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Glossary

Addiction: continued use of a mood-altering substance despite physical, psychological, or social harm. It is characterized by a lack of control in the amount and frequency of use, cravings, continued use in the presence of adverse effects, denial of negative consequences, and a tendency to abuse other mood-altering substances.

Adoption study: a scientific study designed to control for genetic relatedness and environmental influences by comparing siblings adopted into different families.

Akathisia: a subjective sense of inner restlessness resulting in the need to keep moving. Objectively, restless movements or pacing may be signs of akathisia.

Algorithm: a sequence of steps to follow when approaching a particular problem.

Alternative treatment: a treatment for a medical condition that has not undergone scientific studies to demonstrate its efficacy.

Alzheimer's disease: a progressive disease of the brain characterized by a gradual loss of cognitive functions such as memory and reasoning. Personality and behavioral changes can accompany the disease as it progresses.

Anticonvulsant: a drug that controls or prevents seizures. Anticonvulsants often are used in psychiatric practice to treat mania, mood instability, or other mental conditions.

Antidepressant: a drug specifically marketed for and capable of relieving the symptoms of clinical depression. It is often used to treat conditions other than depression.

Antipsychotic: a drug that treats psychotic symptoms, such as hallucinations, delusions, and thought disorders. Antipsychotics can be used to treat certain mood disorders as well.

Anxiolytic: a substance that relieves subjective and objective symptoms of anxiety.

Attachment: the psychologic connection between a child and his or her caretaker. Infants develop attachment behaviors within the first month. Deficits in early attachments can result in problems in later relationships in life.

Atypical antipsychotic: a second-generation antipsychotic with a profile of targeted brain receptors that differs from the older antipsychotics, which have fewer neurologic side effects and also have mood-stabilizing effects.

Augmentation: in pharmacotherapy, a strategy of using a second medication to enhance the positive effects of an existing medication in the regimen.

Automatic thoughts: thoughts that occur spontaneously whenever a specific, common event occurs in one's life and that are often associated with depression.

Axon: a single fiber of a nerve cell through which a message is sent via an electrical impulse to a receiving neuron. Each nerve cell has one axon.

Baby blues: common symptoms of sadness and tearfulness that occur in the days after giving birth that are thought to be the result of hormonal changes associated with the birth event.

Basal ganglia: a region of the brain consisting of three groups of nerve cells—the caudate nucleus, putamen, and the globus pallidus—that are collectively responsible for control of movement. Abnormalities in the basal ganglia can result in involuntary movement disorders.

Benzodiazepine: a drug that is part of a class of medication with sedative and anxiolytic effects. Drugs in this class share a common chemical structure and mechanism of action.

Bereavement: the period of time spent in mourning for the death of a loved one.

Biogenic amines: a group of compounds in the nervous system that participate in the regulation of brain activity, including dopamine, serotonin, and norepinephrine.

Biopsychosocial: a model used to describe the possible origins of risk factors for the development of various mental illnesses, incorporating the biologic, psychological, and societal factors for a given individual.

Bipolar depression: an episode of depression that occurs in the course of bipolar disorder.

Bipolar disorder: a mental illness defined by episodes of mania or hypomania, classically alternating with episodes of depression. However, the condition can take various forms, such as repeated episodes of mania only or a lack of alternating episodes.

Brainstem: the anatomic part of the brain that connects the brain cortex to the spinal cord. It contains the major centers that regulate what are known collectively as "vegetative functions," that is, sleep, appetite, blood pressure, temperature, and respiration.

Cardiac toxicity: damage that occurs to the heart or coronary arteries as a result of medication side effects.

Catastrophic thinking: a type of automatic thought during which the individual quickly assumes the worst outcome for a given situation.

Central nervous system: nerve cells and their support cells in the brain and spinal cord.

Chemical imbalance: a common vernacular for what is thought to be occurring in the brain in patients suffering from mental illness.

