acculturation difficulty A problem stemming from an inability to appropriately adapt to a different culture or environment. The problem is not based on any coexisting mental disorder.

acetylcholine A neurotransmitter in the brain, which helps to regulate memory, and in the peripheral nervous system, where it affects the actions of skeletal and smooth muscle.

acting out This is the process of expressing unconscious emotional conflicts or feelings via actions rather than words. The person is not consciously aware of the meaning or etiology of such acts. Acting out may be harmful or, in controlled situations, therapeutic (e.g., children's play therapy).

actualization The realization of one's full potential - intellectual, psychological, physical, etc.

adiadochokinesia  The inability to perform rapid alternating movements of one or more of the extremities.  This task is sometimes requested by physicians of patients during physical examinations to determine if there exists neurological problems.

adrenergic This refers to neuronal or neurologic activity caused by neurotransmitters such as epinephrine, norepinephrine, and dopamine.

affect This word is used to described observable behavior that represents the expression of a subjectively experienced feeling state (emotion). Common examples of affect are sadness, fear, joy, and anger. The normal range of expressed affect varies considerably between different cultures and even within the same culture. Types of affect include: euthymic, irritable, constricted; blunted; flat; inappropriate, and labile.

affective disorders Refers to disorders of mood.  Examples would include Major Depressive Disorder, Dysthymia, Depressive Disorder, N.O.S., Adjustment Disorder with Depressed Mood, Bipolar Disorder...

age-associated memory impairment (AAMI) The mild disturbance in memory function that occurs normally with aging; benign senescent forgetfulness.  Such lapses in memory are lately humorously referred to as representing "a senior moment".

agitation (psychomotor agitation) Excessive motor activity that accompanies and is associated with a feeling of inner tension. The activity is usually nonproductive and repetitious and consists of such behavior as pacing, fidgeting, wringing of the hands, pulling of clothes, and inability to sit still.

agnosia Failure to recognize or identify objects despite intact sensory function; This may be seen in dementia of various types.  An example would be the failure of someone to recognize a paper clip placed in their hand while keeping their eyes closed.

agonist medication A chemical entity that is not naturally occuring within the body which acts upon a receptor and is capable of producing the maximal effect that can be produced by stimulating that receptor. A partial agonist is capable only of producing less than the maximal effect even when given in a concentration sufficient to bind with all available receptors.

agonist/antagonist medication A chemical entity that is not naturally occuring within the body which acts on a family of receptors (such as mu, delta, and kappa opiate receptors) in such a fashion that it is an agonist or partial agonist on one type of receptor while at the same time it is also an antagonist on another different receptor.

agoraphobia Anxiety about being in places or situations in which escape might be difficut or embarrassing or in which help may not be available should a panic attack occur. The fears typically relate to venturing into the open, of leaving the familiar setting of one's home, or of being in a crowd, standing in line, or traveling in a car or train. Although agoraphobia usually occurs as a part of panic disorder, agoraphobia without a history of panic disorder has been described as also occuring without other disorders.

agraphia The loss of a pre-existing ability to express one's self through the act of writing.

akathisia Complaints of restlessness accompanied by movements such as fidgeting of the legs, rocking from foot to foot, pacing, or inability to sit or stand. Symptoms can develop within a few weeks of starting or raising the dose of traditional neuroleptic medications or of reducing the dose of medication used to treat extrapyramidal symptoms. akathisia is a state of motor restlessness ranging from a feeling of inner disquiet to inability to sit still or lie quietly.

akinesia A state of motor inhibition or reduced voluntary movement.

akinetic mutism A state of apparent alertness with following eye movements but no speech or voluntary motor responses.

alexia Loss of a previously intact ability to grasp the meaning of written or printed words and sentences.

alexithymia A disturbance in affective and cognitive function that can be present in an assortment of diagnostic entities.  Is common in psychosomatic disorders, addictive disorders, and posttraumatic stress disorder. The chief manifestations are difficulty in describing or recognizing one's own emotions, a limited fantasy life, and general constriction in affective life.

algophobia Fear of pain.

