In psychiatry, dissociation is defined as an unconscious defense mechanism involving the segregation of any group of mental or behavioral processes from the rest of the person’s psychic activity

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Dissociative Disorders                                                          

In psychiatry, dissociation is defined as an unconscious defense mechanism involving the segregation of any group of mental or behavioral processes from the rest of the person’s psychic activity. Dissociative disorders involve this mechanism so that there is a disruption in one or more mental functions, such as memory, identity, perception, consciousness, or motor behavior. The disturbance may be sudden or gradual,

transient or chronic, and the signs and symptoms of the disorder are often caused by psychological trauma.

DISSOCIATIVE AMNESIA :  The main feature of dissociative amnesia is an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness. The disorder does not result from the direct physiological effects of a substance or a neurological or other general medical condition.

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Etiology

In many cases of acute dissociative amnesia, the psychosocial environment out of which the amnesia develops is massively conflictual, with the patient experiencing intolerable emotions of shame, guilt, despair, rage, and desperation. Traumatic experiences such as physical or sexual abuse can induce the disorder.

 Differential Diagnosis of Dissociative Amnesia:

  • Ordinary Forgetfulness and Nonpathological Amnesia
  • Dementia, Delirium, and Amnestic Disorders due to Medical Conditions.
  • Posttraumatic Amnesia.
  • Seizure Disorders. .
  • Substance-Related Amnesia. .
  • Transient Global Amnesia.

Course and Prognosis : Acute dissociative amnesia frequently spontaneously resolves once the person is removed to safety from traumatic or overwhelming circumstances. At the other extreme, some patients do develop chronic forms of generalized, continuous, or severe localized amnesia and are profoundly disabled and require high levels of social support .

Treatment :

Cognitive Therapy. Cognitive therapy may have specific benefits for individuals with trauma disorders. Identifying the specific cognitive distortions that are based in the trauma may provide an access into autobiographical memory for which the patient experiences amnesia.

Hypnosis.   Hypnotic interventions can be used to facilitate controlled recall of dissociated memories; to provide support and ego strengthening for the patient; and, finally, to promote working through and integration of dissociated material.

Pharmacologically facilitated interviews using intravenous amobarbital or diazepam (Valium) are used primarily in working with acute amnesias.

 

DEPERSONALIZATION/DEREALIZATION DISORDER : Depersonalization is defined as the persistent or recurrent feeling of detachment or estrangement from one’s self. The individual may report feeling like an automaton or watching himself or herself in a movie . Derealization is somewhat related and refers to feelings of unreality or of being detached from one’s environment. The patient may describe his or her perception of the outside world as lacking lucidity and emotional coloring, as though dreaming or dead .

Transient experiences of depersonalization and derealization are extremely common in normal and clinical populations. They are the third most commonly reported psychiatric symptoms, after depression and anxiety.

Diagnosis and Clinical Features

A number of distinct components comprise the experience of depersonalization, including a sense of (1) bodily changes, (2) duality of self as observer and actor, (3) being cut off from others, and (4) being cut off from one’s own emotions. Patients experiencing depersonalization often have great difficulty expressing what they are feeling. Trying to express their subjective suffering with banal phrases, such as “I feel

dead,” “Nothing seems real,” or “I’m standing outside of myself,”  .

Course and Prognosis

Depersonalization after traumatic experiences or intoxication commonly remits spontaneously after removal from the traumatic circumstances or ending of the episode of intoxication. Depersonalization accompanying mood, psychotic, or other anxiety disorders commonly remits with definitive treatment of these conditions.

Depersonalization disorder itself may have an episodic, relapsing and remitting, or chronic course. Many patients with chronic depersonalization may have a course characterized by severe impairment in occupational, social, and personal functioning. Mean age of onset is thought to be in late adolescence or early adulthood in most cases.

Treatment: SSRI antidepressants, such as fluoxetine (Prozac), may be helpful to patients with depersonalization disorder.

