Glossary of Signs and Symptoms Signs are objective. Symptoms are subjective.

Signs are the clinicians observations, such as noting an agitation; symptoms are the patients experiences, such as a complaint of feeling depressed. In psychiatry, signs and symptoms are not as clearly demarcated as in other fields of medicine: they often overlap. ecause of this, disorders in psychiatry are often described as syndromes ! a constellation of signs and symptoms that together ma"e up a recogni#able condition. abreaction ! $ process by %hich repressed material, particularly a painful experience or a conflict, is brought bac" to consciousness: in this process, the person not only recalls, but also relives the repressed material, %hich is accompanied by the appropriate affective response. abstract thin"ing ! &hin"ing characteri#ed by the ability to grasp the essentials of a %hole, to brea" a %hole into its parts and to discern common properties. &o thin" symbolically. abulia ! 'educed impulse to act and to thin", associated %ith indifference about conse(uences of action. )ccurs as a result of neurological deficit, depression, and schi#ophrenia. acalculia ! *oss of ability to do calculations: not caused by anxiety or impairment in concentration. )ccurs %ith neurological deficit and learning disorder. acataphasia ! +isordered speech in %hich statements are incorrectly formulated. ,atients may express themselves %ith %ords that sound li"e the ones intended but are not appropriate to the thoughts, or they may use totally inappropriate expressions. acathexis ! *ac" of feeling associated %ith an ordinarily emotionally charged subject: in psychoanalysis, it denotes the patients detaching or transferring of emotion from thoughts and ideas. $lso called decathexis. )ccurs in anxiety, dissociative, schi#ophrenic and bipolar disorders. acenesthesia ! *oss of sensation of physical existence. acrophobia ! +read of high places. acting out ! ehavioral response to an unconscious drive or impulse that brings about temporary partial relief of inner tension; relief is attained by reacting to a present situation as if it %ere the situation that originally gave rise to the drive or impulse. -ommon in borderline states. aculalia ! .onsense speech associated %ith mar"ed impairment of comprehension. )ccurs in mania, schi#ophrenia and neurological deficit. /

adiadocho"inesia ! Inability to perform rapid alternating movements. )ccurs %ith neurological deficit and cerebellar lesions. adynamia ! 0ea"ness and fatigability, characteristic of neurasthenia and depression. aerophagia ! 1xcessive s%allo%ing of air. Seen in anxiety disorder. affect ! &he subjective and immediate experience of emotion attached to ideas or mental representations of objects. $ffect has out%ard manifestations that may be classified as restricted, blunted, flattened, broad, labile, appropriate or inappropriate. See also mood. ageusia ! *ac" or impairment of the sense of taste. Seen in depression and neurological deficit. aggression 2 3orceful, goal!directed action that may be verbal or physical: the motor counterpart of the affect of rage, anger or hostility. Seen in neurological deficit, temporal lobe disorder, impulse!control disorders, mania, and schi#ophrenia. agitation ! Severe anxiety associated %ith motor restlessness. agnosia ! Inability to understand the import or significance of sensory stimuli: cannot be explained by a defect in sensory path%ays or cerebral lesion: the term has also been used to refer to the selective loss or disuse of "no%ledge of specific objects because of emotional circumstances, as seen in certain schi#ophrenic, anxious, and depressed patients. )ccurs %ith neurological deficit. 3or types of agnosia see the specific term. agoraphobia ! 4orbid fear of open places or leaving the familiar setting of the home. 4ay be present %ith or %ithout panic attac"s. agraphia ! *oss or impairment of a previously possessed ability to %rite. ailurophobia ! +read of cats. a"athisia ! Subjective feeling of motor restlessness manifested by a compelling need to be in constant movement; may be seen as an extrapyramidal adverse effect of antipsychotic medication. 4ay be mista"en for psychotic agitation. a"inesia ! *ac" of physical movement, as in the extreme immobility of catatonic schi#ophrenia; may also occur as an extrapyramidal effect of antipsychotic medication. a"inetic mutism ! $bsence of voluntary motor movement or speech in a 5

patient %ho is apparently alert 6as evidenced by eye movements7. Seen in psychotic depression and catatonic states. alexia ! *oss of the ability to understand %ritten language; not explained by defective visual acuity. -ompare %ith dyslexia. alexithymia ! Inability or difficulty in describing or being a%are of ones emotions or moods; elaboration of fantasies associated %ith depression, substance abuse, and posttraumatic stress disorder 6,&S+7. algophobia ! +read of pain. alogia ! Inability to spea" because of a mental deficiency or an episode of dementia. ambivalence ! -oexistence of t%o opposing impulses to%ard the same thing in the same person at the same time. Seen in schi#ophrenia, borderline states and obsessive!compulsive disorders 6)-+s7. amimia ! *ac" of the ability to ma"e gestures or to comprehend those made by others. amnesia ! ,artial or total inability to recall past experiences; may be organic 6amnestic disorder7 or emotional 6dissociative amnesia7 in origin. amnestic aphasia ! +isturbed capacity to name objects. even though they are "no%n to the patient. $lso called anomie aphasia. anaclitic ! +epending on others, especially as the infant depends on the mother; anaclitic depression in children results from an absence of mothering. analgesia ! State in %hich one feels little or no pain. -an occur under hypnosis and in dissociative disorder. anancasm ! 'epetitious or stereotyped behavior or thought usually used as a tension!relieving device: used as a synonym for obsession and seen in obsessive!compulsive 6anan"astic7 personality. androgyny ! -ombination of culturally determined female and male characteristics in one person. anergia ! *ac" of energy. anhedonia ! *oss of interest in, and %ithdra%al from, all regular and pleasurable activities. )ften associated %ith depression. anomia ! Inability to recall the names of objects. 8

anorexia ! *oss of, or decrease in appetite. In anorexia nervosa appetite may be preserved but the patient refuses to eat. anosognosia ! Inability to recogni#e a physical deficit in oneself 6e.g.. patient denies paraly#ed limb7. anterograde amnesia ! *oss of memory for events subse(uent to the onset of the amnesia: common after trauma. -ompare %ith retrograde amnesia. anxiety ! 3eeling of apprehension caused by anticipation of danger, %hich may be internal or external. apathy ! +ulled emotional tone associated %ith detachment or indifference: observed in certain types of schi#ophrenia and depression. aphasia ! $ny disturbance in the comprehension or expression of language caused by a brain lesion. 3or types of aphasia see the specific term. aphonia ! *oss of voice. Seen in conversion disorder. apperception ! $%areness of the meaning and significance of a particular sensory stimulus as modified by one9s o%n experiences, "no%ledge, thoughts and emotions. See also perception. appropriate affect ! 1motional tone in harmony %ith the accompanying idea, thought or speech. apraxia ! Inability to perform a voluntary purposeful motor activity; cannot be explained by paralysis or other motor or sensory impairment. In constructional apraxia, a patient cannot dra% t%o! or three!dimensional forms. astasia abasia ! Inability to stand or to %al" in a normal manner, even though normal leg movements can be performed in a sitting or lying do%n position. Seen in conversion disorder. astereognosis ! Inability to identify familiar objects by touch. Seen %ith neurological deficit. See also neurological amnesia. asyndesis ! +isorder of language in %hich the patient unconnected ideas and images. -ommonly seen in schi#ophrenia. combines

ataxia ! *ac" of coordination, physical or mental. 6/7 In neurology, refers to loss of muscular coordination. 657 In psychiatry, the term ataxia refers to lac" of coordination bet%een feelings and thoughts; seen in schi#ophrenia and in severe )-+. atonia ! *ac" of muscle tone. See %axy flexibility. :