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.

alloplastic Referring to adaptation by means of altering the external environment. This can be contrasted to autoplastic, which refers to the alteration of one's own behavior and responses.

alogia An impoverishment in thinking that is inferred from observing speech and language behavior. There may be brief and concrete replies to questions and restriction in the amount of spontaneous speech (poverty of speech). Sometimes the speech is adequate in amount but conveys little information because it is overconcrete, overabstract, repetitive, or stereotyped (poverty of content).

ambivalence 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.

amentia Subnormal development of the mind, with particular reference to intellectual capacities; a type of severe mental retardation.

amimia A disorder of language characterized by an inability to make gestures or to understand the significance of gestures.

amines Organic compounds containing the amino group. Amines such as epinephrine and norepinephrine are significant because they function as neurotransmitters.

amnesia Loss of memory. Types of amnesia include: anterograde Loss of memory of events that occur after the onset of the etiological condition or agent. retrograde Loss of memory of events that occurred before the onset of the etiological condition or agent.

amok A culture specific syndrome from Malay involving acute indiscriminate homicidal mania .

amygdala This is a structure of the brain which is part of the basal ganglia located on the roof of the temporal horn of the lateral ventricle at the inferior end of the caudate nucleus. It is a structure in the forebrain that is an important component of the limbic system.

amyloid Any one of various complex proteins that are deposited in tissues in different disease processes. These proteins have an affinity for Congo red dye. In neuropsychiatry, of particular interest are the beta-amyloid (A4) protein, which is the major component of the characteristic senile plaques of Alzheimer's disease, and the amyloid precursor protein (APP).

anaclitic In psychoanalytic terminology, dependence of the infant on the mother or mother substitute for a sense of well-being. This is considered normal behavior in childhood, but pathologic in later years.

anal stage The period of pregenital psychosexual development, usually from 1 to 3 years, in which the child has particular interest and concern with the process of defecation and the sensations connected with the anus. The pleasurable part of the experience is termed anal eroticism. 

anamnesis The developmental history of a patient and of his or her illness, especially recollections.

anankastic personality Synonym for obsessive-compulsive personality.

androgyny A combination of male and female characteristics in one person.

anhedonia Inability to experience pleasure from activities that usually produce pleasurable feelings. Contrast with hedonism.

anima In Jungian psychology, a person's inner being as opposed to the character or persona presented to the world. Further, the anima may be the more feminine "soul" or inner self of a man, and the animus the more masculine soul of a woman.

anomie Apathy, alienation, and personal distress resulting from the loss of goals previously valued. Emile Durkheim popularized this term when he listed it as a principal reason for suicide.

anosognosia The apparent unawareness of or failure to recognize one's own functional defect (e.g., hemiplegia, hemianopsia).

antagonist medication A chemical entity that is not naturally occuring within the body which occupies a receptor, produces no physiologic effects, and prevents endogenous and exogenous chemicals from producing an effect on that receptor.

anxiety The apprehensive anticipation of future danger or misfortune accompanied by a feeling of dysphoria or somatic symptoms of tension. The focus of anticipated danger may be internal or external.  Anxiety is often distinguished from fear in that fear is a more appropriate word to use when there exists threat or danger in the real world.  Anxiety is reflective more of a threat that is not apparent or imminent in the real world, at least not to the experienced degree.

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

aphasia An impairment in the understanding or transmission of ideas by language in any of its forms--reading, writing, or speaking--that is due to injury or disease of the brain centers involved in language.

anomic or amnestic aphasia Loss of the ability to name objects.

aphonia An inability to produce speech sounds that require the use of the larynx that is not due to a lesion in the central nervous system.

apperception Perception as modified and enhanced by one's own emotions, memories, and biases.

apraxia Inability to carry out previously learned skilled motor activities despite intact comprehension and motor function; this may be seen in dementia.

assimilation A Piagetian term describing a person's ability to comprehend and integrate new experiences.

astereognosis Inability to recognize familiar objects by touch that cannot be explained by a defect of elementary tactile sensation.

ataxia Partial or complete loss of coordination of voluntary muscular movement.

attention The ability to focus in a sustained manner on a particular stimulus or activity. A disturbance in attention may be manifested by easy distractibility or difficulty in finishing tasks or in concentrating on work

auditory hallucination A hallucination involving the perception of sound, most commonly of voices. Some clinicians and investigators would not include those experiences perceived as coming from inside the head and would instead limit the concept of true auditory hallucinations to those sounds whose source is perceived as being external.

aura A premonitory, subjective brief sensation (e.g., a flash of light) that warns of an impending headache or convulsion. The nature of the sensation depends on the brain area in which the attack begins. Seen in migraine and epilepsy.