 

DISSOCIATIVE FUGUE : Dissociative fugue was deleted as a major diagnostic category in DSM-5 and is now diagnosed on a subtype  of dissociative amnesia. Dissociative fugue can be seen in patients with both dissociative amnesia and dissociative identity disorder.   Dissociative fugue is described as sudden, unexpected travel away from home or one’s customary place of daily activities, with inability to recall some or all of one’s past. This is accompanied by confusion about personal identity or even the assumption of a new identity. The disturbance is not due to the direct physiological effects of a substance or a general medical condition. The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Etiology

Traumatic circumstances (i.e., combat, rape, recurrent childhood sexual abuse, massive social dislocations, natural disasters), leading to an altered state of consciousness dominated by a wish to flee, are the underlying cause of most fugue episodes. The disorder is thought to be more common during natural disasters, wartime, or times of major social dislocation and violence.

Course and Prognosis

Most fugues are relatively brief, lasting from hours to days. Most individuals appear to recover, although refractory dissociative amnesia may persist in rare cases.

Treatment

Dissociative fugue is usually treated with psychodynamically oriented psychotherapy that focuses on helping the patient recover memory for identity and recent experience. Hypnotherapy and pharmacologically facilitated interviews are frequently necessary adjunctive techniques to assist with memory recovery.

 

DISSOCIATIVE IDENTITY DISORDER : Dissociative identity disorder (previously called multiple personality disorder ) is characterized by the presence of two or more distinct identities or personality states. The identities or personality states differ from one another in that each presents as having its own pattern of perceiving, relating to, and thinking about the environment and self, in short, its own personality.

Etiology : Dissociative identity disorder is strongly linked to severe experiences of early childhood trauma, usually maltreatment. Physical and sexual abuse are the most frequently reported sources of childhood trauma.

 

OTHER SPECIFIED OR UNSPECIFIED DISSOCIATIVE DISORDER

The category of dissociative disorder covers all of the conditions characterized by a primary dissociative response that do not meet diagnostic criteria for one of the other DSM-5 dissociative disorders.

Dissociative Trance Disorder

Dissociative trance disorder is manifest by a temporary, marked alteration in the state of consciousness or by loss of the customary sense of personal identity without the replacement by an alternate sense of identity. In this possessed state, the individual exhibits stereotypical and culturally determined behaviors or experiences being controlled by the possessing entity. There must be partial or full amnesia for the event. The trance or possession state must not be a normally accepted part of a cultural or religious practice and must cause significant distress or functional impairment in one or more of the usual domains. Finally, the dissociative trance state must not occur exclusively during the course of a psychotic disorder and is not the result of any substance use or general medical condition.

Brainwashing : DSM-5 describes this dissociative disorder as “identity disturbance due to prolonged and intense coercive persuasion. It implies that under conditions of adequate stress and duress, individuals can be made to comply with the demands of those in power, thereby undergoing major changes in their personality, beliefs, and behaviors. Persons subjected to such conditions can undergo considerable harm, including loss of health and life, and they typically manifest a variety of posttraumatic and dissociative symptoms.

Ganser Syndrome :  Found in prisoners and  characterized by the giving of approximate answers (paralogia) together with a clouding of consciousness and is frequently accompanied by hallucinations and other dissociative, somatoform, or conversion symptom.

Abstract Thinking
Thinking characterized by the ability to grasp the essentials of a whole, to break a whole into its parts, and to discern common properties. To think symbollically.
Acting Out

Behavioral 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 were the situation that originally gave rise to the drive or impulse.

 

Common in borderline states.

Affect

The subjective and immediate experience of emotion attached to ideas or mental representations of objects.

 

Affect has outward manifestations that can be classified as: restricted, blunted, flattened, broad, labile, appropriate, or inappropriate.

Agitation
Severe anxiety associated with motor restlessness.
Agoraphobia

Morbid fear of open places or leaving the familiar setting of the home.

 

May be present with or without panic attacks.