attention ! -oncentration: the aspect of consciousness that relates to the amount of effort exerted in focusing on certain aspects of an experience, activity or tas". ;sually impaired in anxiety and depressive disorders. auditory hallucination ! 3alse perception of sound, usually voices, but also other noises, such as music. 4ost common hallucination in psychiatric disorders. aura 6/7 0arning sensations, such as automatisms, fullness in the stomach, blushing and changes in respiration, cognitive sensations, and mood states usually experienced before a sei#ure. 657 $ sensory prodrome that precedes a classic migraine headache,autistic thin"ing. &hin"ing in %hich the thoughts are largely narcissistic and egocentric. %ith emphasis on subjectivity rather than objectivity, and %ithout regard for reality: used interchangeably %ith autism and dereism. Seen in schi#ophrenia and autistic disorder. behavior ! Sum total of the psyche that includes impulses, motivations, %ishes, drives, instincts and cravings, as expressed by a persons behavior or motor activity. $lso called conation. bereavement ! 3eeling of grief or desolation, especially at the death or loss of a loved one. bi#arre delusion ! 3alse belief that is patently absurd or fantastic 6e.g.. invaders from space have implanted electrodes in a persons brain7. -ommon in schi#ophrenia, in nonbi#arre delusion, content is usually %ithin the range of possibility. blac"out ! $mnesia experienced by alcoholics about behavior during drin"ing bouts; usually indicates reversible brain damage. bloc"ing ! $brupt interruption in train of thin"ing before a thought or idea is finished; after a brief pause, the person indicates no recall of %hat %as being said or %as going to be said 6also "no%n as thought deprivation or increased thought latency7. -ommon in schi#ophrenia and severe anxiety. blunted affect ! +isturbance of affect manifested by a severe reduction in the intensity of externali#ed feeling tone: one of the fundamental symptoms of schi#ophrenia, as outlined by 1ugen leuler. brady"inesia ! Slo%ness of motor activity, %ith a decrease in normal spontaneous movement. bradylalia ! $bnormally slo% speech. -ommon in depression. bradylexia ! Inability to read at normal speed. bruxism ! Grinding or gnashing of the teeth, typically occurring during sleep. Seen in anxiety disorder. <

carebaria ! Sensation of discomfort or pressure in the head. catalepsy ! -ondition in %hich persons maintain the body position into %hich they are placed; observed in severe cases of catatonic schi#ophrenia. $lso called %axy flexibility and cerea flexibilitas. See also command automatism. cataplexy ! &emporary sudden loss of muscle tone, causing %ea"ness and immobili#ation: can be precipitated by a variety of emotional states and is often follo%ed by sleep. -ommonly seen in narcolepsy. catatonic excitement 2 1xcited, uncontrolled motor activity seen in catatonic schi#ophrenia. ,atients in catatonic state may suddenly erupt into an excited state and may be violent. catatonic posturing ! =oluntary assumption of an inappropriate or bi#arre posture, generally maintained for long periods of time. 4ay s%itch unexpectedly %ith catatonic excitement. catatonic rigidity ! 3ixed and sustained motoric position that is resistant to change. catatonic stupor ! Stupor in %hich patients ordinarily are %ell a%are of their surroundings. cathexis ! In psychoanalysis, a conscious or unconscious of psychic energy in an idea, concept, object or person. -ompare %ith acathexis. causalgia ! body. cephalgia 2 >eadache. cerea flexibilitas ! -ondition of a person %ho can be molded into a position that is then maintained; %hen an examiner moves the persons limb, the limb feels as if it %ere made of %ax. $lso called catalepsy or %axy flexibility. Seen in schi#ophrenia. chorea ! characteri#ed by random and involuntary (uic", jer"y, purposeless movements. Seen in >untington9s disease. circumstantiality ! +isturbance in the associative thought and speech processes in %hich a patient digresses into unnecessary details and inappropriate thoughts before communicating the central idea. )bserved in schi#ophrenia, obsessional disturbances, and certain cases of dementia. See also tangentiality. ? urning pain that may be organic or psychic in origin.

cenesthesia ! -hange in the normal (uality of feeling tone in a part of the

clang association ! $ssociation or speech directed by the sound of a %ord rather than by its meaning; %ords have no logical connection: punning and rhyming may dominate the verbal behavior. Seen most fre(uently in schi#ophrenia or mania. claustrophobia ! $bnormal fear of closed or confining spaces. clonic convulsion ! $n involuntary, violent muscular contraction or spasm in %hich the muscles alternately contract and relax. -haracteristic phase in grand mal epileptic sei#ure. clouding of consciousness ! $ny disturbance of consciousness in %hich the person is not fully a%a"e, alert, and oriented. )ccurs in delirium, dementia, and cognitive disorder. cluttering ! +isturbance of fluency involving an abnormally rapid rate and erratic rhythm of speech that impedes intelligibility; the affected individual is usually una%are of communicative impairment. cognition ! 4ental process of "no%ing and becoming a%are; function is closely associated %ith judgment. coma ! State of profound unconsciousness from %hich a person cannot be roused %ith minimal or no detectable responsiveness to stimuli; seen in injury or disease of the brain, in systemic conditions such as diabetic "etoacidosis and uremia, and in intoxications %ith alcohol and other drugs. -oma may also occur in severe catatonic states and in conversion disorder. coma vigil ! -oma in %hich a patient appears to be asleep but can be aroused 6also "no%n as a"inetic mutism7. command automatism ! -ondition associated %ith catalepsy in %hich suggestions are follo%ed automatically. command hallucination ! 3alse perception of orders that a person may feel obliged to obey or unable to resist. complex 2 $ feeling!toned idea. complex partial sei#ure ! $ sei#ure characteri#ed by alterations in consciousness that may be accompanied by complex hallucinations 6sometimes olfactory7 or illusions. +uring the sei#ure, a state of impaired consciousness resembling a dreamli"e state may occur, and the patient may exhibit repetitive, automatic, or semipurposeful behavior. compulsion ! ,athological need to act on an impulse that, if resisted produces anxiety; repetitive behavior in response to an obsession or performed according to certain rules, %ith no true end in itself other than to something from @

occurring in the future. conation ! &hat part of a person9s mental life concerned %ith cravings, strivings, motivations, drives, and %ishes, as expressed through behavior or motor activity. concrete thin"ing ! &hin"ing characteri#ed by actual things, events, and immediate experience, rather than by abstractions; seen in young children, in those %ho have lost or never developed the ability to generali#e 6as in certain cognitive mental disorders7, and in schi#ophrenic persons. -ompare %ith abstract thin"ing. condensation ! 4ental process in %hich one symbol stands for a number of components. confabulation ! ;nconscious filling of gaps in memory by imagining experiences or events that have no basis in fact, commonly seen in amnestic syndromes; should be differentiated from lying. See also paramnesia. confusion ! +isturbances of consciousness manifested by a disordered orientation in relation to time, place, or person. consciousness ! State of a%areness, %ith response to external stimuli. constipation ! Inability to defecate or difficulty in defecating. constricted affect ! 'eduction in intensity of feeling tone that is less severe than that of blunted affect. constructional apraxia ! Inability to copy a dra%ing, such as a cube, cloc" or pentagon, as a result of a brain lesion. conversion phenomena ! &he development of symbolic physical symptoms and distortions involving the voluntary muscles or special sense organs; not under voluntary control and not explained by any physical disorder. 4ost common in conversion disorder, but also seen in a variety of mental disorders. convulsion ! $n involuntary, violent muscular contraction or spasm. See also clonic convulsion and tonic convulsion. coprolalia ! Involuntary use of vulgar or obscene language. )bserved in some cases of schi#ophrenia and in &ourettes syndrome. coprophagia ! 1ating of filth or feces. cryptographia ! $ private %ritten language. cryptolalia ! $ private spo"en language. A