autoeroticism Sensual self-gratification. Characteristic of, but not limited to, an early stage of emotional development. Includes satisfactions derived from genital play, masturbation, fantasy, and oral, anal, and visual sources.

automatism Automatic and apparently undirected nonpurposeful behavior that is not consciously controlled. Seen in psychomotor epilepsy.

autoplastic Referring to adaptation by changing the self.

autotopagnosia Inability to localize and name the parts of one's own body. finger agnosia would be autotopagnosia restricted to the fingers.

avolition An inability to initiate and persist in goal-directed activities. When severe enough to be considered pathological, avolition is pervasive and prevents the person from completing many different types of activities (e.g., work, intellectual pursuits, self-care).

B

basal gangliaClusters of neurons located deep in the brain; they include the caudate nucleus and the putamen (corpus striatum), the globus pallidus, the subthalamic nucleus, and the substantia nigra. The basal ganglia appear to be involved in higher-order aspects of motor control, such as planning and execution of complex motor activity and the speed of movements. Lesions of the basal ganglia produce various types of involuntary movements such as athetosis, chorea, dystonia, and tremor. The basal ganglia are involved also in the pathophysiology of Parkinson's disease, Huntington's disease, and tardive dyskinesia. The internal capsule, containing all the fibers that ascend to or descend from the cortex, runs through the basal ganglia and separates them from the thalamus.

bestiality Zoophilia; sexual relations between a human being and an animal. See also paraphilia.

beta-blocker An agent that inhibits the action of beta-adrenergic receptors, which modulate cardiac functions, respiratory functions, and the dilation of blood vessels. Beta-blockers are of value in the treatment of hypertension, cardiac arrhythmias, and migraine. In psychiatry, they have been used in the treatment of aggression and violence, anxiety-related tremors and lithium-induced tremors, neuroleptic-induced akathisia, social phobias, panic states, and alcohol withdrawal.

bizarre delusion A delusion that involves a phenomenon that the person's culture would regard as totally implausible.

blind spot Visual scotoma, a circumscribed area of blindness or impaired vision in the visual field; by extension, an area of the personality of which the subject is unaware, typically because recognition of this area would cause painful emotions.

blocking A sudden obstruction or interruption in spontaneous flow of thinking or speaking, perceived as an absence or deprivation of thought.

blunted affect An affect type that represents significant reduction in the intensity of emotional expression

body image One's sense of the self and one's body.

bradykinesia Neurologic condition characterized by a generalized slowness of motor activity.

Broca's aphasia Loss of the ability to comprehend language coupled with production of inappropriate language.

bruxism Grinding of the teeth, occurs unconsciously while awake or during stage 2 sleep. May be secondary to anxiety, tension, or dental problems.

C 

Capgras' syndrome The delusion that others, or the self, have been replaced by imposters. It typically follows the development of negative feelings toward the other person that the subject cannot accept and attributes, instead, to the imposter. The syndrome has been reported in paranoid schizophrenia and, even more frequently, in organic brain disease.

catalepsy Waxy flexibility--rigid maintenance of a body position over an extended period of time.

cataplexy Episodes of sudden bilateral loss of muscle tone resulting in the individual collapsing, often in association with intense emotions such as laughter, anger, fear, or surprise.

catatonic behavior Marked motor abnormalities including motoric immobility (i.e., catalepsy or stupor), certain types of excessive motor activity (apparently purposeless agitation not influenced by external stimuli), extreme negativism (apparent motiveless resistance to instructions or attempts to be moved) or mutism, posturing or stereotyped movements, and echolalia or echopraxia

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. See also repression.

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

causalgia A sensation of intense pain of either organic or psychological origin.

cerea flexibilitas The "waxy flexibility" often present in catatonic schizophrenia in which the patient's arm or leg remains in the position in which it is placed.

circumstantiality Pattern of speech that is indirect and delayed in reaching its goal because of excessive or irrelevant detail or parenthetical remarks. The speaker does not lose the point, as is characteristic of loosening of associations, and clauses remain logically connected, but to the listener it seems that the end will never be reached.

clanging A type of thinking in which the sound of a word, rather than its meaning, gives the direction to subsequent associations.

climacteric Menopausal period in women. Sometimes used to refer to the corresponding age period in men. Also called involutional period.

