Psychiatry Clerkship

Glossary

A
ADAPTIVE BEHAVIOR
Ability to conduct one's total activity in accordance with one's environment.
AFFECT
An immediately expressed and observed emotion. A feeling state becomes an affect when it is observable, for example, as overall demeanor or tone and modulation of voice. Affect is to be distinguished from mood, which refers to a pervasive and sustained emotion. Common examples of affect are euphoria, anger, and sadness.
A range of affect may be described as broad (normal), restricted (constricted), blunted, or flat. The normal expression of affect involves variability in facial expression, pitch of voice, and the use of hand and body movements. Restricted affect is characterized by a clear reduction in the expressive range and intensity of affects. Blunted affect is market by a severe reduction in the intensity of affective expression. In flat affect there is a lack of signs of affective expression: the voice may be monotonous and the face, immobile.
Affect is inappropriate when it is clearly discordant with the content of the person's speech or ideation.
Affect is labile when it is characterized by repeated, rapid, and abrupt shifts. Example: An elderly man is tearful one moment and combative the next.
AFFECTIVE DISORDERS
Behavior disturbances characterized principally by increased or decreased activity and thought expressive of a predominating mood of depression or elation. Although at times conspicuous, the behavioral change is seldom bizarre.
AGITATION
See psychomotor agitation.
AGORAPHOBIA
Marked fear of leaving the familiar setting of the home. ANHEDONIA - Inability to experience pleasure.
ANXIETY
Apprehension, tension, or uneasiness that stems from the anticipation of danger, which may be internal or external. Anxiety may be focused on an object, situation, or activity which is avoided (phobia), or may be unfocused (free-floating anxiety). It may be experienced in discrete periods of sudden onset and be accompanied by physical symptoms (panic attacks). When anxiety is focused on physical signs or symptoms and causes preoccupation with the fear or belief of having disease, it is termed hypochondriasis.
ARTHUR ADAPTATION OF THE LEITER
Non-verbal test suitable for testing children between the ages of 3 and 8 or adults at those mental ages. Scores yield mental age (MA) and intelligence quotient (10).
ATTENTION
Ability to focus in a sustained manner on one task or activity. A disturbance in attention may be manifested by difficulty in finishing tasks that have been started, easy distractibility, and/or difficulty in concentrating on work.
AUTONOMIC HYPERACTIVITY
Sweatiness, goosebumps, palpitations not caused by external stimuli.

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B
BIPOLAR SYNDROME
A major affective disorder. The individual shifts between manic and depressive symptoms. Similar to a cyclothymic disorder (see), but more intense.
BLOCKING
Interruption of a train of speech before a thought or idea has been completed.
C
CATATONIC BEHAVIOR
Marked motor anomalies, generally limited to disturbances in the context of a diagnosis of a non-organic psychotic disorder. Motor anomalies include excitement, negativism, rigidity, posturing, stupor, and "waxy flexibility."
CIRCUMSTANTIALITY
A term used to describe speech that is indirect and delayed in reaching the point because of unnecessary, tedious details, and parenthetic remarks.
COGNITIVE ABILITIES
Refers to the mental abilities for comprehension, judgment, memory and reasoning as contrasted to emotional and volitional processes.
COMPULSION
Repetitive and seemingly purposeful behavior that is performed according to certain rules or in a stereotyped fashion. The behavior is not an end in itself, but is designed to produce or prevent some future state of affairs; the activity, however, either is not connected in a realistic way with the state of affairs it is designed to produce or prevent, or it may be clearly excessive. The act is performed with a sense of subjective compulsion coupled with a desire to resist it (at least initially); performing the particular act may not be pleasurable, although it may afford some relief of tension. Seen in obsessive compulsive disorder and schizophrenia.
CONVERSION SYMPTOM
A loss or alteration of physical functioning that suggests a physical disorder but that is actually a direct expression of a psychological conflict or need.
CYCLOTHMYIC DISORDER
A personality disorder characterized by alternating moods of cheerfulness, vivacity and mild depression.