Classical conditioning: a type of learning that results when a conditioned and an unconditioned stimulus is associated, resulting in a similar response to both stimuli (see Pavlovian).

Cognitive-behavioral therapy: a combination of cognitive and behavioral approaches in psychotherapy during which the therapist focuses on automatic thoughts and behavior of a self-defeating quality to make one more conscious of them and replace them with more positive thoughts and behaviors.

Comorbid: the presence of two or more mental disorders, such as depression and anxiety.

Compliance: extent that behavior follows medical advice, such as by taking prescribed treatments. Compliance can refer to medications as well as to appointments and psychotherapy sessions.

Concordance: in genetics, a similarity in a twin pair with respect to presence or absence of illness.

Constitutional: referring to a person's biopsychological makeup, that is, the personality and the traits.

Contingency contracting: a behavioral therapy technique that uses reinforcers or rewards to modify behaviors.

Cortex: the outer portion of the brain, which is composed of gray matter and made up of numerous folds that greatly increase the surface area of the brain. Advanced motor function, social abilities, language, and problem solving are coordinated in this area of the brain.

Countertransference: the attitudes, opinions, and behaviors that a therapist attributes to his or her patient, not based on the true nature of the patient but rather the biased nature of the therapist because the patient reminds the therapist of his or her own past relationships.

Dependence: the body's reliance on a drug to function normally. Physical dependence results in withdrawal when the drug is stopped suddenly. Dependence should be contrasted to addiction.

Depression: a medical condition associated with changes in thoughts, moods, and behaviors.

Discontinuation syndrome: physical symptoms that occur when a drug is suddenly stopped.

Diurnal variation: a variation in mood that occurs within a day. Patients with clinical depression commonly experience a diurnal variation in mood such that it is worse after awakening but improves as the day progresses.

Double depression: the co-occurrence of a major depressive episode with dysthymic disorder.

Dynamic: referring to a type of therapy that focuses on one's interpersonal relationships, developmental experiences, and the transference relationship with his or her therapist. It is also known as insight oriented.

Dysthymic: the presence of chronic, mild depressive symptoms.

Efficacy: the capacity to produce a desired effect, such as the performance of a drug or therapy in relieving symptoms of depression, such as feeling down, trouble concentrating, and so on.

Electrochemically: the mechanism by which signals are transmitted neurologically. Brain chemicals, or neurotransmitters, alter the electrical conductivity of nerve tissue, causing a signal to be transmitted or sent.

Electroconvulsive therapy (ECT): a procedure that induces a seizure in the brain through an application of an electric current through the scalp, that is used to treat depression.

Emotional memory: a memory evoked by a sensory experience.

Endocrine disorder: a disorder of the endocrine system. Endocrine glands release chemicals (also known as hormones) directly into the bloodstream whose actions occur at another site. Endocrine glands include the thyroid, ovaries and testes, adrenals, and pancreas.

Enzyme: a protein made in the body that serves to break down or create other molecules. Enzymes serve as catalysts to biochemical reactions in the body.

Extrapyramidal: the parts of the brain responsible for static motor control. The basal ganglia are part of this system. Deficits in this system result in involuntary movement disorders. Antipsychotic medications affect these areas, leading to extrapyramidal side effects, which include muscle spasms (dystonias), tremors, shuffling gait, restlessness (akathisia), and tardive dyskinesias.

Fight or flight: a reaction in the body that occurs in response to an immediate threat. Adrenaline is released, which allows for rapid energy to run (flight) or to face the threat (fight).

First-degree relative: immediate biologically related family member, such as biologic parents or full siblings.

Flooding: a behavioral therapy technique that involves exposure to the maximal level of anxiety as quickly as possible.

Free association: the mental process of saying aloud whatever comes to mind, suppressing the natural tendency to censor or filter thoughts. This is a technique used in psychoanalysis and in psychodynamic psychotherapy.