cognitive Pertaining to thoughts or thinking. Cognitive disorders are disorders of thinking, for example, schizophrenia.

comorbidity The simultaneous appearance of two or more illnesses, such as the co-occurrence of schizophrenia and substance abuse or of alcohol dependence and depression. The association may reflect a causal relationship between one disorder and another or an underlying vulnerability to both disorders. Also, the appearance of the illnesses may be unrelated to any common etiology or vulnerability.

compensation A defense mechanism, operating unconsciously, by which one attempts to make up for real or fancied deficiencies. Also a conscious process in which one strives to make up for real or imagined defects of physique, performance skills, or psychological attributes. The two types frequently merge. See also overcompensation.

compulsion Repetitive ritualistic behavior such as hand washing or ordering or a mental act such as praying or repeating words silently that aims to prevent or reduce distress or prevent some dreaded event or situation. The person feels driven to perform such actions in response to an obsession or according to rules that must be applied rigidly, even though the behaviors are recognized to be excessive or unreasonable.

conative Pertains to one's basic strivings as expressed in behavior and actions

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.

condensation A psychological process, often present in dreams, in which two or more concepts are fused so that a single symbol represents the multiple components.

confabulation Fabrication of stories in response to questions about situations or events that are not recalled.

confrontation A communication that deliberately pressures or invites another to self-examine some aspect of behavior in which there is a discrepancy between self-reported and observed behavior.

constricted affect Affect type that represents mild reduction in the range and intensity of emotional expression.

constructional apraxia An acquired difficulty in drawing two-dimensional objects or forms, or in producing or copying three-dimensional arrangements of forms or shapes.

contingency reinforcement In operant or instrumental conditioning, ensuring that desired behavior is followed by positive consequences and that undesired behavior is not rewarded.

conversion A defense mechanism, operating unconsciously, by which intrapsychic conflicts that would otherwise give rise to anxiety are instead given symbolic external expression. The repressed ideas or impulses, and the psychological defenses against them, are converted into a variety of somatic symptoms. These may include such symptoms as paralysis, pain, or loss of sensory function.

coping mechanisms Ways of adjusting to environmental stress without altering one's goals or purposes; includes both conscious and unconscious mechanisms.

coprophagia Eating of filth or feces.

counterphobia Deliberately seeking out and exposing onself to, rather than avoiding, the object or situation that is consciously or unconsciously feared.

countertransference The therapist's emotional reactions to the patient that are based on the therapist's unconscious needs and conflicts, as distinguished from his or her conscious responses to the patient's behavior. Countertransference may interfere with the therapist's ability to understand the patient and may adversely affect the therapeutic technique. Currently, there is emphasis on the positive aspects of countertransference and its use as a guide to a more empathic understanding of the patient.

cretinism A type of mental retardation and bodily malformation caused by severe, uncorrected thyroid deficiency in infancy and early childhood.

cri du chat A type of mental retardation. The name is derived from a catlike cry emitted by children with this disorder, which is caused by partial deletion of chromosome 5.

conversion symptom A loss of, or alteration in, voluntary motor or sensory functioning suggesting a neurological or general medical condition. Psychological factors are judged to be associated with the development of the symptom, and the symptom is not fully explained by a neurological or general medical condition or the direct effects of a substance. The symptom is not intentionally produced or feigned and is not culturally sanctioned.

culture-specific syndromes Forms of disturbed behavior specific to certain cultural systems that do not conform to western nosologic entities. Some commonly cited syndromes are the following: amok; koro; latah; piblokto, and windigo.

D

Da Costa's syndrome Neurocirculatory asthenia; "soldier's heart"; a functional disorder of the circulatory system that is usually a part of an anxiety state or secondary to hyperventilation.

decompensation The deterioration of existing defenses, leading to an exacerbation of pathological behavior.

defense mechanism Automatic psychological process that protects the individual against anxiety and from awareness of internal or external stressors or dangers. Defense mechanisms mediate the individual's reaction to emotional conflicts and to external stressors. Some defense mechanisms (e.g., projection, splitting, and acting out) are almost invariably maladaptive. Others, such as suppression and denial, may be either maladaptive or adaptive, depending on their severity, their inflexibility, and the context in which they occur.