Akathisia

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.

 

May be mistaken for psychotic agitation.

Anhedonia

Loss of interest in, and withdrawal from, all regular and pleasurable activities.

 

Often associated with depression.

Anorexia

Loss or decrease in appetite. In anorexia nervosa, appetite may be preserved, but the patient refuses to eat.

Apathy

Dulled emotional tone associated with detachment or indifference.

 

Observed in certain types of schizophrenia and depression.

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 draw two-or-three-dimensional forms.

Ataxia

Lack of coordination, physical or mental.

 

1) In neurology, refers to loss of muscular coordination.

2) In psychiatry, term “intrapsychic ataxia” refers to lack of coordination b/t feelings & thoughts.

 

Seen in schizophrenia, severe OCD.

Atonia
Lack of muscle tone.
Auditory Hallucination

False perception of sound, usually voices, but also other noises, such as music.

 

This is the most common hallucination in psychiatric disorders.

Aura

1) Warning sensations, such as automatisms, fullness in the stomach, blushing, and changes in respiration; cognitive sensations & mood states usually experienced before a seizure.

 

2) A sensory prodrome that precedes a classic migraine headache.

Bizarre Delusion

False belief that is patently absurd or fantastic (e.g., invaders from space have implanted electrodes in a person’s brain).

 

Common in schizophrenia.

 

In “nonbizarre delusions,” content is usually within the realm of possibility.

Blackout
Amnesia experienced by alcoholics about behavior during drinking bouts; usually indicates reversible brain damage.
Blocking

Abrupt interruption in train of thinking before a thought ot idea is finished; after a brief pause, the person indicates no recall of what was being said or was going to be said.

 

Also known as “thought deprivation” or “increased thought latency.”

 

Common in schizophrenia and severe anxiety.

Blunted Affect

Disturbance of affect manifested by a severe reduction in the intensity of externalized feeling tone.

 

One of the fundamental symptoms of schizophrenia, as outlined by Eugen Bleuler.

Bruxism

Grinding or gnashing of the teeth, typically occurring during sleep.

 

Seen in anxiety disorder.

Cataplexy

Temporary sudden loss of muscle tone, causing weakness and immobilization; can be precipitated by a variety of emotional states and is often followed by sleep.

 

Commonly seen in narcolepsy.

Circumstantiality

Disturbance in the associative thought and speech processes in which a patient digresses into unnecessary details & inappropriate thoughts before communicating the central idea.

 

Observed in schizophrenia, obsessional disturbances, & certain cases of dementia.

Coma

State of profound unconsciousness from which a person cannot be roused, with minimal or no detectable responsiveness to stimuli.

Seen in injury or disease of the brain, in systemic conditions (diabetes ketoacidosis & uremia) and intoxiations with alcohol and other drugs.

Coma can also occur in severe catatonic states and in conversion disorder.

Command Hallucination
False perception of orders that a person may feel obliged to obey or unable to resist.
Concrete Thinking
Thinking characterized by actual things, events, & immediate experience, rather than by abstractions; seen in young children, in those who have lost or never developed the ability to generalize (as in certain cognitive mental disorders), and in schizophrenia patients.
Confabulation

Unconscious filling of gaps in memory by imagining experiences or events that have no basis in fact; should be differentiated from lying.

 

Commonly seen in amnestic syndromes.

Constricted Affect
Reduction in intensity of feeling tone that is less severe than that of blunted affect.
Constructional Apraxia

Inability to copy a drawing, such as a sube, clock, or pentagon, as a result of brain lesion (also seen in some dementias).

Decompensation

Deterioration of psychic functioning caused by a breakdown of defense mechanisms.

 

Seen in psychotic states.

Delirium
Acute reversible mental disorder characterized by confusion & some impairment of consciousness; generally associated with emotional lability, hallucinations, or illusions, and inappropriate, impulsive, irrational, or violent behavior.
Delirium Tremens

Acute & sometimes fatal reaction to withdrawal from alcohol, usually occuring in the first 72-96 hours after the cessation of heavy drinking; distinctive characteristics are marked autonomic hyperactivity (tachycardia, fever, hyperhidrosis, dilated pupils), usually accompanied by tremulousness, hallucinations, illusions & delusions.