Functional: generally referring to a symptom or condition that has no clearly defined physiologic or anatomic cause.

Gene: DNA sequence that codes for a specific protein or that regulates other genes. Genes are heritable.

Graded exposure: a psychotherapeutic technique that uses gradual exposure through a hierarchy of anxiety-provoking situations. This may begin with imagery techniques first and then progress with limited exposure in time and intensity before full exposure occurs.

Grandiosity: the tendency to consider the self or one's ideas better or more superior to what is reality.

Gray matter: the part of the brain that contains the nerve cell bodies, including the cell nucleus and its metabolic machinery, as opposed to the axons, which are essentially the "transmission wires" of the nerve cell. The cerebral cortex contains gray matter.

Half-life: the time it takes for half of the blood concentration of a medication to be eliminated from the body. Half-life determines as well the time to equilibrium of a drug in the blood and determines the frequency of dosing to achieve that equilibrium.

Hormonal: referring to the chemicals that are secreted by the endocrine glands and act throughout the body.

Hyperarousal: a heightened state of alertness to external and internal stimuli, often resulting in sleep disturbance, problems concentrating, hypervigilance, and exaggerated startle response. This is typically seen in posttraumatic conditions.

Hypersomnia: an inability to stay awake. Oversleeping.

Hypomanic: a milder form of mania with the same symptoms but of lesser intensity.

Hypothyroidism: decreased or absence of thyroid hormone, which is secreted by an endocrine gland near the throat and has wide metabolic effects. When thyroid hormone is low, metabolism can slow, leading to symptoms that can mimic clinical depression.

Informed consent: the premise that patients have a right to determine what happens to their bodies and as such agreement to a treatment requires receipt of information, competence to make the decision, and agreeability for the treatment.

Insight oriented: a form of psychotherapy that focuses on one's developmental history, interpersonal relationships with one's family of origin, and current relationships with friends, spouses, and others. Usually, such relationships are explored through the development of a transference relationship with one's therapist (see dynamic).

Interpersonal therapy: a form of therapy. Unlike insight-oriented or dynamic therapy that focuses on developmental relationships, interpersonal therapy focuses strictly on current relationships and conflicts within them.

Insomnia: the inability to fall asleep, middle of the night awakening, or early morning awakening.

Learned helplessness: a behavioral pattern that occurs after repeated exposure to noxious stimuli that is characterized by withdrawal, passivity, and reduced activity level.

Limbic system: the part of the brain thought to be related to feeding, mating, and most importantly to emotion and memory of emotional events. Brain regions within this system include the hypothalamus, hippocampus, amygdala, and cingulate gyrus as well as portions of the basal ganglia.

Malignant hypertension: elevated blood pressure that is acute and rapidly progressive with severe symptoms, including headache.

Mania: a condition characterized by elevation of mood (extreme euphoria or irritability) associated with racing thoughts, decreased need for sleep, hyperactivity, and poor impulse control. One episode of mania (in the absence of an ingested substance) is needed to diagnose bipolar disorder.

Mental illness: a medical condition defined by functional symptoms with as yet no specific pathophysiology that impairs social, academic, and occupational function.

Mental status: a snapshot portrait of one's cognitive and emotional functioning at a particular point in time. It is always included as part of a psychiatric examination.

Metabolize: the process of breaking down a drug in the blood.

Mood disorder: a type of mental illness that affects mood primarily and cognition secondarily. Mood disorders predominantly consist of depression and bipolar disorder.

Mood stabilizer: typically refers to medications for the treatment and prevention of mood swings, such as from depression to mania.

Morbidity: the impact a particular disease process or illness has on one's social, academic, or occupational functioning.

Mortality: death secondary to illness or disease.

Motor cortex: portion of the cerebral cortex that is directly related to voluntary movement. Also known as the motor strip, its anatomy correlates accurately with specific bodily movements, such as moving the left upper or lower extremities.