déjà vu A paramnesia consisting of the sensation or illusion that one is seeing what one has seen before

delusion A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith). When a false belief involves a value judgment, it is regarded as a delusion only when the judgment is so extreme as to defy credibility. Delusional conviction occurs on a continuum and can sometimes be inferred from an individual's behavior. It is often difficult to distinguish between a delusion and an overvalued idea (in which case the individual has an unreasonable belief or idea but does not hold it as firmly as is the case with a delusion). Delusions are subdivided according to their content. Some of the more common types are: bizarre; delusional jealousy; grandiose; delusion of reference; persecutory; somatic; thought broadcasting; thought insertion.

delusional jealousy The delusion that one's sexual partner is unfaithful. erotomanic A delusion that another person, usually of higher status, is in love with the individual.

delusion of reference A delusion whose theme is that events, objects, or other persons in one's immediate environment have a particular and unusual significance. These delusions are usually of a negative or pejorative nature, but also may be grandiose in content. This differs from an idea of reference, in which the false belief is not as firmly held nor as fully organized into a true belief.

denial A defense mechanism where certain information is not accessed by the conscious mind. Denial is related to repression, a similar defense mechanism, but denial is more pronounced or intense. Denial involves some impairment of reality. Denial would be operating (as an example) if a cardiac patient who has been warned about the potential fatal outcome of engaging in heavy work, decides to start building a wall of heavy stones.

depersonalization An alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).

derailment ("loosening of associations") A pattern of speech in which a person's ideas slip off one track onto another that is completely unrelated or only obliquely related. In moving from one sentence or clause to another, the person shifts the topic idiosyncratically from one frame of reference to another and things may be said in juxtaposition that lack a meaningful relationship. This disturbance occurs between clauses, in contrast to incoherence, in which the disturbance is within clauses. An occasional change of topic without warning or obvious connection does not constitute derailment.

derealization An alteration in the perception or experience of the external world so that it seems strange or unreal (e.g., people may seem unfamiliar or mechanical).

dereistic Mental activity that is not in accordance with reality, logic, or experience.

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

diplopia Double vision due to paralysis of the ocular muscles; seen in inhalant intoxication and other conditions affecting the oculomotor nerve.

disconnection syndrome Term coined by Norman Geschwind (1926¾1984) to describe the interruption of information transferred from one brain region to another.

disinhibition Freedom to act according to one's inner drives or feelings, with less regard for restraints imposed by cultural norms or one's superego; removal of an inhibitory, constraining, or limiting influence, as in the escape from higher cortical control in neurologic injury, or in uncontrolled firing of impulses, as when a drug interferes with the usual limiting or inhibiting action of GABA within the central nervous system.

disorientation Confusion about the time of day, date, or season (time), where one is (place), or who one is (person).

dysphoric mood An unpleasant mood, such as sadness, anxiety, or irritability.

displacement A defense mechanism, operating unconsciously, in which emotions, ideas, or wishes are transferred from their original object to a more acceptable substitute; often used to allay anxiety.

dissociation A disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic.

distractibility The inability to maintain attention, that is, the shifting from one area or topic to another with minimal provocation, or attention being drawn too frequently to unimportant or irrelevant external stimuli.

double bind Interaction in which one person demands a response to a message containing mutually contradictory signals, while the other person is unable either to comment on the incongruity or to escape from the situation.

drive Basic urge, instinct, motivation; a term used to avoid confusion with the more purely biological concept of instinct.

dyad A two-person relationship, such as the therapeutic relationship between doctor and patient in individual psychotherapy.

dysarthria Imperfect articulation of speech due to disturbances of muscular control or incoordination.

dysgeusia Perversion of the sense of taste.

dyskinesia Distortion of voluntary movements with involuntary muscular activity.

dyslexia Inability or difficulty in reading, including word-blindness and a tendency to reverse letters and words in reading and writing.

dyssomnia Primary disorders of sleep or wakefulness characterized by insomnia or hypersomnia as the major presenting symptom. Dyssomnias are disorders of the amount, quality, or timing of sleep.

dystonia Disordered tonicity of muscles.