 

Called “alcohol withdrawal delirium” in DSM-IV-TR.

Delusion
False 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
False belief that a person’s will, thoughts, or feelings are being controlled by external forces.
Delusion of Grandeur
Exaggerated conception of one’s ideas, importance, power, or identity.
Delusion of Persecution

False belief of being harassed or persecuted; often found in litigious patients who have a pathological tendency to take legal action because of imagined mistreatment.

 

Most common delusion.

Delusion of Reference
False belief that the behavior of others refers to oneself or that events, objects, or other people have a particular & unusual significance, usually of a negative nature; derived from idea of reference, in which persons falsely feel that others are talking about them (e.g., belief that people on TV or radio are talking about to or about the person).
Dementia
Mental disorder characterized by general impairment in intellectual functioning without clouding of consciousness; characterized by failing memory, difficulty with calculations, distractibility, alterations in mood & affect, impaired judgment & abstraction, reduced facility with language, & disturbance of orientation. Although irreversible because of underlying degenerative brain disease, dementia may be reversible if the cause can be treated.
Denial
Defense mechanism in which the existence of unpleasant realities is disavowed; refers to keeping out of conscious awareness any aspects of external reality that, if acknowledged, would produce anxiety.
Depersonalization

Sensation of unreality concerning oneself, parts of oneself, or one’s environment that occurs under extreme stress or fatigue.

 

Seen in schizophrenia, depersonalization disorder, & schizotypal personality disorder.

Depression

Mental state characterized by feelings of sadness, loneliness, despair, low self-esteem, & self-reproach; accopmanying signs include psychomotor retardation or, at times, agitation, withdrawal from interpersonal contact, and vegetative symptoms, such as insomnia and anorexia.

 

The term refers to a mood that is so characterized or to a mood disorder.

Derailment
Gradual or sudden deviation in train of thought without blocking; sometimes used synonymously with “loosening of association.”
Detachment
Characterized by distant interpersonal relationships and lack of emotional involvement.
Disinhibition

1) removal of an inhibitory effect, as in the reduction of the inhibitory function of the cerebral cortex by alcohol;

2) In psychiatry, a greater freedom to act in accordance with inner drives or feelings and with less regard for restraints dictated by cultural norms or one’s superego.

Dissociation

Unconscious defense mechanism involving the segregation of any group of mental or behavioral processes from the rest of the person’s 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.

Dysarthria
Difficulty in articulation, the motor activity of shaping phonated sounds into speech, not in word finding or in grammar.
Dyskinesia

Difficulty in performing movements.

 

Seen in extrapyramidal disorders.

Dysphoria

Feeling of unpleasantness or discomfort; a mood of general dissatisfaction and restlessness.

 

Occurs in depression and anxiety.

Dystonia

Extrapyramidal motor disturbance consisting of slow, sustained contractions of the axial or appendicular musculature; one movement often predominates, leading to relatively sustained postural deviations.

 

Acute dystonic reactions (facial grimacing and torticollis) are occasionally seen with the initiation of antipsychotic drug therapy.

Echolalia

Psychopathological repeating of words or phrases of one person by another; tends to be repetitive and persistent.

 

Seen in certain kinds of schizophrenia, particularly the catatonic types.

Egocentric
Self-centered; selfishly preoccupied with one’s own needs; lacking interest in others.
Elevated Mood
Air of confidence and enjoyment; a mood more cheerful than normal but not necessarily pathological.
Emotional Lability
Excessive emotional responsiveness characterized by unstable and rapidly changing emotions.
Encopresis
Involuntary passage of feces, usually occuring at night or durring sleep.
Enuresis
Incontinence of urine during sleep.
Euphoria

Exaggerated feeling of well-being that is inappropriate to real events.

