MENTAL DISORDER. Each of the mental disorders is conceptualized as a
clinically significant behavioral or psychological syndrome or pattern that occurs in
a person and that is associated with present distress (a painful symptom) or
disability (impairment in one or more important areas of functioning) or a
significantly increased risk of suffering death, pain, disability, or an important loss
of freedom. In addition, this syndrome or pattern must not be merely an
expectable response to a particular event e.g., the death of a loved one.
Whatever its original cause, it must currently be considered a manifestation of a
behavioral, psychological, or biological dysfunction in the person. Neither deviant
behavior, e.g. political, religious, or sexual, nor conflicts that are primarily
between the individual and society are mental disorders unless the deviance or
conflict is a symptom of a dysfunction in the person, as described above.
MOOD. A pervasive and sustained emotion that, in the extreme, markedly colors
the person's perception of the world. Common examples of mood include
depression, elation, anger, and anxiety.
Mood, dysphoric An unpleasant mood, such as depression, anxiety, or
irritability.
Mood, elevated. A mood that is more cheerful than normal; it does not
necessarily imply pathology.
Mood, euphoric. An exaggerated feeling of well-being. As a technical term,
euphoria implies a pathological mood. Whereas the person with A normally
elevated mood may describe himself or herself as being in "good spirits," "very
happy, or "cheerful," the euphoric person is likely to exclaim that he or she is "on
top of the world," "up in the clouds," or to say, "I feel ecstatic," 'I'm flying," or "I am
high."
Mood, euthymic. Mood in the "normal" range, which implies the absence of
depressed or elevated mood.
Mood, expansive. Lack of restraint in expressing one's feelings, frequently
with an overvaluation of one's significance or importance. There may also be
elevated or euphoric mood.
Mood, irritable. Internalized feeling of tension associated with being easily
annoyed and provoked to anger.
MOOD-CONGRUENT PSYCHOTIC FEATURES. Delusions or hallucinations
whose content is entirely consistent with either a depressed or a manic mood. If
the mood is depressed, the content of the delusions or hallucinations would
involve themes of either personal inadequacy, guilt, disease, death, nihilism, or
deserved punishment. it the mood is manic, the content of the delusions or
hallucinations would involve themes of inflated worth, power, knowledge, or
identity or special relationship to a deity or a famous person
MOOD-INCONGRUENT PSYCHOTIC FEATURES Delusions or hallucinations
whose content is not consistent with either a depressed or a manic mood: in the
case of depression, a delusion or hallucination whose content does not involve
themes of either personal inadequacy, guilt, disease, death, nihilism, or deserved
punishment; in the case of mania, a delusion or hallucination whose content does
not involve themes of either inflated worth, power, knowledge, or identity or
special relationship to a deity or a famous person. Examples of such symptoms
are persecutory delusions, thought insertion, thought broadcasting, and delusions
of being controlled whose content has no apparent relationship to any of the
themes listed above. (Note: The catatonic symptoms of stupor, mutism,
negativism, and posturing in Manic Episodes are also considered
mood-incongruent psychotic features.)
NEOLOGISMS. New words invented by the subject, distortions of words, or
standard words to which the subject has given new, highly idiosyncratic meaning.
the judgment that the subject uses neologisms should be made cautiously and
take into account his or her educational and cultural background. Examples: "I
was accused of mitigation)" (meaning the subject was accused of breaking the
law). "They had an insinuating machine next door" (person explaining how her
neighbors were bothering her).
Neologisms may be observed in Schizophrenia and other psychotic
disorders.
OBSESSIONS. Recurrent, persistent, senseless 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.
Obsessions are characteristic of Obsessive Compulsive Disorder, and may
also be seen in Schizophrenia.
ORIENTATION. Awareness of where one is in relation to time, place, and
person
OVERVALUED IDEA. An unreasonable and sustained belief or idea that is
maintained with less than delusional intensity. It differs from an obsessional
thought in that the person holding the overvalued idea does not recognize its
absurdity and thus does not struggle against it. As with a delusion, the idea or
belief is not one that is ordinarily accepted by other members of the person's
culture or subculture.
Example: A patient with a longstanding hand-washing compulsion thought
there might be danger in shaking hands with people, because they might have
recently been inoculated against smallpox and be infectious. Although she
acknowledged that the danger might not be real, she could not accept
reassurances that, medically, there was no danger.
PANIC ATTACKS. Discrete periods of sudden onset of intense apprehension,
fearfulness, or terror, often associated with feelings of impending doom. During
the attacks there are such symptoms as dyspnea, palpitations, chest pain or
discomfort, choking or smothering sensations, and fear of going crazy or losing
control.
Panic attacks are characteristic of Panic Disorder, but may also occur in
Somatization Disorder, Major Depression, and Schizophrenia.