cycloplegia ! ,aralysis of the muscles of accommodation in the eye; observed at times, as an autonomic adverse effect 6anticholinergic effect7 of antipsychotic or antidepressant medication. decompensation ! +eterioration of psychic functioning caused by a brea"do%n of defense mechanisms. Seen in psychotic states. deja entendu ! Illusion that %hat one is hearing one has heard previously. See also paramnesia. deja pense ! -ondition in %hich a thought never entertained before is incorrectly regarded as a repetition of a previous thought. See also paramnesia. deja vu ! Illusion of visual recognition in %hich a ne% situation is incorrectly regarded as a repetition of a previous experience. See also paramnesia. delirium ! $cute reversible mental disorder characteri#ed by confusion and some impairment of consciousness; generally associated %ith emotional lability, hallucinations or illusions and inappropriate, impulsive, irrational or violent behavior. delirium tremens 2 $cute and sometimes fatal reaction to %ithdra%al from alcohol usually occurring @5 to B? hours after the cessation of heavy drin"ing; distinctive characteristics are mar"ed autonomic hyperactivity 6tachycardia, fever, hyperhidrosis and dilated pupils7, usually accompanied by tremulousness, hallucinations, illusions and delusions. -alled alcohol %ithdra%al delirium in +S4 I= &'. See also formication. delusion ! 3alse belief, based on incorrect inference about external reality, that is firmly held despite objective and obvious contradictory proof or evidence and despite the fact that other members of the culture do not share the belief. delusion of control ! 3alse belief that a persons %ill, thoughts or feelings are being controlled by external forces. delusion of grandeur 2 1xaggerated conception of ones importance, po%er or identity. delusion of infidelity ! 3alse belief that ones lover is unfaithful. Sometimes called pathological jealous. delusion of persecution ! 3alse belief of being harassed or persecuted: often found in litigious patients %ho have a pathological tendency to ta"e legal action because of imagined mistreatment. 4ost common delusion. delusion of poverty ! 3alse belief that one is bereft or %ill be deprived of all material possessions. B

delusion of reference ! 3alse belief that the behavior of others refers to oneself or that events, objects or other people have a particular and unusual significance, usually of a negative nature; derived from idea of reference, in %hich persons falsely feel that others are tal"ing about them 6e.g.. belief that people on television or radio are tal"ing to or about the person7. See also thought broadcasting. delusion of self!accusation ! 3alse feeling of remorse and guilt. Seen in depression %ith psychotic features. dementia ! 4ental disorder characteri#ed by general impairment in intellectual functioning %ithout clouding of consciousness; characteri#ed by failing memory, difficulty %ith calculations, distractibility, alterations in mood and affect, impaired judgment and abstraction, reduced facility %ith language and disturbance of orientation. $lthough irreversible because of underlying progressive degenerative brain disease, dementia may be reversible if the cause can be treated. denial ! +efense mechanism in %hich the existence of unpleasant realities is disavo%ed; refers to "eeping out of conscious a%areness of any aspects of external reality that, if ac"no%ledged %ould produce anxiety. depersonali#ation ! Sensation of unreality concerning oneself, parts of oneself or ones environment that occurs under extreme stress or fatigue. Seen in schi#ophrenia, depersonali#ation disorder and schi#otypal personality disorder. depression ! 4ental state characteri#ed by feelings of sadness, loneliness, despair, lo% self!esteem and self!reproach; accompanying signs include psychomotor retardation or at times, agitation, %ithdra%al from interpersonal contact, and vegetative symptoms, such as insomnia and anorexia. &he term refers to a mood that is so characteri#ed or a mood disorder. derailment 2 Gradual or sudden deviation in train of thought %ithout bloc"ing; sometimes used synonymously %ith loosening of association. dereali#ation ! Sensation of changed reality or that ones surroundings have altered. ;sually seen in schi#ophrenia, panic attac"s and dissociative disorders. dereism ! 4ental activity that follo%s a totally subjective and idiosyncratic system of logic and fails to ta"e the facts of reality or experience into consideration. -haracteristic of schi#ophrenia. See also autistic thin"ing. detachment ! -haracteri#ed by distant interpersonal relationships and lac" of emotional involvement. devaluation ! +efense mechanism in %hich a person attributes excessively negative (ualities to self or others. Seen in depression and paranoid personality disorder. /C

diminished libido ! +ecreased sexual interest and drive. dipsomania ! -ompulsion to drin" alcoholic beverages. disinhibition ! 6/7 'emoval of an inhibitory effect, as in the reduction of the inhibitory function of the cerebral cortex by alcohol. 657 In psychiatry, a greater freedom to act in accordance %ith inner drives or feelings and %ith less regard for restraints dictated by cultural norms or one9s superego. disorientation 2 -onfusion; impairment of a%areness of time, place and person 6the position of the self in relation to other persons7. -haracteristic of cognitive disorders. displacement ! ;nconscious defense mechanism by %hich the emotional component of an unacceptable idea or object is transferred to a more acceptable one. Seen in phobias. dissociation ! ;nconscious defense mechanism involving the segregation of any group of mental or behavioral processes from the rest of the persons psychic activity; may entail the separation of an idea from its accompanying emotional tone, as seen in dissociative and conversion disorders. Seen in dissociative disorders. distractibility ! Inability to focus one9s attention; the patient does not respond to the tas" at hand but attends to irrelevant phenomena in the environment. dread ! 4assive or pervasive anxiety, usually related to a specific danger. dreamy state ! $ltered state of consciousness, li"ened to a dream situation, that suddenly and usually lasts a fe% minutes; accompanied by visual, auditory and olfactory hallucinations. -ommonly associated %ith temporal lobe lesions. dro%siness ! State of impaired a%areness associated %ith a desire or inclination to sleep. dysarthria ! +ifficulty in articulation, the motor activity of shaping phonated sounds into speech, not in %ord finding or in grammar. dyscalculia ! +ifficulty in performing calculations. dysgeusia ! Impaired sense of taste. dysgraphia ! +ifficulty in %riting. dys"inesia ! +ifficulty in performing movements. Seen in extrapyramidal disorders. //

dyslalia ! 3aulty articulation caused by structural abnormalities of the articulatory organs or impaired hearing. dyslexia ! Specific learning disability syndrome involving an impairment of the previously ac(uired ability to read; unrelated to the persons intelligence. -ompare %ith alexia. dysmetria ! Impaired ability to gauge distance relative to movements. Seen in neurological deficit. dysmnesia ! Impaired memory. dyspareunia ! ,hysical pain in sexual intercourse, usually emotionally caused and more commonly experienced by %omen; may also result from cystitis, urethritis or other medical conditions. dysphagia ! +ifficulty in s%allo%ing. dysphasia ! +ifficulty in comprehending oral language 6reception dysphasia7 or in trying to express verbal language 6expressive dysphasia7 dysphonia ! +ifficulty or pain in spea"ing. dysphoria ! 3eeling of unpleasantness or discomfort; a mood of general dissatisfaction and restlessness. )ccurs in depression and anxiety. dysprosody ! *oss of normal speech melody 6prosody7. -ommon in depression. dystonia ! 1xtrapyramidal motor disturbance consisting of slo%, sustained contractions of the axial or appendicular musculature; one movement often predominates, leading to relatively sustained postural deviations; acute dystonic reactions 6facial grimacing and torticollis7 are occasionally seen %ith the initiation of antipsychotic drug therapy. echolalia ! ,sychopathological repeating of %ords or phrases of one person by another; tends to be repetitive and persistent. Seen in certain "inds of schi#ophrenia, particularly the catatonic types. ego!alien ! +enoting aspects of a persons personality that are vie%ed as repugnant, unacceptable or inconsistent %ith the rest of the personality. $lso called ego!dystonia. -ompare %ith ego!syntonic. egocentric ! Self!centered; selfishly preoccupied %ith one9s o%n needs: lac"ing interest in others. ego!dystonic ! See ego!alien. /5