 

Can occur with drugs such as opiates, amphetamines, and alcohol.

Euthymia
Normal range of mood, implying absence of elevated or depressed mood.
Evasion

Act of not facing up to, or strategically eluding, something; consists of suppressing an idea that is next in a thought series and replacing it with another idea closely related to it.

 

Also called paralogia and perverted logic.

False Memory
A person’s recollection and belief of an event that did not actually occur. In false memory syndrome, person’s erroneously believe that they sustained an emotional or physical (e.g., sexual) trauma early in life.
Flat Affect
Absence or near absence of any signs of affective expression.
Flight of Ideas

Rapid succession of fragmentary thoughts or speech in which content changes abruptly and speech may be incoherent.

 

Seen in mania.

Formication

Tactile hallucination involving the sensation that tiny insects are crawling over the skin.

 

Seen in cocaine addiction and delirium tremens.

Galactorrhea
Abnormal discharge of milk from the breast; may result from the endocrine influence (e.g., prolactin) of dopamine receptor antagonists, such as phenothiazines.
Grandiosity

Exaggerated feelings of one’s importance, power, knowledge, or identity.

 

Occurs in delusional disorder and manic states.

Gynecomastia
Female-like development of the male breasts; can occur as an adverse effect of antipsychotic and antidepressant drugs because of prolactin levels or anabolic-androgenic steroid abuse.
Hallucination
False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved. There are different types of hallucinations (see specific terms listed).
Hyperactivity

Increased muscular activity. The term is commonly used to describe a disturbance found in children that is manifested by constant restlestness, overactivity, distractibility, and difficulties in learning.

 

Seen in ADHD.

Hyperesthesia
Increased sensitivity to tactile stimulation.
Hypersomnia
Excessive time spent asleep. Can be associated with underlying medical or psychiatric disorder or narcolepsy, can be part of Kleine-Levin syndrome, or may be primary.
Hypervigilance

Excessive attention to, and focus on, all internal and external stimuli.

 

Usually seen in delusional or paranoid states.

Hypochondria
Exaggerated concern about health that is based not on real medical pathology, but on unrealistic interpretations of physical signs or sensations as abnormal.
Hypomania

Mood abnormality with the qualitative characteristics of mania, but somewhat less intense.

 

Seen in cyclothymic disorder.

Idea of Reference
Misinterpretation of incidents and events in the outside world as having direct personal reference to oneself; occasionally observed in normal persons, but frequently seen in paranoid patients. If present with sufficient frequency or intensity or if organized and systematized, they constitute delusions of reference.
Illusion

Perceptual misinterpretation of a real external stimulus.

 

(Compare with hallucination)

Impaired Insight
Diminished ability to understand the objective reality of a situation.
Impaired Judgment
Diminished ability to understand a situationcorrectly and to act appropriately.
Impulse Control
Ability to resist an impulse, drive, or temptation to perform some action.
Insight
Conscious recognition of one’s own condition. In psychiatry, it refers to the conscious awareness and understanding of one’s own psychodynamics and symptoms of maladaptive behavior; highly important in effecting changes in the personality and behavior of a person.
Insomnia
Difficulty in falling asleep or difficulty in staying asleep. It can be related to a mental disorder, a physical disorder, or an adverse effect of medication; or it can be primary (not related to a known medical factor or another mental disorder).
Intoxication
Mental 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. The most common psychiatric changes involve disturbances of perception, wakefulness, attention, thinking, judgment, emotional control, and psychomotor behavior; the specific clinical picture depends on the substance ingested.
Irritability
Abnormal or excessive excitability, with easily triggered anger, annoyance, or impatience.
Judgment
Mental act of comparing or evaluating choices within the framework of a given set of values for the purpose of electing a course of action. If the course of action chosen is consonant with reality or with 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 frankly maladaptive, results from impulsive decisions based on the need for immediate gratification, or is otherwise not consistent with reality (as mea
Labile Affect
Affective expression characterized by rapid and abrupt changes, unrelated to external stimuli.
Loosening of Associations

Characteristic schizophrenia thinking or speech disturbance involving a disorder in the logical progfression of thoughts, manifested as a failure to communicate verbally adequately; unrelated and unconnected ideas shift from one subject to another.