E 

echolalia The pathological, parrotlike, and apparently senseless repetition (echoing) of a word or phrase just spoken by another person. echolalia Parrot-like repetition of overheard words or fragments of speech.

echopraxia Repetition by imitation of the movements of another. The action is not a willed or voluntary one and has a semiautomatic and uncontrollable quality.

ego In psychoanalytic theory, one of the three major divisions in the model of the psychic apparatus, the others being the id and the superego. The ego represents the sum of certain mental mechanisms, such as perception and memory, and specific defense mechanisms. It serves to mediate between the demands of primitive instinctual drives (the id), of internalized parental and social prohibitions (the superego), and of reality. The compromises between these forces achieved by the ego tend to resolve intrapsychic conflict and serve an adaptive and executive function. Psychiatric usage of the term should not be confused with common usage, which connotes self-love or selfishness.

ego ideal The part of the personality that comprises the aims and goals for the self; usually refers to the conscious or unconscious emulation of significant figures with whom one has identified. The ego ideal emphasizes what one should be or do in contrast to what one should not be or not do.

ego-dystonic Referring to aspects of a person's behavior, thoughts, and attitudes that are viewed by the self as repugnant or inconsistent with the total personality.

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

elaboration An unconscious process consisting of expansion and embellishment of detail, especially with reference to a symbol or representation in a dream.

elevated mood An exaggerated feeling of well-being, or euphoria or elation. A person with elevated mood may describe feeling "high," "ecstatic," "on top of the world," or "up in the clouds."

engram A memory trace; a neurophysiological process that accounts for persistence of memory

epigenesis Originally from the Greek "epi" (on, upon, on top of) and "genesis" (origin); the theory that the embryo is not preformed in the ovum or the sperm, but that it develops gradually by the successive formation of new parts. The concept has been extended to other areas of medicine, with different shades of meaning. Some of the other meanings are as follows: 1. Any change in an organism that is due to outside influences rather than to genetically determined ones. 2. The occurrence of secondary symptoms as a result of disease. 3. Developmental factors, and specifically the gene-environment interactions, that contribute to development. 4. The appearance of new functions that are not predictable on the basis of knowledge of the part-processes that have been combined. 5. The appearance of specific features at each stage of development, such as the different goals and risks that Erikson described for the eight stages of human life (trust vs. mistrust, autonomy vs. doubt, etc.). The life cycle theory adheres to the epigenetic principle in that each stage of development is characterized by crises or challenges that must be satisfactorily resolved if development is to proceed normally.

ethnology A science that concerns itself with the division of human beings into races and their origin, distribution, relations, and characteristics.

euthymic Mood in the "normal" range, which implies the absence of depressed or elevated mood.

expansive mood Lack of restraint in expressing one's feelings, frequently with an overvaluation of one's significance or importance. irritable Easily annoyed and provoked to anger.

extinction The weakening of a reinforced operant response as a result of ceasing reinforcement. See also operant conditioning. Also, the elimination of a conditioned response by repeated presentations of a conditioned stimulus without the unconditioned stimulus. See also respondent conditioning.

extraversion A state in which attention and energies are largely directed outward from the self as opposed to inward toward the self, as in introversion.

F 

fantasy An imagined sequence of events or mental images (e.g., daydreams) that serves to express unconscious conflicts, to gratify unconscious wishes, or to prepare for anticipated future events.

flashback A recurrence of a memory, feeling, or perceptual experience from the past.

flat affect An affect type that indicates the absence of signs of affective expression.

flight of ideas A nearly continuous flow of accelerated speech with abrupt changes from topic to topic that are usually based on understandable associations, distracting stimuli, or plays on words. When severe, speech may be disorganized and incoherent.

flooding (implosion) A behavior therapy procedure for phobias and other problems involving maladaptive anxiety, in which anxiety producers are presented in intense forms, either in imagination or in real life. The presentations, which act as desensitizers, are continued until the stimuli no longer produce disabling anxiety.

folie à deux A shared psychotic disorder between 2 people, usually people who are mutually dependent upon each other.

formal thought disorder An inexact term referring to a disturbance in the form of thinking rather than to abnormality of content. See blocking; loosening of associations; poverty of speech.

formication The tactile hallucination or illusion that insects are crawling on the body or under the skin.

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.

free association In psychoanalytic therapy, spontaneous, uncensored verbalization by the patient of whatever comes to mind.

frotteurism One of the paraphilias, consisting of recurrent, intense sexual urges involving touching and rubbing against a nonconsenting person; common sites in which such activities take place are crowded trains, buses, and elevators. Fondling the victim may be part of the condition and is called toucherism.

fusion The union and integration of the instincts and drives so that they complement each other and help the organism to deal effectively with both internal needs and external demands.