egomania ! 4orbid self!preoccupation or self!centeredness. See also narcissism. ego!syntonic ! +enoting aspects of a personality that are vie%ed as acceptable and consistent %ith that persons total personality. ,ersonality traits are usually ego!syntonic. -ompare %ith ego!alien. eidetic image ! ;nusually vivid or exact mental image of objects previously seen or imagined. elation ! 4ood consisting of feelings of joy, euphoria, triumph and intense self!satisfaction or optimism. )ccurs in mania %hen not grounded in reality. elevated mood ! $ir of confidence and enjoyment; a mood more cheerful than normal, but not necessarily pathological. emotion ! -omplex feeling state %ith psychic, somatic and behavioral components; external manifestation of emotion is affect emotional insight ! $ level of understanding or a%areness that one has emotional problems. It facilitates positive changes in personality and behavior %hen present. emotional lability ! 1xcessive emotional responsiveness characteri#ed by unstable and rapidly changing emotions. encopresis ! Involuntary passage of feces, usually occurring at night or during sleep. enuresis ! Incontinence of urine during sleep. erotomania ! +elusional belief, more common in %omen than in men, that someone is deeply in love %ith them 6also "no%n as de -lerambault syndrome7. erythrophobia ! $bnormal fear of blushing. euphoria ! 1xaggerated feeling of %ell!being that is inappropriate to real events. -an occur %ith drugs such as opiates, amphetamines and alcohol. euthymia ! .ormal range of mood implying absence of depressed or elevated mood. evasion ! $ct of not facing up to, or strategically eluding, something; consists of suppressing an idea that is next in a thought series and replacing it %ith another idea closely related to it. $lso called paralogia and perverted logic. exaltation ! 3eeling of intense elation and grandeur. /8

excited ! $gitated purposeless motor activity uninfluenced by external stimuli. expansive mood ! 1xpression of feelings %ithout restraint, fre(uently %ith an overestimation of their significance or importance. Seen in mania and grandiose delusional disorder. expressive aphasia ! +isturbance of speech in %hich understanding remains, but ability to spea" is grossly impaired; halting, laborious and inaccurate speech 6also "no%n as rocas, nonfluent and motor aphasias7. expressive dysphasia ! +ifficulty in expressing verbal language; the ability to understand language is intact. externali#ation ! 4ore general term than projection that refers to the tendency to perceive in the external %orld and in external objects elements of ones o%n personality, including instinctual impulses, conflicts, moods, attitudes and styles of thin"ing. extroversion ! State of ones energies being directed outside oneself. -ompare %ith introversion. false memory 2 $ persons recollection and belief of an event that did not actually occur. In false memory syndrome, persons erroneously believe that they sustained an emotional or physical 6e.g.. sexual7 trauma in early life. fantasy 2 +aydream; fabricated mental picture of a situation or chain of events. $ normal form of thin"ing dominated by unconscious material that see"s %ish fulfillment and solutions to conflicts; may serve as the matrix for creativity. &he content of the fantasy may indicate mental illness. fatigue ! $ feeling of %eariness, sleepiness or irritability after a period of mental or bodily activity. Seen in depression, anxiety, neurasthenia and somatoform disorders. fausse reconnaissance ! 3alse recognition, a feature of paramnesia. -an occur in delusional disorders. fear ! ;npleasurable emotional state consisting of psychophysiological changes in response to a realistic threat or danger. -ompare %ith anxiety. flat affect ! $bsence or near absence of any signs of affective expression. flight of ideas ! 'apid succession of fragmentary thoughts or speech in %hich content changes abruptly and speech may be incoherent. Seen in mania. floccillation ! $imless pluc"ing or pic"ing, usually at bedclothes or clothing, /:

commonly seen in dementia and delirium. fluent aphasia ! $phasia characteri#ed by inability to understand the spo"en %ord: fluent but incoherent speech is present. $lso called 0ernic"es sensory and receptive aphasia. folie a deux ! 4ental illness shared by t%o persons, usually involving a common delusional system, if it involves three persons, it is referred to as folie a trois, and so on. $lso called shared psychotic disorder. formal thought disorder ! +isturbance in the form of thought rather than the content of thought; thin"ing characteri#ed by loosened associations, neologisms and illogical constructs; thought process is disordered and the person is defined as psychotic. -haracteristic of schi#ophrenia. formication ! &actile hallucination involving the sensation that tiny insects are cra%ling over the s"in. Seen in cocaine addiction and delirium tremens. free!floating anxiety 2 Severe, pervasive, generali#ed anxiety that is not attached to any particular idea, object or event. )bserved particularly in anxiety disorders, although it may be seen in some cases of schi#ophrenia. fugue ! +issociative disorder characteri#ed by a period of almost complete amnesia, during %hich a person actually flees from an immediate life situation and begins a different life pattern; apart from the amnesia, mental faculties and s"ills are usually unimpaired. galactorrhea ! $bnormal discharge of mil" from the breast; may result from the endocrine influence 6e.g.. prolactin7 of dopamine receptor antagonists, such as phenothia#ines. generali#ed tonic!clonic sei#ure ! Generali#ed onset of tonic!clonic movements of the limbs, tongue biting and incontinence follo%ed by slo%, gradual recovery of consciousness and cognition; also called grand mal sei#ure. global aphasia ! -ombination of grossly nonfluent aphasia and severe fluent aphasia. glossolalia ! ;nintelligible jargon that has meaning to the spea"er but not to the listener. )ccurs in schi#ophrenia. grandiosity ! 1xaggerated feelings of one9s importance, po%er, "no%ledge or identity. )ccurs in delusional disorder and manic states. grief ! $lteration in mood and affect consisting of sadness appropriate to a real loss; normally, it is self!limited. See also depression and mourning. guilt ! 1motional state associated %ith self!reproach and the need for /<

punishment. In psychoanalysis refers to a feeling of culpability that sterns from a conflict bet%een the ego and the superego 6conscience7. Guilt has normal psychological and social functions, but special intensity or absence of guilt characteri#es many mental disorders, such as depression and antisocial personality disorder, respectively. ,sychiatrists distinguish shame as a less internali#ed form of guilt that relates more to others than to the self. See also shame. gustatory hallucination ! >allucination primarily involving taste. gynecomastia ! 3emaleli"e development of the male breasts; may occur as an adverse effect of antipsychotic and antidepressant drugs because of increased prolactin levels or anabolic!androgenic steroid abuse. hallucination ! 3alse sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved. 3or types of hallucinations, see the specific term. hallucinosis ! State in %hich a person experiences hallucinations %ithout any impairment of consciousness. haptic hallucination ! >allucination of touch. hebephrenia ! -omplex of symptoms, considered a form of schi#ophrenia, characteri#ed by %ild or silly behavior or mannerisms, inappropriate affect and delusions and hallucinations that are transient and unsystemati#ed. >ebephrenic schi#ophrenia is no% called disorgani#ed schi#ophrenia. holophrastic ! ;sing a single %ord to express a combination of ideas. Seen in schi#ophrenia. hyperactivity ! Increased muscular activity. &he term is commonly used to describe a disturbance found in children that is manifested by constant restlessness, overactivity, distractibility and difficulties in learning. Seen in attention!deficitDhyperactivity disorder 6$+>+7. hyperalgesia ! 1xcessive sensitivity to pain. Seen in somatoform disorder. hyperesthesia ! Increased sensitivity to tactile stimulation. hypermnesia ! 1xaggerated degree of retention and recall. It can be elicited by hypnosis and may be seen in certain prodigies; also may be a feature of )-+, some cases of schi#ophrenia. and manic episodes of bipolar I disorder. hyperphagia ! Increase in appetite and inta"e of food. hyperpragia 2 1xcessive thin"ing and mental activity. Generally associated %ith manic episodes of bipolar I disorder. /?