Neuroanatomy: the structural makeup of the nervous system and nervous tissue.

Neurologic: referring to all matters of the nervous system that includes brain, brainstem, spinal cord, and peripheral nerves. Problems with specific, identifiable, pathophysiologic processes are generally considered to be neurologic as opposed to psychiatric. Problems with elements of both pathophysiologic and psychiatric manifestations are considered to be neuropsychiatric.

Neuron: a nerve cell made up of a cell body with extensions called the dendrites and the axon. The dendrites carry messages from the synapse to the cell body, and the axon carries messages to the synapse to communicate with other nerve cells.

Neuronal plasticity: the act of nerve growth and change as a result of learning. Mental exercise alters neuronal growth in the same manner physical exercise alters muscle growth.

Neuropathic pain: pain secondary to an abnormal state, such as degeneration, of nerves.

Neurophysiology: the part of science devoted specifically to the physiology, or function and activities, of the nervous system.

Neurotransmitter: chemical in the brain that is released by nerve cells to send a message to other cells via the cell receptors.

Neurovegetative: that part of the nervous system devoted to vegetative or involuntary processes such as respiration, blood pressure, heart rate, temperature, sleep, appetite, and sexual arousal.

Norepinephrine: a neurotransmitter that is involved in the regulation of mood, arousal, and memory.

Numbing: the psychologic process of becoming resistant to external stimuli so that previously pleasurable activities become less desirable.

Off label: prescribing of a medication for indications other than those outlined by the U.S. Food and Drug Administration.

Over-generalization: the act of taking a specific event, usually psychologically traumatic, and applying one's reactions to that event to an ever increasing array of events that are not really in the same class but are perceived as such.

Partial remission: symptoms of an illness have resolved by 50%. An impairment of functioning continues to be present.

Pavlovian: from the discoverer Ivan Pavlov. Pavlov paired a bell tone with delivery of food to dogs. The salivation in response to food became associated with the bell over time, such that the food was no longer needed to cause salivation in the presence of the bell tone (see classical conditioning).

Personality disorder: maladaptive behavior patterns that persist throughout the life span, which cause functional impairments.

Pharmacologic: pertaining to all chemicals that, when ingested, cause a physiologic process to occur in the body. Psychopharmacologic refers to those physiologic processes that have direct psychological effects.

Physiologic: pertaining to functions and activities of the living matter, such as organs, tissues, or cells.

Placebo: an inert substance that when ingested causes absolutely no physiologic process to occur but may have psychological effects.

Platelet inhibition: referring to the inhibition of platelet activity, such as clotting. Some medications can cause interference in the platelet activity.

Postpartum: referring to events occurring within a specified time after giving birth. Usually within the first 4 weeks.

Pressured speech: characterized by the need to keep speaking; it is difficult to interrupt someone with this type of speech. This is commonly seen in manic or hypomanic mood states.

Prevalence: ratio of the frequency of cases in the population in a given time period of a particular event to the number of persons in the population at risk for the event.

Projected: the attribution of one's own unconscious thoughts and feelings to others.

Pseudodementia: literally, "false dementia." Depression in older persons can cause cognitive effects that mimic dementia. However, in pseudodementia, patients are often overly preoccupied with their cognitive loss relative to patients suffering from true dementia, who are often oblivious to their cognitive loss.

Psychomotor agitation: hyperactive or restless movement. It can be seen in highly anxious states, manic mood states, or intoxicated states.

Psychomotor retardation: s lowed movement, usually as a result of severe clinical depression. When emotion and cognition become depressed enough, motor function can also become depressed, causing the appearance of physical slowing.

Psychosocial: pertaining to environmental circumstances that can impact one's psychological well-being.

Psychotropic: usually referring to pharmacologic agents (medications) that, as a result of their physiologic effects on the brain, lead to direct psychological effects.