G 

Gegenhalten "Active" resistance to passive movement of the extremities that does not appear to be under voluntary control.

globus hystericus The disturbing sensation of a lump in the throat.

glossolalia Gibberish-like speech or "speaking in tongues."

gender dysphoria A persistent aversion toward some or all of those physical characteristics or social roles that connote one's own biological sex.

gender identity A person's inner conviction of being male or female.

gender role Attitudes, patterns of behavior, and personality attributes defined by the culture in which the person lives as stereotypically "masculine" or "feminine" social roles.

grandiosity An inflated appraisal of one's worth, power, knowledge, importance, or identity. When extreme, grandiosity may be of delusional proportions.

grandiose delusion A delusion of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person.

gustatory hallucination A hallucination involving the perception of taste (usually unpleasant).

H 

hallucination A sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ. Hallucinations should be distinguished from illusions, in which an actual external stimulus is misperceived or misinterpreted. The person may or may not have insight into the fact that he or she is having a hallucination. One person with auditory hallucinations may recognize that he or she is having a false sensory experience, whereas another may be convinced that the source of the sensory experience has an independent physical reality. The term hallucination is not ordinarily applied to the false perceptions that occur during dreaming, while falling asleep (hypnagogic), or when awakening (hypnopompic). Transient hallucinatory experiences may occur in people without a mental disorder.

hedonism Pleasure-seeking behavior. Contrast with anhedonia.

5-HIAA (5-hydroxyindoleacetic acid) A major metabolite of serotonin, a biogenic amine found in the brain and other organs. Functional deficits of serotonin in the central nervous system have been implicated in certain types of major mood disorders, and particularly in suicide and impulsivity.

hippocampus Olfactory brain; a sea-horse¾shaped structure located within the brain that is an important part of the limbic system. The hippocampus is involved in some aspects of memory, in the control of the autonomic functions, and in emotional expression.

hyperacusis Inordinate sensitivity to sounds; it may be on an emotional or an organic basis.

hypersomnia Excessive sleepiness, as evidenced by prolonged nocturnal sleep, difficulty maintaining an alert awake state during the day, or undesired daytime sleep episodes. ideas of reference The feeling that casual incidents and external events have a particular and unusual meaning that is specific to the person. This is to be distinguished from a delusion of reference, in which there is a belief that is held with delusional conviction

hypnagogic Referring to the semiconscious state immediately preceding sleep; may include hallucinations that are of no pathological significance.

hypnopompic Referring to the state immediately preceding awakening; may include hallucinations that are of no pathological significance.

I 

id In Freudian theory, the part of the personality that is the unconscious source of unstructured desires and drives. See also ego; superego.

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

ideas of reference Incorrect interpretations of casual incidents and external events as having direct reference to oneself. May reach sufficient intensity to constitute delusions.

identification 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.

idiot savant A person with gross mental retardation who nonetheless is capable of performing certain remarkable feats in sharply circumscribed intellectual areas, such as calendar calculation or puzzle solving.

illusion A misperception or misinterpretation of a real external stimulus, such as hearing the rustling of leaves as the sound of voices. See also hallucination.

imprinting A term in ethology referring to a process similar to rapid learning or behavioral patterning that occurs at critical points in very early stages of animal development. The extent to which imprinting occurs in human development has not been established.

inappropriate affect An affect type that represents an unusual affective expression that does not match with the content of what is being said or thought.

incoherence Speech or thinking that is essentially incomprehensible to others because words or phrases are joined together without a logical or meaningful connection. This disturbance occurs within clauses, in contrast to derailment, in which the disturbance is between clauses. This has sometimes been referred to as "word salad" to convey the degree of linguistic disorganization. Mildly ungrammatical constructions or idiomatic usages characteristic of particular regional or cultural backgrounds, lack of education, or low intelligence should not be considered incoherence. The term is generally not applied when there is evidence that the disturbance in speech is due to an aphasia.

incorporation A primitive defense mechanism, operating unconsciously, in which the psychic representation of a person, or parts of the person, is figuratively ingested.