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D
DECOMPENSATION
Exacerbation of signs and symptoms following an individual's unsuccessful attempt to adapt to stressful circumstances.
DELUSION
A false personal belief based on incorrect inference about external reality and firmly sustained in spite of what almost everyone else believes and in spite of what constitutes incontrovertible and obvious proof of evidence to the contrary.
DELUSION OF REFERENCE
A delusion whose theme is that events, objects, or the people in the person's immediate environment have a particular and unusual significance, usually of a negative or pejorative nature.
DEMENTIA
Deterioration (due to organic brain syndrome) from a previous level of intellectual functioning involving personality change and resulting in impairment of memory, abstract thinking, judgment and impulse control. Clouding of consciousness does not occur. May be chronic or acute and reversible or irreversible.
DEPERSONALIZATION
An alteration in the perception or experience of the self so that the feeling of one's own reality is temporarily lost. Manifested by a sense of being outside one's own body, or that parts of the body are very large, very small, or not under one's control, etc. Seen in various psychiatric disorders and also in the absence of any mental disorder in the presence of overwhelming anxiety, stress or fatigue.
DEPRESSION
A mood, often described as sad, hopeless, discouraged or as an inability to experience pleasure.
DISORIENTATION
Confusion about the date or time of day, where one is (place), or who one is (identity).
DISTRACTIBILITY
Attention drawn too frequently to unimportant or irrelevant external stimuli. Example: While being interviewed, a subject's attention is repeatedly drawn to noise from an adjoining office, a book that is on a shelf or the interviewer's school ring.
DYSTHYMIC DISORDER
See "Depressive Neurosis"

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EF
FLIGHT OF IDEAS
A nearly continuous flow of accelerated speech with abrupt changes from topic to topic, usually based on understandable associations, distracting stimuli, or plays on words. When severe, the speech may be disorganized and incoherent.
FUNCTIONAL DISORDER
A broad class of mental impairments that cannot be traced to an organic or physical origin.
G
GRANDIOSITY
An inflated appraisal of one's worth, power, knowledge, importance, or identity. When extreme, grandiosity may be of delusional proportions. Example: A professor who frequently puts his students to sleep with his boring lectures is convinced that he is one of the more dynamic and exciting teachers at the university.
H
HALLUCINATION
A sensory perception without external stimulation of the relevant sensory organ. Hallucination, auditory - A hallucination of sound, most commonly of voices, but sometimes of clicks, rushing noises, music, etc. Hallucination, visual - A hallucination involving sight, which may consist of formed images, such as of people, or of unformed images, such as flashes of light. Visual hallucinations should be distinguished from illusions, which are misperceptions of real external stimuli.
HALSTEAD-REITAN
A comprehensive battery of psychological tests which demonstrate cognitive and motor abilities.
HYPOCHONDRIASIS
Unrealistic interpretation of physical signs or sensations as abnormal, leading to preoccupation with the fear or belief of having a disease

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.
I
IDEA OF REFERENCE
An idea, held less firmly than a delusion, that events, objects, or other people in the person's immediate environment have a particular and unusual meaning specifically for him or her. See also "delusion of reference."
ILLOGICAL THINKING
Thinking that contains clear internal contradictions or in which conclusions are reached that are clearly erroneous, given the initial premises.
INSIGHT
Refers to the extent to which the patient is aware he is ill, recognizes the nature of the illness and understands the dynamic factors involved in producing the illness.
INSOMNIA
Difficulty falling or staying asleep.
JK
JUDGMENT
The ability to compare facts and ideas, understand their relations and draw correct conclusions from them. This ability is evaluated during psychiatric examination for evidence of impairment.
L
LABILITY
(See also AFFECT.) Emotional instability with rapid shift in mood or affect; e.g. sudden, unexpected crying.
LEITER INTERNATIONAL PERFORMANCE SCALE (LIPS/LIS)
A non-verbal matching or grouping test which is arranged in levels to indicate years of accomplishment. Scores yield MA and 10. LURIA -NEBRASKA - A comprehensive battery of psychological tests which demonstrate cognitive and motor abilities.
LOOSENING OF ASSOCIATIONS
Thinking characterized by speech in which ideas shift from one subject to another that is completely unrelated or only obliquely related without the speaker's showing any awareness that the topics are unconnected.

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M
MANIC SYNDROME
Characterized by a predominant mood which is either elevated, expansive or irritable. Includes symptoms such as hyperactivity, pressure of speech, flight of ideas, inflated self esteem, decreased need for sleep, distractibility, and excessive involvement in activities that have a high potential for painful consequences, which is not recognized. MARKED - Where "marked" is used as a standard for measuring the degree of limitation, it means more than moderate, but less than extreme. A marked limitation may arise when several activities or functions are impaired or even when only one is impaired, so long as the degree of limitation is such as to seriously interfere with the ability to function independently, appropriately and effectively.
MENTAL RETARDATION
Insufficient intellectual capacity (due to genetic endowment, disease or injury) to cope with environmental demands resulting in the inability to establish an independent social existence.
MINNESOTA MULTIPHASIC PERSONALITY INVENTORY (MMPI)
A verbal response test concerning behavior, feelings, social attitudes and symptoms of psychopathology. Used to establish diagnostic groups and personality types.
MOOD
A pervasive and sustained emotion that in the extreme, markedly colors the person's perception of the world. Mood is to affect as climate is to weather.