PARANOlD IDEATION. Ideation, of less than delusional proportions, involving
suspiciousness or the belief that one is being harassed, persecuted or unfairly
treated. In some instances the term is used when the clinician is unsure of
whether the disturbances are actually delusional. Ideas of reference often involve
paranoid ideation
PERSEVERATION. Persistent repetition of words, ideas, or subjects so that,
once a person begins speaking about a particular subject or uses a particular
word, it continually recurs. Perseveration differs from the repetitive use of "stock
words or interjections such as "you know" or "like."
Examples: "I think I'll put on my hat, my hat, my hat, my hat." Interviewer;
"Tell me what you are like, what kind of person you are." Subject: I'm from
Marshalltown, Iowa. That's 60 miles northwest, northeast of Des Moines! Iowa.
And I�m married at the present time. l'm 36 years old. My wife is 35. She lives in
Garwin, Iowa. That's 15 miles southeast of Marshal town, Iowa. I�m getting a
divorce at the present time. And I am at present in a mental institution in Iowa
City, Iowa, which is 100 miles southeast of Marshalltown, Iowa."
Perseveration is most commonly seen in Organic Mental Disorders,
Schizophrenia, and other psychotic disorders.
PERSONALITY. Deeply ingrained patterns of behavior, which include the way
one relates to, perceives, and thinks about the environment and oneself.
Personality traits are prominent aspects of personality, and do not imply
pathology. 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). More commonly, the person does actually avoid the feared
situation or object, though he or she recognizes that the fear is unreasonable and
unwarranted by the actual dangerousness of the object, activity, or situation.
Some people with a phobia claim that their avoidance is rational because they
anticipate overwhelming anxiety or some other strong emotion that is out of their
control; they do not claim, however, that their anxiety is rationally justified.
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. The interviewer may observe that the person
has spoken at some length, but has not given adequate information to answer a
question. Alternatively, the person may provide enough information to answer the
question, but require many words to do so, so that his or her lengthy reply can be
summarized in a sentence or two. The expression poverty of content of speech is
generally not used when the speech is, for the most part, not understandable
(incoherence).
Example: Interviewer: "O.K. Why is it, do you think, that people believe in God?"
Patient: "Well, first of all because, He is the person that, is their personal savior.
He walks with me and talks with me. And uh, the understanding that I have, a lot
of peoples, they don't really know their own personal self. Because they ain't, they
all, just don't know their own personal self. They don't, know that He uh, seemed
like to me, a lot of em don't understand that He walks and talks with them. And
uh, show 'em their way to go. I understand also that, every man and every lady, is
just not pointed in the same direction. Some are pointed different. They go in their
different ways. the way that Jesus Christ wanted 'em to go. Myself, I am pointed
in the ways of uh, knowing right from wrong, and doing it. I can't do any more, or
not less than that."
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 severe, replies may be monosyllabic, and some questions may be
unanswered.
Poverty of speech occurs frequently in Schizophrenia, Major Depressive
Episodes, and Organic Mental Disorders, such as Dementia.
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 person talks without any social stimulation, and may continue to talk even
though no one is listening.
Pressure of speech is most often seen in manic episodes, but may also occur
in some cases of Organic Mental Disorders, Major Depression with psychomotor
agitation, Schizophrenia, other psychotic disorders, and, occasionally, acute
reactions to stress.
PRODROMAL. Early signs or symptoms of a disorder.
PSEUDODEMENTIA. Clinical features resembling a Dementia that are not due to
organic brain dysfunction or disease. Pseudodementia may occur in a Major
Depressive Episode or may be seen in Factitious Disorder with Psychological
Symptoms.
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. The term should be used in a technical sense to refer only to states
of tension or restlessness that are accompanied by observable excessive motor
activity. 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. Gross impairment in reality testing and the creation of a new reality
The term may be used to describe a person at a given time, or a mental disorder
in which at some time during its course all people with the disorder are psychotic.
When a person is psychotic, he or she incorrectly evaluates the accuracy of his
or her perceptions and thoughts and makes incorrect inferences about external
reality, even in the face of contrary evidence. The term psychotic does not apply
to minor distortions of reality that involve matters of relative judgment. For
example, a depressed person who underestimates his achievements would not
be described as psychotic, whereas one who believes he has caused a natural
catastrophe would be so described.
Direct evidence of psychotic behavior is the presence of either delusions or
hallucinations (without insight into their pathological nature). Thc term psychotic is
sometimes appropriate when a person's behavior is so grossly disorganized that
a reasonable inference can be made that reality testing is markedly disturbed.
Examples include markedly incoherent speech without apparent awareness by
the person that the speech is not understandable, and the agitated, inattentive,
and disoriented behavior seen in Alcohol Withdrawal Delirium.
RESIDUAL. The phase of an illness that occurs after remission of the florid
symptoms or the full syndrome. Examples: The residual stales of Autistic
Disorder, Attention-deficit Hyperactivity Disorder, and Schizophrenia.