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

indoleamine One of a group of biogenic amines (e.g., serotonin) that contains a five-membered, nitrogen-containing indole ring and an amine group within its chemical structure. inhibition Behavioral evidence of an unconscious defense against forbidden instinctual drives; may interfere with or restrict specific activities.

insomnia A subjective complaint of difficulty falling or staying asleep or poor sleep quality. Types of insomnia include:

initial insomnia Difficulty in falling asleep.

instinct An inborn drive. The primary human instincts include self-preservation, sexuality, and according to some proponents the death instinct, of which aggression is one manifestation.

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 A mental mechanism in which the person engages in excessive abstract thinking to avoid confrontation with conflicts or disturbing feelings.

intersex condition A condition in which an individual shows intermingling, in various degrees, of the characteristics of each sex, including physical form, reproductive organs, and sexual behavior.

introspection Self-observation; examination of one's feelings, often as a result of psychotherapy.

introversion Preoccupation with oneself and accompanying reduction of interest in the outside world. Contrast to extraversion.

isolation A defense mechanism operating unconsciously 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.

K

Klinefelter's syndrome Chromosomal defect in males in which there is an extra X chromosome; manifestations may include underdeveloped testes, physical feminization, sterility, and mental retardation.

koro  A culture specific syndrome of China involving fear of retraction of penis into abdomen with the belief that this will lead to death.

L

la belle indifférence Literally, "beautiful indifference." Seen in certain patients with conversion disorders who show an inappropriate lack of concern about their disabilities. labile Rapidly shifting (as applied to emotions); unstable.

labile affect An affect type that indicates abnormal sudden rapid shifts in affect.

latah A culture specific syndrome of Southeast Asia involving startle-induced disorganization, hypersuggestibility, automatic obedience, and echopraxia.

latent content The hidden (i.e., unconscious) meaning of thoughts or actions, especially in dreams or fantasies. In dreams, it is expressed in distorted, disguised, condensed, and symbolic form.

learned helplessness A condition in which a person attempts to establish and maintain contact with another by adopting a helpless, powerless stance.

lethologica Temporary inability to remember a proper noun or name.

libido The psychic drive or energy usually associated with the sexual instinct. (Sexual is used here in the broad sense to include pleasure and love-object seeking.)

locus coeruleus A small area in the brain stem containing norepinephrine neurons that is considered to be a key brain center for anxiety and fear.

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, contradictions, or illogicality of speech.

M 

macropsia The visual perception that objects are larger than they actually are.

magical thinking 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.

manifest content The remembered content of a dream or fantasy, as contrasted with latent content, which is concealed and distorted.

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 a prerequisite to sexual gratification. It is the converse of sadism, although the two tend to coexist in the same person.

memory consolidation The physical and psychological changes that take place as the brain organizes and restructures information that may become a permanent part of memory.

mental retardation A major group of disorders of infancy, childhood, or adolescence characterized by intellectual functioning that is significantly below average (IQ of 70 or below), manifested before the age of 18 by impaired adaptive functioning (below expected performance for age in such areas as social or daily living skills, communication, and self-sufficiency). Different levels of severity are recognized: an IQ level of 50/55 to 70 is Mild; an IQ level of 35/40 to 50/55 is Moderate; an IQ level of 20/25 to 35/40 is Severe; an IQ level below 20/25 is Profound.

MHPG (3-methoxy-4-hydroxyphenylglycol) A major metabolite of brain norepinephrine excreted in urine.

magical thinking The erroneous belief that one's thoughts, words, or actions will cause or prevent a specific outcome in some way that defies commonly understood laws of cause and effect. Magical thinking may be a part of normal child development.

micropsia The visual perception that objects are smaller than they actually are.

middle insomnia Awakening in the middle of the night followed by eventually falling back to sleep, but with difficulty.

mirroring 1) The empathic responsiveness of the parent to the developing child's grandiose-exhibitionistic needs. Parental expressions of delight in the child's activities signal that the child's wishes and experiences are accepted as legitimate. This teaches the child which of his or her potential qualities are most highly esteemed and valued. Mirroring validates the child as to who he or she is and affirms his or her worth. The process transforms archaic aims to realizable aims, and it determines in part the content of the self-assessing, self-monitoring functions and their relationships to the rest of the personality. The content of the superego is the residue of the mirroring experience. 2) A technique in psychodrama in which another person in the group plays the role of the patient, who watches the enactment as if gazing into a mirror. The first person may exaggerate one or more aspects of the patient's behavior. Following the portrayal, the patient is usually encouraged to comment on what he or she has observed.

mood A pervasive and sustained