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NO
NEUROLEPTICS
A class of psychotropic drugs which modify psychotic behavior in general. They have become the major therapeutic agents in treating schizophrenia with the capacity to modify affective states without seriously impairing cognitive functioning.
OBSESSIONS
Recurrent, persistent ideas, thoughts, images, or impulses that are ego-dystonic, that is, they are not experienced as voluntarily produced, but rather as ideas that invade consciousness.
ORGANIC MENTAL DISORDER
A type of organic bran syndrome in which the etiology is known or presumed involving a psychological or behavioral abnormality associated with transient or permanent dysfunction of the brain.

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P
PARANOID DISORDERS
A group of psychotic disorders characterized by delusions of grandeur and persecution, suspiciousness, hypersensitivity, hyperalertness, jealousy, guardedness, resentment, humorlessness, litigiousness (tending to engage in lawsuits) and sullenness.
PARANOID IDEATION
Ideation, of less than delusional proportions, involving suspiciousness or the belief that one is being harassed, persecuted, or unfairly treated.
PERSONALITY DISORDER
Implies inflexible and maladaptive patterns of sufficient severity to cause either significant impairment in adaptive functioning or subjective distress.
PHOBIA
A persistent, irrational fear of a specific object, activity, or situation that results in a compelling desire to avoid the dreaded object, activity, or situation (the phobic stimulus).
POVERTY OF CONTENT OF SPEECH
Speech that is adequate in amount but conveys little information because of vagueness, empty repetitions, or use of stereotyped or obscure phrases.
POVERTY OF SPEECH
Restriction in the amount of speech, so that spontaneous speech and replies to questions are brief and unelaborated. When the condition is marked, replies may be monosyllabic, and some questions may be unanswered.
PRESSURE OF SPEECH
Speech that is increased in amount, accelerated, and difficult or impossible to interrupt. Usually it is also loud and emphatic. Frequently, the individual talks without any social stimulation and may continue to talk even though no one is listening.
PSYCHOGENIC
Of emotional or mental origin. Used to describe the etiology of symptoms that cannot be traced through examination and testing to any physical abnormality.
PSYCHOGENIC PAIN DISORDER
Characterized by complaints of pain, not associated with signs of physical illness and with evidence of psychological disturbance.
PSYCHOMOTOR AGITATION
Excessive motor activity associated with a feeling of inner tension; the activity is usually nonproductive and repetitious. When the agitation is severe, it may be accompanied by shouting or loud complaining. Examples: Inability to sit still, pacing, wringing of hands, pulling at clothes.
PSYCHOMOTOR RETARDATION
Visible generalized slowing down of physical reactions, movements, and speech.
PSYCHOTIC
A term indicating gross impairment in reality testing. It may be used to describe the behavior of an individual at a given time, or a mental disorder in which at some time during its course all individuals with the disorder have grossly impaired reality testing.

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QR
RAVEN PROGRESSIVE MATRICES
A verbal intelligence test. It uses abstract designs which must be completed by the participants.
RORSCHACH
A verbal response test of ten inkblots used to obtain a picture of the participant's personality to aid in diagnosis and prognosis.
S
SCHIZOPHRENIA
A group of disorders of differing etiologies with certain psychotic features during the active phase of the illness such as delusions, hallucinations and incoherence. Onset is usually before age 45, a deterioration from previous level of social and occupational functioning is noted and duration continues for at least six months.
SENSORIUM
The functional state of the special senses, especially as related to the condition of consciousness.
SOMATOFORM DISORDERS
Physical symptoms of several years duration of psychic, mental, or emotional origin, which have no known demonstrable organic basis but which have caused the individual to take medicine frequently, seek medical treatment and alter life patterns.
SYNDROME
A grouping of symptoms that occur together and that constitute a recognizable condition.

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T
TESTS
See specific tests:
Arthur Adaptation of the Leiter
Halstead-Reitan
Leiter International Performance Scale LIPS/LIS)
Luria -Nebraska
Minnesota Multiphasic Personality Inventory (MMPI)
Raven Progressive Matrices
Rorschach
Thematic Apperception Test (TAT)
Wechsler Adult Intelligence Scale (WAIS)
WAIS - R
THEMATIC APPERCEPTION TEST (TAT)
A verbal response test wherein the participants tell stories of pictures shown to them. It focuses primarily on interpersonal relationships and is a diagnostic tool.
THOUGHT DISORDER
Any disturbance of thinking that affects language, communication, thought content or thought process.
UVW
VIGILANCE AND SCANNING
Increased watchfulness with visual examining of a small or isolated area.
WAIS - R
An updated (copyright 1981) revised version of the WAIS.
WECHSLER ADULT INTELLIGENCE SCALE (WAIS)
A verbal and performance test of several parts which measures IQ and MA in three different scoring yields.

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