 

See also tangentiality.

Magical Thinking
A form of dereistic thought; thinking similar to that of the preoperational phase in children (Jean Piaget), in which thoughts, words or actions assume power (e.g., to cause or to prevent events).
Malingering
Feigning disease to achieve a specific goal, for example, to avoid an unpleasant responsibility.
Mania

Mood state characterized by elation, agitation, hyperactivity, hypersexuality, and accelerated thinking and speaking (flight of ideas).

 

Seen in Bipolar I disorder.

Mental Retardation
Subaverage general illectual functioning that originates in the developmental period and is associated with impaired maturation and learning, and social maladjustment. Retardation is commonly defined in terms of IQ: mild is 50-55 to 70; moderate is 35-40 to 50-55; severe is 20-25 to 35-40; and profound is below 20-25.
Mood
Pervasive and sustained feeling tone that is experienced internally and that, in the extreme, can markedly influence virtually all aspects of a person’s behavior and perception of the world. Distinguished from affect, the external expression of the internal feeling tone.
Motor Aphasia

Aphasia in which understanding is intact, but the ability to speak is lost.

 

Also called Broca’s, expressive, or nonfluent aphasia.

Mydriasis
Dilation of the pupil; sometimes occurs as an autonomic (anticholinergic) or atropine-like 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, when the child has not differentiated the self from the outside world, and all sources of pleasure are unrealistically recognized as coming from within the self, giving the child a false sense of omnipotence; secondary narcissism, when the libido, once attached to external love objects, is redirected back to the self.
Neologism
New word or phrase whose derivation cannot be understood; often seen in schizophrenia. It has also been used to mean a word that is incorrectly constructed but whose origins are nonetheless understandable (e.g., headshoe to mean hat) but such constructions are more properly referred to as word approximations.
Obsession
Persistent and recurrent idea, thought, or impulse that cannot be eliminated from consciousness by logic or reasoning; obsessions are involuntary and ego-dystonic.
Olfactory Hallucination
Hallucination primarily involving smell or odors; most common in medical disorders, especially in the temporal lobe.
Orientation
State of awareness of oneself and one’s surroundings in terms of time, place, and person.
Panic
Acute, intense attack of anxiety associated with personality disorganization; the anxiety is overwhelming and accompanied by feelings of impending doom.
Paranoia
Rare psychiatric syndrome marked by the gradual development of a highly elaborate and complex delusional system, generally involving persecutory or grandiose delusions delusions, with few other signs of personality disorganization or thought disorder.
Paranoid Delusions
Includes persecutory delusions and delusions of reference, control and grandeur.
Paranoid Ideation
Thinking dominated by suspicious, persecutory, or grandiose content of less than delusional proportions.
Perseveration

1) Pathological repetition of the same response to different stimuli, as in a repetition of the same verbal response to different questions; 2) Persistent repetition of specific words or concepts in the process of speaking.

 

Seen in cognitive disorders, schizophrenia, and other mental illness.