SIGN. An objective manifestation of a pathological condition. Signs are observed
by the examiner rather than reported by the individual.
SYMPTOM. A manifestation of a pathological condition. Although in some uses
of the term it is limited to subjective complaints, in common use "symptom"
includes objective signs of pathological conditions as well.
SYNDROME A group of symptoms that occur together and that constitute a
recognizable condition. "Syndrome" is less specific than "disorder" or "disease"
The term disease generally implies a specific etiology or pathophysiologic
process. Most of the disorders are, in fact, syndromes.
Page 20
Adoption World Main Site
MOOD. A pervasive and sustained emotion that, in the extreme, markedly colors the person's perception of the world. Common examples of mood include depression, elation, anger, and anxiety.
Mood, dysphoric An unpleasant mood, such as depression, anxiety, or irritability.
Mood, elevated. A mood that is more cheerful than normal; it does not necessarily imply pathology.
Mood, euphoric. An exaggerated feeling of well-being. As a technical term, euphoria implies a pathological mood. Whereas the person with A normally elevated mood may describe himself or herself as being in "good spirits," "very happy, or "cheerful," the euphoric person is likely to exclaim that he or she is "on top of the world," "up in the clouds," or to say, "I feel ecstatic," 'I'm flying," or "I am high."
Mood, euthymic. Mood in the "normal" range, which implies the absence of depressed or elevated mood.
Mood, expansive. Lack of restraint in expressing one's feelings, frequently with an overvaluation of one's significance or importance. There may also be elevated or euphoric mood.
Mood, irritable. Internalized feeling of tension associated with being easily annoyed and provoked to anger.
MOOD-CONGRUENT PSYCHOTIC FEATURES. Delusions or hallucinations whose content is entirely consistent with either a depressed or a manic mood. If the mood is depressed, the content of the delusions or hallucinations would involve themes of either personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. it the mood is manic, the content of the delusions or hallucinations would involve themes of inflated worth, power, knowledge, or identity or special relationship to a deity or a famous person
MOOD-INCONGRUENT PSYCHOTIC FEATURES Delusions or hallucinations whose content is not consistent with either a depressed or a manic mood: in the case of depression, a delusion or hallucination whose content does not involve themes of either personal inadequacy, guilt, disease, death, nihilism, or deserved punishment; in the case of mania, a delusion or hallucination whose content does not involve themes of either inflated worth, power, knowledge, or identity or special relationship to a deity or a famous person. Examples of such symptoms are persecutory delusions, thought insertion, thought broadcasting, and delusions of being controlled whose content has no apparent relationship to any of the themes listed above. (Note: The catatonic symptoms of stupor, mutism, negativism, and posturing in Manic Episodes are also considered mood-incongruent psychotic features.)
NEOLOGISMS. New words invented by the subject, distortions of words, or standard words to which the subject has given new, highly idiosyncratic meaning. the judgment that the subject uses neologisms should be made cautiously and take into account his or her educational and cultural background. Examples: "I was accused of mitigation)" (meaning the subject was accused of breaking the law). "They had an insinuating machine next door" (person explaining how her neighbors were bothering her).
Neologisms may be observed in Schizophrenia and other psychotic disorders.
OBSESSIONS. Recurrent, persistent, senseless 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.
Obsessions are characteristic of Obsessive Compulsive Disorder, and may also be seen in Schizophrenia.
ORIENTATION. Awareness of where one is in relation to time, place, and person
OVERVALUED IDEA. An unreasonable and sustained belief or idea that is maintained with less than delusional intensity. It differs from an obsessional thought in that the person holding the overvalued idea does not recognize its absurdity and thus does not struggle against it. As with a delusion, the idea or belief is not one that is ordinarily accepted by other members of the person's culture or subculture.
Example: A patient with a longstanding hand-washing compulsion thought there might be danger in shaking hands with people, because they might have recently been inoculated against smallpox and be infectious. Although she acknowledged that the danger might not be real, she could not accept reassurances that, medically, there was no danger.
PANIC ATTACKS. Discrete periods of sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. During the attacks there are such symptoms as dyspnea, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of going crazy or losing control.
Panic attacks are characteristic of Panic Disorder, but may also occur in Somatization Disorder, Major Depression, and Schizophrenia.
PARANOlD IDEATION. Ideation, of less than delusional proportions, involving suspiciousness or the belief that one is being harassed, persecuted or unfairly treated. In some instances the term is used when the clinician is unsure of whether the disturbances are actually delusional. Ideas of reference often involve paranoid ideation
PERSEVERATION. Persistent repetition of words, ideas, or subjects so that, once a person begins speaking about a particular subject or uses a particular word, it continually recurs. Perseveration differs from the repetitive use of "stock words or interjections such as "you know" or "like."