hypersomnia 2 1xcessive time spent a sleep. 4ay be associated %ith underlying medical or psychiatric disorder or narcolepsy, may be part of the Eleine!*evin syndrome or may be primary. hyperventilation ! 1xcessive breathing, generally associated %ith anxiety, %hich can reduce blood carbon dioxide concentration and can produce lightheadedness, palpitations, numbness, tingling periorally and in the extremities and occasionally, syncope. hypervigilance ! 1xcessive attention to and focus on all internal and external stimuli usually seen in delusional or paranoid states. hypesthesia ! +iminished sensitivity to tactile stimulation. hypnagogic hallucination ! >allucination occurring %hile falling asleep, not ordinarily considered pathological. hypnopompic hallucination ! >allucination occurring %hile a%a"ening from sleep not ordinarily considered pathological. hypnosis ! $rtificially induced alteration of consciousness characteri#ed by increased suggestibility and receptivity to direction. hypoactivity ! +ecreased motor and cognitive activity, as in psychomotor retardation; visible slo%ing of thought, speech and movements. $lso called hypo"inesis. hypochondria ! 1xaggerated concern about health that is based not on real medical pathology but on unrealistic interpretations of physical signs or sensations as abnormal. hypomania 2 4ood abnormality %ith the (ualitative characteristics of mania but some%hat less intense. Seen in cyclothymic disorder. idea of reference ! 4isinterpretation of incidents and events in the outside %orld as having direct personal reference to oneself; occasionally observed in normal persons, but fre(uently seen in paranoid patients. If present %ith sufficient fre(uency or intensity or if organi#ed and systemati#ed, they constitute delusions of reference. illogical thin"ing ! &hin"ing containing erroneous conclusions or contradictions; psychopathological only %hen it is mar"ed and not caused by cultural values or intellectual deficit. illusion ! ,erceptual of a real external stimulus. -ompare %ith hallucination. immediate memory 2 'eproduction, recognition, or recall of perceived /@

material %ithin seconds after presentation. -ompare %ith long!term memory and short!term memory. impaired insight ! +iminished ability to understand the objective reality of a situation. impaired judgment ! +iminished ability to understand a situation correctly and to act appropriately. impulse control ! $bility to resist an impulse, drive or temptation to perform some action. inappropriate affect ! 1motional tone out of harmony %ith the idea, thought or speech accompanying it. Seen in schi#ophrenia. incoherence ! -ommunication that incomprehensible. See also %ord salad. is disconnected disorgani#ed or

incorporation ! ,rimitive unconscious defense mechanism in %hich the psychic representation of another person or aspects of another person are assimilated into oneself through a figurative process of symbolic oral ingestion; represents a special form of introjection and is the earliest mechanism of identification. increased libido ! Increase in sexual interest and drive. )ften associated %ith mania. ineffability ! 1cstatic state in %hich persons insist that their experience is inexpressible and indescribable and that it is impossible to convey %hat it is li"e to one %ho never experienced it. initial insomnia ! 3alling asleep %ith difficulty; usually seen in anxiety disorder. -ompare %ith middle insomnia and terminal insomnia. insight ! -onscious recognition of ones o%n condition. In psychiatry, it refers to the conscious a%areness and understanding of ones o%n psychodynamics and symptoms of maladaptive behavior; highly important in effecting changes in the personality and behavior of a person. insomnia ! +ifficulty in falling asleep or difficulty in staying asleep. It can be related to a mental disorder, can be related to a physical disorder or an adverse effect of medication, or can be primary 6not related to a "no%n medical factor or another mental disorder7. See also initial insomnia, middle insomnia and terminal insomnia. intellectual insight ! Eno%ledge of the reality of a situation %ithout the ability to use that "no%ledge successfully to effect an adaptive change in behavior or to master the situation. -ompare %ith true insight. /A

intelligence ! -apacity for learning and ability to recall, to integrate constructively and to apply %hat one has learned; the capacity to understand and to thin" rationally. intoxication ! 4ental disorder caused by recent ingestion or presence in the body of an exogenous substance producing maladaptive behavior by virtue of its effects on the central nervous system 6-.S7. &he most common psychiatric changes involve disturbances of perception, %a"efulness, attention, thin"ing, judgment, emotional control and psychomotor behavior; the specific clinical picture depends on the substance ingested. intropunitive ! &urning anger in%ard to%ard oneself. -ommonly observed in depressed patients. introspection ! -ontemplating ones o%n mental processes to achieve insight. introversion ! State in %hich a persons energies are directed in%ard to%ard the self %ith little or no interest in the external %orld. irrelevant ans%er ! $ns%er that is not responsive to the (uestion. irritability ! $bnormal or excessive excitability, %ith easily triggered anger, annoyance, or impatience. irritable mood ! State in %hich one is easily annoyed and provo"ed to anger. See also irritability. jamais vu ! ,aramnestic phenomenon characteri#ed by a false feeling of unfamiliarity %ith a real situation that one has previously experienced. jargon aphasia ! $phasia in %hich the %ords produced are neologistic, that is, nonsense %ords created by the patient. judgment ! 4ental act of comparing or evaluating choices %ithin the frame%or" of a given set of values for the purpose of electing a course of action. If the course of action chosen is consonant %ith reality or %ith mature adult standards of behavior, judgment is said to be intact or normal; judgment is said to be impaired if the chosen course of action is fran"ly maladaptive, results from decisions based on the need for immediate gratification or is other%ise not consistent %ith reality as measured by mature adult standards. "leptomania ! ,athological compulsion to steal. la belle indifference ! Inappropriate attitude of calm or lac" of concern about ones disability. 4ay be seen in patients %ith conversion disorder. /B

labile affect ! $ffective expression characteri#ed by rapid and abrupt changes, unrelated to external stimuli. labile mood ! )scillations in mood bet%een euphoria and depression or anxiety. laconic speech ! -ondition characteri#ed by a reduction in the (uantity of spontaneous speech: replies to (uestions are brief and unelaborated and little or no unprompted additional information is provided. )ccurs in major depression, schi#ophrenia and organic mental disorders. $lso called poverty of speech. lethologica ! 4omentary forgetting of a name or proper noun. See bloc"ing. lilliputian hallucination ! =isual sensation that persons or objects are reduced in si#e; more properly regarded as an illusion. See also micropsia. locali#ed amnesia ! ,artial loss of memory; amnesia restricted to specific or isolated experiences. $lso called lacunar amnesia and patch amnesia. logorrhea 2 -opious, pressured coherent speech; uncontrollable, excessive tal"ing; observed in manic episodes of bipolar disorder. $lso called tachylogia. verbomania and volubility. long!term memory 2 'eproduction, recognition or recall of experiences or information that %as experienced in the distant past. $lso called remote memory. -ompare %ith immediate memory and short!term memory. loosening of associations ! -haracteristic schi#ophrenic thin"ing or speech disturbance involving a disorder in the logical progression of thoughts, manifested as a failure to communicate verbally ade(uately; unrelated and unconnected ideas shift from one subject to another. See also tangentiality. macropsia ! 3alse perception that objects are larger than they really are. -ompare %ith micropsia. magical thin"ing ! $ form of dereistic thought; thin"ing similar to that of the preoperational phase in children 6Fean ,iaget7, in %hich thoughts, %ords or actions assume po%er 6e.g.. to cause or to prevent events7. malingering ! 3eigning disease to achieve a specific goal, for example, to avoid an unpleasant responsibility. mania ! 4ood state characteri#ed by elation, agitation, hyperactivity, hypersexuality and accelerated thin"ing and spea"ing 6flight of ideas7. Seen in bipolar I disorder. See also hypomania. manipulation ! 4aneuvering by patients to get their o%n %ay, characteristic of antisocial personalities. 5C