Phobia
Persistent, pathological, unrealistic, intense fear of an object or situation; the phobic person may realize the fear is irrational but, nonetheless, cannot dispel it.
Pica
Craving and eating of nonfood substances, such as paint and clay.
Positive Signs
In schizophrenia: hallucinations, delusions, and thought disorder.
Poverty of Content of Speech
Speech that is adequate in amount, but conveys little information because of vagueness, emptiness, or stereotyped phrases.
Poverty of Speech
Restriction in the amount of speech used; replies may be monosyllabic.
Preoccupation of Thought
Centering of thought sontent on a particular idea, associated with 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, schizophrenia, and cognitive disorders.
Projection
Unconscious defense mechanism in which persons attribute to another those generally unconscious ideas, thoughts, feelings, and impulses that are in themselves undesirable or unacceptable as a form of protection form anxiety arising from an inner conflict; by externalizing whatever is unacceptable, they deal with itas a situation apart from themselves.
Psychomotor Agitation
Physical and mental overactivity that is usually nonproductive and is associated with a feeling of inner turmoil, as seen in agitated depression.
Psychosis
Mental disorder in which the thoughts, affective response, ability to recognize reality, and ability to communicate and relate to others are sufficiently impaired to interfere grossly with the capacity to deal with reality; the classic characteristics of psychosis are impaired reality testing, hallucinations, delusions, and illusions.
Psychotic
1) Person experiencing psychosis. 2) Denoting or characteristic of psychosis.
Rationalization
An unconscious defense mechanism in which irrational or unacceptable behavior, motives, or feelings are logically justified or made consciously tolerable by plausible means.
Recall
Process of bringing stored memories into consciousness.
Recent Memory
Recall of events over the past few days.
Regression
Unconscious defense mechanism in which a person undergoes a partial or total return to earlier patterns of adaptation; observed in many psychiatric conditions, particularly schizophrenia.
Remote Memory
Recall of events from the distant past.
Repression
Freud’s term for an unconscious defense mechanism in which unacceptable mental contents are banished or kept out of consciousness; important in normal psychological developement and in neurotic and psychotic symptom formation. Freud recognized two types of repressions: 1) repression proper, in which the repressed material was once in the conscious domain, and 2) primal repression, in which the repressed material was never in the conscious realm.
Restricted Affect

Reducation in intensity of feeling tone, which is less severe than in blunted affect, but clearly reduced.

 

See also constricted affect.

Rigidity
In psychiatry, a person’s resistance to change, a personality trait.
Rumination
Constant preoccupation with thinking about a single idea or theme, as in OCD.
Short-term Memory
Reproduction, recognition, or recall of perceived material within minutes of the presentation.
Somnolence
Pathological sleepiness or drowsiness from which one can be aroused to a normal state of consciousness.
Stupor
1) State of decreased reactivity to stimuli and less than full awarenessof one’s surroundings; as a disturbance of consciousness, it indicates a condition of partial coma or semicoma; 2) In psychiatry, used synonymously with mutism and does not necessarily imply a disturbance of consciousness; in catatonic stupor, patients are ordinarily aware of their surroundings.
Suicidal Ideation
Thoughts or act of taking one’s own life.
Suppression
Conscious act of controlling and inhibiting an unacceptable impulse, emotion, or idea; differentiated from repression in that repression is an unconscious process.
Tactile Hallucination
Hallucination primarily involving the sense of touch. Also called haptic hallucination.
Tangentiality
Oblique, digressive, or irrelevant manner of speech in which the central idea is not communicated.
Thought Broadcasting
Feeling that one’s thoughts are being broadcast or projected into the environment.
Thought Disorder
Any disturbance of thinking that affects language, communication, or thought content; the hallmark feature of schizophrenia. Manifestations range from simple blocking and mild circumstantiality to profound loosening of associations, incoherence, and delusions; characterized by a failure to follow semantic and syntactic rules that is inconsistent with the person’s education, intelligence, or cultural background.
Thought Insertion
Delusion that thoughts are being implanted in one’s mind by other people or forces.
Thought Latency
The period of time between a thought and its verbal expression. Increased in schizophrenia (see blocking) and decreased in mania (see pressured speech).
Tic Disorders
Predominantly psychogenic disorders characterized 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.
Vegetative Signs
In depression, denoting characteristic symptoms such as sleep disturbance (especially early morning awakening), decreased appetite, constipation, weight loss, and loss of sexual response.
Word Salad
Incoherent, essentially incomprehensible, mixture of words and phrases commonly seen in far-advanced cases of schizophrenia.
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