Refuse Treatment
The right, not recognized in all states, of involuntarily committed people to refuse drugs or other treatment. A legal principle according to which a committed mental patient may decline to participate in unconventional or risky treatments.

Right to Treatment
A legal principle according to which a committed mental patient must be provided some minimal amount and quality of professional intervention, enough to afford a realistic opportunity for meaningful improvement. Fundamental right of involuntarily committed people to active treatment for their disorders, rather than the mental health facility providing shelter only.

Risk Factor
A condition or variable that, if present, increases the likelihood of developing a disorder.

S

Safety Signal Hypothesis
The hypothesis that people vividly remember the places in which they have been anxious and associate such locations or situations with symptoms of anxiety, while seeking out situations associated with lowered anxiety.

Schema
A mental structure for organizing information about the world.

Schizophrenia
A functional psychosis characterized by apathy, withdrawal from reality, excessive fantasy, and also in some cases delusions and hallucinations. There are several different diagnostic types.

School Phobia
An acute, irrational dread of attending school, usually accompanied by somatic complaints. It is the most common phobia of childhood.

Seasonal Affective Disorder
(SAD) Disorder identified by a two-year period in which a person experiences major depression during winter months and then recovers fully during the summer. Some people with this disorder also experience mild mania during summer months.

Sedative
A drug that slows bodily activities, especially those of the central nervous system. It is used to reduce pain and tension and to induce relaxation and sleep.

Selective Serotonin Reuptake Inhibitors (SSRI)
(SSRIs) Group of drugs that reduces symptoms of depression and anxiety by affecting the functional levels of serotonin.

Self-Actualization
Fulfilling one's potential as an always growing human being.

Self-Efficacy
Person's belief that he or she can execute the behaviors necessary to control desired outcomes.

Self-Esteem
Refers to the feelings the individual has relative to himself as a person - that is, his subjective feelings of worth.

Self-Monitoring
Method of assessment in which a client records the number of times per day that he or she engages in a specific behavior and the conditions surrounding the behavior. In behavioral assessment, a procedure whereby the individual observes and reports certain aspects of his or her own behavior, thoughts or emotions.

Senile Dementia
A disorder that can be brought on by progressive deterioration of the brain caused in part by aging. This disorder is marked by memory impairment, inability to think abstractly, loss of standards, loss of impulse control, poor personal hygiene, great disorientation, and eventually obliviousness.

Sensitivity Training Group
A small group of people who spend a period of time together both for therapy and for educational purposes. Participants are encouraged or forced to examine their interpersonal functioning and their often overlooked feelings about themselves and others.

Separation Anxiety
The normal fear and apprehension noted in infants when they are removed from the mother (or surrogate mother) or when approached by strangers. Most marked from age 6 to 10 months. In later life, similar reactions may be caused by separation from significant persons or familiar surroundings.

T

Tachycardia
A racing of the heart, often associated with high levels of anxiety.

Therapeutic Community
Type of residence where people with mental disorders live with mental health workers and share responsibility for the maintenance of the residence and the development of healthy behavior in one another. A concept in mental health care that views the total environment as contributing to prevention or treatment.

Thought Stopping Techniques
Strategy that involves finding ways to stop intrusive thoughts.

Trait
A somatic characteristic or an enduring predisposition to respond in a particular way, distinguishing one individual from another.

Tranquilizer
A drug that reduces anxiety and agitation, such as Valium.

Trauma
A severe physical injury of wound to the body caused by an external force. It can also be defined as a psychological shock having a lasting effect on mental life. Pl. traumata.

Traumatic Disease                               
An illness produced by external assault, such as poison, a blow, or stress.

Tremor
An involuntary quivering of voluntary muscle, usually limited to the small muscles in particular areas.

Tricyclic Drugs
A group of drugs with molecular structures characterized by three fused rings. Tricyclics are assumed to interfere with the reuptake of norepinephrine, serotonin, and other neurotransmitters by the neuron after it has fired. These drugs reduce symptoms of depression and anxiety.

Tumor
Abnormal growth that when located in the brain can either be malignant and directly destroy brain tissue or be benign and disrupt functioning by increasing intracranial pressure.

Type A Behavior Patterns
One of two contrasting psychological patterns revealed through studies seeking the cause of coronary heart disease. Type A people are competitive, rushed, hostile, and overcommitted to their work. Type A's are believed to be at heightened risk for heart disease. Those who meet the other pattern, Type B people are more relaxed and relatively free of pressure.

U

Unconditional Positive Regard
A crucial attitude for the client-centered therapist to adopt toward the client, who needs to feel complete acceptance as a person in order to evaluate the extent to which current behavior contributes to self-actualization.

Unconscious Motives
Motives that the individual is unaware of, but that still influence his behavior.

Unipolar Depression
A term applied to the disorder of individuals who have experienced episodes of depression but not mania. Referred to as major depression in DSM-IV.

V

Valence
Used with reference to the attractiveness or repulsiveness of goals - for example, an attractive goal is said to have a positive valence, while an unattractive goal is said to have a negative valence.

Valium
An anxiety-reducing drug, or anxiolytic, believed to be the most widely prescribed of those available to physicians.

Vascular Dementia
Second most common type of dementia, associated with symptoms of cerebrovascular disease.

Visual Acuity
The ability to perceive objects with clarity.

Visual Hallucination
Visual perception of something that is not actually present.

Vulnerability Schema
The schema of people who are socially anxious and who generally think about danger, harm, and unpleasant events that may come to them.

W

Whole Learning
Refers to learning by wholes rather than parts. For example, a person with a poem to memorize using the whole method starts at the beginning and goes all the way through the poem to the very end. Then the next trial starts at the beginning and goes all the way through to the end again.

X

X Chromosome
The female chromosome contributed by the mother. It produces a female when paired with another X chromosome, and produces a male when paired with a Y chromosome.

Y

Y Chromosome
The male chromosome contributed by the father. It produces a male when paired with an X chromosome. Fathers may contribute either an X chromosome or a Y chromosome to their offspring.

Z

Zeitgeist
The German word for the trends of thought and feeling of culture and taste of a specific time period.

 

 

 

 

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