mannerism ! Ingrained habitual involuntary movement. melancholia ! Severe depressive state. ;sed in the term involutional melancholia as a descriptive term and also in reference to a distinct diagnostic entity. memory ! ,rocess %hereby %hat is experienced or learned is established as a record in the -.S 6registration7, %here it persists %ith a variable degree of permanence 6retention7 and can be recollected or retrieved from storage at %ill 6recall7. 3or types of memory, see immediate memory, long!term and short!term memory. mental disorder ! ,sychiatric illness or disease %hose manifestations are primarily characteri#ed by behavioral or psychological impairment of function, measured in terms of deviation from some normative concept; associated %ith distress or disease, not just an expected response to a particular event or limited to relations bet%een a person and society. mental retardation ! Subaverage general intellectual functioning that originates in the developmental period and is associated %ith impaired maturation and learning, and social maladjustment. 'etardation is commonly defined in term; of IG: mild 6bet%een <C and << to @C7, moderate 6bet%een 8< and :C to bet%een <C and <<7. severe 6bet%een 5C and 5< to bet%een 8< and !:C7, and profound 6belo% 5C to 5<7. metonymy ! Speech disturbance common in schi#ophrenia in %hich the affected person uses a %ord or phrase that is related to the proper one but is not the one ordinarily used; for example, the patient spea"s of consuming a menu rather than a meal, or refers to losing the piece of string of the conversation, rather than the thread of the conversation. See also paraphasia and %ord approximation. microcephaly ! -ondition in %hich the head is unusually small as a result of defective brain development and premature ossification of the s"ull. micropsia ! 3alse perception that objects are smaller than they really are. Sometimes called lilliputian hallucination. -ompare %ith macropsia. middle insomnia ! 0a"ing up after falling asleep %ithout difficulty and then having difficulty in falling asleep again. -ompare %ith initial insomnia and terminal insomnia. mimicry ! Simple, imitative motion activity of childhood. monomania ! 4ental state characteri#ed by preoccupation %ith one subject. mood ! ,ervasive and sustained feeling tone that is experienced internally 5/

and that, in the extreme, can mar"edly influence virtually all aspects of a person9s behavior and perception of the %orld. +istinguished from affect, the external expression of the internal feeling tone. 3or types of mood see the specific term. mood!congruent delusion ! +elusion %ith content that is mood appropriate 6e.g.. depressed patients %ho believe that they are responsible for the destruction of the %orld7. mood!congruent hallucination ! >allucination %ith content that is consistent %ith a depressed or manic mood 6e.g.. depressed patients hearing voices telling them that they are bad persons and manic patients hearing voices telling them that they have inflated %orth, po%er or "no%ledge7. mood!incongruent delusion ! +elusion based on incorrect reference about external reality, %ith content that has no association to mood or is mood inappropriate 6e.g.. depressed patients %ho believe that they are the ne% 4essiah7. mood!incongruent hallucination ! >allucination not associated %ith real external stimuli. %ith content that is not consistent %ith depressed or manic mood 6e.g.. in depression. hallucinations not involving such themes as guilt, deserved punishment or inade(uacy; in mania. not involving such themes as inflated %orth or po%er7. mood s%ings ! )scillation of a persons emotional feeling tone bet%een periods of elation and periods of depression. motor aphasia ! $phasia in %hich understanding is intact, but the ability to spea" is lost. $lso called rocas, expressive or nonfluent aphasias. mourning ! Syndrome follo%ing loss of a loved one, consisting of preoccupation %ith the lost individual, %eeping, sadness and repeated reliving of memories. See also bereavement and grief. muscle rigidity ! State in %hich the muscles remain immovable; seen in schi#ophrenia. mutism ! )rganic or functional absence of the faculty of speech. See also stupor. mydriasis ! +ilation of the pupil; sometimes occurs as an autonomic 6anticholinergic7 or atropineli"e adverse effect of some antipsychotic and antidepressant drugs. narcissism ! In psychoanalytic theory, divided into primary and secondary types; primary narcissism, the early infantile phase of object relationship development, %hen the child has not differentiated the self from the outside %orld and all sources of pleasure are unrealistically recogni#ed as coming from %ithin 55

the self, giving the child a false sense of omnipotence; secondary narcissism, %hen the libido, once attached to external love objects, is redirected bac" to the self. See also autistic thin"ing. needle phobia ! &he persistent, intense, pathological fear of receiving an injection. negative signs ! In schi#ophrenia; flat affect, alogia, abulia and apathy. negativism ! =erbal or nonverbal opposition or resistance to outside suggestions and advice: commonly seen in catatonic schi#ophrenia in %hich the patient resists any effort to be moved or does the opposite of %hat is as"ed. neologism ! .e% %ord or phrase %hose derivation cannot be understood; often seen in schi#ophrenia. It has also been used to mean a %ord that has been incorrectly constructed but %hose origins are nonetheless understandable 6e.g.. headshoe to mean hat7, but such constructions are more properly referred to as %ord approximations. neurological amnesia ! 6/7 $uditory amnesia; loss of ability to comprehend sounds or speech. 657 &actile amnesia: loss of ability to judge the shape of objects by touch. See also astereognosis. 687 =erbal amnesia: loss of ability to remember %ords. 6:7 =isual amnesia: loss of ability to recall or to recogni#e familiar objects or printed %ords. nihilism ! +elusion of the nonexistence of the self or part of the self: also refers to an attitude of total rejection of established values or extreme s"epticism regarding moral and value judgments. nihilistic delusion ! +epressive delusion that the %orld and everything related to it have ceased to exist. noesis ! 'evelation in %hich immense illumination occurs in association %ith a sense that one has been chosen to lead and command. -an occur in manic or dissociative states. nominal aphasia ! $phasia characteri#ed by difficulty in giving the correct name of an object. See also anomia and amnestic aphasia. nymphomania 2 $bnormal, excessive, insatiable desire in a %oman for sexual intercourse. -ompare %ith satyriasis. obsession ! ,ersistent and recurrent idea, thought or impulse that cannot be eliminated from consciousness by logic or reasoning; obsessions are involuntary and ego!dystonic. See also compulsion. olfactory hallucination ! >allucination primarily involving smell or odors; most common in medical disorders, especially in the temporal lobe. 58

orientation ! State of a%areness of oneself and ones surroundings in terms of time, place and person. overactivity ! $bnormality in motor behavior that can manifest itself as psychomotor agitation, hyperactivity 6hyper"inesis7, tics, sleep%al"ing or compulsions. overvalued idea ! 3alse or unreasonable belief or idea that is sustained beyond the bounds of reason. It is held %ith less intensity or duration than a delusion but is usually associated %ith mental illness. panic ! $cute, intense attac" of anxiety associated %ith personality disorgani#ation; the anxiety is over%helming and accompanied by feelings of impending doom. panphobia ! )ver%helming fear of everything. pantomime ! Gesticulation; psychodrama %ithout the use of %ords. paramnesia ! +isturbance of memory in %hich reality and fantasy are confused. It is observed in dreams and in certain types of schi#ophrenia and organic mental disorders; it includes phenomena such as dHjI vu and deja entendu, %hich may occur occasionally in normal persons. paranoia ! 'are psychiatric syndrome mar"ed by the gradual development of a highly elaborate and complex delusional system, generally involving persecutory or grandiose delusions, %ith fe% other signs of personality disorgani#ation or thought disorder. paranoid delusions ! Includes persecutory delusions and delusions of reference, control, and grandeur. paranoid ideation ! &hin"ing dominated by suspicious, persecutory or grandiose content of less than delusional proportions. paraphasia ! $bnormal speech in %hich one %ord is substituted for another, the irrelevant %ord generally resembling the re(uired one in morphology, meaning or phonetic composition; the inappropriate %ord may be a legitimate one used incorrectly, such as clover instead of hand, or a bi#arre nonsense expression, such as treen instead of train. ,araphasic speech may be seen in organic aphasias and in mental disorders such as schi#ophrenia. See also metonymy and %ord approximation. parapraxis ! 3aulty act, such as a slip of the tongue or the misplacement of an article. 3reud ascribed parapraxes to unconscious motives. paresis ! 0ea"ness or partial paralysis of organic origin. 5:

paresthesia ! $bnormal spontaneous tactile sensation, such as a burning, tingling or pins!and!needles sensation. perception ! -onscious a%areness of elements in the environment by the mental processing of sensory stimuli; sometimes used in a broader sense to refer to the mental process by %hich all "inds of data, intellectual, emotional and sensory, are meaningfully organi#ed. See also apperception. perseveration ! 6l7 ,athological repetition of the same response to different stimuli as in a repetition of the same verbal response to different (uestions. 657 ,ersistent repetition of specific %ords or concepts in the process of spea"ing. Seen in cognitive disorders, schi#ophrenia and other mental illness. See also verbigeration. phantom limb ! 3alse sensation that an extremity that has been lost is, in fact, present. phobia 2 ,ersistent, pathological, unrealistic, intense fear of an object or situation; the phobic person may reali#e that the fear is irrational but, nonetheless, cannot dispel it. 3or types of phobias, see the specific term. pica ! -raving and eating of nonfood substances, such as paint and clay. polyphagia ! ,athological overeating. positive signs ! In schi#ophrenia: hallucinations, delusions and thought disorder. posturing 2 Strange, fixed and bi#arre bodily positions held by a patient for an extended time. See also catatonia. poverty of content of speech ! Speech that is ade(uate in amount but conveys little information because of vagueness, emptiness or stereotyped phrases. poverty of speech ! 'estriction in the amount of speech used: replies may be monosyllabic. See also laconic speech. preoccupation of thought ! -entering of thought content on a particular idea, associated %ith a strong affective tone, such as a paranoid trend or a suicidal or homicidal preoccupation. pressured speech ! Increase in the amount of spontaneous speech; rapid loud, accelerated speech, as occurs in mania, schi#ophrenia and cognitive disorders. primary process thin"ing ! In psychoanalysis, the mental activity directly 5<

related to the functions of the Id and characteristic of unconscious mental processes; mar"ed by primitive, prelogical thin"ing and by the tendency to see" immediate discharge and gratification of instinctual demands. Includes thin"ing that is dereistic, illogical and magical; normally found in dreams, abnormally in psychosis. -ompare %ith secondary process thin"ing. projection ! ;nconscious defense mechanism in %hich persons attribute to another those generallyscious ideas, thoughts, feelings and impulses that are in themselves undesirable or unacceptable as a form of protection from anxiety arising from an inner conflict; by externali#ing %hatever is unacceptable, they deal %ith it as a situation apart from themselves. prosopagnosia ! Inability to recogni#e familiar faces that is not due to impaired visual acuity or level of consciousness. pseudocyesis ! 'are condition in %hich a nonpregnant patient has the signs and symptoms of pregnancy, such as abdominal distention, breast enlargement, pigmentation, cessation of menses and morning sic"ness. pseudodementia ! 6/7 +ementiali"e disorder that can be reversed by appropriate treatment and is not caused by organic brain disease. 657 -ondition in %hich patients sho% exaggerated indifference to their surroundings in the absence of a mental disorder, also occurs in depression and factitious disorders. pseudologia phantastica ! +isorder characteri#ed by uncontrollable lying in %hich patients elaborate extensive fantasies that they freely communicate and act on. psychomotor agitation ! ,hysical and mental overactivity that is usually nonproductive and is associated %ith a feeling of inner turmoil, as seen in agitated depression. psychosis ! 4ental disorder in %hich the thoughts, affective response, ability to recogni#e reality and ability to communicate and relate to others are sufficiently impaired to interfere grossly %ith the capacity to deal %ith reality; the classical characteristics of psychosis are impaired reality testing, hallucinations, delusions and illusions. psychotic ! 6/7 ,erson experiencing psychosis. 657 +enoting or characteristic of psychosis. rationali#ation ! $n unconscious defense mechanism in %hich irrational or unacceptable behavior, motives, or feelings are logically justified or made consciously tolerable by plausible means. reaction formation ! ;nconscious defense mechanism in %hich a person develops a sociali#ed attitude or interest that is the direct antithesis of some infantile %ish or impulse that is harbored consciously or unconsciously. )ne of the 5?

earliest and most unstable defense mechanisms, closely related to repression; both are defenses against impulses or urges that are unacceptable to the ego. reality testing ! 3undamental ego function that consists of tentative actions that test and objectively evaluate the nature and limits of the environment: includes the ability to differentiate bet%een the external %orld and the internal %orld and to accurately judge the relation bet%een the self and the environment. recall ! ,rocess of bringing stored memories into consciousness. See also memory. recent memory ! 'ecall of events over the past fe% days. recent past memory ! 'ecall of events over the past fe% months. receptive aphasia ! )rganic loss of ability to comprehend the meaning of %ords; fluid and spontaneous, but incoherent and nonsensical speech. See also fluent aphasia and sensory aphasia. receptive dysphasia ! +ifficulty in comprehending oral language; the impairment involves comprehension and production of language. regression ! ;nconscious defense mechanism in %hich a person undergoes a partial or total return to earlier patterns of adaptation; observed in many psychiatric conditions, particularly schi#ophrenia. remote memory ! 'ecall of events in the distant past. repression 2 3reuds term for an unconscious defense mechanism in %hich unacceptable mental contents are banished or "ept out of important in normal psychological development and in neurotic and psychotic symptom formation. 3reud recogni#ed t%o "inds of repression: 6/7 repression proper, in %hich the repressed material %as once in the conscious domain and 657 primal repression, in %hich the repressed material %as never in the conscious realm. -ompare %ith suppression. restricted affect ! 'eduction in intensity of feeling tone that is less severe than in blunted affect but clearly reduced. See also constricted affect. retrograde amnesia ! *oss of memory for events preceding the onset of the amnesia. -ompare %ith anterograde amnesia. retrospective falsification ! 4emory becomes unintentionally 6unconsciously7 distorted by being filtered through a persons present emotional, cognitive and experiential state. rigidity ! In psychiatry, a persons resistance to change, a personality trait, ritual 6/7 3ormali#ed activity practiced by a person to reduce anxiety, as in )-+. 5@

657 -eremonial activity of cultural origin. rumination ! -onstant preoccupation %ith thin"ing about a single idea or theme, as in )-+. satyriasis ! 4orbid insatiable sexual need or desire in a man. -ompare %ith nymphomania. scotoma ! 6/7 In psychiatry, a figurative blind spot in a person9s psychological a%areness. 657 In neurology, a locali#ed, visual field defect. secondary process thin"ing ! In psychoanalysis, the form of thin"ing that is logical, organi#ed, reality oriented and influenced by the demands of the environment; characteri#es the mental activity of the ego. -ompare %ith primary process thin"ing. sei#ure ! $n attac" or sudden onset of certain symptoms, such as convulsions, loss of consciousness and psychic or sensory disturbances; seen in epilepsy and can be substance induced. 3or types of sei#ures, see the specific term. sensorium ! >ypothetical sensory center in the brain that is involved %ith clarity of a%areness about oneself and ones surroundings, including the ability to perceive and to process ongoing events in light of past experiences, future options and current circumstances; sometimes used interchangeably %ith consciousness. sensory aphasia ! )rganic loss of ability to comprehend the meaning of %ords; fluid and spontaneous, but incoherent and nonsensical speech. See also fluent aphasia and receptive aphasia. sensory extinction ! .eurological sign operationally defined as failure to report one of t%o simultaneously presented sensory stimuli, despite the fact that either stimulus alone is correctly reported. $lso called sensory inattention. shame ! 3ailure to live up to self!expectations; often associated %ith fantasy of ho% person %ill be seen by others. See also guilt. memory 2 'eproduction, recognition or recall of perceived material %ithin minutes after the initial presentation. -ompare %ith immediate memory and long! term memory. simultanagnosia ! Impairment in the perception or integration of visual stimuli appearing simultaneously. somatic delusion ! +elusion pertaining to the functioning of ones body. somatic hallucination ! >allucination involving the perception of a physical 5A