Examples: "I think I'll put on my hat, my hat, my hat, my hat." Interviewer; "Tell me what you are like, what kind of person you are." Subject: I'm from Marshalltown, Iowa. That's 60 miles northwest, northeast of Des Moines! Iowa. And I�m married at the present time. l'm 36 years old. My wife is 35. She lives in Garwin, Iowa. That's 15 miles southeast of Marshal town, Iowa. I�m getting a divorce at the present time. And I am at present in a mental institution in Iowa City, Iowa, which is 100 miles southeast of Marshalltown, Iowa."
Perseveration is most commonly seen in Organic Mental Disorders, Schizophrenia, and other psychotic disorders.
PERSONALITY. Deeply ingrained patterns of behavior, which include the way one relates to, perceives, and thinks about the environment and oneself. Personality traits are prominent aspects of personality, and do not imply pathology. 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). More commonly, the person does actually avoid the feared situation or object, though he or she recognizes that the fear is unreasonable and unwarranted by the actual dangerousness of the object, activity, or situation. Some people with a phobia claim that their avoidance is rational because they anticipate overwhelming anxiety or some other strong emotion that is out of their control; they do not claim, however, that their anxiety is rationally justified.
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. The interviewer may observe that the person has spoken at some length, but has not given adequate information to answer a question. Alternatively, the person may provide enough information to answer the question, but require many words to do so, so that his or her lengthy reply can be summarized in a sentence or two. The expression poverty of content of speech is generally not used when the speech is, for the most part, not understandable (incoherence).
Example: Interviewer: "O.K. Why is it, do you think, that people believe in God?" Patient: "Well, first of all because, He is the person that, is their personal savior. He walks with me and talks with me. And uh, the understanding that I have, a lot of peoples, they don't really know their own personal self. Because they ain't, they all, just don't know their own personal self. They don't, know that He uh, seemed like to me, a lot of em don't understand that He walks and talks with them. And uh, show 'em their way to go. I understand also that, every man and every lady, is just not pointed in the same direction. Some are pointed different. They go in their different ways. the way that Jesus Christ wanted 'em to go. Myself, I am pointed in the ways of uh, knowing right from wrong, and doing it. I can't do any more, or not less than that."
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 severe, replies may be monosyllabic, and some questions may be unanswered.
Poverty of speech occurs frequently in Schizophrenia, Major Depressive Episodes, and Organic Mental Disorders, such as Dementia.
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 person talks without any social stimulation, and may continue to talk even though no one is listening.
Pressure of speech is most often seen in manic episodes, but may also occur in some cases of Organic Mental Disorders, Major Depression with psychomotor agitation, Schizophrenia, other psychotic disorders, and, occasionally, acute reactions to stress.
PRODROMAL. Early signs or symptoms of a disorder.
PSEUDODEMENTIA. Clinical features resembling a Dementia that are not due to organic brain dysfunction or disease. Pseudodementia may occur in a Major Depressive Episode or may be seen in Factitious Disorder with Psychological Symptoms.
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. The term should be used in a technical sense to refer only to states of tension or restlessness that are accompanied by observable excessive motor activity. 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. Gross impairment in reality testing and the creation of a new reality The term may be used to describe a person at a given time, or a mental disorder in which at some time during its course all people with the disorder are psychotic. When a person is psychotic, he or she incorrectly evaluates the accuracy of his or her perceptions and thoughts and makes incorrect inferences about external reality, even in the face of contrary evidence. The term psychotic does not apply to minor distortions of reality that involve matters of relative judgment. For example, a depressed person who underestimates his achievements would not be described as psychotic, whereas one who believes he has caused a natural catastrophe would be so described.
Direct evidence of psychotic behavior is the presence of either delusions or hallucinations (without insight into their pathological nature). Thc term psychotic is sometimes appropriate when a person's behavior is so grossly disorganized that a reasonable inference can be made that reality testing is markedly disturbed. Examples include markedly incoherent speech without apparent awareness by the person that the speech is not understandable, and the agitated, inattentive, and disoriented behavior seen in Alcohol Withdrawal Delirium.
RESIDUAL. The phase of an illness that occurs after remission of the florid symptoms or the full syndrome. Examples: The residual stales of Autistic Disorder, Attention-deficit Hyperactivity Disorder, and Schizophrenia.
SIGN. An objective manifestation of a pathological condition. Signs are observed by the examiner rather than reported by the individual.
SYMPTOM. A manifestation of a pathological condition. Although in some uses of the term it is limited to subjective complaints, in common use "symptom" includes objective signs of pathological conditions as well.
SYNDROME A group of symptoms that occur together and that constitute a recognizable condition. "Syndrome" is less specific than "disorder" or "disease" The term disease generally implies a specific etiology or pathophysiologic process. Most of the disorders are, in fact, syndromes.