Receptor: a protein on a cell on which specific chemicals from within the body or from the environment bind to cause changes in the cell that result in an electrochemical message for a certain action to be taken by that cell.

Recovery: achievement of baseline, premorbid functioning after successful treatment for a mental illness. Recovery is the term used after a time period of 6 months symptom free. Up to that point, the term is referred to as remission.

Recurrence: the return of symptoms of a mental illness after complete recovery, considered to have occurred after a period of 6 months symptom free.

Reexperiencing: the phenomenon of having a previous lived experience vividly recalled and accompanied by the same strong emotions one originally experienced.

Refractory depression: depressive illness that does not respond to a therapeutic intervention. The term is not typically applied unless such a lack of response has occurred to several different interventions.

Relapse: the return of symptoms of a mental illness for which one is currently receiving active treatment. Relapse occurs during response to treatment or during remission of symptoms. If it occurs after 6 months of successful treatment, during what is termed the recovery phase, the term used is recurrence.

Relative risk: a ratio of incidence of a disorder in persons exposed to a risk factor to the incidence of a disorder in persons not exposed to the same risk factor.

Remission: complete cessation of all symptoms associated with a specific mental illness. This occurs within the first 6 months of treatment, after which the term used is recovery.

Resistance: the tendency to avoid treatment interventions, often unconsciously (e.g., missed appointments, arriving late, forgetting medication).

Response: referring to at least a 50% reduction but not complete cessation of all symptoms associated with a specific mental illness, such as depression.

Ruminations: obsessive thinking over an idea or decision.

Schema: representations of the world in the mind that affect perception of and response to the environment.

Second-generation antipsychotic: see atypical antipsychotic.

Serotonin: a neurotransmitter found in the brain and throughout the body. Serotonin is involved in mood regulation, anxiety, pain perception, appetite, sleep, sexual behavior, and impulsive behavior.

Serotonin syndrome: an extremely rare but life-threatening syndrome associated with the direct physiologic effects of serotonin overload on the body. Symptoms include flushing, high fever, tachycardia, and seizures.

Somatic: referring to the body. Somatic therapy refers to all treatments that have direct physiologic effects, such as medication and ECT. Somatic complaints refer to all physical complaints that refer to the body, such as aches and pains.

Somatoform: pertaining to conditions with physical symptoms thought to be due to psychological factors.

Stressors: environmental influences on the body and mind that can have gradual adverse effects.

Synaptic cleft: the junction between two neurons where neurotransmitters are released, resulting in the communication of a message between the two neurons.

Tarasoff: the name of the family who sued the therapist involved in the care of a young man who murdered a family member. As a result of the lawsuit, therapists are now required to protect and warn potential victims from violent acts or threats made by patients under their care.

Tardive dyskinesia: a late-onset involuntary movement disorder, often irreversible, typically of the mouth, tongue, or lips and less commonly of the limbs and trunk. These movements are a consequence of antipsychotic use but are less commonly observed with the newer atypical antipsychotics.

Thought stopping: a technique used to suppress repetitive thoughts.

Transference: the unconscious assignment of feelings and attitudes to a therapist from previous important relationships in one's life (parents and siblings). The relationship follows the pattern of its prototype and can be either negative or positive. The transference relationship is a critical event for the progress of a patient in insight oriented or psychodynamic therapy.

Treatment plan: the plan agreed on by patient and clinician that will be implemented to treat a mental illness. It incorporates all modalities (therapy and medication).

Tryptophan: 1 of the 20 amino acids that constitute the building blocks of proteins in the body. Tryptophan is the building block for serotonin.

Unconscious: an underlying motivation for behavior that is not available to the conscious or thoughtful mind, which has developed over the course of life experience.

Visceral: a bodily sensation usually referencing the gut; also a feeling or thought attributed to intuition rather than reason, such as "a gut instinct."

White matter: tracts in the brain that consist of sheaths (called myelin) covering long nerve fibers.

 
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