experience locali#ed %ithin the body. somatopagnosia ! Inability to recogni#e a part of ones body as ones o%n 6also called ignorance of the body and autotopagnosia7. somnolence ! ,athological sleepiness or dro%siness from %hich one can be aroused to a normal state of consciousness. spatial agnosia ! Inability to recogni#e spatial relations. spea"ing in tongues ! 1xpression of a revelatory message through unintelligible %ords; not considered a disorder of thought if associated %ith practices of specific ,entecostal religions. See also glossolalia. stereotypy ! -ontinuous mechanical repetition of speech or physical activities; observed in catatonic schi#ophrenia. stupor ! 6/7 State of decreased reactivity to stimuli and less than full a%areness of ones surroundings; as a disturbance of consciousness, it indicates a condition of partial coma or semicoma. 657 In psychiatry, used synonymously %ith mutism and does nor necessarily imply a disturbance of consciousness; in catatonic stupor; patients are ordinarily a%are o f their surroundings. stuttering ! 3re(uent repetition or prolongation of a sound or syllable, leading to mar"edly impaired speech fluency. sublimation ! ;nconscious defense mechanism in %hich the energy associated %ith unacceptable impulses or drives is diverted into personally and socially acceptable channels; unli"e other defense mechanisms, it offers some minimal gratification of the instinctual drive or impulse. substitution ! ;nconscious defense mechanism in %hich a person replaces an unacceptable %ish, drive, emotion or goal %ith one that is more acceptable. suggestibility ! State of uncritical compliance %ith influence or of uncritical acceptance of an idea, believe or attitude; commonly among persons %ith hysterical traits. suicidal ideation ! &houghts or act of ta"ing ones o%n life. suppression ! -onscious act of controlling and inhibiting an unacceptable impulse, emotion or idea; differentiated from repression in that repression is an unconscious process. symboli#ation ! ;nconscious defense mechanism in %hich one idea or object comes to stand for another because of some common aspect or (uality in both; based on similarity and association; the symbols formed protect the person from the anxiety that may be attached to the original idea or object. 5B

synesthesia ! -ondition in %hich the stimulation of one sensory modality is perceived as sensation in a different modality, as %hen a sound produces a sensation of color. syntactical aphasia ! $phasia characteri#ed by difficulty in understanding spo"en speech, associated %ith gross disorder of thought and expression. systemati#ed delusion ! Group of elaborate delusions related to a single event or theme. tactile hallucination ! >allucination primarily involving the sense of touch. $lso called haptic hallucination. tangentiality 2 )bli(ue, digressive or even irrelevant manner of speech in %hich the central idea is not communicated. tension ! ,hysiological or psychic arousal, uneasiness or pressure to%ard action; an unpleasurable alteration in mental or physical state that see"s relief through action. terminal insomnia ! 1arly morning a%a"ening or %a"ing up at least 5 hours before planning to %a"e up. -ompare %ith initial insomnia and middle insomnia. thought broadcasting ! 3eeling that ones thoughts are being broadcast or projected into the environment. See also thought %ithdra%al. thought disorder ! $ny disturbance of thin"ing that affects language, communication or thought content; the hallmar" feature of schi#ophrenia. 4anifestations range from simple bloc"ing and mild circumstantiality to profound loosening of associations, incoherence and delusions; characteri#ed by a failure to follo% semantic and syntactic rules that is inconsistent %ith the persons education, intelligence or cultural bac"ground. thought insertion ! +elusion that thoughts are being implanted in ones mind by other people or forces. thought latency ! &he period of time bet%een a thought and its verbal expression. Increased in schi#ophrenia 6see bloc"ing7 and decreased in mania 6see pressured speech7. thought %ithdra%al ! +elusion that one9s thoughts are being removed from one9s mind by other people or forces. See also thought broadcasting. tic disorders ! ,redominantly psychogenic disorders characteri#ed by involuntary, spasmodic, stereotyped movement of small groups of muscles; seen most predominantly in moments of stress or anxiety, rarely as a result of organic disease. 8C

tinnitus ! .oises in one or both ears, such as ringing, bu##ing or clic"ing; an adverse effect of some psychotropic drugs. tonic convulsion ! -onvulsion in %hich the muscle contraction is sustained. trailing phenomenon ! ,erceptual abnormality associated %ith hallucinogenic drugs in %hich moving objects are seen as a series of discrete and discontinuous images. trance ! Sleepli"e state of reduced consciousness and activity. tremor ! 'hythmical alteration in movement, %hich is usually faster than one beat a second; typically, tremors decrease during periods of relaxation and sleep and increase during periods of anger and increased tension. true insight ! ;nderstanding of the objective reality of a situation coupled %ith the motivational and emotional impetus to master the situation or change behavior. t%ilight state ! +isturbed consciousness %ith hallucinations. t%irling 2 Sign present in autistic children %ho continually rotate in the direction in %hich their head is turned. unconscious ! 6/7 )ne of three divisions of 3reud9s topographic theory of the mind 6the others being the conscious and the preconscious7 in %hich the psychic material is not readily accessible to conscious a%areness by ordinary means; its existence may be manifest in symptom formation, in dreams or under the influence of drugs. 657 In popular 6but more ambiguous7 usage, any mental material not in the immediate field of a%areness. 687 +enoting a state of una%areness, %ith lac" of response to external stimuli, as in a coma. undoing ! ;nconscious primitive defense mechanism, repetitive in nature, by %hich a person symbolically acts out in reverse something unacceptable that has already been done or against %hich the ego must defend itself; a form of magical expiatory action, commonly observed in )-+. unio mystica ! 3eeling of mystic unity %ith an infinite po%er. =egetative signs ! In depression, denoting characteristic symptoms such as sleep disturbance 6especially early morning a%a"ening7, decreased appetite, constipation, %eight loss and loss of sexual response. verbigeration ! 4eaningless and stereotyped repetition of %ords or phrases, as seen in schi#ophrenia. $lso called cataphasia. See also perseveration. vertigo ! Sensation that one or the %orld around one is spinning or 8/

revolving; a hallmar" of vestibular dysfunction, not to be confused %ith di##iness. visual agnosia ! Inability to recogni#e objects or persons. visual amnesia ! See neurological amnesia. visual hallucination ! >allucination primarily involving the sense of sight. %axy flexibility ! -ondition in %hich a person maintains the body position into %hich they are placed. $lso called catalepsy. %ord approximation ! ;se of conventional %ords in an unconventional or inappropriate %ay 6metonymy or of ne% %ords that are developed by conventional rules of %ord formation7 6e.g.. handshoes for glares and time measure for cloc"7; distinguished from a neologism, %hich is a ne% %ord %hose derivation cannot be understood. See also paraphasia. %ord salad 2 Incoherent, essentially incomprehensible, mixture of %ords and phrases commonly seen in far!advanced cases of schi#ophrenia. See also incoherence. xenophobia ! $bnormal fear of strangers. #oophobia ! $bnormal fear of animals. 3or further information please refer to -omprehensive Glossary of ,sychiatry and ,sychology by >.I. Eaplan. 4.+. and . F. Sadoc". ,4.+. 0illiams J 0il"ins. altimore. /BB/.

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